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Cromoglicic acid
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| Systematic (IUPAC) name | |
| 5-(3-(6-carboxy-8-oxo-5,8-dihydronaphthalen-1-yloxy) -2-hydroxypropoxy)-4-oxo-4H-chromene-2-carboxylic acid |
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| Identifiers | |
| CAS number | |
| ATC code | R03 R01 A07 |
| PubChem | |
| DrugBank | |
| Chemical data | |
| Formula | C23H16O11 |
| Mol. mass | 468.367 g/mol |
| Pharmacokinetic data | |
| Bioavailability | 1% |
| Metabolism | ? |
| Half life | 1.3 hours |
| Excretion | ? |
| Therapeutic considerations | |
| Pregnancy cat. |
? |
| Legal status |
inhaler POM, eye OTC(UK) |
| Routes | topical: oral, nasal spray, inhaled, eye drops |
Cromoglicic acid (INN) (also referred to as cromolyn (USAN), cromoglycate (former BAN), or cromoglicate) is traditionally described as a mast cell stabilizer, and is commonly marketed as the sodium salt sodium cromoglicate or cromolyn sodium. This drug prevents the release of inflammatory chemicals such as histamine from mast cells.
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History
Cromolyn sodium, was discovered by Dr. Roger Altouynan who was himself a lifelong asthma sufferer. It is considered a breakthrough drug in management of asthma as the patients can be freed from steroids in many cases. Dr.Roger was investigating certain plants and herbs which have bronchodilating properties. One such plant was Khellin found in Egypt. Khellin was used as a muscle relaxant since ancient times in Egypt. Dr.Roger deliberately inhaled derivatives of khellin to determine if they could block his asthma attacks. After several years of trial he isolated an effective and safe asthma-preventing compound called cromolyn sodium.
Uses
It is available as a nasal spray (Rynacrom(UK), Nasalcrom, Prevalin (Netherlands)) to treat allergic rhinitis, as an inhaler (Intal) for preventive management of asthma, as eye drops (Opticrom and Optrex Allergy (UK), Crolom) for allergic conjunctivitis, or in an oral form (Gastrocrom) to treat mastocytosis, dermatographic urticaria and ulcerative colitis.
Sodium cromoglicate has also been shown to reduce symptoms of food allergies, including some cases of chronic migraines.citation needed
Mechanism of action
"Cromolyn works because it prevents the release of mediators that would normally attract inflammatory cells and because it stabilizes the inflammatory cells."[1] The underlying mechanism of action is not fully understood; for while cromoglicate stabilizes mast cells, this mechanism is probably not why it works in asthma.[2] Pharmaceutical companies have produced 20 related compounds that are equally or more potent at stabilising mast cells and none of them have shown any anti-asthmatic effect.[2] It is more likely that these work by inhibiting the response of sensory C fibres to the irritant capsaicin, inhibiting local axon reflexes involved in asthma, and may inhibit the release of preformed T cell cytokines and mediators involved in asthma. (see review by Garland, 1991)
Allergic reactions
Allegic reactions may include severe rash internally and externally.
It is known to somewhat inhibit chloride channels (37% +/- 7%) [3] and thus may inhibit the:
- exaggerated neuronal reflexes triggered by stimulation of irritant receptors on sensory nerve endings (e.g. exercise-induced asthma)
- release of preformed cytokines from several type of inflammatory cells (T cells, eosinophils) in allergen-induced asthma
Note: Another chemical (NPPB (5-nitro-2(3-phenyl) propylamino-benzoic acid)) was shown, in the same study, to be a more effective chloride channel blocker.
Finally it may act by inhibiting calcium influx.
Cromoglicate is classified as a chromone.
References
- ^ Werner's Pathophysiology page 224
- ^ a b H. P. Rang et al, Pharmacology, Fifth Edition. (2003) ISBN 0 443 07145 4
- ^ Heinke, S; Szucs G, Norris A, Droogmans G, Nilius B (August 1995). "Inhibition of volume-activated chloride currents in endothelial cells by chromones". Br J Pharmacol. 115(8): 1393–8. PMID 8564197.
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Wikipedia content modification information:
- This page was last modified on 16 September 2008, at 15:50.
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