The Role of Bradykinin Receptors in the Etiopathogenesis of Chronic Spontaneous Urticaria

Background and Objectives: Chronic spontaneous urticaria (CSU) is a distressing skin condition, which manifests as red, swollen, itchy, and sometimes painful hives or wheals appearing on skin. Recently, CSU has been associated with bradykinin release, which was previously discovered to be the main trigger of hereditary angioedema attacks. To study the role of bradykinin receptors 1 (BR1) and 2 (BR2) in the etiopathogenesis of CSU. Materials and Methods: A total of 60 individuals, 30 patients with CSU and 30 healthy subjects, were recruited to the study. CSU was diagnosed in accordance with the standardized protocol of dermatological assessment of skin symptoms. The level of bradykinin receptors was determined in populations of CD3+, CD4+, and CD8+ lymphocytes as well as in CD14++CD16−, CD14++CD16+ and CD14+CD16+ monocytes. In addition, urticaria activity score summed over 7 days (UAS-7) was assessed and correlated with BR1 and BR2 expression. Results: A statistically significant higher concentration of BR1 expression in lymphocytes was found in patients with CSU, compared to the control group (p < 0.001). Moreover, a statistically significant positive correlation was observed between UAS-7 and BR1/BR2 expression in CD14++CD16− cells (p = 0.03, R = 0.4). Conclusions: Bradykinin receptors are elevated in selected populations of lymphocytes in symptomatic CSU patients compared to healthy controls, indicating their role in the etiopathogenesis of the disease.

Bradykinin receptors in GtoPdb v.2021.3

Bradykinin (or kinin) receptors (nomenclature as agreed by the NC-IUPHAR subcommittee on Bradykinin (kinin) Receptors [91]) are activated by the endogenous peptides bradykinin (BK), [des-Arg9]bradykinin, Lys-BK (kallidin), [des-Arg10]kallidin, [Phospho-Ser6]-Bradykinin, T-kinin (Ile-Ser-BK), [Hyp3]bradykinin and Lys-[Hyp3]-bradykinin. Variation in pharmacology and activity of B1 and B2 receptor antagonists at species orthologs has been documented. icatibant (Hoe140, Firazir) is approved in North America and Europe for the treatment of acute attacks of hereditary angioedema.

Effect of ACEI and ARB treatment on nitric oxide-dependent endothelial function

Summary: Background: Angiotensin-converting-enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB) are widely used as a first-line therapy for the treatment of cardiovascular disease. Here, ACEI modulate the bradykinin receptor (BDKRB1 and BDKRB2) system and NO-dependent endothelial function, thus determining cardiovascular health and regenerative arteriogenesis. The current study aims at evaluating nitric oxide-dependent endothelial function, and gene expression of bradykinin receptors in peripheral blood mononuclear cells (PBMC) from patients with ACEI or ARB treatment. Patients and methods: The WalkByLab has been established to screen cardiovascular patients for peripheral artery disease and coronary artery disease. In total 177 patients from WalkByLab with heterogenous disease and risk status were randomly selected, divided according to their medication history into the following groups: 1. ACEI group, 2. ARB group or 3. non-ACE/ARB group. Total plasma nitrite/nitrate (NO) levels were measured, endothelial function was evaluated by assessing flow meditated dilation (FMD). PBMC were isolated from peripheral whole blood, and gene expression (qRT-PCR) of bradykinin receptors and angiotensin converting enzyme were assessed. Results: Plasma total NO concentration in the ACEI group (24.66±16.28, µmol/l) was increased as compared to the ARB group (18.57±11.58, µmol/l, P=0.0046) and non-ACE/ARB group (16.83±8.64, µmol/l, P=0.0127) in patients between 40 to 90 years of age. However, FMD values (%) in the ACEI group (7.07±2.40, %) were similar as compared to the ARB (6.35±2.13, %) and non-ACE/ARB group (6.51±2.15, %), but significantly negatively correlated with age. Interestingly, BDKRB1 mRNA level was significantly higher and BDKRB2 mRNA level lower in the ACEI group (BDKRB1 3.88-fold±1.05, BDKRB2 0.22-fold±0.04) as compared to the non-ACE/ARB group (BDKRB1 1.00-fold±0.39, P<0.0001, BDKRB2 1.00-fold±0.45, P=0.0136). Conclusions: ACEI treatment enhances total nitrite/nitrate concentration, furthermore, upregulates BDKRB1 in PBMC, but downregulates BDKRB2 mRNA expression. FMD is a strong determinant of vascular aging and is sensitive to underlying heterogenous cardiovascular diseases.

