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Growing collateral arteries on demand. 根据需要生长侧支动脉。
Pub Date : 2011-09-01 DOI: 10.2174/157489011797377031
Charles C Oh, Jason D Klein, Raymond Q Migrino, Kent L Thornburg

Recent studies have significantly advanced our understanding of arteriogenesis, raising hope that therapies to increase collateral arterial formation may become important new tools in the treatment of ischemic disease. The most important initiating trigger for arteriogenesis is the marked increase in shear stress which is sensed by the endothelium and leads to characteristic changes. Intracellularly, it was shown that platelet endothelial cell adhesion molecule (PECAM-1) becomes tyrosine-phosphorylated in response to increased shear stress, suggesting a role as a possible mechanoreceptor for dynamic and continual monitoring of shear stress. The signal generated by PECAM-1 leads to the activation of the Rho pathway among others. More than 40 genes have been shown to have a shear stress responsive element. The Rho pathway is activated early and appears to be essential to the arteriogenic response as inhibiting it abolished the effect of fluid shear stress. Overexpression of a Rho pathway member, Actin-binding Rho protein (Abra), led to a 60% increase in collateral perfusion over simple femoral artery occlusion. A patent for the Abra gene has been filed recently. It may be a harbinger of a future where collateral arteries grown on demand may become an effective treatment for ischemic vascular disease.

最近的研究大大提高了我们对动脉发生的理解,增加侧支动脉形成的疗法可能成为治疗缺血性疾病的重要新工具。动脉发生最重要的触发因素是剪应力的显著增加,剪应力被内皮细胞感知并导致特征性变化。在细胞内,研究表明血小板内皮细胞粘附分子(PECAM-1)随着剪切应力的增加而酪氨酸磷酸化,这表明它可能是一种动态和持续监测剪切应力的机械受体。PECAM-1产生的信号导致Rho通路的激活。超过40个基因已被证明具有剪切应力响应元件。Rho通路被早期激活,似乎对动脉生成反应至关重要,因为抑制它可以消除流体剪切应力的影响。Rho通路成员肌动蛋白结合Rho蛋白(Abra)的过度表达导致单纯性股动脉闭塞时侧支灌注增加60%。Abra基因最近申请了专利。这可能预示着一个未来,按需生长的侧支动脉可能成为缺血性血管疾病的有效治疗方法。
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引用次数: 2
Effects of ranolazine on cardiovascular system. 雷诺嗪对心血管系统的影响。
Pub Date : 2011-09-01 DOI: 10.2174/157489011797377103
Ivano Bonadei, Enrico Vizzardi, Filippo Quinzani, Barbara Piovanelli, Riccardo Rovetta, Antonio D'Aloia, Livio D Cas

Chronic stable angina affects 6-7 million Americans and contributes to a significant reduction in quality of life and life expectancy. Current pharmacotherapy for reducing episodes of exertional angina includes β-blockers, calcium channel blockers and long-acting nitrates. Patients may have contraindications to the use of one or more of these agents or be unable to tolerate initial or larger therapeutic doses. As a result of the inability of current management strategies to optimally control episodes of chronic angina, new therapies have been investigated that do not have some of the limitations of current therapies. New therapies for chronic stable angina are based on a mechanism involving membrane current such as the funny current and the late Na current. Ranolazine (Ran) is an antianginal drug acting on I(Na). After its current indication in the chronic stable angina, the role of this molecule is still being studied for prophylaxis of certain arrhythmias and treatment of heart failure. Moreover, have been recently developed new interesting patents of novel pharmaceutical effects and derivates of Ran.

