Prostaglandins Flashcards

1
Q
2013.02.13 prostaglandins
•	See Slide 11
•	See Slide 14
•	See Slide 21
•	See Slide 44
A
2013.02.13 prostaglandins
•	See Slide 11
•	See Slide 14
•	See Slide 21
•	See Slide 44
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2
Q

What are the precursors to Prostaglandins, Leukotrieines, and Thromboxanes?

A

• unsaturated membrane fatty acids, the 20-carbon eicosaenoic acids aka eicosanoids.

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3
Q

What cells produce eicosanoids?

A
  • Virtually all cells and tissues produce eicosanoids

* the specific types produced vary widely from cell-type to cell-type.

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4
Q

Explain the general cycle of synthesis, release, localization, and degradation of eicosanoids.

A
  • synthesized and released in response to inflammatory, mechanical, neurological, or hormonal stimuli.
  • Rapidly degraded by dehydrogenase enzymes, most effectively in the lung.
  • Eicosanoids have very short half-lives and thus, eicosanoids are “local” autocrine or paracrine hormones.
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5
Q

NOMENCLATURE & MECHANISM OF ACTION OF EICOSANOIDS
• Letters designate ring structure;
• Numbers denote # of double bonds–important for receptor binding and function;
• Receptors, usually G-protein coupled, are specific for each different eicosanoid;
e.g. DP1 and DP2 are receptors for Prostaglandin D.
EP1, EP2, EP3 and EP4 are four distinct receptors for E prostaglandins.

A

NOMENCLATURE & MECHANISM OF ACTION OF EICOSANOIDS
• Letters designate ring structure;
• Numbers denote # of double bonds–important for receptor binding and function;
• Receptors, usually G-protein coupled, are specific for each different eicosanoid;
e.g. DP1 and DP2 are receptors for Prostaglandin D.
EP1, EP2, EP3 and EP4 are four distinct receptors for E prostaglandins.

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6
Q

What is the precursors to eicosanoids? What is the primary precursor?

A
  • arachidonic (eicosatetraenoic) acid.
  • fatty acids cleaved from membrane phospholipids following activation of phospholipases (e.g. PLA2) are rapidly converted to eicosanoids.
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7
Q

What causes the release of eicosanoids?

A
  • Inflammatory, mechanical, neurological, or hormonal stimuli activate the phospholipase A2 family to release membrane fatty acids (eicosaenoic acids).
  • Also…
  • —injury (exposed collagen; thrombin; damaged cells)
  • —heat (thermal injury)
  • —hormones (angiotensin; vasopressin, cytokines …)
  • —Ag-Ab complexes, activated complement
  • —bacteria, LPS (endotoxin)
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8
Q

What is Cyclooxygenase?
What is Prostaglandin H Synthase I and II?
What eicosanoids are formed by these enzymes?

A
  • Prostaglandins and thromboxanes (prostanoids) are formed via the cyclooxygenase (COX) pathways
  • prostaglandin H synthase I (PGHS-1 = COX-1) and PGHS-2 (COX-2).
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9
Q

What eicosanoid is formed via…
5-lipoxygenase?
5-, 12-, 15- lipoxygenase?

A
  • Leukotrienes are produced via the enzyme 5-lipoxygenase.

* Lipoxins are products of 5-, 12-, and 15-lipoxygenases.

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10
Q

Explain the inflammatory pathway with regard to eicosanoid production.

A

• IL-1, TNF, LPS ==> COX-2 ==> phospholipase A2 (PLA2) ==> eicosanoid production at sites of inflammation.

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11
Q

How do eicosanoids affect pain sensation?

A

• Eicosanoids are hyperalgesic–do not produce pain directly but increase tissue sensitivity to other stimuli. E-prostaglandins induce hyperalgesia via EP4.

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12
Q

How do eicasanoids affect edema?

A

• Eicosanoids enhance edema caused by bradykinin, histamine and the C5a anaphylatoxin.

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13
Q

How do eicosanoids affect chemotaxis? Which one is noted?

A

• Eicosanoids contribute to leukocyte activation and chemotaxis. e.g. LTB4 is chemotactic for both T cells and PMNs.

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14
Q

What is the effect of PGE2 (E-prostaglandin) on inflammation?

A

• PGE2 induces all cardinal signs of inflammation when injected into an animal or person (rubor, calor, dolor, tumor)

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15
Q

Which eicosanoids are part of asthma?

A

• Cysteinyl leukotrienes (cysLTs; LTC4, D4, E4) induce many of the abnormalities seen in both acute and chronic asthma.

