Skip to main content

Effects of omapatrilat on pharmacodynamic biomarkers of neutral endopeptidase and angiotensin-converting enzyme activity in humans

  • Published:
Current Hypertension Reports Aims and scope Submit manuscript

Abstract

Vasopeptidase inhibition is a new concept in blood pressure management. A single molecule simultaneously inhibits two enzymes that regulate cardiovascular function: neutral endopeptidase (NEP) and angiotensin-converting enzyme (ACE) [1]. Development of vasopeptidase inhibitors stemmed from the need for new and more efficacious antihypertensive agents that not only reduce blood pressure but also treat hypertension as part of a larger syndrome involving endothelial dysfunction [2]. By inhibiting NEP and ACE, vasopeptidase inhibitors enhance the natriuretic peptide and kallikrein-kinin systems and inhibit the renin-angiotensinaldosterone system. This article outlines the pharmacodynamic effects of the vasopeptidase inhibitor omapatrilat on biomarkers of NEP and ACE activity in humans.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Burnett JC: Vasopeptidase inhibition: a new concept in blood pressure management. J Hypertens 1999, 17(Suppl 1):S37-S43.

    CAS  Google Scholar 

  2. Asher JR, Naftilan AJ: Vasopeptidase inhibition: a new direction in cardiovascular treatment. Curr Hypertens Rep 2000, 2:384–391.

    Article  PubMed  CAS  Google Scholar 

  3. Erdös EG, Skidgel RA: Neutral endopeptidase 24.11 (enkephalinase) and related regulators of peptide hormones. FASEB J 1989, 3:145–151.

    PubMed  Google Scholar 

  4. Roques BP, Noble F, Daugé V, et al.: Neutral endopeptidase 24.11: structure, inhibition, and experimental and clinical pharmacology. Pharmacol Rev 1993, 45:87–146.

    PubMed  CAS  Google Scholar 

  5. Chappell MC, Allred AJ, Ferrario CM: Pathways of angiotensin-(1-7) metabolism in the kidney. Nephrol Dial Transplant 2001, 16(Suppl):122–126.

    Google Scholar 

  6. Bevan EG, Connell JMC, Doyle J, et al.: Candoxatril, a neutral endopeptidase inhibitor: efficacy and tolerability in essential hypertension. J Hypertens 1992, 10:607–613.

    Article  PubMed  CAS  Google Scholar 

  7. Richards AM, Crozier IG, Kosoglou T, et al.: Endopeptidase 24.11 inhibition by SCH 42495 in essential hypertension. Hypertension 1993, 22:119–126.

    PubMed  CAS  Google Scholar 

  8. Stergiou GS, Hannah JA, Bevan EG, et al.: Combined atriopeptidase inhibition and angiotensin converting enzyme inhibition in hypertensive patients. J Hypertens 1994, 12:1310–1311.

    Article  Google Scholar 

  9. Robl JA, Sun C-Q, Stevenson J, et al.: Dual metalloprotease inhibitors: mercaptoacetyl-based fused heterocyclic dipeptide mimetics as inhibitors of angiotensin-converting enzyme and neutral endopeptidase. J Med Chem 1997, 40:1570–1577.

    Article  PubMed  CAS  Google Scholar 

  10. Trippodo NC, Robl JA, Asaad MM, et al.: Effects of omapatrilat in low, normal, and high renin experimental hypertension. Am J Hypertens 1998, 11:363–372.

    Article  PubMed  CAS  Google Scholar 

  11. Intengan HD, Schiffrin EL: Vasopeptidase inhibition has potent effects on blood pressure and resistance arteries in stroke-prone spontaneously hypertensive rats. Hypertension 2000, 35:1221–1225.

    PubMed  CAS  Google Scholar 

  12. Quaschning T, d‘Uscio LV, Shaw S, et al.: Vasopeptidase inhibition exhibits endothelial protection in salt-sensitive hypertension. Hypertension 2001, 37:1108–1113.

