Drug spotlight- Icatibant, FDA 2011

Icatibant (trade name Firazyr) is a peptidomimetic drug consisting of ten amino acids, which is a selective and specific antagonist of bradykinin B2 receptors. It has been approved by the European Commission for the symptomatic treatment of acute attacks,^[1][2] of hereditary angioedema (HAE) in adults (with C1-esterase-inhibitor deficiency).

Bradykinin is a peptide-based hormone that is formed locally in tissues, very often in response to a trauma. It increases vessel permeability, dilates blood vessels

and causes smooth muscle cells to contract . Bradykinin plays an important role as the mediator of pain. Surplus bradykinin is responsible for the typical symptoms of inflammation, such as swelling, redness, overheating and pain. These symptoms are mediated by activation of bradykinin B2 receptors. Icatibant acts as a bradykinin inhibitor by blocking the binding of native bradykinin to the bradykinin B2 receptor.

Icatibant has received orphan drug status in Australia, EU, Switzerland and US.

In the EU, the approval by the European Commission (July 2008) allows Jerini to market Firazyr in the European Union's 27 member states, as well as Switzerland, Lichtenstein and Iceland, making it the first product to be approved in all EU countries for the treatment of HAE.^[1] In the US, the drug was granted FDA approval on August 25, 2011.^[3]

1.      1 "Jerini Receives European Commission Approval for Firazyr (Icatibant) in the Treatment of HAE" (Press release). Jerini AG. 2008-07-15. Retrieved 2008-07-22.

2.       2 "Jerini Receives Positive CHMP Opinion Recommending European Approval for Icatibant in the Treatment of HAE; FDA Issues Not Approvable Letter" (Press release).Jerini AG. 2008-04-24. Retrieved 2008-07-22.

3.      3 FDA Approves Shire’s FIRAZYR (icatibant injection) for Acute Attacks of Hereditary Angioedema (HAE)" (Press release). Shire. Retrieved 2011-08-28.

On the August 25th 2011, the FDA approved Icatibant (trade name: Firazyr^TM), a bradykinin B2 receptor (B2R) antagonist indicated for the treatment of acute attacks of hereditary angioedema (HAE) in patients aged 18 or older.

HAE is a rare genetic disease and is caused by low levels of C1-esterase inhibitor (C1-INH), the major endogenous inhibitor and regulator of the protease plasma kallikrein and the key regulator of the Factor XII/kallikrein cascade. One component this cascade is the production of bradykinin by plasma kallikrein. During HAE attacks, disregulated activity of plasma kallikrein leads to excessive bradykinin production; bradykinin is a potent vasodilator, which s thought to be responsible for the characteristic HAE symptoms of localised swelling, inflammation and pain.

Icatibant treats the clinical symptoms of HAE attack by selective- and competitively binding, as an antagonist, to the B2 bradykinin receptor (B2R) , with similar affinity to bradykinin (1-10 nM for the B2R, while affinity for the B1R is 100-fold lower). Icatibant is the first in class agent against this target. The -tibant stem covers bradykinin antagonists.

B2R is a Rhodopsin-like receptor, 391 amino acid long, which belongs to the G protein-coupled receptor (GPCR) A3 family and is encoded by the BDKRB2 gene in humans. The amino acid sequence of B2R is:

>B2R

---

MFSPWKISMFLSVREDSVPTTASFSADMLNVTLQGPTLNGTFAQSKCPQVEWLGWLNTIQ

PPFLWVLFVLATLENIFVLSVFCLHKSSCTVAEIYLGNLAAADLILACGLPFWAITISNN

FDWLFGETLCRVVNAIISMNLYSSICFLMLVSIDRYLALVKTMSMGRMRGVRWAKLYSLV

IWGCTLLLSSPMLVFRTMKEYSDEGHNVTACVISYPSLIWEVFTNMLLNVVGFLLPLSVI

TFCTMQIMQVLRNNEMQKFKEIQTERRATVLVLVVLLLFIICWLPFQISTFLDTLHRLGI

LSSCQDERIIDVITQIASFMAYSNSCLNPLVYVIVGKRFRKKSWEVYQGVCQKGGCRSEP

IQMENSMGTLRTSISVERQIHKLQDWAGSRQ

Sulforaphane, a natural product present in cruciferous vegetables like broccoli, reduces childhood leukemia progression

