title: Carbohydrates in therapeutics.
abstract: Awareness of the importance of carbohydrates in living systems and medicine is growing due to the increasing understanding of their biological and pharmacological relevance. Carbohydrates are ubiquitous and perform a wide array of biological roles. Carbohydrate-based or -modified therapeutics are used extensively in cardiovascular and hematological treatments ranging from inflammatory diseases and anti-thrombotic treatments to wound healing. Heparin is a well-known and widely used example of a carbohydrate-based drug but will not be discussed as it has been extensively reviewed. We will detail carbohydrate-based and -modified therapeutics, both those that are currently marketed or in various stages of clinical trials and those that are potential therapeutics based on promising preclinical investigations. Carbohydrate-based therapeutics include polysaccharide and oligosaccharide anti-inflammatory, anti-coagulant and anti-thrombotic agents from natural and synthetic sources, some as an alternative to heparin and others which were designed based on known structure-functional relationships. Some of these compounds have multiple biological effects, showing anti-adhesive, anti-HIV and anti-arthrithic activities. Small molecules, derivatives or mimetics of complement inhibitors, are detailed for use in limiting ischemia/ reperfusion injuries. Monosaccharides, both natural and synthetic, have been investigated for their in vivo anti-inflammatory and cardioprotective properties. Modification by glycosylation of natural products, or glycosylation-mimicking modification, has a significant effect on the parent molecule including increased plasma half-life and refining or increasing desired functions. It is hoped that this review will highlight the vast therapeutic potential of these natural bioactive molecules.
authors.affiliation: Harrington Department of Bioengineering and the Centre for Glycosciences and Technology, the Biodesign Institute, Arizona State University, Tempe, AZ 85287, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Kilcoyne
authors.forename: Lokesh
authors.initials: L
authors.lastname: Joshi
mesh_terms: D000818:Animals; D002241:Carbohydrates / Q000737:chemistry / Q000627:therapeutic use*; D004194:Disease; D006801:Humans; D015394:Molecular Structure
chemical_list: D002241:Carbohydrates