    PubMed  CAS  Google Scholar 

  13. Trippodo NC, Fox M, Monticello TM, et al.: Simultaneous inhibition of neutral endopeptidase and angiotensin covering enzyme by omapatrilat increased survival in heart failure hamsters greater than ACE inhibition [abstract]. Circulation 1998, 98:I-781.

    Google Scholar 

  14. Vesterqvist O, Manning JA, Uderman H, et al.: Effects of BMS-186716, a new dual metalloprotease inhibitor, on pharmacodynamic markers of neutral endopeptidase (NEP) and angiotensin converting enzyme (ACE) activity in healthy men [abstract]. Clin Pharmacol Ther 1997, 61:230.

    Google Scholar 

  15. Vesterqvist O, Liao W, Manning JA, et al.: Pharmacodynamic effects of multiple doses of omapatrilat in healthy subjects [abstract]. Clin Pharmacol Ther 1999, 65:132.

    Google Scholar 

  16. Ferrario CM, Smith RD, Yunis C, et al.: Angiotensin-(1-7) and vasopeptidase inhibition [abstract]. Am J Hypertens 2000, 13:23A.

    Article  Google Scholar 

  17. Flickinger AL, Burnett JC, Turner ST: Atrial natriuretic peptide and blood pressure in a population-based sample. Mayo Clin Proc 1995, 70:932–938.

    Article  PubMed  CAS  Google Scholar 

  18. Deutch A, Frishman WH, Sukenik D, et al.: Atrial natriuretic peptide and its potential role in pharmacotherapy. J Clin Pharmacol 1994, 34:1133–1147.

    Google Scholar 

  19. Northridge DB, Newby DE, Rooney E, et al.: Comparison of the short-term effects of candoxatril, an orally active neutral endopeptidase inhibitor, and frusemide in the treatment of patients with chronic heart failure. Am Heart J 1999, 138:1149–1157.

    Article  PubMed  CAS  Google Scholar 

  20. Yandle TG, Richards AM, Nicholls MG, et al.: Metabolic clearance rate and plasma half life of alpha-human atrial natriuretic peptide in man. Life Sci 1986, 38:1827–1833.

    Article  PubMed  CAS  Google Scholar 

  21. Epstein M, Loutzenhiser R, Friedland E, et al.: Relationship of increased plasma atrial natriuretic factor and renal sodium handling during immersion-induced central hypervolemia in normal humans. J Clin Invest 1987, 79:738–745.

    Article  PubMed  CAS  Google Scholar 

  22. Solomon LR, Atherton JC, Bobinski H, et al.: Effect of posture on plasma immunoreactive atrial natriuretic peptide concentrations in man. Clin Sci 1986, 71:299–305.

    PubMed  CAS  Google Scholar 

  23. Campese VM, Ferrario CM, Ruddy MC, et al.: Omapatrilat or lisinopril in salt-sensitive hypertensives [abstract]. Am J Hypertens 2000, 13:A15.

    Article  Google Scholar 

  24. McClean DR, Ikram H, Garlick AH, et al.: The clinical, cardiac, renal, arterial and neurohormonal effects of omapatrilat, a vasopeptidase inhibitor, in patient with chronic heart failure. J Am Coll Cardiol 2000, 36:479–486.

    Article  PubMed  CAS  Google Scholar 

  25. Levin ER, Gardner DG, Samson WK: Natriuretic peptides. N Engl J Med 1998, 339:321–328.

    Article  PubMed  CAS  Google Scholar 

  26. Richards AM, Wittert G, Espiner EA, et al.: Effect of inhibition of endopeptidase 24.11 on responses to angiotensin II in human volunteers. Circ Res 1992, 71:1501–1507.

    PubMed  CAS  Google Scholar 

  27. Motwani JG, Lang CC, Cramb G, et al.: Natriuretic responses to neutral endopeptidase inhibition is blunted by enalapril in healthy men. Hypertension 1995, 25:637–642.

