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'''
[[File:ACE and inhibitor.jpg|thumb]] [[File:Captopril structure.svg|thumb]] [[File:Enalapril structure.svg|thumb]] [[File:Lisinopril structure.svg|thumb]] 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]].
The discovery and development of Angiotensin-Converting Enzyme (ACE) inhibitors represent a significant advancement in the field of cardiovascular medicine. These drugs are primarily used to treat hypertension and congestive heart failure, and they work by inhibiting the activity of the enzyme responsible for converting angiotensin I to angiotensin II, a potent vasoconstrictor.


==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 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 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 ACE ==
Angiotensin-Converting Enzyme (ACE) was first identified in the 1950s. It was found to be a dipeptidyl carboxypeptidase that converts the inactive decapeptide angiotensin I into the active octapeptide angiotensin II. This conversion is crucial for the regulation of blood pressure and electrolyte balance.


==Development==
== Development of ACE Inhibitors ==
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]].
The development of ACE inhibitors was inspired by the study of snake venom. In the 1960s, researchers discovered that the venom of the Brazilian pit viper, *Bothrops jararaca*, contained peptides that could inhibit ACE. This led to the synthesis of the first ACE inhibitor, teprotide, which was effective but not suitable for oral administration.


==Mechanism of Action==
=== Captopril ===
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.
The first orally active ACE inhibitor, captopril, was developed in the late 1970s by researchers at Squibb (now Bristol-Myers Squibb). Captopril was designed based on the structure of teprotide and was approved by the FDA in 1981. It was a breakthrough in the treatment of hypertension and heart failure.


==Clinical Uses==
=== Enalapril and Other ACE Inhibitors ===
Following the success of captopril, other ACE inhibitors were developed, including enalapril, lisinopril, and ramipril. Enalapril, a prodrug that is converted to the active form enalaprilat in the body, offered improved pharmacokinetic properties and was approved in 1985.
 
== Mechanism of Action ==
ACE inhibitors work by blocking the conversion of angiotensin I to angiotensin II. This leads to vasodilation, reduced secretion of aldosterone, and decreased blood pressure. By reducing the effects of angiotensin II, ACE inhibitors also decrease the workload on the heart, making them effective in treating heart failure.
 
== Clinical Applications ==
ACE inhibitors are used to treat a variety of cardiovascular conditions, including:
ACE inhibitors are used to treat a variety of cardiovascular conditions, including:
* [[Hypertension]]
* Hypertension
* [[Congestive heart failure]]
* Congestive heart failure
* [[Chronic kidney disease]]
* Myocardial infarction
* [[Diabetic nephropathy]]
* Diabetic nephropathy
* [[Post-myocardial infarction]]


==Side Effects==
== Side Effects and Contraindications ==
Common side effects of ACE inhibitors include:
Common side effects of ACE inhibitors include cough, hyperkalemia, and hypotension. They are contraindicated in patients with a history of angioedema related to previous ACE inhibitor therapy and in pregnant women due to the risk of fetal toxicity.
* [[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:Pharmacology]]
[[Category:Cardiovascular drugs]]
[[Category:Cardiovascular drugs]]
[[Category:Antihypertensive agents]]
[[Category:Drug discovery]]
[[Category:Enzyme inhibitors]]
[[Category:Pharmacology]]
 
{{medicine-stub}}

Revision as of 15:39, 9 December 2024

File:ACE and inhibitor.jpg
File:Captopril structure.svg
File:Enalapril structure.svg
File:Lisinopril structure.svg

Discovery and Development of ACE Inhibitors

The discovery and development of Angiotensin-Converting Enzyme (ACE) inhibitors represent a significant advancement in the field of cardiovascular medicine. These drugs are primarily used to treat hypertension and congestive heart failure, and they work by inhibiting the activity of the enzyme responsible for converting angiotensin I to angiotensin II, a potent vasoconstrictor.

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 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 ACE

Angiotensin-Converting Enzyme (ACE) was first identified in the 1950s. It was found to be a dipeptidyl carboxypeptidase that converts the inactive decapeptide angiotensin I into the active octapeptide angiotensin II. This conversion is crucial for the regulation of blood pressure and electrolyte balance.

Development of ACE Inhibitors

The development of ACE inhibitors was inspired by the study of snake venom. In the 1960s, researchers discovered that the venom of the Brazilian pit viper, *Bothrops jararaca*, contained peptides that could inhibit ACE. This led to the synthesis of the first ACE inhibitor, teprotide, which was effective but not suitable for oral administration.

Captopril

The first orally active ACE inhibitor, captopril, was developed in the late 1970s by researchers at Squibb (now Bristol-Myers Squibb). Captopril was designed based on the structure of teprotide and was approved by the FDA in 1981. It was a breakthrough in the treatment of hypertension and heart failure.

Enalapril and Other ACE Inhibitors

Following the success of captopril, other ACE inhibitors were developed, including enalapril, lisinopril, and ramipril. Enalapril, a prodrug that is converted to the active form enalaprilat in the body, offered improved pharmacokinetic properties and was approved in 1985.

Mechanism of Action

ACE inhibitors work by blocking the conversion of angiotensin I to angiotensin II. This leads to vasodilation, reduced secretion of aldosterone, and decreased blood pressure. By reducing the effects of angiotensin II, ACE inhibitors also decrease the workload on the heart, making them effective in treating heart failure.

Clinical Applications

ACE inhibitors are used to treat a variety of cardiovascular conditions, including:

  • Hypertension
  • Congestive heart failure
  • Myocardial infarction
  • Diabetic nephropathy

Side Effects and Contraindications

Common side effects of ACE inhibitors include cough, hyperkalemia, and hypotension. They are contraindicated in patients with a history of angioedema related to previous ACE inhibitor therapy and in pregnant women due to the risk of fetal toxicity.

Also see

Template:Cardiovascular pharmacology