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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2008;28:1767.)
© 2008 American Heart Association, Inc.

Integrative Physiology/Experimental Medicine

A Novel Sartan Derivative With Very Low Angiotensin II Type 1 Receptor Affinity Protects the Kidney in Type 2 Diabetic Rats

Yuko Izuhara; Toshio Sada; Hiroaki Yanagisawa; Hiroyuki Koike; Shuichi Ohtomo; Takashi Dan; Sadayoshi Ito; Masaomi Nangaku; Charles van Ypersele de Strihou; Toshio Miyata

From the Center for Translational and Advanced Research (Y.I., S.O., T.D., T.M.), Tohoku University Graduate School of Medicine, Sendai, Japan; R & D Division (T.S., H.Y., H.K.), Daiichi-Sankyo Co Ltd, Tokyo, Japan; the Division of Nephrology and Hypertension (S.I.), Tohoku University Graduate School of Medicine, Sendai, Japan; the Division of Nephrology and Endocrinology (M.N.), University of Tokyo School of Medicine, Tokyo, Japan; and the Service de Nephrologie (C.v.Y.d.S.), Universite Catholique de Louvain, Brussels, Belgium.

Correspondence to Toshio Miyata, MD, PhD, Center for Translational and Advanced Research, Tohoku University Graduate School of Medicine, 2-1 Seiryo-Machi, Aoba-ku, Sendai, 980-8575, Japan. E-mail t-miyata{at}mail.tains.tohoku.ac.jp

Background— Antihypertensive angiotensin II receptor blockers (ARBs) protect the kidney, at least in part, independently of blood pressure lowering. Still, the extent to which blood pressure lowering is related to renoprotection remains unclear.

Methods and Results— 139 newly synthesized ARB-derivatives were assayed for inhibition of advanced glycation (AGEs). The 9 most powerful compounds were then tested for transition metal chelation, angiotensin II type 1 receptor (AT1R) affinity, and pharmacokinetic parameters. R-147176 was eventually selected as it strongly inhibits advanced glycation but is 6700 times less effective than olmesartan in AT1R binding. It is orally bioavailable and toxicologically safe. Despite a minimal blood pressure lowering effect, it provides significant renoprotection in 3 experimental rat models with renal injury, ie, obese, hypertensive, type 2 diabetic rats (SHR/NDmcr-cp), normotensive type 2 diabetic rats (Zucker diabetic fatty), and remnant kidney rats.

Conclusion— R-147176 retains renal protective properties despite a minimal blood pressure–lowering effect. Clearly, the renal benefits of ARBs do not necessarily depend on blood pressure lowering and AT1R affinity, but rather on the inhibition of AGEs and oxidative stress inherent to their chemical structure. R-147176 opens new avenues in the treatment of cardiovascular and kidney diseases.

We have designed an ARB-derivative, R-147176, with a marked inhibitory effect on oxidative stress and advanced glycation but an extremely low affinity for the angiotensin II type 1 receptor. Despite a minimal blood pressure lowering effect, R-147176 provides significant renoprotection in three different experimental rat models with renal injury.

Key Words: blood pressure • renoprotection • advanced glycation end products • oxidative stress • type 2 diabetes

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