慢性稳定型心绞痛影响着600 - 700万美国人,并导致生活质量和预期寿命的显著下降。目前用于减少劳役性心绞痛发作的药物治疗包括β受体阻滞剂、钙通道阻滞剂和长效硝酸盐。患者可能有使用一种或多种药物的禁忌症,或者无法耐受初始剂量或更大的治疗剂量。由于目前的管理策略无法最佳地控制慢性心绞痛的发作,新的治疗方法已经被研究,这些治疗方法没有当前治疗方法的一些局限性。慢性稳定型心绞痛的新疗法是基于一种涉及膜电流的机制,如滑稽电流和晚钠电流。雷诺嗪(Ranolazine, Ran)是一种作用于I(Na)的抗心绞痛药物。在目前的慢性稳定型心绞痛适应症后,该分子在预防某些心律失常和治疗心力衰竭方面的作用仍在研究中。此外,最近还开发了一些新的令人感兴趣的药物作用及其衍生物的专利。
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引用次数: 5
Relation between sleep quality and physical activity in chronic heart failure patients. 慢性心力衰竭患者睡眠质量与体力活动的关系
Pub Date : 2011-09-01 DOI: 10.2174/157489011797377004
Kazuhiro P Izawa, Satoshi Watanabe, Koichiro Oka, Koji Hiraki, Yuji Morio, Yusuke Kasahara, Naoya Takeichi, Takae Tsukamoto, Naohiko Osada, Kazuto Omiya, Haruo Makuuchi

To determine self-reported sleep quality-related differences in physical activity (PA) and health-related quality of life (HRQOL) and target values of PA for high-quality sleep in chronic heart failure (CHF) outpatients, 149 CHF outpatients (mean age 58 years) were divided into two groups by sleep-quality level determined via self-reported questionnaire: shallow sleep (SS) group (n = 77) and deep sleep (DS) group (n = 72). Steps were assessed by electronic pedometer, HRQOL was assessed with the Short Form 36 (SF-36) survey, and data were compared between groups. PA resulting in high-quality sleep was determined by receiver-operating characteristics curves. All SF-36 subscale scores except that of bodily pain were significantly decreased in the SS versus DS group. A cutoff value of 5723.6 steps/day and 156.4 Kcal/day for 1 week were determined as target values for PA. Sleep quality may affect PA and HRQOL, and attaining target values of PA may improve sleep quality and HRQOL of CHF outpatients. Patents relevant to heart failure are also discussed in this article.

为了确定慢性心力衰竭(CHF)门诊患者自我报告的睡眠质量相关体力活动(PA)和健康相关生活质量(HRQOL)的差异以及高质量睡眠的PA目目值,149例CHF门诊患者(平均年龄58岁)根据自我报告的睡眠质量水平分为浅睡眠(SS)组(n = 77)和深睡眠(DS)组(n = 72)。采用电子计步器评估步数,采用SF-36量表评估HRQOL,并进行组间数据比较。PA导致的高质量睡眠由接受者-操作特征曲线决定。除躯体疼痛外,SS组SF-36各分量表得分均显著低于DS组。截止值为5723.6步/天和156.4千卡/天,持续1周作为PA的目标值。睡眠质量可影响PA和HRQOL,达到PA目标值可改善CHF门诊患者的睡眠质量和HRQOL。本文还讨论了与心力衰竭相关的专利。
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引用次数: 7
Clinical pharmacotherapy and drug development for pulmonary arterial hypertension. 肺动脉高压的临床药物治疗及药物开发。
Pub Date : 2011-09-01 DOI: 10.2174/157489011797377059
Massimiliano Mulè, Marilena Scarabelli, Davide Capodanno, Gian P Ussia, Corrado Tamburino

Pulmonary arterial hypertension (PAH) is a rare, but serious condition which, if untreated, is associated with a poor survival. Currently, even if several trials have led to the approval of many drugs for PAH, there is no established cure for this disease. However, approved drugs for PAH have contributed to significantly improve symptoms, exercise capacity, quality of life and survival of these patients. The aim of this review is to overview the standard treatment of PAH and to give some insights about new treatments that are currently under investigation along with the discussion of recent patents.

