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PPARalpha and PPARgamma dual agonists for the treatment of type 2 diabetes and the metabolic syndrome.

Abstract
The discovery of the crucial role of peroxisome proliferator-activated receptors (PPARs) as regulators of lipid and glucose metabolism has raised interest in the development of synthetic ligands as potential tools for therapeutic intervention in type 2 diabetes and the metabolic syndrome. PPARalpha activators primarily improve dyslipidemia, whereas thiazolidinediones are potent PPARgamma activators that improve insulin resistance. Important research programs to develop agonists that combine the therapeutic effects of both PPARalpha- and PPARgamma-selective agonists, creating the expectation of greater efficacy and other advantages in the treatment of type 2 diabetes and the metabolic syndrome, have therefore been undertaken. Among these dual PPARalpha/gamma agonists, compounds that belong to the glitazar class are in the most advanced stage of development. However, although they demonstrated beneficial impact over selective PPAR agonists by improving both lipid and glucose homeostasis, safety has been a critical issue and has led to the discontinuation of their development because of adverse toxicity profiles. However, the target-related mechanism responsible for the identified safety issues and the relevance of rodent toxicities to the human situation are unclear. Therefore, future development of dual PPARalpha/gamma agonists with selective PPAR modulator activity appears appropriate and should be feasible.
AuthorsCatherine Fiévet, Jean-Charles Fruchart, Bart Staels
JournalCurrent opinion in pharmacology (Curr Opin Pharmacol) Vol. 6 Issue 6 Pg. 606-14 (Dec 2006) ISSN: 1471-4892 [Print] England
PMID16973418 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
Chemical References
  • Alkanesulfonates
  • Oxazoles
  • PPAR alpha
  • PPAR gamma
  • Phenylpropionates
  • tesaglitazar
  • Glycine
  • muraglitazar
Topics
  • Alkanesulfonates (pharmacology, therapeutic use)
  • Animals
  • Diabetes Mellitus, Type 2 (drug therapy)
  • Glycine (analogs & derivatives, pharmacology, therapeutic use)
  • Humans
  • Metabolic Syndrome (drug therapy)
  • Models, Biological
  • Oxazoles (pharmacology, therapeutic use)
  • PPAR alpha (agonists)
  • PPAR gamma (agonists)
  • Phenylpropionates (pharmacology, therapeutic use)

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