Renin inhibition

Cloning and characterization of marmoset renin: comparison with human renin

The poor interspecies conservation of the renin-angiotensin system prevents the use of nonprimate in vivo models to test renin inhibitors. Thus the small New-World monkey marmoset is used in many instances as a model. However, large differences between the potencies of renin inhibitors as measured in human and marmoset plasma were observed. To understand this phenomenon, we cloned marmoset renin and angiotensinogen. They were highly homologous to their human counterparts, except for a six-residue deletion in the marmoset renin propeptide. Human and marmoset recombinant renins were found in vitro to display comparable activities, suggesting that the observed differences in plasma apparent affinity of inhibitors could be due to different plasma protein binding of the inhibitors.

Substituted piperidines--highly potent renin inhibitors due to induced fit adaptation of the active site

The identification, synthesis and activity of a novel class of piperidine renin inhibitors is presented. The most active compounds show activities in the picomolar range and are among the most potent renin inhibitors ever identified.

Renin inhibition by substituted piperidines: a novel paradigm for the inhibition of monomeric aspartic proteinases?

BACKGROUND

The aspartic proteinase renin catalyses the first and rate-limiting step in the conversion of angiotensinogen to the hormone angiotensin II, and therefore plays an important physiological role in the regulation of blood pressure. Numerous potent peptidomimetic inhibitors of this important drug target have been developed, but none of these compounds have progressed past clinical phase II trials. Limited oral bioavailability or excessive production costs have prevented these inhibitors from becoming new antihypertensive drugs. We were interested in developing new nonpeptidomimetic renin inhibitors.

RESULTS

High-throughput screening of the Roche compound library identified a simple 3, 4-disubstituted piperidine lead compound. We determined the crystal structures of recombinant human renin complexed with two representatives of this new class. Binding of these substituted piperidine derivatives is accompanied by major induced-fit adaptations around the enzyme's active site.

CONCLUSIONS

The efficient optimisation of the piperidine inhibitors was facilitated by structural analysis of the renin active site in two renin-inhibitor complexes (some of the piperidine derivatives have picomolar affinities for renin). These structural changes provide the basis for a novel paradigm for inhibition of monomeric aspartic proteinases.

New developments in drug therapy of hypertension

The explosion of new knowledge about the complex mechanisms mediating high blood pressure is providing new targets for drug therapy of hypertension and other cardiovascular disorders. This article reviews the current status of several new approaches in the management of hypertension, including vasopressin antagonists, natriuretic peptide clearance inhibitors, endothelin antagonists, renin inhibitors, angiotensin receptor antagonists, and selective T-type calcium ion channel antagonists.

Renin inhibitors: cardiovascular drugs of the future?

This review explores whether the therapeutic attractiveness of renin inhibitors compared with angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor antagonists, is sufficient to warrant continued interest in their development for the treatment of cardiovascular disease. Clinical and experimental data available to date indicate that patients with hypertension and congestive heart failure will benefit from renin inhibition. However, clinical experience is very limited, and extra benefits of renin inhibitors compared with the other blockers of the renin-angiotensin system (RAS) have yet to be demonstrated. Some experimental data in animals and humans point to a greater effect of acute renin inhibition on renal blood flow than other modes of interference with the RAS. Again, the clinical benefits of such an effect, and particularly after long-term treatment, in hypertension and renal disease need to be determined. In today's cost-conscious health setting, only new drugs that bring additional clinical benefits have a good chance of being commercially viable. It remains to be seen whether renin inhibitors will fulfill these criteria.