肺动脉高压(PAH)是一种罕见但严重的疾病,如果不治疗,则与生存率低有关。目前,即使几项试验已经导致许多治疗多环芳烃的药物获得批准,也没有确定的治疗这种疾病的方法。然而,批准的PAH药物已显著改善了这些患者的症状、运动能力、生活质量和生存率。本综述的目的是概述多环芳烃的标准治疗方法,并就目前正在研究的新治疗方法以及最近专利的讨论提供一些见解。
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引用次数: 1
P2Y12 receptor antagonists in acute coronary syndrome: clinical implications of pharmacologic and pharmacogenetic differences. P2Y12受体拮抗剂在急性冠脉综合征:药理学和药理学差异的临床意义。
Pub Date : 2011-09-01 DOI: 10.2174/157489011797376960
Mukesh Singh, Sasikanth Adigopula, Niaz Ahmad, Rohit Arora, Sandeep Khosla

Platelet activation and aggregation are key events in the pathophysiological process of thrombosis, and vascular occlusions. Antiplatelet therapy has proven to be crucial for managing patients with acute coronary syndromes, coronary artery disease and in patients undergoing percutaneous coronary interventions. However, residual platelet reactivity on antiplatelet treatment confers a five-fold increased risk of major adverse cardiovascular events which indicates a need for more effective antiplatelet medications to address the substantial burden of cardiovascular disease. This article reviews the P2Y(12) receptor antagonists with regards to pharmacologic and pharmacogenetic differences and their clinical implications along with the discussion of recent patents.

血小板活化和聚集是血栓形成和血管闭塞病理生理过程中的关键事件。抗血小板治疗已被证明对急性冠状动脉综合征、冠状动脉疾病患者和经皮冠状动脉介入治疗患者至关重要。然而,抗血小板治疗的残余血小板反应性使主要不良心血管事件的风险增加了5倍,这表明需要更有效的抗血小板药物来解决心血管疾病的沉重负担。本文综述了P2Y(12)受体拮抗剂的药理学和药理学差异及其临床意义,并讨论了最近的专利。
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引用次数: 2
Atrial fibrillation following cardiac surgery: established and emerging strategies of prevention. 心脏手术后心房颤动:已建立的和新兴的预防策略。
Pub Date : 2011-09-01 DOI: 10.2174/157489011797377121
Nasir Shariff, Abdul Aleem, Larry E Jacobs, Christopher Cutitta, Sultan M Siddique, Matthew W Martinez, Martin E Matsumura, Ronald Freudenberger

More than 250,000 patients undergo cardiac surgery every year. Although advances in surgical techniques have reduced the peri-operative morbidity and mortality in these patients, atrial fibrillation persists to commonly occur following these surgeries. Traditional therapies have reduced their occurrence; however there are still a significant number of patients who develop this complication. Newer and non-conventional medications are being studied to reduce this cardiac arrhythmia. This review will elaborate on the patho-physiology, and prevention of this arrhythmia. We also aim to summarize recent investigated and patented medications which may result in more effective strategies for prophylaxis against this cardiac arrhythmia.

每年有超过25万名患者接受心脏手术。尽管手术技术的进步降低了这些患者的围手术期发病率和死亡率,但房颤仍然普遍发生在这些手术后。传统疗法减少了它们的发生;然而,仍有相当数量的患者出现这种并发症。正在研究新的和非传统的药物来减少这种心律失常。本文将对其病理、生理及预防作一综述。我们还旨在总结最近研究和专利的药物,这可能导致更有效的策略预防这种心律失常。
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引用次数: 0
Human embryonic and induced pluripotent stem cells in cardiovascular drug discovery: patents and patented uses. 人类胚胎和诱导多能干细胞在心血管药物发现中的应用:专利和专利用途。
Pub Date : 2011-09-01 DOI: 10.2174/157489011797377077
Christine Y Ivashchenko

