Synthesis and ocular effects of imidazole nitrolic acid and amidoxime esters.

Esters of 1-(H)-imidazole-5-nitrolic acid and 1-methyl-imidazole-5-carboxamide oxime were prepared to study the effect of esterification on the ocular effects of these compounds. Esterifications were performed with acid chloride. Acid chloride also reacts with the ring nitrogen of 1-(H)-imidazole-5-nitrolic acid, but the desired esters could be selectively prepared by adjustment of the reaction conditions. Esterification led to loss of the ocular effects exhibited by the parent compounds.

Synthesis and ocular effects of imidazole nitrolic acids.

Novel 1-R-imidazole-2-nitrolic acids and 1-R-imidazole-5-nitrolic acids (R: H, Me, Bn) were synthesized from oximes by treatment with a mixture of fuming nitric acid and acetic acid. The effects of these potential nitric oxide-donating compounds were tested on ocular variables such as intraocular pressure and formation of cyclic guanosine-3,5'-monophosphate in the incubation of porcine iris-ciliary body.

Aqueous humour flow after a single oral dose of isosorbide-5-mononitrate in healthy volunteers.

PURPOSE: To investigate whether a nitric oxide donor given as a single oral dose is able to modify aqueous humour flow in healthy volunteers. METHODS: Ten healthy volunteers participated in a randomized, double-masked and placebo-controlled cross-over study. Aqueous humour flow was assessed by fluorophotometry after intake of isosorbide-5-mononitrate (ISMN), 10 mg. Topical timolol maleate, which is known to reduce aqueous humour flow, was used as a positive control. Intraocular pressure (IOP) was measured by applanation tonometry and blood pressure was registered. RESULTS: The basal rate of aqueous humour flow did not change significantly after a single oral dose of ISMN. The aqueous humour flow in the timolol-treated eye was reduced as compared to the contralateral control eye (p = 0.002). Mean IOP 6 hours after placebo and ISMN intake did not differ significantly. Timolol lowered IOP by 4 mmHg (p < 0.001). ISMN did not lower systolic blood pressure, but diastolic blood pressure was reduced by 4 mmHg (p = 0.048). CONCLUSION: A single oral dose of 10 mg ISMN had no significant effect on aqueous humour flow in healthy volunteers.

Nitric oxide and cyclic GMP enhance aqueous humor outflow facility in rabbits.

PURPOSE: Nitric oxide (NO) may control intraocular pressure (IOP)-regulating mechanisms physiologically and in ocular diseases such as glaucoma. The aim of the present study was to clarify whether an increase in aqueous humor outflow facility could explain the IOP-lowering effect of the NO/cyclic GMP pathway we recently described. METHODS: Test compounds were administered to anesthetized rabbits (New Zealand White, n = 6) intracamerally (5 microl) in the following doses: nitrosocaptopril 12.3 microg, captopril 10.9 microg, sodium nitroprusside (SNP) 13.1 microg and 8-Br-cGMP 22.3 microg. Outflow facility (C) was determined by the two-level constant pressure infusion method. Outflow facility, C( 1) and C(2), was measured at lower and higher pressure levels, respectively. RESULTS: Outflow facility was increased after treatment with SNP (increase in C in the experimental eye as compared to the control eye C( 1) 80% and C(2) 74%), nitrosocaptopril (C(1) 69% and C(2) 64%) and 8-Br-cGMP (C(1) 35% and C(2) 33%). Captopril had no effect on outflow facility (C(1) -12% and C(2) 2%). Blood pressure was not affected by the drugs. CONCLUSIONS: We conclude that enhancement of outflow facility by nitrosocaptopril, SNP and 8-Br-cGMP, their second messenger derivative, at least partly explains the IOP-lowering effect of NO releasing compounds.

Incubation of porcine iris-ciliary bodies to study the mechanisms by which nitric oxide donors lower intraocular pressure.

