Hie development of orally active renin inhibitors has been plagued by limited bioavailability in animals and humans. A-74273 is a novel, potent nonpeptide inhibitor of human renin (1050=3.1 nM). This compound was absorbed into the portal and systemic circulations of anesthetized rats, ferrets, monkeys, and dogs after intraduodenal dosing. This favorable pattern also was observed after oral dosing in conscious animals, except in monkeys. Hepatic extraction of A-74273 was more efficient in rats and monkeys than in dogs or ferrets. A-74273 modestly inhibits dog renin, and when given orally as the base (0, 03, 1, 3, 10, and 30 mg/kg; n=8 per dose) to conscious, salt-depleted dogs it induced dose-related reductions in mean arterial pressure and plasma renin activity. Peak falls in mean arterial pressure from normotensive baselines were -14±1, -26±3, and -44±3 mm Hg for the 3, 10, and 30 mg/kg groups, respectively (p<0.05). Baseline plasma renin activity values (10.9±l.l-12.7±l.l ng angiotensin I/ml/hr) were maximally inhibited, ranging from 43±8% at 03 mg/kg to 98±1% at 30 mg/kg. Bioavailability in this model was estimated to be 54±13% when plasma drug levels were determined by a renin inhibitory activity assay, but bioavailability was lower when compared with high-performance liquid chromatographic analysis of A-74273. This discrepancy was accounted for by the identification of structurally similar metabolites that are as active as the parent drug against human renin but much less potent against dog renin. Despite overall lower in vitro activity in dog plasma than in human plasma, A-74273 is an active prodrug that is orally efficacious in dogs. 2 The effector hormone angiotensin II (Ang II) is primarily formed as a result of two sequential reactions catalyzed by renin and angiotensin converting enzyme (ACE), in that order. The inhibition of ACE is of notable therapeutic value in the treatment of hypertension and congestive heart failure.
-4 More than likely, the hemodynamic activity of ACE inhibitors is mediated through inhibition of the RAS, 5 -6 but the observed side effects associated with this line of therapy (e.g., cough and angioedema) may be attributed to the promiscuous nature of ACE in recognizing a host of functionally active peptide substrates such as bradykinin, neuropeptide Y, and substance P.
7The inhibition of renin as the site of RAS blockade has several virtues. Renin inhibition interrupts the synthesis of Ang II at the first and rate-limiting step of the biochemical cascade, precluding the accumulation of bioactive products. Further, the high degree of