Current Pharmaceutical Design - Volume 10, Issue 25, 2004

Ever since the isolation of erythromycin from Streptomyces erythreus more than 50 years ago, macrolide antibiotics have assumed a prominent position in our pharmacological armamentarium against a variety of microbial pathogens. The broad spectrum activity and intracellular accumulation of this class of antibiotics account for the substantial clinical efficacy of macrolides against both extracellular and intracell Read More

The macrolide antimicrobial family is a comprised of 14, 15 and 16 member-ringed compounds that are characterized by similar chemical structures, mechanisms of action and resistance, but vary in the different pharmacokinetic parameters, and spectrum of activity. The macrolides accumulate in many tissues such as the epithelial lining fluid and easily enter the host defense cells, predominantly macrophages and p Read More

Pseudomonas aeruginosa is an opportunistic pathogen, and this organism is a major cause of pulmonary damage and mortality in patients with cystic fibrosis (CF), diffuse panbronchiolitis (DPB) and other forms of bronchiectasis. A break-through in the treatment of DPB and associated chronic P. aeruginosa pulmonary infection was realized when a patient with DPB improved dramatically after treatment with erythromyc Read More

Macrolide antimicrobials have stimulated worldwide interest owing to their therapeutic effects in various inflammatory, apparently non infectious, diseases. Abundant data are now available on their interactions with host cell (specially phagocyte) functions. Modulation of oxidant production by neutrophils and of pro-inflammatory cytokine synthesis and release by leukocytes are the two main effects observed in vitro. However, Read More

Macrolide antibiotics appear to play a role in the management of diseases of chronic airway inflammation, distinctly separate from their antibactericidal activity. In the last fifteen years, their success in human clinical trials has prompted both in-vitro and in-vivo investigations to determine the mechanisms by which this family of antibiotics modulate the immune response. A large body of evidence suggests that m Read More

Macrolides have broad antibacterial spectrum and proven efficacy in the management of respiratory tract infections. Over the past decade there has been progressive interest in these agents for their potential role as tissue modifying, anti-inflammatory agents. Increasingly, the effect of macrolides on numerous cell types has been documented. Preliminary data have suggested a beneficial clinical role of chronic macrolid Read More

Alzheimer's disease (AD) is characterized by progressive dementia caused by the loss of the presynaptic markers of the cholinergic system in the brain areas related to memory and learning and brain deposits of amyloid beta peptide (Aβ) and neurofibrillary tangles (NFT). A small fraction of early onset familial AD (FAD) is caused by mutations in genes, such as the b-amyloid precursor protein (APP) and presenilins that increas Read More

Several cellular processes could be targeted if the complex nature of Alzheimer's disease (AD) was already understood. Most of AD treatments have been focused on the inhibition of acetylcholinesterase (AChE) in order to raise the levels of its substrate, i.e. the neurotransmitter acetylcholine (ACh), to augment cognitive functions of affected patients. Effectiveness in AChE inhibition and side-effect issues of clinical Read More

The interest for acetylcholinesterase as a target for the palliative treatment of Alzheimer's disease has been renewed in the last years owing to the evidences that support the role of this enzyme in accelerating the aggregation and deposition of the β-amyloid peptide. A large amount of structural information on the acetylcholinesterase enzyme and of its complexes with inhibitors acting at the catalytic site, the peripheral Read More

At present the only FDA-approved therapy for Alzheimer's disease involves the administration of acetylcholinesterase inhibitors, to alleviate the cholinergic deficit associated with this disease. However, none of the approved drugs is ideal in efficacy or tolerability. One possible strategy to improve selectivity and potency is to design drugs that can simultaneously bind to the catalytic and peripheral anionic sites of AChE. In t Read More

The knowledge about the pathogenesis and the development of the neurodegeneration associated with Alzheimer's disease (AD) has been organised throughout the years into two theories, namely the cholinergic and the amyloid hypotheses. The loss of cholinergic neurotransmission and the abnormal aggregation and deposition of the amyloid-β peptide (Aβ) in the brain are retained as the central events by the two th Read More

Insufficient cholinergic neurotransmission in AD is responsible for a progressive loss of cognition and motor capacities. The cholinergic hypothesis has provided the rationale for the current treatment approaches based on acetylcholinesterase inhibitors. However, recent data focus on the complex nature of AD and disclose the involvement of other neurotransmitters such as serotonin, noradrenalin, dopamine, histamine, e Read More

Alzheimer's disease (AD) is associated to a gradual loss of attention and memory that have been associated to impairment of brain cholinergic neurotransmission, particularly a deficit of cholinergic neurons in the nucleus basalis of Meynert. Thus, it is not surprising that the first therapeutic target that has demonstrated therapeutic efficacy on cognition, behaviour and functional daily activities has been the inhibitors of acetyl Read More