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16
Q

What effects do cysteinyl leukotrienes have on asthma?

A
  • -Induce smooth muscle contraction and protracted bronchoconstriction;
    - -Promote of microvascular permeability, bronchovascular leakage & mucous secretion;
    - -Promote leukocyte infiltration and production of pro-inflammatory cytokines.
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17
Q

What inhibits eicosanoid production? (long list)

A
  • anti-inflammatory NSAIDs, coxibs (COX-2 inhibitors) and glucocorticoids.
  • 5-lipoxygenase inhibitors and leukotriene receptor antagonists (anti-asthma drugs).
  • Lipoxins, resolvins & protectins counter the inflammatory effects of leukotrienes.
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18
Q

How do glucocorticoids affect eicosaniods?

A
  • induce synthesis of annexin-1 which blocks cPLA2
  • inhibit synthesis of COX-2 (but not COX-1)
  • induce MAPK phosphatase 1
  • inhibiting production of inflammatory cytokines that stimulate PG production.
  • Thus, GCs can inhibit production of prostaglandins, thromboxanes and leukotrienes.
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19
Q

How do NSAIDs affect eicosanoids?

A
  • block cyclooxygenases 1 and 2 (COX-1 and COX-2);

* But do not inhibit and may lead to enhanced leukotriene production.

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20
Q

How do 5-lipoxygenase inhibitors affect eicosanoids?

A

• block production of leukotrienes.

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21
Q

How do Coxibs (new COX-2 selective inhibitors) affect eicosaniods? Why are they special?

A
  • block the inflammation-
  • induced cyclooxygenase (COX-2) enzyme with little effect on COX-1.
  • selectively inhibit COX-2 at inflammatory sites.
  • do not inhibit cytoprotective E-prostaglandins that are produced by gut epithelial cells via COX-1 (ie. You can block inflammation without causing ulcers)
22
Q

What inhibits eicosanoid production in asthma?

A

• 5-lipoxygenase inhibitors and leukotriene receptor antagonists (anti-asthma drugs).

23
Q

How are eicosanoids part of lung inflammation?

A

• lung inflammation–mast cells produce PGD2 and slow reacting substance of anaphylaxis (LTC4 and LTD4) causing bronchoconstiction, bronchovascular leakage, microvascular permeability & mucous secretion.

24
Q

What is the effect of Thromboxane on platelet and blood vessel function?

A

• platelets (via COX-1) ==> Thromboxane A2 ==> platelet aggregation and vasoconstriction.

25
Q

What is the effect of prostaglandin I2/ prostacyclin (PGI2) on platelet and blood vessel function?

A

• vascular endothelial cells (via COX-1 and COX-2) ==> Prostacyclin (PGI2) ==> inhibits platelet aggregation and causes vasodilation.

26
Q

Recap: Compare Thromboxane and Prostacyclin with regard to platelet and blood vessel function.

A
  • platelets (via COX-1) ==> Thromboxane A2 ==> platelet aggregation and vasoconstriction.
  • vascular endothelial cells (via COX-1 and COX-2) ==> Prostacyclin (PGI2) ==> inhibits platelet aggregation and causes vasodilation.
27
Q

How does aspirin affect platelet and blood vessel function?
What about other NSAIDs?
When and How are the affects of aspirin reversed?

A
  • Aspirin, unlike other NSAIDs, irreversibly inhibits COX-1 and COX-2.
  • anucleate platelets cannot synthesize new COX-1, thromboxane production is markedly impaired.
  • Endothelial cells, via synthesis of new COX-1 and 2, can produce prostacyclin once aspirin levels decline.
  • Details: Aspirin donates its acetyl group to a Serine near the PGH2 synthase active site, blocking arachidonate binding, and causing irreversible inhibition of the PG synthase enzyme.
  • Details: The anti-clotting effect of aspirin is due to irreversible inhibition of COX-1, needed to form thromboxanes in blood platelets. The effect is long-lived since platelets (as anucleate progeny of megakaryocytes) can not make new enzyme. Endothelial cells can regenerate COX and thus continue to produce Prostacyclin (PGI2).
28
Q

What is Patent Ductus Arteriosus (PDA)?

A

• a congenital disorder in the heart wherein a neonate’s ductus arteriosus fails to close after birth.

29
Q

Which eicosanoids contribute to Ductus Arteriosus Patency?

A

• maintained in the fetus by locally produced and circulating I and E prostaglandins.

30
Q

What is a pharmacological treatment for Ductus Arteriosus Patency early after birth?

A

• Indomethacin and ibuprofen (eicasonoid inhibitors) can dramatically reduce blood flow through the ductus within 24 hours and eliminate the need for surgery in many premature infants.