BACKGROUND: We previously reported that several nitric oxide (NO) donors, guanylate cyclase activators, and cyclic GMP lower intraocular pressure (IOP) in rabbits. MATERIAL/METHODS: This study evaluated a novel method for studying cGMP production in the iris-ciliary body after the administration of different NO donors and guanylate cyclase activators. Tissue samples of porcine iris-ciliary body were incubated for 30 or 60 minutes with the test compounds and with or without the phosphodiesterase inhibitor zaprinast. The concentration of cGMP in the iris-ciliary body as an indicator of soluble guanylate cyclase activation was measured by radioimmunoassay. RESULTS: The tested NO donors - SNOG, NONOate, NOR-3, and SNAP - were shown to release NO in incubation medium, and clearly increase cGMP concentration in the iris-ciliary body. Cyclic GMP production was 2-5 times higher with nitrosocaptopril and about 10 times higher with SNP than in the unstimulated control tissue incubation. Captopril, the reference for nitrosocaptopril, did not induce cGMP production in the porcine iris-ciliary body. ODQ, a guanylate cyclase inhibitor, shut down the production of cGMP after the administration of nitrosocaptopril and SNP. The guanylate cyclase activators YC-1 and atriopeptin III increased cGMP dose-dependently. CONCLUSIONS: In this novel tissue incubation method, several NO donors and guanylate cyclase activators increased cGMP production in the porcine iris-ciliary body. This method can be used to screen new molecules in terms of cGMP production, since the ciliary body is important in lowering intraocular pressure.

Biochemical markers of the L-arginine-nitric oxide pathway in the aqueous humour in glaucoma patients.

PURPOSE: To study the role of the L-arginine-nitric oxide (NO) pathway in aqueous humour dynamics by measuring nitrate, nitrite and cyclic (cGMP) levels in guanosine 3',5'-monophosphate the aqueous humour of glaucomatous and nonglaucomatous cataract patients. METHODS: The study involved 38 glaucoma patients undergoing unilateral cataract surgery in the glaucomatous eye and 38 cataract control patients matched for sex, age, smoking habits and organic nitrate medication. All subjects underwent ophthalmic examination, and blood pressure was measured preoperatively. Nitrite, nitrate and cGMP levels were measured in aqueous humour and serum. RESULTS: The NOx (nitrite + nitrate), nitrite and cGMP concentrations in the aqueous humour were slightly higher in the glaucoma patients than in the control patients, but the differences did not reach statistical significance. The levels of cGMP in serum were higher in the glaucoma patients (P = 0.053). The subgroup of glaucoma patients with pseudoexfoliation had lower NOx and nitrite values in the aqueous humour (P = 0.046 and P = 0.345, respectively) than the matched controls, while cGMP levels were higher (P = 0.043). Levels of NOx and nitrite in the aqueous humour were higher in patients using oral nitroglycerin (P = 0.062 and P = 0.042, respectively) than in patients without this medication. Blood pressure was higher in the glaucoma patients, with a mean of 165/89 mmHg as compared to 153/81 mmHg in the controls (P-values 0.071/0.008). CONCLUSIONS: No differences in NO metabolites were found between glaucoma and control patients. However, any real changes may have been disguised by optimal medication of glaucoma. Low NOx and high cGMP levels in the aqueous humour of pseudoexfoliation patients warrant further evaluation in a larger study.

Comparison of nitric oxide donors in lowering intraocular pressure in rabbits: role of cyclic GMP.

L-arginine-nitric oxide (NO) pathway participates in the physiology and in many pathological processes in the eye, such as glaucoma. The aim of the present study was to compare the ocular hypotensive effect of different NO-donors, and to get more information on the role of cyclic guanosine 3',5'-monophosphate (cGMP) in this process. The test compounds were administered topically or intravitreally in the eye of a normotensive rabbit. Intraocular pressure (IOP) was measured with a pneumatonometer after topical anesthesia. The metabolites of NO (nitrite, nitrate, NOx) and cGMP were assayed from the aqueous humor and plasma. NO-synthase (NOS) protein expression was assayed in the ciliary body by Western blotting. The maximal lowering of IOP was achieved as follows: atriopeptin III (concentration 78 (microM, decrease in IOP 50%), atriopeptin II (84 (microM 37%). 8-Br-cGMP (90 mM, 37%), zaprinast + 8-Br-cGMP (1 mM + 90 mM, 34%), L-arginine (1 mM, 29%), SNP (40 mM, 28%), nitrosocaptopril (100 mM, 28%), S-nitrosothiol (SNOG) (10 mM, 27%), YC-1 (10 (microM, 25%), zaprinast + SNP (1 mM + 40 mM, 22%), spermine NONOate (100 mM, 20%) [corrected]. The decrease in IOP lasted for 2-5 hr, except with atriopeptin II and III, when IOP values were first normalized in 6 hr and 2 days, respectively. In conclusion, the results of the present study indicate that by increasing the activity of L-arginine/NO/cGMP-pathway it is possible to lower IOP in rabbits equally to the currently used antiglaucomatous drugs.