Inibidores da enzima prolil hidroxilase induzida por hipóxia na saúde e no desempenho desportivo
Resumo
Os inibidores da enzima prolil hidroxilase induzida por hipóxia (HIF-PHI) é um agente terapêutico sob uma nova classe de fármacos que estimulam a resposta do corpo à hipóxia sem alterar a pressão parcial de oxigênio nos tecidos, o que suprime e induz os genes responsáveis ao processo hematopoiético. Esses agentes estimulantes de eritropoiese podem influenciar a saúde humana possibilitando novas oportunidades no tratamento de anemia com doença renal crônica, no entanto, os mesmos têm também chamando a atenção de atletas que buscam a melhoria da performance. O objetivo deste estudo foi descrever por meio de uma revisão de literatura os fatores fisiológicos e terapêuticos dos inibidores da HIF-PHI na saúde, e no desempenho desportivo. Realizou-se um levantamento a partir de bancos de dados PubMed, Lilacs, Scopus e ScienceDirect entre os anos de 2011 a 2019. As palavras-chave empregadas foram, HIF stabilizers, HIF-PHI, FG-4592 e high performance.Os resultados mostraram que os HIF-PHI podem influenciar positivamente a saúde e o desempenho esportivo,por estímulo na producão de células vermelhas do sangue, favorecendo assim uma maior oferta de oxigênio no organismo. Um diferencial dessa classe de fármacos é de diminuirem os níveis de hepcidina não causando deficiência nos estoques de ferro no organismo. Outros efeitos foram a diminuição do colesterol total e LDL, e possíveis reduções nos níveis de pressão arterial. São necessários mais estudos que envolvam essa classe de fármacos nos seres humanos, visto que os mesmos podem ser efetivos no tratamento de algumas patologias, melhorando assim, a qualidade de vida da população.
Referências
Bernhardy, W.M., Wiesener, M.S., Scigalla, P., Chou J., Schmieder, R.E., e Gunzler, V. (2010). Inhibition of prolyl hydroxylases increases erythropoietin production in ESRD. J Am Soc Nephrol, v. 21, 2151-2156. https://doi.org/10.1681/ASN.2010010116
Brigandi, RA, Johnson, B., Oei, C., Westerman, M., Olbina, G., Zoysa, J., Roger, SD, Sahay, M., Cross, N., McMahon, L., Guptha, V., Smolyarchuk, EA, Singh, N., Russ, SF, e Kumar, S. (2016). Novel hypoxia inducible factor-prolyl hydroxylase inhibitor (GSK1278863) for anemia in CKD: a 28-day, phase 2A randomized trial. Am J Kidney Dis. 67(6), 861-871. https://doi.org/10.1053/j.ajkd.2015.11.021
Buisson, C., Marchand, A., Bailoux, I., Lahaussois, A., e Martin, L. (2016). Detection by LC-MS/MS of HIF stabilizer FG-4592 used as a new doping agent: investigation on a positive case. Journal of Pharmaceutical and Biomedical, 20(121), 181-187. https://doi.org/10.1016/j.jpba.2016.01.029
Drueke, TB, Locatelli, F., Clyne, N., Eckardt, KU, Macdougall, IC, Tsakiris, D., Burger, HU, e Scherhag, A. (2006). Normalization of hemoglobin level in patients with chronic kidney disease and anemia. N Engl J Med., 355(20), 2071-2084. https://doi.org/10.1056/NEJMoa062276
Forristal, C., e Levesque, J.P. (2014). Targeting the Hypoxia-Sensing Pathway in Clinical Hematology. Stem Cells Transl. Med. 3(2), 135-140. https://doi.org/10.5966/sctm.2013-0134
Forristal, C.E., Winkler, I.G., Nowlan, B., Barbier, V., e Walkinshaw C.E. (2013). Pharmacologic stabilization of HIF-1alpha increases hematopoietic stem cell quiescence in vivo and accelerates blood recovery after severe irradiation. Blood, 121(5), 759-769. https://doi.org/10.1182/blood-2012-02-408419
Franklin Bunn, H. (2013). Erythropoietin. Cold Spring Harb Perspect Med., 3, a011619. https://doi.org/10.1101/cshperspect.a011619
Gupta, N., e Wish, J.B. (2017). Hypoxia-Inducible Factor Prolyl Hydroxylase Inhibitors: A Potential New Treatment for Anemia in Patients With CKD. Am J Kidney Dis., 69(6), 815-826. https://doi.org/10.1053/j.ajkd.2016.12.011
Hasse, V.H. (2017). Therapeutic targeting of the HIF oxygen-sensing pathway: Lessons learned from clinical studies. Exp Cell Res., 356(2), 160-165. https://doi.org/10.1016/j.yexcr.2017.05.004
