Chronic inhibition of fatty acid amide hydrolase by URB597 produces differential effects on cardiac performance in normotensive and hypertensive rats : Cardiac effects of chronic FAAH inhibition
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Abstract
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<h5 class="section-title" id="d9112435e259">Background and Purpose</h5>
<p id="d9112435e261">Fatty acid amide hydrolase (FAAH) inhibitors are postulated to
possess anti‐hypertensive
potential, because their acute injection decreases BP in spontaneously hypertensive
rats (SHR), partly through normalization of cardiac contractile function. Here, we
examined whether the potential hypotensive effect of chronic FAAH inhibition by URB597
in hypertensive rats correlated with changes in cardiac performance.
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<h5 class="section-title" id="d9112435e264">Experimental Approach</h5>
<p id="d9112435e266">Experiments were performed using perfused hearts and left atria
isolated from 8‐ to
10–week‐old SHR, age‐matched deoxycorticosterone acetate (DOCA)‐salt rats and normotensive
controls chronically treated with URB597 (1 mg·kg
<sup>−1</sup>) or vehicle.
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<h5 class="section-title" id="d9112435e272">Key Results</h5>
<p id="d9112435e274">URB597 decreased BP only in the DOCA‐salt rats, along with a
reduction of ventricular
hypertrophy and diastolic stiffness, determined in hypertension. We also observed
normalization of the negative inotropic atrial response to the cannabinoid receptor
agonist CP55940. In the SHR model, URB597 normalized (atria) and enhanced (hearts)
the positive ino‐ and chronotropic effects of the β‐adrenoceptor agonist isoprenaline
respectively. Ventricular CB
<sub>1</sub> and CB
<sub>2</sub> receptor expression was decreased only in the DOCA‐salt model, whereas
FAAH expression
was reduced in both models. URB597 caused translocation of CB
<sub>1</sub> receptor immunoreactivity to the intercalated discs in the hearts of
SHR. URB597
increased cardiac diastolic stiffness and modified the ino‐ and lusitropic effects
of isoprenaline in normotensive rats.
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<h5 class="section-title" id="d9112435e286">Conclusion and Implications</h5>
<p id="d9112435e288">Hypotensive effect of chronic FAAH inhibition depend on the model
of hypertension
and partly correlate with improved cardiac performance. In normotensive rats, chronic
FAAH inhibition produced several side‐effects. Thus, the therapeutic potential of
these agents should be interpreted cautiously.
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Endocannabinoids and cannabinoid 1 (CB1) receptors have been implicated in cardiac dysfunction, inflammation, and cell death associated with various forms of shock, heart failure, and atherosclerosis, in addition to their recognized role in the development of various cardiovascular risk factors in obesity/metabolic syndrome and diabetes. In this study, we explored the role of CB1 receptors in myocardial dysfunction, inflammation, oxidative/nitrative stress, cell death, and interrelated signaling pathways, using a mouse model of type 1 diabetic cardiomyopathy. Diabetic cardiomyopathy was characterized by increased myocardial endocannabinoid anandamide levels, oxidative/nitrative stress, activation of p38/Jun NH2-terminal kinase (JNK) mitogen-activated protein kinases (MAPKs), enhanced inflammation (tumor necrosis factor-α, interleukin-1β, cyclooxygenase 2, intracellular adhesion molecule 1, and vascular cell adhesion molecule 1), increased expression of CB1, advanced glycation end product (AGE) and angiotensin II type 1 receptors (receptor for advanced glycation end product [RAGE], angiotensin II receptor type 1 [AT1R]), p47(phox) NADPH oxidase subunit, β-myosin heavy chain isozyme switch, accumulation of AGE, fibrosis, and decreased expression of sarcoplasmic/endoplasmic reticulum Ca2+-ATPase (SERCA2a). Pharmacological inhibition or genetic deletion of CB1 receptors attenuated the diabetes-induced cardiac dysfunction and the above-mentioned pathological alterations. Activation of CB1 receptors by endocannabinoids may play an important role in the pathogenesis of diabetic cardiomyopathy by facilitating MAPK activation, AT1R expression/signaling, AGE accumulation, oxidative/nitrative stress, inflammation, and fibrosis. Conversely, CB1 receptor inhibition may be beneficial in the treatment of diabetic cardiovascular complications.
In the present article, we review the pharmacological properties of KDS-4103 (URB597), a highly potent and selective inhibitor of the enzyme fatty-acid amide hydrolase (FAAH), which catalyzes the intracellular hydrolysis of the endocannabinoid anandamide. In vitro, KDS-4103 inhibits FAAH activity with median inhibitory concentrations (IC(50)) of 5 nM in rat brain membranes and 3 nM in human liver microsomes. In vivo, KDS-4103 inhibits rat brain FAAH activity after intraperitoneal (i.p.) administration with a median inhibitory dose (ID(50)) of 0.15 mg/kg. The compound does not significantly interact with other cannabinoid-related targets, including cannabinoid receptors and anandamide transport, or with a broad panel of receptors, ion channels, transporters and enzymes. By i.p. administration to rats and mice KDS-4103 elicits significant, anxiolytic-like, antidepressant-like and analgesic effects, which are prevented by treatment with CB1 receptor antagonists. By contrast, at doses that significantly inhibit FAAH activity and substantially raise brain anandamide levels, KDS-4103 does not evoke classical cannabinoid-like effects (e.g., catalepsy, hypothermia, hyperphagia), does not cause place preference, and does not produce generalization to the discriminative effects of the active ingredient of cannabis, Delta9-tetrahydrocannabinol (Delta9-THC). These findings suggest that KDS-4103 acts by enhancing the tonic actions of anandamide on a subset of CB(1) receptors, which may normally be engaged in controlling emotions and pain. KDS-4103 is orally available in rats and cynomolgus monkeys. Sub-chronic repeated dose studies (1,500 mg/kg, per os) in these two species have not demonstrated systemic toxicity. Likewise, no toxicity was noted in bacterial cytotoxicity tests in vitro and in the Ames test. Furthermore, no deficits were observed in rats on the rotarod test after acute i.p. treatment with KDS-4103 at doses up to 5 mg/kg or in a functional observation battery after oral doses up to 1,500 mg/kg. The results suggest that KDS-4103 will offer a novel approach with a favorable therapeutic window for the treatment of anxiety, depression and pain.
Endocannabinoids are novel lipid mediators with hypotensive and cardiodepressor activity. Here, we examined the possible role of the endocannabinergic system in cardiovascular regulation in hypertension. In spontaneously hypertensive rats (SHR), cannabinoid-1 receptor (CB1) antagonists increase blood pressure and left ventricular contractile performance. Conversely, preventing the degradation of the endocannabinoid anandamide by an inhibitor of fatty acid amidohydrolase reduces blood pressure, cardiac contractility, and vascular resistance to levels in normotensive rats, and these effects are prevented by CB1 antagonists. Similar changes are observed in 2 additional models of hypertension, whereas in normotensive control rats, the same parameters remain unaffected by any of these treatments. CB1 agonists lower blood pressure much more in SHR than in normotensive Wistar-Kyoto rats, and the expression of CB1 is increased in heart and aortic endothelium of SHR compared with Wistar-Kyoto rats. We conclude that endocannabinoids tonically suppress cardiac contractility in hypertension and that enhancing the CB1-mediated cardiodepressor and vasodilator effects of endogenous anandamide by blocking its hydrolysis can normalize blood pressure. Targeting the endocannabinoid system offers novel therapeutic strategies in the treatment of hypertension.
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