Description
Although it is a rare disease, HAE is an autosomal dominant disorder
that can be potentially life-threatening when swelling manifests itself
within the upper airways. Antagonism of the constitutively expressed B2
receptor, therefore, would not only be beneficial in the treatment of HAE but also find application in inflammatory, allergic, and hyperalgesic
disorders.Designed to possess enhanced metabolic stability with the
inclusion of five non-proteinogenic amino acids, icatibant is a competitive and selective B2 receptor antagonist (devoid of activity against
the inducible B1 receptor) with a K
i of 2.2±0.7 nM, and it is the first
downstream targeting agent to receive regulatory approval. It joins
purified C1 esterase inhibitor, danazol (an attenuated androgen), and
tranexamic acid (an antifibrinolytic agent) as acute and prophylactic
treatments for HAE.
Originator
Jerini (Germany)
Uses
Icatibant Acetate is a bradykinin B2 receptor antagonist that has been recently approved for treatment of acute attacks of hereditary angioedema (HAE).
Uses
Antagonist (bradykinin).
Definition
ChEBI: An acetate salt obtained by combining icatibant with acetic acid. Used for the treatment of acute attacks of hereditary angioedema in adult patients.
brand name
Metastat (CollaGenex);Firazyr.
Biochem/physiol Actions
B2 bradykinin receptors are present in the sensory neurons. Activation of B2 receptor by bradykinin is associated with pro-inflammatory, pain producing and cardiovascular responses. HOE-140 is a selective B2 bradykinin receptor antagonist. Presence of HOE-140 suppresses the effects of bradykinin and has been shown to have anti-hyperalgesic response, particularly towards inflammatory pain.
Synthesis
The peptidomimetic is prepared by standard solidphase technology on Wang resin employing Fmoc chemistry. Following trifluoroacetic acid cleavage with appropriate scavengers and HPLC purification, icatibant is ultimately isolated as its acetate salt.