31
Q

What are the mechanisms through which E and I prostaglandins affect blood vessels?

A
  • reduce arterial blood pressure
  • direct vasodilator action on resistance vessels
  • modulation of norepinephrine release
  • modulation of renal hormones.
32
Q

What is the role of eicosanoids in artherogenesis?

A
  • 5-lipoxygenase gene polymorphisms are linked to coronary occlusion
  • Omega-3 fatty acid rich diet decreases cardiovascular disease
  • Thromboxane B3 inactive, PGI3 active
  • Low dose aspirin reduces arterial thrombosis.
33
Q

What is the mechanism of Coxibs (Cox-2 inhibitors) for increasing thrombosis?

A

• increase thrombosis by selectively inhibiting prostocyclin but not thromboxane.

34
Q

In general, how do E- and F- Prostaglandins affect reproduction?

A

— production stimulated by LH
— induce follicular rupture, release of ovum
— stimulate cervical ripening/dilation
— stimulate uterine smooth muscle contraction
— induce penile erection

35
Q

Explain the effects of PGE2 and PGF2 in ovulation and parturition.

A
  • PGE2 and PGF2 ==> follicular rupture and release of the ovum.
  • PGE2 & PGF2 ==> cervical softening/dilation & uterine contractions.
36
Q

What is the drug Misoprostol, a PGE1 analogue, is effective for?

A

cervical ripening and induction of labor
• Reducing postpartum hemorrhage
• Medical abortion (combined with RU486)

37
Q

Explain the effects of PGE2 in the penis.

A

• PGE2 induces penile erection.

38
Q

How do NSAIDs affect gestation time?

A

• NSAIDs can prolong gestation and are sometimes effective in arresting premature labor.

39
Q

Which prostaglandin is used for termination of pregnancy? At what time during pregnancy is it effective?

A

• E-prostaglandins can be used for termination of both early and late pregnancies.

40
Q

In general what are the effects of eicosanoids in the kidneys?

A
  • PGI2 and PGE2 normally low, but increased by angiotensin II, norepinephrine and vasopressin
  • Maintain renal blood flow through direct renal vasodilatory action, thus ameliorating renal vasoconstriction by angiotensin II and norepinehrine.
  • Antagonize both hydroosmotic and vascular effects of ADH.
  • PGI2 (and PGE2) play a positive role in baroreceptor-induced renin release.
41
Q

What is the effect of RAAS on PGI2 and PGE2?

A

• PGI2 and PGE2 normally low, but increased by angiotensin II, norepinephrine and vasopressin (ADH)

42
Q

What is the effect of PGI2 and PGE2 on renal blood flow?

A

• PGI2 and PGE2 maintain renal blood flow through direct renal vasodilatory action.

43
Q

What is the effect of prostaglandins on ADH?

A

• Prostaglandins antagonize both hydroosmotic and vascular effects of ADH

44
Q

What is the role (+ or -) of PGI2 and PGE2 on rennin release?

A

• PGI2 (and PGE2) play a positive role in baroreceptor-induced renin release.

45
Q

Recap: What is the effect of PGI2 and PGE2 on…
on renal blood flow?
on ADH?
on rennin release?

A
  • PGI2 and PGE2 maintain renal blood flow through direct renal vasodilatory action.
  • Prostaglandins antagonize both hydroosmotic and vascular effects of ADH
  • PGI2 (and PGE2) play a positive role in baroreceptor-induced renin release.
46
Q

What is the effect of eicosanoids int the gut?

A
  • PGE»PGA>PGI decrease acidity
  • ↑ bicarbonate secretion by epithelial cells
  • ↑ mucous secretion by epithelial cells
  • protect the gastric mucosa.
47
Q

What is the effect of NSAIDs on the gut?

A
  • Increase acidity and gastric ulcers
  • ↓ bicarbonate secretion by epithelial cells
  • ↓ mucous secretion by epithelial cells
48
Q

For patients who must receive NSAID therapy, is there an treatment that can help protect their gut?

A

• Misoprostol, an E prostaglandin analog, is useful for protection against gastric ulcers in high-risk groups, such as patients receiving NSAID therapy for arthritis and other inflammatory diseases.

49
Q

What is the effect of NSAIDs and COX-2 inhibitors on GI tumors?

A
  • NSAIDs and COX-2 inhibitors decrease the frequency of colorectal polyps.
  • Low dose aspirin reduces the occurrence of familial adenomas.
50
Q

Don’t forget the diagrams…

A

Don’t forget the diagrams…