• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
  • 引用文献
  • 法律状态
  • 优先权
    • 专利摘要:
    This invention provides a method of and compositions for increasing or maintaining glomerular filtration rate while preserving renal structure in a patient comprising administering an angiotensin II type 1 vascular receptor antagonist to the patient, independent of its effects on systemic blood pressure.The invention provides that, by administering the AII type 1 receptor antagonist, blood flow to the kidney can be improved without sacrificing intraglomerular pressure and therefore glomerular filtration and that even with this enhanced glomerular pressure and filtration, renal structure is preserved. Also provided is a method of screening AII type 1 receptor antagonists for the ability to maintain or increase glomerular filtration rate while decreasing mesangial matrix accumulation comprising the steps of administering the antagonist in an animal model characterized by decreased glomerular filtration rate and increased mesangial matrix accumulation and selecting the compounds that increase glomerular filtration rate while decreasing mesangial matrix accumulation.
    公开号:CA2309805A1
    申请号:C002309805
    申请日:1993-09-09
    公开日:1994-03-17
    发明作者:Valentina Kon；Agnes Fogo；Iekuni Ichikawa
    申请人:Valentina Kon；Vanderbilt University；Agnes Fogo；Iekuni Ichikawa；
    IPC主号:C12Q1-00
    专利说明:
    EXPRES,~ '~Lr ', N0. HB260327056US METHOD AND COMPOSITIONS FOR MAINTAINING GLOMERULAR FILTRATION RATE WHILE INHIBITING EXTRACELLULAR MATRIX ACCUMULATION S This invention was made with government support under Grants DK-42159, DK-39547, DK-44757 and DK-37869 from the National Institutes of Health. The U.S. Government may have certain rights in this invention. Throughout this application various publications are referenced by numbers within parentheses. Full citations for these publications may be found at the end of the specification immediately preceding the claims. The disclosures of these publications in their entireties are hereby incorporated by reference into this application in order to more fully describe the state of the art to which this invention pertains. BACKGROUND OF THE INVENTION Angiotensin II (AII) is now known to act on the systemic vasculaturc and at several sites within the renal microcirculation with effects on vascular tone and vascular growth and extraccllular matrix accumulation (1-6, 40). Angiotensin~I converting enzyme inhibitor (ACEI) has been used as a primary tool to control hypertension, increase organ blood flow and preserve organ structure. However, while ACEI causes vasodilation, including within the renal circulation, its specific effects, to decrc;ase resistance of both glomerular afferent and efferent arterioles, can reduce glomerular capillary pressure and therefore filtration. The renin angiotcnsin system (RAS) has been postulated to be linked to other vasoactive substances, notably bradykinin, which may account for part of ACEI-induced vasodilatation (7-12). Assessment of the specific effects of endogenous All on the renal circulation has been limited by this uncertain non-specific action of ACEI, and also by the partial agonist effects of previously available All analogues. Recently, the availability of both a specific nonpeptide All type 1 receptor antagonist (AIIRA) which lacks agonist effects (13, 14), and a specific bradykinin receptor antagonist (15) has circumvented these difficulties.
    These developments are important, since it is frequently necessary to inhibit RAS effects in patients, including vasoconstriction, vascular growth and extracellular matrix accumulation. S Thus, there is a great need for a method of inhibiting RAS while maintaining or increasing GFR levels and protecting the kidney from structural injury. The invention provides that this can be accomplished by antagonizing All type 1 vascular receptor in a patient. Further, this invention provides that these beneficial effects on the kidney can be accomplished independently of All type 1 vascular receptor antagonist effects on systemic blood pressure or other cardiac pathologies. -SUMMARY OF THE INVENTION This invention provides a method of and compositions for increasing or maintaining glomerular filtration rate while preserving renal structure in a patient comprising administering an angiotcnsin II type 1 vascular receptor antagonist to the patient, independent of its effects on systemic blood pressure.The invention provides that, by administering the All type 1 receptor antagonise, blood flow to the kidney can be improved without sacrificing intraglomerular pressure and therefore glomerular filtration and that even with this enhanced glomerular pressure and filtration, renal structure is preserved. Also provided is a method of screening All type 1 receptor antagonists for the ability to maintain or increase glomerular filtration rate while decreasing mesangial matrix accumulation comprising the steps of administering the antagonist in an animal model characterized by decreased glomerular filtration rate and increased mesangial matrix accumulation and selecting the compounds that increase glomerular filtration rate while decrezsing mesangial matrix accumulation.
    BRIEF DESCRIPTION OF THE FIGURES Figure 1 shows individual glomerular capillary pressure (P~~ values in Group II AWD rats during baseline and following angiotensin II receptor antagonist (AIIRA) and angiotensin I converting enzyme (ACED showing markedly greater fall in P~~ with ACEI. Figure 2 shows mean arterial pressure (MAP) and glomerular filtration rate (GFR) in AWD rats treated with Furosemidc. MAP decreased similarly in both ACEI, Group IIIA (~) and AIIRA, Group IIIB ( J ). By contrast, GFRwas unchanged with ACEI (O) and increased significantly with AIIRA (~). Figure 3 is a summary of effects of ACEI and bradykinin antagonist (Hoe) in AWD+Furosemide Group IVA rats. The decrease in glomerular capillary pressure (P~~) with ACEI was restored with Hoe, primarily reflecting elevation in efferent arteriolar resistance, RE.
