Discovery and development of ACE inhibitors: Difference between revisions

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[[file:ACE_and_inhibitor.jpg|thumb|ACE and inhibitor]] [[file:Captopril_structure.svg|thumb|Captopril structure|left]] [[file:Enalapril_structure.svg|thumb|Enalapril structure]] [[file:Lisinopril_structure.svg|thumb|Lisinopril structure|left]] [[file:Keto-ACE.jpg|thumb|Keto-ACE]] [[file:A58365A.jpg|thumb|A58365A]] '''Discovery and development of ACE inhibitors'''
{{Short description|Overview of the discovery and development of ACE inhibitors}}


The [[discovery]] and [[development]] of [[ACE inhibitors]] (Angiotensin-Converting Enzyme inhibitors) represent a significant advancement in the field of [[cardiovascular medicine]]. ACE inhibitors are a class of medication primarily used for the treatment of [[hypertension]] (high blood pressure) and [[congestive heart failure]].
== Discovery and Development of ACE Inhibitors ==
The discovery and development of [[ACE inhibitors]] (Angiotensin-Converting Enzyme inhibitors) represent a significant advancement in the treatment of [[hypertension]] and [[heart failure]]. These medications work by inhibiting the enzyme responsible for the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor, thereby lowering blood pressure and reducing strain on the heart.


==History==
=== Historical Background ===
The journey to the discovery of ACE inhibitors began with the study of the [[renin-angiotensin system]] (RAS), a hormone system that regulates blood pressure and fluid balance. In the 1950s, researchers identified the role of [[angiotensin II]], a potent vasoconstrictor, in increasing blood pressure. The enzyme responsible for converting angiotensin I to angiotensin II was named [[angiotensin-converting enzyme]] (ACE).
The journey to the development of ACE inhibitors began with the study of the [[renin-angiotensin system]] (RAS), a hormone system that regulates blood pressure and fluid balance. In the 1950s, researchers identified angiotensin II as a key player in blood pressure regulation. The search for inhibitors of this system led to the discovery of ACE inhibitors.


In the 1960s, Brazilian scientist [[Sérgio Henrique Ferreira]] discovered a peptide in the venom of the [[Bothrops jararaca]] snake that inhibited the action of ACE. This peptide, known as bradykinin potentiating factor (BPF), laid the groundwork for the development of synthetic ACE inhibitors.
=== Discovery of Captopril ===
[[File:Captopril_structure.svg|thumb|Structure of Captopril]]
Captopril was the first ACE inhibitor to be developed and approved for clinical use. Its discovery was inspired by the venom of the Brazilian pit viper, ''Bothrops jararaca'', which was found to contain peptides that inhibited ACE. Researchers at [[Squibb]] (now part of [[Bristol-Myers Squibb]]) synthesized captopril in the late 1970s, and it was approved by the [[FDA]] in 1981. Captopril's development marked a breakthrough in cardiovascular medicine, providing a new mechanism to control hypertension.


==Development==
=== Development of Enalapril ===
The first synthetic ACE inhibitor, [[captopril]], was developed in the late 1970s by researchers at [[Squibb Corporation]] (now part of [[Bristol-Myers Squibb]]). Captopril was approved by the [[Food and Drug Administration]] (FDA) in 1981 for the treatment of hypertension. Its success led to the development of other ACE inhibitors, including [[enalapril]], [[lisinopril]], and [[ramipril]].
[[File:Enalapril_structure.svg|thumb|Structure of Enalapril]]
Following the success of captopril, further research led to the development of enalapril, a prodrug that is converted to its active form, enalaprilat, in the body. Enalapril was developed by [[Merck & Co.]] and approved in 1985. It offered improved pharmacokinetic properties over captopril, such as a longer half-life, allowing for once-daily dosing.


==Mechanism of Action==
=== Introduction of Lisinopril ===
ACE inhibitors work by inhibiting the activity of the angiotensin-converting enzyme, which decreases the production of angiotensin II. This results in the dilation of blood vessels, reduced blood pressure, and decreased workload on the heart. Additionally, ACE inhibitors increase the levels of bradykinin, a peptide that promotes vasodilation.
[[File:Lisinopril_structure.svg|thumb|Structure of Lisinopril]]
Lisinopril, another ACE inhibitor, was developed by [[Merck & Co.]] and [[Zeneca]] (now part of [[AstraZeneca]]). It was approved in 1987 and is unique among ACE inhibitors because it is not a prodrug and is excreted unchanged by the kidneys. Lisinopril's long duration of action and favorable side effect profile have made it a widely used medication in the management of hypertension and heart failure.


