Abstract

Pulmonary arterial hypertension (PAH) is a rare and progressive disease arising from various etiologies and pathogenesis. PAH decreases life expectancy due to pulmonary vascular remodeling, elevation of mean pulmonary arterial pressure, and ultimately progresses to heart failure. While clinical treatments are available to reduce the associated symptoms, a complete cure has yet to be found. Phosphodiesterase-5 (PDE-5) inhibition has been identified as a possible intervention point in PAH treatment. The functional vasodilation response to N2,N4-diamino quinazoline analogues with differing PDE-5 inhibitory activities and varying physicochemical properties were assessed in both endothelium-intact and denuded rat pulmonary arteries to gain greater insight into their mode of action. All analogues produced vasorelaxant effects with EC50s ranging from 0.58 ± 0.22 µM to ˃30 µM. It was observed that vasodilation response in intact vessels was highly correlated with that of denuded vessels. The ~10% drop in activity is consistent with a loss of the nitric oxide mediated cyclic guanosine monophosphate (NO/cGMP) pathway in the latter case. A moderate correlation between the vasodilation response and PDE-5 inhibitory activity in the intact vessels was observed. Experimental protocol using the alpha-adrenergic (α1) receptor agonist, phenylephrine (PE), was undertaken to assess whether quinazoline derivatives showed competitive behavior similar to the α1 receptor blocker, prazosin, itself a quinazoline derivative, or to the PDE-5 inhibitor, sildenafil. Competitive experiments with the α1-adrenergic receptor agonist point to quinazoline derivatives under investigation here act via PDE-5 inhibition and not the former. The pre-incubation of pulmonary arterial rings with quinazoline test compounds (10 μM) reduced the contractile response to PE around 40–60%. The most promising compound (9) possessed ~32 folds higher selectivity in terms of vasodilation to its mammalian A549 cell cytotoxicity. This study provides experi0 0mental basis for PDE-5 inhibition as the mode of action for vasodilation by N2,N4-diamino quinazoline analogues along with their safety studies that may be beneficial in the treatment of various cardiovascular pathologies.

Highlights

  • Pulmonary arterial hypertension (PAH) is a rare (~15 cases/million) [1] and progressive disease based on diverse etiologies [2]

  • Compound 8 was found most potent in endothelium-intact vessels (EC50 = 0.58 ± 0.22 μM; Emax = 98.80 ± 0.79%) while compound 5 displayed highest potency in endothelium-denuded vessels (EC50 = 1.15 ± 0.18 μM; Emax = 95.83 ± 2.40%)

  • Vasorelaxant effects were generally higher in endothelium-intact vessels compared to endothelium-denuded vessels at a given concentration

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Summary

Introduction

Pulmonary arterial hypertension (PAH) is a rare (~15 cases/million) [1] and progressive disease based on diverse etiologies [2]. This disease reduces life expectancy due to pulmonary vascular remodeling, elevation of mean pulmonary arterial pressure, right ventricular (RV) hypertrophy, and heart failure [3]. The causative factors responsible for progression of PAH include endothelial dysfunction, resulting in an imbalance of vasoconstrictors and vasodilators. The former leads to more extensive vascular smooth muscle remodeling and increases pulmonary arterial pressure and advancement of PAH [4,5]. Endothelin receptor antagonists (Bosentan, etc.) are being used as first line oral treatment [10], their shortcomings include significant expense, catheter induced sepsis, relatively low response rates, and risk of drug interactions

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