    DETAILED DESCRIPTION OF THE INVENTION This invention provides a method of maintaining or increasing glomerular filtration rate (GFR) while inhibiting mesangial matrix accumulation in a patient. The method comprises administering an amount of an All type 1 vascular receptor antagonist that would maintain or increase GFR while preserving renal structure in the patient. The invention provides that, by administering the All type 1 receptor antagonist, blood flow to the kidney can be improved without sacrificing intraglomerular pressure and therefore glomerular filtration, and that even with this enhanced glomerular pressure and filtration, renal structure is prcscrved. Onc antagonist which has proven appropriate is L-158,809 (5,7-dimethyl-2-ethyl-3-([2'-(1H-tetrazol-Syl)(1,1')-biphenyl-4-yl)-methyl)-3H-imidazo(4,5-b)pyridine). Other appropriate antagonists include DuP 753 and any non-peptide All type 1 receptor antagonist now known or later discovered. Such antagonists can be screened and selected by the methods provided herein. The amount of an All type 1 vascular receptor antagonist that can maintain or increase GFR and inhibit mesangial matrix accumulation may not be related to pressor dose. As used herein, the "pressor dosage" means the dosage of antagonist one would administer to normalize hypertension. In patients with an accumulation of mcsangial matrix or a history of renal failure, the preferred dosage can be greater than the pressor dosage. Any pharmaceutically acceptable water or lipid soluble carrier would be appropriate as a carrier for antagonist compositions in doses greater than the pressor dosage. All type 1 receptor antagonist is administered to patients in whom systemic/renal vasodilation is desired without compromising glomerular filtration. Such patients would include those suffering from hypertension with or without renal structural injury in whom maintenance or increase in GFR can be accomplished with control of systemic hypertension and inhibition of progressive renal structural injury. Such patients would also include those with ischemic cardiac disease, cardiac dysfunction following infarction, and cardiomyopathy, whether or not these patients have systemic hypertension. Therefore, the invention allows for the intentional simultaneous treatment of systemic hypertension and function and structure of the kidneys utilizing an All type 1 receptor antagonist. As used herein, "hypcrtensive" means a blood pressure above 150/90 mm Hg in adults which is above the normal range of 120/80 mm Hg. The range for hypertension in children varies and is dependent on age and body size. The invention also provides a method of screening All type 1 receptor antagonists for the ability to maintain or increase GFR while decreasing mesangial matrix accumulation. The method comprises the steps of administering the antagonist in an animal model characterized by decreased GFR and increased mesangial matrix accumulation and selecting the compounds that maintain or increase GFR while decreasing mesangial matrix accumulation. One such model to evaluate effects on glomerular filtration, the AWD rat model, is set forth in the Examples. A model to examine effects on glomcrular filtration and structure chronically, the renal ablation model, is described in Reference 40. RAS is important in regulating vasomotor tone in the systemic and organ vasculatures. Interruption of the RAS to decrease vasoconstriction is often a therapeutic goal, but is associated with variable effects on GFR (6, 17, 21-30). Studies in the AWD rat, a model characterized by hypoperfusion and hypofiltration with activation of the RAS, examined these issues. Antagonizing All actions by inhibition of converting enzyme vasodilated the systemic and renal circulations; systemic blood pressure decreased and renal plasma flow increased, however, there was no improvement in GFR. Analysis of the microcirculatory hemodynamics revealed that arteriolar resistances decreased, particularly in the efferent arteriole, which contributed to the increase in Q,,.However, the efferent arteriolar dilatation also caused a profound fall in P~c (by 16 mm Hg), which offset the effects of increases in QA and Kt, and resulted in no improvement in single nephron glomerular filtration rate (SNGFR). These findings are in accord with reports that inhibition of RAS can increase, decrease, or leave unchanged the rate of filtration, and emphasize that the net effect on GFR depends upon the balance of AII's effects on RA, RE and I~ (6, 16, 17, 24). S In more severe hemodynamic decompensation, glomerular filtration may be critically dependent on heightened RAS which promotes efferent arteriolar maintenance of P~~ and GFR. Removal of this critical compensation then leads to a fall in GFR (17). This notion is supported by the observation that decreased GFR and azotemia develop in patients on ACEI with superimposed circulatory stress such as blood loss, addition of diuretics or other fluid loss, which overwhelms already maximal compensation by RAS (22, 23, 25-28, 31). It should be emphasized that hypofiltration occurs even in the absence of profound systemic hypotension (22, 31). Further, for similar decrease in systemic blood pressure, hypofiltration occurs more frequently when RAS is inhibited compared with systemic vasodilatation achieved with maneuvers not involving RASinhibition. These findings then