No abstract

No abstract

Tachykinins (TKs) are small peptides widely distributed in the central and peripheral nervous systems where they act as neurotransmitters. Potent and selective TKs antagonists have been developed in the last 20 years and many efforts have been made to prove their efficacy in the treatment of various diseases. Herein the most prominent results in the clinical development are reported and discussed. For aprepitant, the only compound of this class to have been launched to date, results of clinical studies and postmarketing cost-effectiveness data for the treatment of chemotherapy-induced emesis are discussed. The field is still well active, as currently proof-of-concept studies for indications initially missed (i.e., depression) are ongoing and new targets are under investigation.

1 The pharmacological pro®le was studied of MEN 11420, or cyclo{[Asn(b-D-GlcNAc)-Asp-Trp-PheDap-Leu]cyclo(2b-5b)}, a glycosylated derivative of the potent, selective, conformationally-constrained tachykinin NK 2 receptor antagonist MEN 10627 (cyclo(Met-Asp-Trp-Phe-Dap-Leu)cyclo(2b-5b)). and ion channels. 4 In the rabbit isolated pulmonary artery and rat urinary bladder MEN 11420 potently and competitively antagonized tachykinin NK 2 receptor-mediated contractions (pK B =8.6+0.07, n=10, and 9.0+0.04, n=12; Schild plot slope=71.06 (95% c.l.=71.3; 70.8) and 71.17 (95% c.l.=71.3; 71.0), respectively). MEN 11420 produced an insurmountable antagonism at NK 2 receptors in the hamster trachea and mouse urinary bladder. However, in both preparations, the eect of MEN 11420 was reverted by washout and an apparent pK B of 10.2+0.14, n= 9, and 9.8+0.15, n=9, was calculated in the hamster trachea and mouse urinary bladder, respectively. 5 MEN 11420 showed low anity (pK B 56) at guinea-pig and rat tachykinin NK 1 (guinea-pig ileum and rat urinary bladder) and NK 3 (guinea-pig ileum and rat portal vein) receptors. On the whole, the anities (potency and selectivity) showed by MEN 11420 for dierent tachykinin receptors, measured either in binding or in functional bioassays, were similar to those shown by the parent compound, MEN 10627. ) and intraduodenal (100 ± 300 nmol kg 71 ) administration of MEN 11420. MEN 11420 was more potent (about 10 fold) and longer lasting than its parent compound MEN 10627, possibly due to a greater metabolic stability. 7 A dose of MEN 11420 (100 nmol kg 71 , i.v.), that produced potent and long lasting inhibition of the contraction of the rat urinary bladder induced by challenge with the NK 2 selective receptor agonist [bAla 8 ]neurokinin A(4 ± 10) (10 ± 300 nmol kg 71 ), was without eect on the responses produced by the NK 1 receptor selective agonist [Sar 9 ]substance P sulphone (1 ± 10 nmol kg 71 ). 8 These ®ndings indicate that MEN 11420 is a potent and selective tachykinin NK 2 receptor antagonist. The introduction of a sugar moiety did not produce major changes in the anity pro®le of this antagonist as compared to MEN 10627, but markedly improved its in vivo potency and duration of action. With these characteristics, MEN 11420 is a suitable candidate for studying the pathophysiological signi®cance of tachykinin NK 2 receptors in humans.