    PubMed  CAS  Google Scholar 

  28. Massien C, Azizi M, Guyene TT, et al.: Pharmacodynamic effects of dual neutral endopeptidase-angiotensin-converting enzyme inhibition versus angiotensin-converting enzyme inhibition in humans. Clin Pharmacol Ther 1999, 65:448–459.

    Article  PubMed  CAS  Google Scholar 

  29. Kitamura K, Kangawa K, Kawamoto M, et al.: Adrenomedullin: a novel hypotensive peptide isolated from human pheochromocytoma. Biochem Biophys Res Commun 1993, 192:553–560.

    Article  PubMed  CAS  Google Scholar 

  30. Jougasaki M, Wei C, Aarhus L, et al.: Renal localization and actions of adrenomedullin: a natriuretic peptide. Am J Physiol 1995, 268:F657-F663.

    PubMed  CAS  Google Scholar 

  31. Lainchbury J, Cooper G, Coy D, et al.: Adrenomedullin: a hypotensive hormone in man. Clin Sci 1997, 92:467–472.

    PubMed  CAS  Google Scholar 

  32. Jougasaki M, Wei C, McKinley L, et al.: Elevation of circulating and ventricular adrenomedullin in human congestive heart failure. Circulation 1995, 92:286–289.

    PubMed  CAS  Google Scholar 

  33. Lisy O, Jougasaki M, Schirger J, et al.: Neutral endopeptidase inhibition potentiates the natriuretic actions of adrenomedullin. Am J Physiol 1998, 275:F410-F414.

    PubMed  CAS  Google Scholar 

  34. Vesterqvist O, Campese VM, Liao W, et al.: Omapatrilat increases plasma concentrations of adrenomedullin in salt-sensitive hypertensives [abstract]. Am J Hypertens 2000, 13:125A.

    Article  Google Scholar 

  35. Ferrario CM: Angiotensin-(1-7) and antihypertensive mechanisms. J Nephrol 1998, 11:278–283.

    PubMed  CAS  Google Scholar 

  36. Liao W, Delaney CL, Manning JA, et al.: Marked elevation in plasma renin activity [PRA] in response to omapatrilat in healthy, normotensive males [abstract]. Circulation 1998, 98:3802.

    Google Scholar 

  37. Ruddy M, Guthrie R, Papademetriou V: The safety and 24-hour antihypertensive efficacy of the vasopeptidase inhibitor omapatrilat: a pilot study [abstract]. Am J Hypertens 1999, 12:125A.

    Article  Google Scholar 

  38. Zusman R, Atlas S, Kochar M, et al.: Efficacy and safety of omapatrilat, a vasopeptidase inhibitor [abstract]. Am J Hypertens 1999, 12:125A.

    Article  Google Scholar 

  39. Weber M: Emerging treatments for hypertension: Potential role for vasopeptidase inhibition. Am J Hypertens 1999, 12:139S-147S.

    Article  PubMed  CAS  Google Scholar 

  40. Liao W, Delaney CL, Beierle FA, et al.: Omapatrilat, a novel vasopeptidase inhibitor, reduces blood pressure in normotensive subjects [abstract]. J Am Coll Cardiol 1999, 33:309A.

    Google Scholar 

  41. Rouleau JL: The neurohumoral hypothesis and the treatment of heart failure. Can J Cardiol 1996, 12(Suppl F):3–8.

    Google Scholar 

  42. Rouleau JL, Pfeffer MA, Stewart DJ, et al.: Comparison of vasopeptidase inhibitor, omapatrilat, and lisinopril on exercise tolerance and morbidity in patients with heart failure: IMPRESS randomised trial. Lancet 2000, 356:615–620.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vesterqvist, O., Reeves, R.A. Effects of omapatrilat on pharmacodynamic biomarkers of neutral endopeptidase and angiotensin-converting enzyme activity in humans. Current Science Inc 3 (Suppl 2), S22–S27 (2001). https://doi.org/10.1007/s11906-001-0103-x

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11906-001-0103-x

Keywords

Navigation