Abstract
The heart is a pump, but also a furnace able to produce at each moment a large amount of energy and to adapt fast enough to face the changes in both fuel supply and energy demand. The pharmacological treatment of angina has been largely focused on the “pump” through hemodynamic agents aimed at decreasing cardiac effort to decrease energy demand. A new concept arose focusing the “furnace” through metabolic agents aimed at decreasing the oxygen cost of ATP production. This goal can be achieved by shifting energy production from fatty acid β-oxidation to glucose oxidation. CPT1 inhibitors were developed to prevent the fatty acid entry into mitochondria but induced cardiac hypertrophy. Regulation of carnitine biology either by carnitine supply or by γ-butyrobetaine hydroxylase inhibitors have led to controversial data both in pharmacological and clinical concerns. Trimetazidine and ranolazine increase the glucose / fatty acid oxidation balance and exhibit benefical effects in animal studies as well as in clinical trials, both in monotherapy and in association with a traditional hemodynamic drug. The association of metabolic and hemodynamic agents brings additive benefits in angina, whereas associations of hemodynamics do not. The mecanism of these drugs has not been fully understood in terms of specific target. In animal studies, dietary docosahexaenoic acid allowed similar protection, through a mechanism related to membrane conformation without specific enzymic target. From the mechanistic research published in this field, enough has now been understood to foresee some future possible targets, mainly related to the cardiomyocyte fatty acid metabolism.
Keywords: atp, cardiac myocyte, pyruvate dehydrogenase, ischaemia, phosphorylation, respiratory chain, mitochondria, Carnitine Palmitoy
Current Pharmaceutical Design
Title: Effectors of Fatty Acid Oxidation Reduction: Promising New Anti-Ischaemic Agents
Volume: 11 Issue: 4
Author(s): Alain Grynberg
Affiliation:
Keywords: atp, cardiac myocyte, pyruvate dehydrogenase, ischaemia, phosphorylation, respiratory chain, mitochondria, Carnitine Palmitoy
Abstract: The heart is a pump, but also a furnace able to produce at each moment a large amount of energy and to adapt fast enough to face the changes in both fuel supply and energy demand. The pharmacological treatment of angina has been largely focused on the “pump” through hemodynamic agents aimed at decreasing cardiac effort to decrease energy demand. A new concept arose focusing the “furnace” through metabolic agents aimed at decreasing the oxygen cost of ATP production. This goal can be achieved by shifting energy production from fatty acid β-oxidation to glucose oxidation. CPT1 inhibitors were developed to prevent the fatty acid entry into mitochondria but induced cardiac hypertrophy. Regulation of carnitine biology either by carnitine supply or by γ-butyrobetaine hydroxylase inhibitors have led to controversial data both in pharmacological and clinical concerns. Trimetazidine and ranolazine increase the glucose / fatty acid oxidation balance and exhibit benefical effects in animal studies as well as in clinical trials, both in monotherapy and in association with a traditional hemodynamic drug. The association of metabolic and hemodynamic agents brings additive benefits in angina, whereas associations of hemodynamics do not. The mecanism of these drugs has not been fully understood in terms of specific target. In animal studies, dietary docosahexaenoic acid allowed similar protection, through a mechanism related to membrane conformation without specific enzymic target. From the mechanistic research published in this field, enough has now been understood to foresee some future possible targets, mainly related to the cardiomyocyte fatty acid metabolism.
Export Options
About this article
Cite this article as:
Grynberg Alain, Effectors of Fatty Acid Oxidation Reduction: Promising New Anti-Ischaemic Agents, Current Pharmaceutical Design 2005; 11 (4) . https://dx.doi.org/10.2174/1381612053382061
DOI https://dx.doi.org/10.2174/1381612053382061 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Human Embryonic and Induced Pluripotent Stem Cell Based Toxicity Testing Models: Future Applications in New Drug Discovery
Current Medicinal Chemistry Current Use of Cardiac Biomarkers in Various Heart Conditions
Endocrine, Metabolic & Immune Disorders - Drug Targets Angiogenetic Potential of Ad2/Hif-1α/Vp16 after Regional Application in a Preclinical Pig Model of Chronic Ischemia
Current Vascular Pharmacology Cardiac Tumors: Clinical Perspective and Therapeutic Considerations
Current Drug Targets Therapy Against Ischemic Injury
Current Pharmaceutical Design Mitochondrially Targeted Antioxidants for the Treatment of Cardiovascular Diseases
Recent Patents on Cardiovascular Drug Discovery MicroRNAs and the Heart: Small Things Do Matter
Current Topics in Medicinal Chemistry Generation of Human Cardiomyocytes for Cardiac Regenerative Therapies: Differentiation and Direct Reprogramming
Current Pharmaceutical Design Using Extracellular Matrix-Derived Peptides to Alter the Microenvironment for Myocardial Repair
Current Vascular Pharmacology Incretins Yesterday, Pleiotropic Gastrointestinal Hormones Today:Glucagon-Like Peptide-1 (GLP-1) and Glucose-ependent Insulinotropic Polypeptide (GIP)
Recent Patents on Endocrine, Metabolic & Immune Drug Discovery Clinical Applications and Biosafety of Human Adult Mesenchymal Stem Cells
Current Pharmaceutical Design Stem Cells in Cardiovascular Regeneration: From Preservation of Endogenous Repair to Future Cardiovascular Therapies
Current Pharmaceutical Design Genes Involved in Hereditary Hearing Impairment
Current Genomics Incidence and Prevalence of Hypothyroidism in Patients Affected by Chronic Heart Failure: Role of Amiodarone
Endocrine, Metabolic & Immune Disorders - Drug Targets Infective Endocarditis Complicating Hypertrophic Obstructive Cardiomyopathy: Is Antibiotic Prophylaxis Really Unnecessary?
Current Cardiology Reviews The Role of the Chemokines in Myocardial Ischemia and Reperfusion
Current Vascular Pharmacology Chronic Eosinophilic Leukemia, Not Otherwise Specified (CEL, NOS)
Current Cancer Therapy Reviews Epigenetic Regulation in Particulate Matter-Mediated Cardiopulmonary Toxicities: A Systems Biology Perspective
Current Pharmacogenomics and Personalized Medicine The L-Type Ca2+ Channel as a Therapeutic Target in Heart Disease
Current Medicinal Chemistry Understanding and Avoiding Antiretroviral Adverse Events
Current Pharmaceutical Design