Human embryonic stem cells, hES, and the recently created human induced pluripotent stem cells, hiPS, have a multitude of uses in cardiovascular drug discovery with a significant patent coverage for most applications. The research involving hiPS and hES cells may be subdivided into two main areas: one utilizing undifferentiated cells, and the other using hES and hiPS for in vitro differentiation of mature cell types. Both areas are of use in basic discovery, high throughput screening, and toxicology research. A number of methods have been developed to differentiate stem cells to mature cardiac cell types and to obtain pure populations of cardiomyocytes. This review will discuss three major aspects of stem cell patent landscape: 1) patents pertaining to the basic methodology of obtaining hES and hiPS cells, 2) patents pertaining to the methods of hiPS and hES differentiation to cardiovascular cell types, and 3) patents concerned with the applied uses of differentiated cardiac cells.

人类胚胎干细胞(hES)和最近创造的人类诱导多能干细胞(hiPS)在心血管药物发现中具有广泛的用途,大多数应用都有重要的专利覆盖范围。涉及hiPS和hES细胞的研究可细分为两个主要领域:一个是利用未分化的细胞,另一个是利用hES和hiPS体外分化成熟细胞类型。这两个领域在基础发现、高通量筛选和毒理学研究中都有应用。已经开发了许多方法来将干细胞分化为成熟的心肌细胞类型并获得纯心肌细胞群。本综述将讨论干细胞专利领域的三个主要方面:1)有关获得hES和hiPS细胞的基本方法的专利,2)有关hiPS和hES向心血管细胞类型分化的方法的专利,以及3)有关分化心肌细胞应用的专利。
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引用次数: 1
Oxidative stress induced mitochondrial DNA deletion as a hallmark for the drug development in the context of the cerebrovascular diseases. 氧化应激诱导线粒体DNA缺失是脑血管疾病药物开发的一个标志。
Pub Date : 2011-09-01 DOI: 10.2174/157489011797376942
Gjumrakch Aliev, Yi Li, Hector H Palacios, Mark E Obrenovich

Oxidative stress in the cardiovascular system, including brain microvessels and/or parenchymal cells results in an accumulation of reactive oxygen species (ROS) and reactive nitrogen species (RNS) compounds thus promoting leukocyte adhesion and increasing endothelial permeability. The resulting chronic injury stimulus results in progressive cellular hypometabolism. We propose that hypometabolism, coupled with oxidative stressors, is responsible for most Alzheimer disease (AD) and cerebrovascular accidents (CVAs) and appears to be a central initiating factor for vascular abnormalities, mitochondrial damage and an imbalance in the activity of vasoactive substances, such as different isoforms of nitric oxide synthase (NOS), endothelin-1 (ET-1), oxidative stress markers, mtDNA and mitochondrial enzymes in the vascular wall and in brain parenchymal cells. At higher concentrations, ROS induces cell injury and death, which occurs during the aging process, where accelerated generation of ROS and a gradual decline in cellular antioxidant defense mechanisms, especially in the mitochondria. Vascular endothelial and neuronal mitochondria are especially vulnerable to oxidative stress due to their role in energy supply and use, which can cause a cascade of debilitating factors such as the production of giant and/or vulnerable young mitochondrion who's DNA has been compromised. Therefore, mitochondrial DNA abnormalities such as overproliferation and or deletion can be used as a key marker for diseases differentiation and effectiveness of the treatment. We speculate that specific antioxidants such as acetyl-L-carnitine and R-alpha lipoic acid seem to be potential treatments for AD. They target the factors that damage mitochondria and reverse its effect, thus eliminating the imbalance seen in energy production and restore the normal cellular function, making these antioxidants very powerful alternate strategies for the treatment of cardiovascular cerebrovascular as well as neurodegenerative diseases including AD. Future potential exploration using mtDNA markers can be considered more accurate hallmarks for diagnosis and monitoring treatment of human diseases. The present article discusses some of the patents regarding the oxidative stress.