implicate renal, rather than systemic, changes which are responsible for decreasing filtration. The effects of a specific All type I receptor antagonist (AURA) were examined, as set forth in the following Examples. The angiotensin type Ireceptor is one of two angiotensin receptor types identified in humans, and is the subtype that mediates cardiovascular actions of All (32). The renal distribution of the mRNA of this receptor was examined in our recent in hybridization studies. No signal was detected in interlobular arteries while this signal was prominent in vessels regulating blood flow and filtration, including both afferent and efferent arterioles and the mesangium (33). In contrast to ACEI, the present data shows that antagonizing type I All vascular receptor caused renal vasodilatation, which was accompanied by a striking increase in filtration (Table 1 and Figs. 1 and 2). This difference was apparent between periods within an animal and also between groups. While the magnitude of decrease in systemic blood pressure and increase in Q~ were similar, antagonism of All with a receptor antagonist resulted in lesser reduction in efferent arteriolar tone than inhibition of ACE (Table 1 and Fig. 3). This is reflected by the changes in P~~. Thus, although systemic blood pressures was decreased to the same degree by both ACEI and AIIRA, ACEI caused P~~ to fall by 16 inm Hg, compared with 7 mm Hg fall following AURA. Differences in the microcirculatory hemodynamic changes after interrupting the RAS at these different sites of action, i.e. at the interaction of ligand and type I receptor vs. inhibition of conversion of angiotensin I to AII, demonstrate that other All effects or non-All actions contribute, at least in part, to the dyssynchrony between renal vasodilatation and filtration following ACEI. In this regard, circulating levels of All modulate expression of the genes of the RAS, including renin, angiotensinogen and ACE (34). Since circulating All levels are higher after AIIRA than ACEI treatment (35), this higher levels of unbound All can interact with other vasoactive substances, or bind with type II receptor or other angiotensin binding proteins. The possibility of additional, non-All effects (e.g. interaction with vasodilators) is of interest in view of the previous observation that rats with renal hypoperfusion because of congestive heart failure and AWD developed a paradoxical fall in efferent arteriolar tone in response to superimposed reduction in renal perfusion pressure (17). In this setting, the expected renal vasodilatation is postulated to reflect attenuation of All actions. However, the observations demonstrate that the failure to increase or actually even decreasing GFR during such renal vasodilatation is not simply attenuation of All effects, rather it is an active vasodilatation. . ZS Some vasodilators are associated with RAS, including bradykinin, endothelium-derived relaxing factor and prostaglandins, although the data demonstrates that the latter does not have a major role in this regard. Of note, angiotensin I converting en2yme inhibitors inactivate kininase II, a kinin-degrading enryme which would result in accumulation of bradykinin.Bradykinin's contribution to ACEI-induced vasodilatation has been controversial (8-12, 36-38), There is accumulating evidence that kinins play an important role in regulating renal function, including recent evidence that kinins can be formed in the renal circulation. 'Ibis is of particular relevance since among isolated rabbit interlobular, efferent and afferent arteriolar preparations, bradykinin caused marked vasodilatation only in the efferent arteriole (39). Bradykinin's role in the ACEI-induced vasodilatation was investigated, in particular whether S the dramatic decrease in efferent arteriolar resistance is related to the enhanced bradykinin activity. The data in animals treated with ACEI clearly show that antagonizing bradykinin opposed the decrease in efferent arteriolar resistance effected by converting enzyme inhibition (Fig. 3). This in turn caused an elevation in glomerular pressure which was pivotal in increasing GFR. Interruption of the RAS by ACEI is now used in many circumstances to lower blood pressure, to effect aftcrload reduction, decrease proteinuria and also to forestall chronic deterioration in renal function. While vasodilatation and renal sparing is a desirable therapeutic end point in the kidney, a decrease in vascular resistance can cause not only renal vasodilatation but also may decrease glomerular capillary pressure, and therefore remove an important compensatory mechanism to maintain GFR. These data show that renal vasodilatation following inhibition of angiotensin I converting enzyme is at least in part related to bradykinin. These data further indicate that in conditions where high P~~ is crucial in maintaining GFR, activation of bradykinin by ACEI can precipitate severe compromise in GFR, and that this untoward effect can be largely avoided with a more specific vasodilator for antagonism of All effects. EXAMPLES2:5 Experiments were done in adult male Munich-Wistar rats. All animals were deprived of water for 48 hours (acute water deprivation, AWD), a model characterized by hypoperfusion, hypofiltration and activated RAS (6, 16, 17). Renal function was then assessed as described in detail below. AWD decreased the body weight, on average, by 15%.
