Human plasma-mediated hypoxic activation of indolequinone-based naloxone pro-drugs

Bioorg Med Chem Lett. 2009 Sep 1;19(17):5016-20. doi: 10.1016/j.bmcl.2009.07.061. Epub 2009 Jul 12.

Abstract

Hypoxia is known to occur in tissues in response to narcotic analgesic therapy using as a result of respiratory depression. The aim of this study was to synthesize a narcotic antagonist pro-drug that can be activated by tissue hypoxia to prevent the damage associated with respiratory depression. We synthesized three different pro-drugs of the narcotic antagonist naloxone utilizing indolequinone as the hypoxia-sensitive moiety. The indolequinone structure in the pro-drugs was designed to have an open reactive point at the N-1 position offering the possibility of further conjugation with macromolecules to modify the bio-availability of these pro-drugs in vivo. A pro-drug (labeled 1) where naloxone and the indolequinone moiety were linked through a carbonate bond was rapidly hydrolyzed in phosphate buffered saline. However, two additional pro-drugs (labeled 2 and 3) having carbamate linkers were stable in phosphate buffered saline for 24h. The reductive release of naloxone from the pro-drugs was achieved in the presence of the bio-reductive enzyme DT-Diaphorase, with about 80% release occurring from the two pro-drugs in 24h. More than 99% of naloxone was released from pro-drug 2 in 30% human plasma, however the release only occurred under hypoxic conditions. This system provides a potential means for feedback control to counter critical respiratory depression induced by narcotic analgesics.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Blood Cells / drug effects
  • Cell Hypoxia
  • Humans
  • Indolequinones / chemistry*
  • NAD(P)H Dehydrogenase (Quinone) / metabolism
  • Naloxone / analogs & derivatives*
  • Naloxone / chemical synthesis
  • Naloxone / pharmacology
  • Narcotic Antagonists / chemical synthesis*
  • Narcotic Antagonists / chemistry
  • Narcotic Antagonists / pharmacology
  • Prodrugs / chemical synthesis*
  • Prodrugs / chemistry
  • Prodrugs / pharmacology

Substances

  • Indolequinones
  • Narcotic Antagonists
  • Prodrugs
  • Naloxone
  • NAD(P)H Dehydrogenase (Quinone)
  • NQO1 protein, human