心血管系统,包括脑微血管和/或实质细胞中的氧化应激导致活性氧(ROS)和活性氮(RNS)化合物的积累,从而促进白细胞粘附和增加内皮细胞的通透性。由此产生的慢性损伤刺激导致进行性细胞低代谢。我们认为,低代谢,加上氧化应激源,是大多数阿尔茨海默病(AD)和脑血管意外(cva)的原因,似乎是血管异常、线粒体损伤和血管活性物质活性失衡的中心启动因素,如血管壁和脑实质细胞中一氧化氮合酶(NOS)、内皮素-1 (ET-1)、氧化应激标志物、mtDNA和线粒体酶的不同同工型。在较高浓度下,ROS诱导细胞损伤和死亡,这发生在衰老过程中,其中ROS的生成加速,细胞抗氧化防御机制逐渐下降,特别是在线粒体中。由于血管内皮细胞和神经元线粒体在能量供应和使用中的作用,它们特别容易受到氧化应激的影响,氧化应激会导致一系列的衰弱因素,比如产生巨大的和/或脆弱的年轻线粒体,这些线粒体的DNA已经受损。因此,线粒体DNA异常,如过度增殖和/或缺失,可以作为疾病分化和治疗效果的关键标志。我们推测,特定的抗氧化剂,如乙酰左旋肉碱和r - α硫辛酸似乎是治疗AD的潜在方法。它们针对破坏线粒体的因素并逆转其作用,从而消除能量产生中的不平衡并恢复正常的细胞功能,使这些抗氧化剂成为治疗心脑血管以及包括AD在内的神经退行性疾病的强有力的替代策略。未来利用mtDNA标记的潜在探索可以被认为是诊断和监测人类疾病治疗的更准确的标志。本文讨论了氧化应激方面的一些专利。
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引用次数: 52
Novel design and synthesis of modified structure of carvedilol. 卡维地洛改性结构的新设计与合成。
Pub Date : 2011-09-01 DOI: 10.2174/157489011797376988
Mehrnoosh Hashemzadeh, Mohammad R Movahed, Wade A Russu, Ladan Soroush, Diné N Hill

β-adrenergic blocking agents have been in use for nearly 40 years. β-blockers have been more thoroughly studied in the past twenty years as they have become commonly prescribed to heart failure patients. The class of β-blockers has grown considerably and has many pharmaceutical applications in patients with heart failure. Carvedilol has been the most effective beta-blocker in the treatment of the systolic heart failure. Carvedilol is a non-selective β- and α-blocker enantiomer with antioxidant effects that are attributed to its carbazole moiety. Carvedilol is taken twice daily because it is extensively metabolized and therefore loses its effectiveness due to a short half-life. Recently a long acting carvedilol has become available, as Coreg CR. Coreg CR is available for once-a-day administration as controlled-release oral capsules containing 10, 20, 40, or 80 mg carvedilol phosphate. The subject of the current report is to design a new structural analog of carvedilol that incorporates a protecting group such as a fluorine atom at position 8 of the carbazole ring for the purpose of blocking a critical metabolic pathway thus increasing its half life. This will follow discussion regarding current carvedilol patents. We believe that carvedilol activity will remain unchanged. The synthesis of 8-Fluoro-1, 2, 3, 9- tetrahydro-4H-carbazol-4-one, a key synthetic intermediate of the designed carvedilol analog, was carried out and successfully characterized.