    Group 1 AWD treated with ACEI (n=6). Rats were prepared for micropuncture as previously descrbed (6, 16, 17). Briefly, under Inactin anesthesia (70 mg/kg body wt i.p., BYK, Konstanz, Germany), tracheotomy was performed, and indwelling polyethylene catheters were inserted into the femoral artery and vein and the jugular vein for blood sampling, monitoring of systemic blood pressure, and infusion of inulin and plasma, as previously described (6, 16, 17). Determinations of SNGFR, hydraulic pressures in glomerular capillaries (Pcc), proximal tubules (Pr), and efferent arterioles were made. Femoral arterial (CA) and efferent arteriolar (CE) plasma protein concentrations were also obtained, permitting calculation of glomerular plasma flow rate (Q,J and ultrafiltration coefficient (K~), as well as resistances of afferent (R,~ and efferent (RE) arterioles. Colloid osmotic pressures of plasma entering and leaving the glomerular capillaries were estimated from CA and CE using derivations of Deen et al. (18, 19). Details of the analytical procedure for inulin in plasma and nanoliter tubule fluid samples, and that for CA and CE are desenbed elsewhere (18, 19). After baseline measurements and collections, each rat was treated with ACEI (enalapril, 0.3 mg/kg i.v. bolus, then 0.3 mg/hr continuous i.v. infusion). After 60 minutes, micropuncture measurements were repeated. Group II AWD treated with AlIRA and ACEI (n=6). Rats were prepared as in Group I except that, after baseline measurements, AIIRA (4 mg/kg body wt i.v. as bolus and then as continuous infusion, L-158,809, Merck, Sharp &Dohme), a specific type I angiotensin receptor II antagonist, was started. Renal micropuncture measurements were performed 1 hour after AURA was started.AIIRA was then discontinued and ACEI was infused as in Group I with repeat micropuncture measurements after 1 hour. Since the AIIRA has half life exceeding 6 hours in the rat (14) and effects in the ACEI period may in part reflect alterations of the RAS after receptor inhibition, we studied separate groups of animals treated with either ACEI or AIIRA. Groups IIIA and B, AWD+Furosemide, treated with ACEI (n=6) or AIIRA (n=6). To confirm differences in renal function between ACEI versus AURA under conditions with extreme stimulation of the RAS, we studied animals that received furosemide in addition to water deprivation. Furosemide (2.5 mg/kg body wt i.p.) was administered at the start of water deprivation and again the next day which was at least 24 hours prior to micropuncture/clearance studies to avoid confounding effects of furosemide activation of tubuloglomerular feedback. Following surgical preparation, baseline clearance studies were obtained as previously described (6, 16, 17). The animals were then treated with either ACEI (Group IIIA, n=6) or AIIRA (Group IIIB, n=6), as described above. Measurements were repeated 60 minutes later. Group IYA and B, AWD+Furosemide, treated with ACEI+bradykinin receptor antagonist, Hoe (n=9), or Hoe (n=6). These animals were prepared as Group IIIA (baseline, then ACEI) but, in addition, a third period of study was added. Thus, during ACEI treatment renal hemodynamic studies were performed, and then a newly developed bradykinin antagonist was added (0.1 mg/kg body wt i.v. bolus and s.c, Hoc-140, HOECHT, Frankfurt, Germany). Micropuncture measurements were then performed. The bradykinin antagonist has previously been shown to be highly protective in vivo, completely preventing bradykinin-induced systemic hypotension after 1 hour and with only minimal hypotension (-5% decrease in blood pressure) 2 hours following subcutaneous administration (15). Group IVB rats were treated identically, except that no ACEI was given. The same dose of Hoe-140 was administered before measurement of renal clearances at 1 hour. To assess a potential role for prostaglandins in the effects of ACEI versus AIIRA, a separate group was pretreated with indomethacin, 2 mg/kg body wtlhr i.v. Following micropuncture/clearance studies, the animals received either ACEI (n=4) or AIIRA (n=4) as above, and renal studies were repeated. Group 1, AWD treated with ACEI. Whole kidney GFR, SNGFR, and QA(0.4610.07 ml/min, 16.211.9 nl/min, and 5316 nl/min, respectively) were characteristic of the hypoperfusion/ hypofiltration pattern of renal hemodynamics and distinct from normal euvolemic rats (6, 16, 17). These parameters reflect higher than normal afferent and efferent arteriolar resistances (0.40210.044 mm Hgmin/nl and 0.54310.085, respectively). Inhibition of angiotensin I converting enzyme activity decreased MAP from 10716 mm Hg to 9415, and caused renal dilatation. Thus, Q" values increased to 102124 nl/min, due to a decrease in arteriolar resistances, particularly of the efferent arteriole (from 0.54310.085 mm Hgmin/nl to 0.23510.048, p<0.025). The fall in RE was apparent in the profound decrease in the intraglomerular pressure; P~~ fell from the higher than typical euvolemic value of 6512 mm Hg to 4911 (p<0.005). As expected, inhibition of All activity caused an increase in the value of Kt (1.02010.240 nl/(miwmm Hg) vs. 2.70010.600, p<0.025]. The cumulative effect of these changes was the lack of consistent improvement in filtration (GFR0.4610.07 vs. 0.5410.06, p NS). In the