Holdstock, L., Meadowcroft, AM, Maier, R., Johnson, BM, Jones, D., Rastogi, A., Zeig, S., Lepore, JJ, e Cobitz, AR (2016). Four-Week Studies of Oral Hypoxia-Inducible Factor-Prolyl Hydroxylase Inhibitor GSK1278863 for Treatment of Anemia. J Am Soc Nephrol, 27(4), 1234-1244. https://doi.org/https://doi.org/10.1681/ASN.2014111139
Hong, Y.R., Kim, H.T., Ro, S., Cho, J.M., Lee, S.H., Kim, I.S., e Jung, Y.H. (2014). Discovery of novel 2-[2-(3-hydroxy-pyridin-2-yl)-thiazol-4-yl]-acetamide derivatives as HIF prolyl 4-hydroxylase inhibitors; SAR, synthesis and modeling evaluation, Bioorg. Med & Chem. Lett., 24(14), 3142-3145. https://doi.org/10.1016/j.bmcl.2014.05.003
Hung, S.C., e Tarng, D.C. (2014). ESA and iron therapy in chronic kidney disease: a balance between patient safety and hemoglobina target. Kidney Int., 86, 676–678. https://doi.org/10.1038/ki.2014.179
Jelkmann, W. (2011). Regulation of erythropoietin production. J Physiol., 589(Pt 6), 1251–1258. https://doi.org/10.1113/jphysiol.2010.195057
Lee, DC, Sohn HA, Park, ZY, Oh, S., Kang, YK, Lee, KM, Kang, M., Jang, IJ, Yang, SJ, Hong YK, Noh, H., Kim, JA, Kim, DJ, Bae, KH, Kim, DM, Chung, SJ, Yoo, HS, Yu, DY, Park, KC, e Yeom, YI (2015) A lactate-induced response to hypoxia. Cell., 161(3), 595-609. https://doi.org/10.1016/j.cell.2015.03.011
Locatelli, F., Fishbane, S., Bloco, G.A., e MacDougall, I.C. (2017). Targeting Hypoxia Inducible Factors for the Treatment of Anemia in Chronic Kidney Disease Patients. Am J Nephrol., 45(3), 187-199. https://doi.org/10.1159/000455166
López-Gómes, J.M., Abad, S., e Vega, A. (2016). New expectations in the treatment of anemia in chronic kidney disease. Nefrología, 36(3), 232-6. https://doi.org/10.1016/j.nefroe.2016.07.002
Mitchell, C.J., Shawki, A., Ganz, T., Nemeth, E., e Mackenzie, B. (2014). Functional properties of human ferroportin, a cellular iron exporter reactive also with cobalt and zinc. Am J Physiol Cell Physiol., 306(5), C450–C459. https://doi.org/10.1152/ajpcell.00348.2013
Nagel, S., Talbot, N.P., Mecinović, J., Smith, T.G., Buchan A.M., e Schofield, C.J. (2010). Therapeutic Manipulation of the HIF Hydroxylases. Antioxid. Redox Signal, 12(4), 481-501. https://doi.org/10.1152/ajpcell.00348.2013
Pergola, P.E., Spinowitz, B.S., Hartman, C.S., Maroni, B.J., e Hasse, V.H. (2016). Vadadustat, a novel oral HIF stabilizer, provides effective anemia treatment in nondialysis-dependent chronic kidney disease. Kidney Int., 90, 1115-1122. https://doi.org/10.1016/j.kint.2016.07.019
Provenzano, R., Besarab, A., Sun, C.H., Diamond, S.A., Durham, J.H., e Cangiano, J.L. (2016). Oral Hypoxia-Inducible Factor Prolyl Hydroxylase Inhibitor Roxadustat (FG-4592) for the Treatment of Anemia in Patients with CKD. Clin J Am Soc Nephrol., 11, 982-991. https://doi.org/10.2215/CJN.06890615
Van Der Weerd, NC, Grooteman, MPC, Bots, ML, Van Den Dorpel, MA, Den Hoedt, CH, Mazairac, AHA, Nubé, MJ, Lars Penne, E., Gaillard, CA, Wetzels, JFM, Wiegerinck, ET, Swinkels, DW, Blankestijn, PJ, e Ter Wee, PM (2012). Investigators. Hepcidin-25 in chronic hemodialysis patients is related to residual kidney function and not to treatment with erythropoiesis stimulating agents. PLoS One, 7(7), e39783. https://doi.org/10.1371/journal.pone.0039783
World Anti Doping Agency (2015). The 2015 prohibited list International Standard. http://www.amawada.org
Yousaf, F., e Spinowitz B. (2016). Hypoxia-inducible factor stabilizers: A new avenue for reducing BP while helping hemoglobin? Curr Hypertens Rep, 18(23), 1-14. https://doi.org/10.1007/s11906-016-0629-6
Zhong, H., Zhou, T., Li, H., Zhong, Z. (2018) The role of hypoxia-inducible factor stabilizers in the treatment of anemia in patients with chronic kidney disease. Drug Design, Development and Therapy, 12, 3003-3011. https://doi.org/10.2147/DDDT.S175887
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