==Clinical Uses==
=== Mechanism of Action ===
ACE inhibitors are used to treat a variety of cardiovascular conditions, including:
ACE inhibitors work by blocking the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor, thereby reducing blood pressure. This action also decreases the secretion of [[aldosterone]], leading to a reduction in sodium and water retention. The overall effect is a decrease in blood pressure and a reduction in the workload on the heart.
* [[Hypertension]]
 
* [[Congestive heart failure]]
=== Clinical Applications ===
* [[Chronic kidney disease]]
ACE inhibitors are primarily used in the treatment of hypertension and heart failure. They are also beneficial in patients with [[diabetic nephropathy]] and after [[myocardial infarction]] to improve survival. Their use is associated with a reduction in the progression of kidney disease in patients with diabetes.
* [[Diabetic nephropathy]]
* [[Post-myocardial infarction]]


==Side Effects==
=== Side Effects ===
Common side effects of ACE inhibitors include:
Common side effects of ACE inhibitors include cough, hyperkalemia, and hypotension. Rarely, they can cause angioedema, a potentially life-threatening condition. Patients with [[renal artery stenosis]] or [[pregnancy]] should avoid ACE inhibitors due to the risk of adverse effects.
* [[Cough]]
* [[Hyperkalemia]] (elevated potassium levels)
* [[Hypotension]] (low blood pressure)
* [[Angioedema]] (swelling of deeper layers of the skin)


==Related Pages==
== Also see ==
* [[Renin-angiotensin system]]
* [[Renin-angiotensin system]]
* [[Hypertension]]
* [[Hypertension]]
* [[Congestive heart failure]]
* [[Heart failure]]
* [[Captopril]]
* [[Angiotensin II receptor blockers]]
* [[Enalapril]]
* [[Lisinopril]]
* [[Ramipril]]


==References==
{{Cardiovascular pharmacology}}
{{Reflist}}
 
==External Links==
{{Commons category|ACE inhibitors}}


[[Category:Antihypertensive agents]]
[[Category:Cardiovascular drugs]]
[[Category:Cardiovascular drugs]]
[[Category:Antihypertensive agents]]
[[Category:Drug discovery]]
[[Category:Enzyme inhibitors]]
[[Category:Pharmacology]]
 
{{medicine-stub}}

Latest revision as of 00:50, 10 December 2024

Overview of the discovery and development of ACE inhibitors


Discovery and Development of ACE Inhibitors[edit]

The discovery and development of ACE inhibitors (Angiotensin-Converting Enzyme inhibitors) represent a significant advancement in the treatment of hypertension and heart failure. These medications work by inhibiting the enzyme responsible for the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor, thereby lowering blood pressure and reducing strain on the heart.

Historical Background[edit]

The journey to the development of ACE inhibitors began with the study of the renin-angiotensin system (RAS), a hormone system that regulates blood pressure and fluid balance. In the 1950s, researchers identified angiotensin II as a key player in blood pressure regulation. The search for inhibitors of this system led to the discovery of ACE inhibitors.

Discovery of Captopril[edit]

Structure of Captopril

Captopril was the first ACE inhibitor to be developed and approved for clinical use. Its discovery was inspired by the venom of the Brazilian pit viper, Bothrops jararaca, which was found to contain peptides that inhibited ACE. Researchers at Squibb (now part of Bristol-Myers Squibb) synthesized captopril in the late 1970s, and it was approved by the FDA in 1981. Captopril's development marked a breakthrough in cardiovascular medicine, providing a new mechanism to control hypertension.

Development of Enalapril[edit]

Structure of Enalapril

Following the success of captopril, further research led to the development of enalapril, a prodrug that is converted to its active form, enalaprilat, in the body. Enalapril was developed by Merck & Co. and approved in 1985. It offered improved pharmacokinetic properties over captopril, such as a longer half-life, allowing for once-daily dosing.

Introduction of Lisinopril[edit]

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Structure of Lisinopril

Lisinopril, another ACE inhibitor, was developed by Merck & Co. and Zeneca (now part of AstraZeneca). It was approved in 1987 and is unique among ACE inhibitors because it is not a prodrug and is excreted unchanged by the kidneys. Lisinopril's long duration of action and favorable side effect profile have made it a widely used medication in the management of hypertension and heart failure.

Mechanism of Action[edit]

ACE inhibitors work by blocking the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor, thereby reducing blood pressure. This action also decreases the secretion of aldosterone, leading to a reduction in sodium and water retention. The overall effect is a decrease in blood pressure and a reduction in the workload on the heart.

Clinical Applications[edit]

ACE inhibitors are primarily used in the treatment of hypertension and heart failure. They are also beneficial in patients with diabetic nephropathy and after myocardial infarction to improve survival. Their use is associated with a reduction in the progression of kidney disease in patients with diabetes.

Side Effects[edit]

Common side effects of ACE inhibitors include cough, hyperkalemia, and hypotension. Rarely, they can cause angioedema, a potentially life-threatening condition. Patients with renal artery stenosis or pregnancy should avoid ACE inhibitors due to the risk of adverse effects.

Also see[edit]

Template:Cardiovascular pharmacology