Current Medicinal Chemistry - Volume 17, Issue 6, 2010

Although recent progress in highly active antiretroviral therapy (HAART) has provided an effective way to treat AIDS patients, the emergence of drug-resistant HIV-1 strains and drug toxicity during long-term treatment of HIVinfected patients necessitate the search for new targets that can be used to develop novel antiviral agents. One such target is the nuclear import process of the HIV pre-integration complex (PIC). The ability of HIV-1 using host cell nuclear import machinery to translocate the viral PIC into the cell nucleus is the critical determinant in the replication of the virus in non-dividing cells, such as macrophages. Compounds inhibiting HIV-1 nuclear import may be attractive candidates for novel anti-HIV development. In this review, we will describe the mechanisms of HIV-1 PIC translocation into the nucleus and the structure-function of the viral and cellular factors involved in this process, as well as several classes of novel anti- HIV compounds which target the nuclear import of HIV-1 PIC and effectively block viral replication.

The past two decades have witnessed an exponential increase in research into cancer. This effort, however, has not been translated into better perspectives as regards the problem, although several fields of research have certainly been promising (the human genome project, gene therapy, the search for new cytostatic agents and stem cell research). New pathways must be opened up to offer future hope to oncologic patients. Thus, there is a need to explore other research initiatives in cancer ways to improve this chronic global problem. Substance P (SP) has a widespread distribution in both the central and peripheral nervous systems. It is known that after binding to the specific neurokinin-1 (NK-1) receptor, SP regulates biological functions related to cancer, such as tumour cell proliferation, angiogenesis, and migration of the tumour cells for invasion and metastasis. By contrast, it is also known that after binding to NK-1 receptors, the NK-1 receptor antagonists specifically inhibit tumour cell proliferation (tumour cells die by apoptosis), angiogenesis and the migration of the tumour cells. It is also known that NK-1 receptors are overexpressed in tumours. All these observations suggest that the SP/NK-1 receptor system could play an important role in the development of cancer and metastasis; that the NK-1 receptor could be a new promising target in the treatment of cancer, and that NK-1 receptor antagonists could improve cancer treatment.

Diabetes mellitus is a common disease and contributes to a high degree of morbidity and mortality. Cardiovascular complications, including diabetic cardiomyopathy are major causes of morbidity and mortality in diabetic patients. Diabetic cardiomyopathy is a condition that affects the myocardium, primarily. It is not necessarily associated with ischemic heart disease, high blood pressure, valvular or congenital anomalies. The pathology of diabetic cardiomyopathy includes interstitial fibrosis, apoptosis of cardiomyocytes, abnormal energy utilization, small vessel disease and cardiac neuropathy. These pathologies are induced by hyperglycemia and oxidative stress. Biochemical as well as electrolyte changes, especially reduced calcium availability also occurs in the myocardium of diabetic patients. The abnormal structure and biochemistry of the myocardium result in functional problems such as diastolic and systolic dysfunctions, which may cause symptoms of dyspnea and inability to tolerate exercise. No single specific therapeutic agent can treat diabetic cardiomyopathy because once the disease is overt, the management may require a variety of approaches such as risk factors and lifestyle modification, glucose control (insulin, alpha glucosidase inhibitors, sulfonylureas, biguanides, meglitinides, thiazolidinediones and dipeptidyl peptidase 4 (DPP-4) inhibitors); hormones (IGF-1); ACE inhibitors (captopril, enalapril); angiotensin II receptor antagonists (losartan, olmesartan); beta adrenoreceptor antagonists (acebutolol, carvedilol); peptides (adrenomedullin); endothelin-1 receptor antagonists (bosentan, tezosentan); calcium channel blockers (amlodipine, verapamil); antioxidants (methalothionein, alpha tocopherol, alpha lipoic acid) and antihyperlipidemic drugs (simvastatin, fenofibrate, ezetimibe) to effectively treat patients with diabetic cardiomyopathy.