next set of experiments, the mechanism of AII's actions on the glomerular microcirculation was explored by interrupting the RAS at different sites in the same animals. Group II AWD treated with AIIRA and ACEI. Group II rats were prepared identically to Group I and again showed the typical renal hypoperfusion of AWD. These data are shown in Table 1 and Figure 1. In contrast to Group I ACEI-treated rats, both GFR (p<0.05) and SNGFR(p<0.025) increased significantly with AIIRA. Evaluation of individual parameters that affect filtration revealed vasodilatation, particularly due to a fall in efferent arteriolar resistance (p<0.05). Of note, while P~~ fell from 6713 mm Hg to 6012 (p<0.05), this decrease was markedly less than that observed in Group I ACEI-treated rats, where average P~~ decreased by 16 mm Hg. Whether inhibition of converting enzyme in the setting of previous antagonism of All receptor had an additional independent effect on filtration was then examined. ACEI following AIIRA caused a' profound fall in the rate of filtration: GFR and SNGFR fell even below baseline (Table 1). Of note, the profound hypobltration occurred in the face of renal dilatation. QA increased further to 134119 nl/min (p<0.025 vs. baseline), largely reflecting a marked decrease in the efferent arteriolar resistance. As in Group 1, this was associated with a precipitous decrease in Pea which was on average 15 mm Hg lower than baseline value. Groups IIIA and B, AWD+Furosemide, treated with ACEI or AURA. Due to the potential persisting actions of the long lasting AIIRA, separate groups of animals were treated with ACEI (Group IIIA) or AIIRA (Group IIIB). To confirm differences in renal microcirculatory responses to ACEI versus AIIRAunder conditions with extreme stimulation of the RAS, these animals received furosemide in addition to AWD. Group III rats were more profoundly dehydrated than Groups I and II as evidenced by higher hematocrit (6011 % vs.5211 and Sltl, respectively, for Group III versus Group I and 2, p<0.0005). MAP decreased from baseline in both Groups IIIA and IIIB with treatment:9316 mm Hg to 8715 (p<0.025), and 9316 mm Hg to 8313 (p<0.05), respectively (Fig. 2). Similar to Groups I and II, ACEI did not affect GFR(0.6110.04 ml/min versus 0.6110.05). In contrast to ACEI, inhibition of All with receptor antagonist resulted in marked improvement in GFR which, on average, increased from 0.5110.07 ml/min to 0.7210.09 (p<0.01). Group IYA and B, AWD+Furosemide, treated with ACL~'I and bradykinin receptor antagonist, Hoe (n=9) or Hoe (n=6). To further explore the mechanisms underlying these differing effects on the rate of glomerular filtration, we studied the potential contribution of bradykinin, as ACEI, unlike AIIRA, acts as a kininase inhibitor. For this purpose, we evaluated the renal microcirculation in response to a specific bradykinin receptor antagonist. ACEIdecreased MAP (9813 mm Hg to 9012) and increased renal perfusion without improving hypofiltration, GFR 0.5010.08 ml/min versus 0.5810.08, SNGFR2112 nl/min versus 2212. The individual parameters are shown in Figure 3, again emphasizing the marked decrease in P~~ following ACEI (6314 mm Hg vs. 5313, p<0.005). The contnbution of bradykinin was evaluated in the third period. MAP was unchanged from that during ACEI treatment. Filtration increased significantly; GFR rose to 0.7110.10 ml/min (p<0.005 vs. ACED, and SNGFR increased to 2813 nl/min (p<0.05 vs. ACED. This improvement in filtration was due to an increase in glomerular pressure which returned toward the baseline level (6216 mm Hg, p<0.05 ACEI vs. Hoe), reflecting return of efferent arteriolar resistance to baseline levels, 0.31210.050 mm Hg~minlnl. The value for ICS was not affected by the bradykinin antagonist (1.73510.320 nl/(minTnm Hg) vs. 1.46510.472 , ACEI vs. Hoe, respectivelyj. In Group IVB, AWD+furosemide animals treated with the bradykinin antagonist alone, GFRwas 0.8110.10 ml/min at baseline, with no significant change after bradykinin antagonist, 0.8910.19 ml/min. Separate rats were treated with either ACEI or AIIRA after prostaglandin inhibition with indomethacin. SNGFR showed -20% increase over baseline after ACEI versus 100% increase after AIIRA (p<0.05), Q"increased -70% versus -140%, and R,, decreased -30% versus -60%(p<0.05), respectively. These findings are taken to suggest that prostaglandins are not the major intermediary mechanism for the greater divergence between vasodilatation and perfusion seen after ACEI versus AIIRA. The likelihood of achieving success in humans based on these specific findings in the rat is based on several facts. First, systemic and renal hemodynamics in normal and disease states have been investigated extensively in the rat and found to be relevant to clinical conditions in humans. Second, the _ RAS is phylogenetically tightly preserved, with activation in response to similar stimuli in both rats and humans, and the type 1 vascular receptor is found in both rats and humans with over 90% homology. Further, inhibition of the RASby ACEI has been shown to have parallel effects in both rats and humans. -Therefore, inhibition of RAS by the All type 1 vascular receptor antagonist is expected to have the same effects in humans as shown in these rat studies.