β-肾上腺素能阻滞剂已经使用了近40年。β受体阻滞剂在过去的二十年中已经被更彻底地研究,因为它们已经成为心力衰竭患者的常用处方。β受体阻滞剂的种类已经大大增加,并有许多药物应用于心力衰竭患者。卡维地洛是治疗收缩期心力衰竭最有效的受体阻滞剂。卡维地洛是一种非选择性β-和α-阻滞剂对映体,由于其咔唑部分具有抗氧化作用。卡维地洛每天服用两次,因为它被广泛代谢,因此由于半衰期短而失去有效性。最近有一种长效卡维地洛,叫做Coreg CR, Coreg CR为控释口服胶囊,每天一次给药,含有10、20、40或80毫克磷酸卡维地洛。本报告的主题是设计一种新的卡维地洛结构类似物,其中包含一个保护基团,如咔唑环8号位置的氟原子,目的是阻断关键代谢途径,从而延长其半衰期。接下来将讨论当前卡维地洛专利。我们认为卡维地洛的活性将保持不变。合成了卡维地洛类似物的关键合成中间体8-氟- 1,2,3,9 -四氢- 4h -咔唑-4- 1,并对其进行了表征。
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引用次数: 3
Heparins with reduced anti-coagulant activity reduce myocardial reperfusion injury. 降低抗凝活性的肝素可减少心肌再灌注损伤。
Pub Date : 2011-05-01 DOI: 10.2174/157489011795933855
William H Barry, Thomas P Kennedy

Heparin which is desulfated at the 2-O and 3-O positions (ODSH) has reduced anti-coagulant properties, and reduced interaction with heparin antibodies. Because of the reduced anti-coagulant effect, ODSH can be safely administered to animals and humans intravenously at doses up to 20 mg/kg, resulting in a serum concentration of up to 250µg/ml. Administration of ODSH causes a 35% reduction in infarct size in dogs and pigs subjected to coronary artery occlusion and reperfusion when given 5 min before reperfusion. ODSH has anti-inflamatory effects, manifest as a decrease in neutrophil infiltration into ischemic tissue at high doses, but this effect does not entirely account for the reduction in infarct size. ODSH decreases Na(+) and Ca(2+) loading in isolated cardiac myocytes subjected to simulated ischemia. This effect appears due to an ODSH-induced reduction in an enhanced Na(+) influx via the Na channel in the membrane of cardiac myocyes caused by oxygen radicals generated during ischemia and reperfusion. Reduction in Na(+) influx decreases Ca(2+) loading by reducing Ca2(+) influx via Na/Ca exchange, thus reducing Ca(2+) - dependent reperfusion injury. ODSH does not appear to interact with antibodies to the heparin/platelet factor 4 complex, and does not cause heparin-induced thrombocytopenia. Because of these therapeutic and safety considerations, ODSH would appear to be a promising heparin derivative for prevention of reperfusion injury in humans undergoing thrombolytic or catheter-based reperfusion for acute myocardial infarction. The review article discussed the use of heparin and the discussion of some of the important patents, including: US6489311; US7478358; PCTUS2008070836 and PCTUS2009037836.

在2-O和3-O位置(ODSH)去硫的肝素降低了抗凝血性能,并减少了与肝素抗体的相互作用。由于抗凝作用降低,ODSH可以安全地静脉给药给药,剂量高达20mg /kg,导致血清浓度高达250µg/ml。在冠状动脉再灌注前5分钟给予ODSH,可使冠状动脉闭塞和再灌注的狗和猪的梗死面积减少35%。ODSH具有抗炎作用,表现为在高剂量下减少中性粒细胞对缺血组织的浸润,但这种作用并不能完全解释梗死面积的减少。ODSH降低模拟缺血下离体心肌细胞的Na(+)和Ca(2+)负荷。这种效应的出现是由于odsh诱导的缺血和再灌注期间产生的氧自由基引起的通过心肌膜Na通道的增强的Na(+)内流的减少。Na(+)内流的减少通过Na/Ca交换减少Ca2(+)内流,从而减少Ca(2+)负荷,从而减少Ca(2+)依赖性再灌注损伤。ODSH似乎不会与肝素/血小板因子4复合物抗体相互作用,也不会引起肝素诱导的血小板减少症。由于这些治疗和安全性方面的考虑,ODSH似乎是一种有前途的肝素衍生物,可用于预防急性心肌梗死患者进行溶栓或导管再灌注的再灌注损伤。本文综述了肝素的应用,并讨论了一些重要专利,包括:US6489311;US7478358;PCTUS2008070836和PCTUS2009037836。
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引用次数: 6
期刊
Recent patents on cardiovascular drug discovery
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