Pathologies involving oxidative stress are indicative of malfunction of endogenous antioxidant capacity. Numerous efforts were made to design and synthesize biologically active antioxidants and free oxygen radical scavenging substances that could improve the endogenous antioxidant status. The antioxidant and reactive-oxygen-species-scavenging activity of STB was well demonstrated in many in vitro and in vivo studies. These properties of STB seem to be closely related to its beneficial effects in models of oxidative-stress-involving pathologies, including myocardial infarction, stroke, neurodegenerative disorders, hypoxic-ischemic tissue injury, diabetic complications, chronic inflammation, etc. STB has a good affinity to lipids and exerts its protective activity against free-radical-mediated damage by preventing lipid peroxidation. Rather than interacting with the radicals initiating lipid peroxidation, STB was shown to act in its propagation stage via scavenging peroxyl and/or alkoxyl radicals. STB was also found to protect proteins, predominantly by a mechanism involving protection of thiol groups and by preventing oxidation of amino acids. The first findings on antioxidant and pharmacodynamic effects of STB, tested in a variety of biological models, were summarized in 1998. Recently, chemical modification of STB, which we considered as the leading structure, led to the synthesis of pyridoindole derivatives with significantly increased intrinsic antiradical activity and overall antioxidant efficacy compared to the parental molecule. The present paper provides a complete overview of the literature published since 1998 on both STB and STB congeners. Moreover, appropriate structural modifications of STB provided the opportunity to modulate lipophilicity and acidobasic behavior, thus optimizing bioavailability of the novel derivatives and attenuating their unwanted sideeffects, with the result of decreased toxicity. Hence, STB congeners might be prospectively used as medicinal antioxidants, i.e. remedies effective in conditions involving oxidative stress-mediated injury.

Aging is known to be associated with an increased prevalence of multiple chronic diseases, which frequently causes the use of complex therapeutic regimens. The aging process is characterized by relevant changes in drug handling, physiological reserve, and pharmacodynamic response. Hepatic drug clearance of several drugs decreases with aging, mainly due to reduced blood flow, and hepatocyte mass. Renal function also declines with aging, mainly due to sclerotic changes in the glomeruli. Furthermore, due to reduced muscle mass, older subjects frequently have depressed glomerular filtration rate despite normal serum creatinine, and such a concealed renal insufficiency may impact significantly the clearance of hydrosoluble drugs. Changes in pharmacodynamics are also well documented in the cardiovascular and nervous system. Age-related changes in pharmacokinetics and pharmacodynamics, together with comorbidity and polypharmacy, make elderly patients at special risk for advers drug reactions, which in turn are cause of relevant health burden and costs. Selected measures can assist in preventing or detecting timely such adverse events.

This review focuses on the development of nanoparticle systems for antimicrobial drug delivery. Numerous antimicrobial drugs have been prescribed to kill or inhibit the growth of microbes such as bacteria, fungi and viruses. Even though the therapeutic efficacy of these drugs has been well established, inefficient delivery could result in inadequate therapeutic index and local and systemic side effects including cutaneous irritation, peeling, scaling and gut flora reduction. Nanostructured biomaterials, nanoparticles in particular, have unique physicochemical properties such as ultra small and controllable size, large surface area to mass ratio, high reactivity, and functionalizable structure. These properties can be applied to facilitate the administration of antimicrobial drugs, thereby overcoming some of the limitations in traditional antimicrobial therapeutics. In recent years, encapsulation of antimicrobial drugs in nanoparticle systems has emerged as an innovative and promising alternative that enhances therapeutic effectiveness and minimizes undesirable side effects of the drugs. Here the current progress and challenges in synthesizing nanoparticle platforms for delivering various antimicrobial drugs are reviewed. We also call attention to the need to unite the shared interest between nanoengineers and microbiologists in developing nanotechnology for the treatment of microbial diseases.