    The preceding examples are intended to illustrate but not limit the invention. While they are typical of those that might be used, other procedures known to those skilled in the art maybe alternatively employed. -,a ~ ~ c v E. o ~a ~ E o 0 o O c ~-I -H ~-I O~ 'C N o0 00 .C y N ~C1 O C .-. ' C N C Oc0 v v. C N l~~ N 'S w_ r O O OE O O O tL G NH NEO C O v ,.Nr C v ~" ca E O'~ l: ~ Z_~ v y O G (~ ~ E O O O m o ~ ~ ~=a E' : Q E O O O .-Ow 60 n ~e~ ~ ~v1 O 00++ ;p (y~ O H~ t~'1r ~ Vr.-~ .~. N Q, ~ ~"fl ~-1 ~f~la ~~ G. n O NH o ~o ~., o3 ~;;a ,~-yr . LL W V C M N U "00 ... r. ~ .G N v1 U y O O ++ G. v~ d . _, V~ C N N ~' ~ a ~ cV r y C1. EC7+a +a +a ~ N C N CV rC. b~ a .G E E~~'. V .~O e~ E +~ +I +~ ~ $ a C7vo ~ ~~ ~o vo o , C 'y _ ~ eC1w ,~1'.,N N N i~l ii ii .o C 0~0 O~O v E-.._ _ R ~ G a ~oa a mm References 1. Blantz, R. C., K S. Konnen, and B. J. Tucker. 1976. Angiotensin II effects upon the glomerular microcirculation and ultrafiltration coefficient of the rat. I. Clin. Invest. 57: 419-434.2. Clappison, B. H., W. P. Anderson, and C. I. Johnston. 1981. Renal hemodynamics and renal kinins after angiotensin converting enryme inhibition. Kidney Ins 20: 6I5-620.3. Navar, L. G., J. D., P. D. Bell, C. E. Thomas, and W. C. Huang. 1982. Influence of converting enzyme inhibition on renal hemodynamics in sodium-restricted dogs. Hypertension. 4: 58-68.4. Rosivall, L. and L. G: Navar. 1983. Effects on renal hemodynamics of intra-arterial infusions of angiotcnsins I and II. Am 1. Physiol. 245: F181-F187. S. Kastner, P. R., J. E. Hall, and A. C. Guyton. 1984. Control of glomerular filtration rate: Role of intrarenally formed angiotensin II. Am. J. PhySioL 246: F897-F906.6. Kon, V., A. Pared, and I. Ichikawa. 1985. Role of renal sympathetic nerves in mediating hypoperfusion of renal cortical microcirculation in experimental congestive heart failure and acute extraccJlular fluid volume depletion. J. Clin. Invest 76: 1913-1920.7. Zusman, R. M. 1984. Renin- and non-renin-mediated and antihypcrtensive actions of converting enzyme inhibitors. Kidney Int. 25: 969-983.8. Scicli, A. G. and O. A. Carretero. 1986. Renal kallikrein-kinin system. Kidney Int. 29: 120-130.9. Williams, G. H. 1988. Converting-enzyme inhibitors in the treatment of hypertension. N. Eng1 J. Med 319: 1517-1525.10. Gardes, J., T. Baussant, P. Corvol, J. M~nard, and F. Alhenc-Gelas. 1990. Effect of bradykinin and kininogens in isolated rat kidney vasoconstricted by angiotensin II. Am. J. PhySiol. 258: F1273-F1281.11. Fenoy, F. J., G. Scicli, O. Carretero, and R. J. Roman. 1991. Effect of an angiotensin II and a kinin receptor antagonist on the renal hemodynamic response to captopril. Hypertension. 17: 1038-1044.12. Hajj-ali, A. F. and B. G. Zimmerman. 1991. Kinin contnbution to renal vasodilator effect of captopril in rabbit. Hypertension. 17: 504-509. 13. Mantlo, N. B., P. K Chakravarty, D. Ondeyka, A. Chen, V. I. Camara, R.S. L. Chang, V. J. Lotti, P. K S. Siegl, A. A.. Patchett, and W. J. Greenlee. 1991.Potent, orally active imidazol(4,5-b]pyridine angiotensin II receptor antagonists..I. Med Chem. 34: 2919-2922.14. Siegl, P. K S., R. S. L. Chang, N. B. Mantlo, P. K Chakravarty, D. L.Ondeyka, W. J. Greenlee, A. A. Patchctt, C. S. Sweet, and V. J. Lotti. In vivo pharmacology of L-158,809, a new highly potent and selective nonpeptide angiotensin II receptor antagonist. J. PharmacoL Exp. lherap. In press.15. Wirth, K, F. J. Hock, U. Albus, W. Lint, H. G. Alpermann, H. Anagnostopoulos, S. Henke, G. Breipohl, W. Konig, J. Knolle, and B. A.. Scholkens. 1991. Hoe 140 a new potent and long acting bradykinin-antagonist: In vivo studies. Br. J .Pharmacol 102: 774-777.
