Identification of telmisartan as a unique angiotensin II receptor antagonist with selective PPARgamma-modulating activity.
The metabolic syndrome is a common precursor of cardiovascular disease and type 2 diabetes that is characterized by the clustering of insulin resistance, dyslipidemia, and increased blood pressure. In humans, mutations in the peroxisome proliferator-activated receptor-gamma (PPARgamma) have been reported to cause the full-blown metabolic syndrome, and drugs that activate PPARgamma have proven to be effective agents for the prevention and treatment of insulin resistance and type 2 diabetes. Here we report that telmisartan, a structurally unique angiotensin II receptor antagonist used for the treatment of hypertension, can function as a partial agonist of PPARgamma; influence the expression of PPARgamma target genes involved in carbohydrate and lipid metabolism; and reduce glucose, insulin, and triglyceride levels in rats fed a high-fat, high-carbohydrate diet. None of the other commercially available angiotensin II receptor antagonists appeared to activate PPARgamma when tested at concentrations typically achieved in plasma with conventional oral dosing. In contrast to ordinary antihypertensive and antidiabetic agents, molecules that can simultaneously block the angiotensin II receptor and activate PPARgamma have the potential to treat both hemodynamic and biochemical features of the metabolic syndrome and could provide unique opportunities for the prevention and treatment of diabetes and cardiovascular disease in high-risk populations.
Benson
Stephen C
SC
Department of Biological Sciences, California State University, Hayward, USA.
Pershadsingh
Harrihar A
HA
Ho
Christopher I
CI
Chittiboyina
Amar
A
Desai
Prashant
P
Pravenec
Michal
M
Qi
Nianning
N
Wang
Jiaming
J
Avery
Mitchell A
MA
Kurtz
Theodore W
TW
D017667:Adipocytes / Q000187:drug effects; D047228:Angiotensin II Type 1 Receptor Blockers; D000818:Animals; D001562:Benzimidazoles / Q000737:chemistry / Q000494:pharmacology*; D001565:Benzoates / Q000737:chemistry / Q000494:pharmacology*; D001713:Biphenyl Compounds / Q000494:pharmacology; D001786:Blood Glucose / Q000032:analysis; D002454:Cell Differentiation / Q000187:drug effects; D002478:Cells, Cultured / Q000187:drug effects; D002522:Chlorocebus aethiops; D004353:Drug Evaluation, Preclinical; D005786:Gene Expression Regulation / Q000187:drug effects; D007093:Imidazoles / Q000494:pharmacology; D007328:Insulin / Q000097:blood; D000077405:Irbesartan; D019808:Losartan / Q000494:pharmacology; D008297:Male; D051379:Mice; D008958:Models, Molecular; D032446:Myoblasts / Q000187:drug effects; D011487:Protein Conformation / Q000187:drug effects; D051381:Rats; D017207:Rats, Sprague-Dawley; D018160:Receptors, Cytoplasmic and Nuclear / Q000819:agonists* / Q000737:chemistry / Q000235:genetics; D000077154:Rosiglitazone; D013329:Structure-Activity Relationship; D000077333:Telmisartan; D013777:Tetrazoles / Q000494:pharmacology; D013844:Thiazoles / Q000494:pharmacology; D045162:Thiazolidinediones / Q000494:pharmacology; D053778:Thiazolidines; D014157:Transcription Factors / Q000819:agonists* / Q000737:chemistry / Q000235:genetics; D014280:Triglycerides / Q000097:blood; D014633:Valine / Q000031:analogs & derivatives / Q000494:pharmacology; D000068756:Valsartan; D015430:Weight Gain / Q000187:drug effects
D047228:Angiotensin II Type 1 Receptor Blockers; D001562:Benzimidazoles; D001565:Benzoates; D001713:Biphenyl Compounds; D001786:Blood Glucose; C119543:GW0072; D007093:Imidazoles; D007328:Insulin; D018160:Receptors, Cytoplasmic and Nuclear; D013777:Tetrazoles; D013844:Thiazoles; D045162:Thiazolidinediones; D053778:Thiazolidines; D014157:Transcription Factors; D014280:Triglycerides; D000077154:Rosiglitazone; D000068756:Valsartan; C066026:losartan carboxylic acid; D014633:Valine; D000077405:Irbesartan; D019808:Losartan; D000077333:Telmisartan