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Advances in the stereoselective synthesis of antifungal agents and ...

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Chapter 1 17was syn<strong>the</strong>sized by <strong>the</strong> Bayer AG <strong>in</strong> 1972 61 . It has been shown to have abroad spectrum <strong>of</strong> antimicrobial activity aga<strong>in</strong>st dermatophytes, pathogenicyeasts, filamentous <strong>and</strong> dimorphic fungi, as well as aga<strong>in</strong>st some grampositivebacteria. Studies have shown that 6d required only a very shortcontact time <strong>in</strong> order to achieve maximum <strong>in</strong>hibitory activity 62 Itsubstantially <strong>in</strong>hibits <strong>the</strong> uptake <strong>and</strong> <strong>in</strong>tracellular pool<strong>in</strong>g <strong>of</strong> leuc<strong>in</strong>e, lys<strong>in</strong>e<strong>and</strong> o<strong>the</strong>r am<strong>in</strong>oacids <strong>in</strong> <strong>the</strong> absence <strong>of</strong> glucose 63 .Clotrimazole 6d was shown to be orally active <strong>in</strong> early <strong>in</strong> vivo studiesbut problems with toxicity <strong>and</strong> side effects directed <strong>the</strong> developmenttowards topic applications. The efficacy <strong>in</strong> <strong>the</strong> treatment <strong>of</strong> experimentalfungal <strong>in</strong>fections decreases as a function <strong>of</strong> time 64 . A progressive decl<strong>in</strong>e <strong>in</strong>serum concentrations <strong>of</strong> <strong>the</strong> drug after adm<strong>in</strong>istration over several days hasnot been observed. This means a high metabolic stability <strong>and</strong> a long halflife. O<strong>the</strong>r problems follow<strong>in</strong>g oral adm<strong>in</strong>istration 65 are unacceptable high<strong>in</strong>cidences <strong>of</strong> gastro<strong>in</strong>test<strong>in</strong>al disturbances, as well as hepatic <strong>and</strong> adrenalchanges.Clotrimazole 6d has been proven to be effective <strong>and</strong> safe <strong>in</strong> <strong>the</strong> topicaltreatment <strong>of</strong> a variety <strong>of</strong> fungal <strong>in</strong>fections. It is as effective as hystat<strong>in</strong> <strong>in</strong> <strong>the</strong>treatment <strong>of</strong> superficial C<strong>and</strong>ida <strong>in</strong>fections. Clotrimazole 6d has beenshown to be also active <strong>in</strong> <strong>the</strong> treatment <strong>of</strong> oral C<strong>and</strong>idiasis.1.3. Inhibitory activity <strong>of</strong> anticancer drugs on Aromatase.The biosyn<strong>the</strong>sis <strong>of</strong> steroids occurs <strong>in</strong> <strong>the</strong> gonads where sexualsteroids are produced <strong>and</strong> <strong>in</strong> adrenals where glucocorticoids <strong>and</strong>m<strong>in</strong>eralcorticoids are syn<strong>the</strong>sized. However, extra gl<strong>and</strong>ular production <strong>of</strong>some steroids also takes place <strong>in</strong> peripheral tissues. For example,aromatase, which converts <strong>and</strong>rogens <strong>in</strong>to estrogens has been identified <strong>in</strong> awide variety <strong>of</strong> tissues.A number <strong>of</strong> cl<strong>in</strong>ical situations are documented <strong>in</strong> which steroidhormones, ei<strong>the</strong>r <strong>in</strong> normal amounts or when produced <strong>in</strong> excess play arole <strong>in</strong> <strong>the</strong> pathogenesis <strong>of</strong> diseases. Thus, <strong>in</strong>hibiton <strong>of</strong> <strong>the</strong> steroidproduc<strong>in</strong>genzymes is a valuable means <strong>of</strong> treat<strong>in</strong>g <strong>the</strong>se conditions. Untilrecently, however, <strong>the</strong>re were relatively few <strong>in</strong>hibitors available thatwere specific for any one steroidogenic enzyme. Most <strong>of</strong> <strong>the</strong>secompounds <strong>in</strong>hibit steroid hydroxylation <strong>and</strong> <strong>in</strong>teract with <strong>the</strong>Cytochrome P-450 component <strong>of</strong> <strong>the</strong> enzymes.

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