    16. Pared, A., V. Kon, and I. Ichikawa. 1985. Mechanism of preservation of glomerular perfusion and filtration during acute extracellular fluid volume depletion. J. Clip. Invest. 75: 1477-1487.
    17. Yoshioka, T., A. Pared, V. Kon, and I. Ichikawa. 1989. Impaired preservation of GFR during hypotension in preexistent renal hypoperfusion. Am..7. PhysioL 256: F314-F320.
    18. Deen, W. M., J. L. Troy, C. R. Robertson, and B. M. Brenner. 1973.Dynamics of glomerular ultrafiltration in the rat IV. Determination of the ultrafiltration coefficient. J. Clip. Invest. 52: 1500-1508.
    19. Deen, W. M., D. A. Maddox, C. R. Robertson; B. M. Brcnner, J. L. Tray, and I. F. Ueki. 1974. Dynamics of glomerular uItrafiltration in the rat. VII. Response to reduced renal mass. Am. J. Physiol 227: 556-562.
    20. Chang, R. S. L., P. K S. Siegl, B. V. Clineschmidt, N. B. Mantlo, P. K Chakravarty, W. J. Greenlee, A. A. Patchett, and V. J. Lotti. 1991. In vitro pharmacology of a highly potent and selective nonpeptide angiotensin II (AII) receptor antagonist: L-158,809. FASEB .l. 5(Part III): 6993. (Abstr.) Z1. Dzau, V. J., W: S. Colucci, G. H. Williams, G. Curfman, L. Meggs, and N.K. Hollenberg. 1980. Sustained effectiveness of converting-enzyme inhibition in patients with severe congestive heart failure. N. EngG J. Med 302: 1373-1379.22. Hricik, D. E., P. J. Browning, R. Kopelinan, W. E. Goorno, N. E. Madias, and V. J. Dzau. 1983. Captopril-induced functional renal insufF~ciency in patients with bilateral renal-artery stenoses or renal-artery stenosis in a solitary kidney. N. Eng~ I Med 308: 373-376.23. Packer, M., N. Medina, and M. Yushak. 1984. Efficacy of captopril in Iow-renin congestive heart failure: Importance of sustained reactive hyperreninemia in distinguishing responders from nonresponders. Am. .I. CardioLS4: 771-777.24. Ichikawa, L, J. M. Pfeffer, M. A. Pfeffer, T. H. Hostetter, and B. M.Brenner. 1984. Role of angiotensin II in the altered renal function of congestive heart failure. CirG Res. SS: 669-675.2S. Murphy, B. F., J. A. Whitworth, and P. Kincaid-Smith. 1984. Renal insufficiency with combinations of angiotensin converting enzyme inhibitors and diuretics. Brit. Med I. 288: 844-845.26. Packer, M., W. H. Lee, M. Yushak, and N. Medina. 1986. Comparison of captopril and enalapril in patients with severe chronic heart failure. N. EngL J. Med 315: 847-853.27. Packer, M., W. H. Lee, N. Medina, M. Yushak, and P. D. Kessler. 1987.Functional renal insufficiency during long-term therapy with captopril and enalapril in severe chronic heart failure. Ann. Int. Med 106: 346-354.28. McMurray, J. and D. M. Matthews. 1987. Consequences of fluid loss in patients treated with ACE inhibitors. Postgrad Med J. 63: 38S-387.29. Badr, K F. and I. Ichikawa. 1988. Prerenal failure: A deleterious shift from renal compensation to decompcnsation. N.. Engl. I. Med 319: 623-629.30. Dzau, V. J. 1992. Angiotensin converting enzyme inhibitors and the cardiovascular system. I Hypertens. 10: S3-S10.31. Deedwania, P. C. 1990. Angiotensin-converting enzyme inhibitors in congestive heart failure. Arch. Intern. Med 150: 1798-1805.32. Whitebread, S., M. Mele, B. Kamber, and M. de Gasparo. 1989. Preliminary biochemical characterization of two angiotensin II receptor subtypes. Biochem. Biophys Res Camm. 163: 284-291. .33. Kakinuma, T., T. Inagami, A. Fogo, and I. Ichikawa. In situ hybridization studies of the intrarenal localization of angiotensin II type 1 receptor (ATl) mRNA in the rat. I Ainer. Soc. NephroL In press. (Abstr.) 34. Kohara, K, K B. Brosnihan, C. M. Ferrario, and A. Milsted. 1992.Peripheral and central angiotensin II regulates expression of genes of the renin-angiotensin system. Am. I PhysioL 262: E6S1-E6S7.3S. Campbell, D. J. 1987. Circulating and tissue angiotensin systems. !. Clin. Invest 79: 1-6.36. Aubert, J. F., B. Waeber, J. Nussberger, R. Vavrek, J. M. Stewart, and H.R. Brunner. 1987. Lack of a role of circulating bradykinin in the blood pressure response to acute angiotensin converting inhibition in rats. Agents Actions. 22:349-354.37. Camacho, A. A, M. C. O. Salgado, and E. M. Krieger. 1990. Reversal of hyperreactivity to bradykinin in renal hypertensive rats. Hypertension. 15(Suppl I): I140-II43.38. Bao, G., P. Gohlke, F. Qadri, and T. Unger. 1992. Chronic kinin receptor blockade attenuates the antihypertensive effect of ramipril. Hypertension. 20:74-79.39. Edwards, R.M. 1985. Response of isolated renal arterioles to acetylcholine, dopamine, and bradykinin. Am. ,l. PhysioL 248:F183-F189.40. Kakinuma, Y., T. Kawamura, T. Bills, T. Yoshioka, I. Ichikawa, and A..Fogo. 1992. Blood pressure-independent effect of angiotensin inhibition on vascular lesions of chronic renal failure. Kidney Int. 42:46-55.