Discovery of a Bradykinin B2 Partial Agonist Profile of Raloxifene in a Drug Repurposing Campaign

Covid-19 urges a deeper understanding of the underlying molecular mechanisms involved in illness progression to provide a prompt therapeutical response with an adequate use of available drugs, including drug repurposing. Recently, it was suggested that a dysregulated bradykinin signaling can trigger the cytokine storm observed in patients with severe Covid-19. In the scope of a drug repurposing campaign undertaken to identify bradykinin antagonists, raloxifene was identified as prospective compound in a virtual screening process. The pharmacodynamics profile of raloxifene towards bradykinin receptors is reported in the present work, showing a weak selective partial agonist profile at the B2 receptor. In view of this new profile, its possible use as a therapeutical agent for the treatment of severe Covid-19 is discussed.

Molecular Features of Non-Selective Small Molecule Antagonists of the Bradykinin Receptors

Angiotensin converting enzyme 2 (ACE2) downregulation is a key negative factor for the severity of lung edema and acute lung failure observed in patients infected with SARS-CoV-2. ACE2 downregulation affects the levels of diverse peptide mediators of the renin-agiotensin-aldestosterone and kallikrein-kinin systems, compromising vascular hemostasis. Increasing evidence suggests that the inflammatory response observed in covid-19 patients is initiated by the action of kinins on the bradykinin receptors. Accordingly, the use of bradykinin antagonists should be considered as a strategy for therapeutic intervention against covid-19 illness progression. Presently, icatibant is the only bradykinin antagonist drug approved. In the present report, we investigated the molecular features characterizing non-selective antagonists targeting the bradykinin receptors and carried out a in silico screening of approved drugs, aimed at the identification of compounds with a non-selective bradykinin antagonist profile that can be evaluated for drug repurposing. The study permitted to identify eight compounds as prospective non-selective antagonists of the bradykinin receptors, including raloxifene; sildenafil; cefepime; cefpirome; imatinib; ponatinib; abemaciclib and entrectinib.

Participation of bradykinin, cannabinoid, and vanilloid receptors in the infarct-limiting effect of adaptation to normobaric hypoxia

