Die Geschichte der Entdeckung und der klinischen Anwendung von Calciumantagonisten

  • G. Fleckenstein-Grün
Chapter

Zusammenfassung

Die Auffindung hochspezifischer Calciumantagonisten vom Verapamil-, Nifedipin- und Diltiazem-Typ hat neue Wege in Wissenschaft und Therapie gewiesen. Ihr breites therapeutisches Spektrum beweist die große pathophysiologische Bedeutung einer gestörten zellulären Ca2+-Homöostase. Tatsächlich beruhen so unterschiedliche Erkrankungen wie koronare Herzkrankheit (KHK), arterielle Gefäßspasmen, Hypertonie, bestimmte Formen der Kardiomyopathie, der Herzmuskelnekrosen und der Arrhythmien ebenso wie Ca2+-geprägte Typen von Arteriosklerosen letztlich auf einer defekten Kontrolle zellulärer Ca2+-Transportmechanismen. Sie sind dementsprechend mögliche Indikationen für die Therapie mit Calciumantagonisten. Der Einsatz spezifischer Calciumantagonisten als experimentelle Werkzeuge ließ die charismatische Rolle von Ca2+-Ionen als elektrische Ladungsträger und intrazelluläre Messenger erkennen. Sie haben das Interesse der Molekularbiologie auf Ionenkanäle als pharmakologisch steuerbare Mediatoren physiologischer und pathophysiologischer Ca2+-Funktionen gelenkt. Die zelluläre Protektion mittels Calciumantagonisten gegenüber zytotoxischen Ca2+-„Killer“-Effekten erstreckt sich offensichtlich weit über das Myokard hinaus, an dem sie erstmals experimentell nachgewiesen wurde. In dieser Hinsicht erscheinen die Verhütung neuronaler Degenerationen, renaler und hepatischer Zellnekrosen und Ca2+-dominierter Arteriosklerosen als vielversprechende Ziele zukünftiger Calciumantagonistischer Interventionen.

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© Dr. Dietrich Steinkopff Verlag, GmbH & Co. KG, Darmstadt 1996

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  • G. Fleckenstein-Grün

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