    权利要求:
    Claims (2)
    [1] 1. A method of screening angiotensin II type 1 receptor antagonists for the ability to increase glomerular filtration rate while decreasing mesangial matrix accumulation comprising the steps of administering the antagonist in an animal model characterized by decreased glomerular filtration rate and increased mesangial matrix accumulation and selecting the compounds that increase glomerular filtration rate while decreasing mesangial matrix accumulation.
    [2] 2. A method of screening angiotensin II type 1 receptor antagonists for the ability to maintain glomerular filtration rate while decreasing mesangial matrix accumulation comprising the steps of administering the antagonist in an animal model characterized by increased mesangial matrix accumulation and selecting the compounds that maintain glomerular filtration rate while decreasing mesangial matrix accumulation.
    类似技术:
    公开号 | 公开日 | 专利标题
    Kon et al.1993|Bradykinin causes selective efferent arteriolar dilation during angiotensin I converting enzyme inhibition
    Burnier et al.1993|Salt-dependent renal effects of an angiotensin II antagonist in healthy subjects.
    Martinez-Maldonado1991|Pathophysiology of renovascular hypertension.
    Plum et al.1998|Effects of the angiotensin II antagonist valsartan on blood pressure, proteinuria, and renal hemodynamics in patients with chronic renal failure and hypertension.
    Kelleher et al.1984|Sympathetic nervous system in the loss of autoregulation in acute renal failure
    Benter et al.1995|Pressor and reflex sensitivity is altered in spontaneously hypertensive rats treated with angiotensin-|
    RU2183128C2|2002-06-10|Pharmaceutical composition
    Blackshear et al.1979|Dissociation of renin release and renal vasodilation by prostaglandin synthesis inhibitors
    Kivlighn et al.1994|Effects of BQ-123 on renal function and acute cyclosporine-induced renal dysfunction
    Madeddu et al.1998|Renovascular hypertension in bradykinin B2-receptor knockout mice
    Huang et al.1988|Angiotensin influences on tubuloglomerular feedback mechanism in hypertensive rats
    Xu et al.2002|Amlodipine, but not verapamil or nifedipine, dilates rabbit femoral artery largely through a nitric oxide-and kinin-dependent mechanism
    Zimmerman et al.1990|Bradykinin contribution to renal blood flow effect of angiotensin converting enzyme inhibitor in the conscious sodium-restricted dog.
    US5660813A|1997-08-26|Method of screening of angiotens in II type I receptor antagonists
    US5212165A|1993-05-18|Method for rehabilitating the vasorelaxant action of the coronary arteries impaired through atherosclerosis or hypercholesterolemia employing an ace inhibitor
    Denton et al.1985|Role of angiotensin II in renal wrap hypertension.
    Verseput et al.1998|Tubuloglomerular feedback and prolonged ACE-inhibitor treatment in the hypertensive fawn-hooded rat.
    Vlasses et al.1982|Low-dose captopril: its use in mild to moderate hypertension unresponsive to diuretic treatment
    Haas et al.1981|Adenosine induced fall in glomerular capillary pressure
    US6531482B1|2003-03-11|Method and compositions for maintaining glomerular filtration rate while inhibiting extracellular matrix accumulation
    Kline et al.1994|Modification of pressure natriuresis by long-term losartan in spontaneously hypertensive rats.
    Davis et al.1994|Effects of selective endothelin antagonists on the hemodynamic response to cyclosporin A.
    Duke et al.2005|AT2 receptors mediate tonic renal medullary vasoconstriction in renovascular hypertension
    Elisaf et al.1999|Effectiveness and metabolic effects of perindopril and diuretics combination in primary hypertension
    CA2309805A1|1994-03-17|Method and composition for maintaining glomerular filtration rate while inhibiting extracellular matrix accumulation
    同族专利:
    公开号 | 公开日
    引用文献:
    公开号 | 申请日 | 公开日 | 申请人 | 专利标题
    法律状态:
    2000-06-13| EEER| Examination request|
    2005-09-09| FZDE| Dead|
    优先权:
    申请号 | 申请日 | 专利标题
    US94275692A| true| 1992-09-09|1992-09-09||
    US07/942,756||1992-09-09||
    CA002144047A|CA2144047C|1992-09-09|1993-09-09|Method and compositions for maintaining glomerular filtration rate while inhibiting extracellular matrix accumulation|
    [返回顶部]