Известно, что при хронической умеренной гипоксии формируется неспецифическая резистентность миокарда к повреждению при ишемии и следующей за ней реперфузии. Однако рецепторные механизмы формирования подобной устойчивости исследованы недостаточно. Цель исследования - изучение участия брадикининовых, каннабиноидных и ванилоидных рецепторов (TRPV1-каналов) в реализации инфаркт-лимитирующего эффекта хронической нормобарической гипоксии. Методика. Исследование выполнено на самцах крыс Вистар адаптированных к гипоксии, для чего животных подвергали непрерывной нормобарической гипоксии (ННГ) в течение 21 сут при 12% pO2, 0,3% pCO2. У крыс воспроизводили коронароокклюзию наложением лигатуры на левую нисходящую коронарную артерию в ее верхней трети на 45 мин. Реперфузию осуществляли путем освобождения лигатуры с визуальным контролем возобновления коронарного кровообращения по гиперемии ишемизированной области. Продолжительность реперфузии 2 ч. Для выявления зоны риска лигатуру вновь затягивали и в аорту вводили 5%-й раствор перманганата калия. Участок миокарда, не подвергшийся ишемии, окрашивался, неокрашенный участок являлся зоной риска. Срезы левого желудочка толщиной 2 мм окрашивали 1% раствором 2,3,5-трифенилтетразолия (37 °С, 30 мин). Размер зоны некроза и зоны риска определяли планиметрически с помощью программы Ellipse 2.02 (ViDiTo, Чешская республика). Для ингибирования каннабиноидных СВ1-рецепторов и СВ2-рецепторов использовали соответственно их селективные антагонисты римонабант (1 мг/кг) и AM630 (2,5 мг/кг); селективный антагонист HOE140 (50 мкг/кг) применяли для инактивации брадикининовых B2-рецепторов, капсазепин (3 мг/кг) - ванилоидных рецепторов (TRPV1-каналов). Все антагонисты вводили за 15 мин до коронароокклюзии. Результаты. Показано, что размер некротического повреждения миокарда у крыс адаптированных к гипоксии составляет 33% процента от размера зоны риска (53% у неадаптированных), что свидетельствует о выраженном инфаркт-лимитирующем эффекте. Этот эффект не проявлялся при ингибировании B2-брадикинировых рецепторов. Блокада каннабиноидных или ванилоидных рецепторов не влияла на инфаркт-лимитирующее действие ННГ. Следовательно, инфаркт-лимитирующий эффект ННГ зависит от активации брадикининовых B2-рецепторов, адаптационное повышение толерантности сердца к ишемии/реперфузии не зависит от каннабиноидных или ванилоидных рецепторов. Заключение. Брадикининовые рецепторы можно рассматривать в качестве одного из ключевых механизмов формирования инфаркт-лимитирующего действия ННГ. Учитывая данные о важной роли опиоидных рецепторов в кардиопротекции при ННГ, можно говорить о реализации инфаркт-лимитирующего эффекта хронической гипоксии через Gi/o-протеин-сопряженные опиоидные и брадикининовые рецепторы. Каннабиноидные рецепторы и TRPV1-каналы не участвуют в инфаркт-лимитирующем действии адаптации к нормобарической гипоксии. Aim. Chronic moderate hypoxia is known to induce nonspecific myocardial resistance to ischemia-reperfusion injury. However, receptor-mediated mechanisms of this resistance are understudied. The aim of this study was to investigate the involvement of bradykinin, cannabinoid, and vanilloid (TRPV1 channel) receptors in development of the infarction-limiting effect of chronic normobaric hypoxia (CNH). Methods. The study was performed on male Wistar rats exposed to CNH at 12% pO2 and 0.3% pCO2 for 21 days. Coronary occlusion was induced by ligation of the left descending coronary artery at the upper third of the artery for 45 min, which was followed by 2-h reperfusion produced by releasing the ligature under visual control of the recovery of coronary blood flow by hyperemia of the ischemic area. For detection of the area at risk, the ligature was tightened again, and 5% potassium permanganate solution was infused into the aorta to stain the nonischemic myocardial area. 2-mm sections of the left ventricle were stained with 1% solution of 2,3,4-triphenyl tetrazolium (37 oC, 30 min). Necrotic area and area at risk were measured planimetrically with the tEllipse 2.02 (ViDiTo, Czech Republic) software. Cannabinoid CB1 and CB2 receptors were inhibited with their respective antagonists, rimonabant (1 mg/kg) and AM630 (2.5 mg/kg); bradykinin B2 receptors were inactivated with the selective antagonist HOE140 (50 μg/kg); and vanilloid receptors (TRPV1 channels) were inhibited with capsazepine (3 mg/kg). All antagonists were administered 15 minutes prior to coronary occlusion. Results. The size of necrotic area was 33% of the area at risk in rats adapted to hypoxia vs. 53% in non-adapted rats. This infarct-limiting effect of adaptation to hypoxia was abolished by inhibition of B2-bradykinin receptors. Blockade of cannabinoid or vanilloid receptors did not change the infarct-limiting effect of CNH. Therefore, the infarction-limiting effect of CNH depends on activation of bradykinin B2 receptors but not of cannabinoid or vanilloid receptors. Conclusion. Activation of bradykinin receptors can be considered a key mechanism of the infarct-limiting effect of CNH. Since opioid receptors are known to play an important role in CNH cardioprotection, the infarct-limiting effect of CNH may be mediated by Gi/o-coupled opioid and bradykinin receptors. Cannabinoid receptors and TRV1-channels do not contribute to the infarct-limiting effect of adaptation to normobaric hypoxia.