Sulforaphane

1-Isothiocyanato-4-methylsulfinylbutane

Sulforaphane is a molecule, ref1 within the isothiocyanate group of organosulfur compounds. It exhibits anti-cancer and antimicrobial properties in experimental models. It is obtained from cruciferous vegetables such as broccoli, Brussels sprouts or cabbages. It is produced when the enzyme myrosinase transforms glucoraphanin, a glucosinolate, into sulforaphane upon damage to the plant (such as from chewing) which allows the two compounds to mix and react. Young sprouts of broccoli and cauliflower are particularly rich in glucoraphanin.

glucoraphanin, glucosinolate precursor to sulforaphane Sulforaphane, discovered by accident in 1995 by a group of scientists researching the anticancer compounds in broccoli, is a phytochemical compound that can be obtained by eating cruciferous vegetables such as arugula, watercress, Brussels sprouts, broccoli, broccoli sprouts, cabbage, cauliflower, bok choy, kale, collards, kohlrabi, mustard, turnip, radish and rutabaga.  Sulforaphane is particularly abundant in watercress and broccoli sprouts. Sulforaphane, a natural product present in cruciferous vegetables like broccoli, reduces childhood leukemia progression article Sulforaphane Induces Cell Cycle Arrest and Apoptosis in Acute Lymphoblastic Leukemia Cells, K. Suppipat, C. Shik Park, Y. Shen, X. Zhu, H. D. Lacorazza,  PLOS ONE 2012. DOI: 10.1371/journal.pone.0051251   http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0051251 click on above link Sulforaphane is a phytochemical belonging to the family of isothiocyanates, which means it contains the typical NCS group. Sulforaphane was identified in broccoli sprouts, which, of the cruciferous vegetables, have the highest concentration of sulforaphane. It is also found in Brussels sprouts, cabbage,cauliflower, bok choy, kale, collards, Chinese broccoli, broccoli raab, kohlrabi, mustard,turnip, radish, arugula, and watercress The optimal level of intake is not known, but some doctors recommend 200 to 400 mcg of sulforaphane daily from broccoli-sprout extracts.

Acute lymphoblastic leukemia is the most common form of blood cancer affecting children. Although the current treatments cure 8 % of the patients, in the remaining cases the disease recurs and it can be fatal. Thus, novel drugs effective against relapses are needed.

To this regard, Koramit Suppipat, Texas Children’s Hospital, USA, and colleagues investigated the anti leukemic properties of sulforaphane, a dietary isothiocyanate abundant in cruciferous vegetables, such as broccoli. This compound blocked the proliferation of pediatric leukemic cells and selectively promoted their death, mostly by inhibiting Akt and mTOR, two serine/threonine kinases necessary for the survival of these malignant cells. When administered orally to mice affected by leukemia, moreover, sulforaphane reduced the progression of the tumor.

This compound may thus be beneficial for acute lymphoblastic leukemia patients at high risk of relapse.
We know that stress accelerates aging and disease.  When you are under stress, your immune system is also compromised, weakening your ability to ward off invading organisms.  Chronic stress raises the level of the excitatory hormones, including norepinephrine and cortisol, which can wear your body down and lead to disease.  Sulforaphane inhibits the norepinephrine-mediated increase in the interleukin-6 levels in the cells, which is a very good thing.  Interleukin-6 is responsible for the shift from acute inflammation to chronic inflammation, the root of so many diseases.  Finding a safe and effective substance that can inhibit the overproduction of norepinephrine, like sulforaphane,  is a significant accomplishment.

Consumption of broccoli sprouts has shown to be potentially effective at inhibitingHelicobacter pylori growth,^[2][3] with sulforaphane being at least one of the active agents.^[4][2]

Sulforaphane and dietary consumption of cruciferous vegetables are known to affect the action of drug-metabolizing enzymes in vitroand in preliminary human studies.^[5] Although no side effects or direct drug interactions have been reported as of 2008, people taking prescription drugs are advised to consult a doctor before taking sulforaphane or broccoli-sprout extracts.

The possible anticancer activity of sulforaphane may be related to the induction of phase-II enzymes of xenobiotic transformation (such as quinone reductase and glutathione S-transferase), and enhancing the transcription of tumor suppressor proteins, possibly via inhibitory effects on histone deacetylase.^[6]

Sulforaphane and diindolylmethane (another compound from Brassica vegetables) inhibit cancer growth in vitro and in experimental animals.^[7] Sulforaphane downregulated the Wnt/beta-catenin self-renewal pathway in breast cancer stem cells.^[7]

Sulforaphane

MW: 177
Formula: C₆H₁₁NOS₂

links

1. Zhang Y, Talalay P, Cho CG, Posner GH (March 1992). "A major inducer of anticarcinogenic protective enzymes from broccoli: isolation and elucidation of structure". Proc. Natl. Acad. Sci. U.S.A. 89 (6): 2399–2403. doi:10.1073/pnas.89.6.2399. PMC 48665.PMID 1549603.
2. Yanaka A, Fahey JW, Fukumoto A, Nakayama M, Inoue S, Zhang S, Tauchi M, Suzuki H, Hyodo I, Yamamoto M (April 2009). "Dietary sulforaphane-rich broccoli sprouts reduce colonization and attenuate gastritis in Helicobacter pylori–infected mice and humans". Cancer Prev. Res. 2 (4): 353–360. doi:10.1158/1940-6207.CAPR-08-0192. PMID 19349290. Lay summary.
3. Galan MV, Kishan AA, Silverman AL (August 2004). "Oral broccoli sprouts for the treatment of Helicobacter pylori infection: a preliminary report". Dig Dis Sci. 49 (7–8): 1088–1090. doi:10.1023/B:DDAS.0000037792.04787.8a. PMID 15387326.
4. Fahey JW, Haristoy X, Dolan PM et al. (May 2002). "Sulforaphane inhibits extracellular, intracellular, and antibiotic-resistant strains of Helicobacter pylori and prevents benzo[a]pyrene-induced stomach tumors". Proc. Natl. Acad. Sci. U.S.A. 99 (11): 7610–7615.doi:10.1073/pnas.112203099. PMC 124299. PMID 12032331.
5. Kall MA, Vang O, Clausen J (March 1997). "Effects of dietary broccoli on human drug metabolising activity". Cancer Lett. 114 (1–2): 169–170. doi:10.1016/S0304-3835(97)04652-1. PMID 9103281.
6. Hayes, JD; Kelleher, MO; Eggleston, IM (2008). "The cancer chemopreventive actions of phytochemicals derived from glucosinolates".European Journal of Nutrition 47 Suppl 2: 73–88. doi:10.1007/s00394-008-2009-8. PMID 18458837.
7. Li et al. (May 2010). "Sulforaphane, a dietary component of broccoli/broccoli sprouts, inhibits breast cancer stem cells". Clinical Cancer Research 16 (9): 2580–2590. doi:10.1158/1078-0432.CCR-09-2937. PMC 2862133. PMID 20388854.

read about synthesis
[PDF] 

A Facile and Green Synthesis of Sulforaphane

imm.ac.cn/journal/ccl/1709/170905-1152-c060185-p3.pdf

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by D Tong Jian - 2006 - Cited by 3 - Related articles
A Facile and Green Synthesis of Sulforaphane. Tong Jian DING, Ling ZHOU, Xiao Ping CAO*. Sate Key Laboratory of Applied Organic Chemistry and College of ...

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