Update in glaucoma medicinal chemistry: emerging evidence for the importance of melatonin analogues.
Study Goal
The researchers aimed to review the potential of melatonin and its analogues as novel ocular hypotensive drugs for glaucoma treatment, focusing on their molecular targets and pharmacological characteristics.
Results Summary
Melatonin and its analogues effectively reduce intraocular pressure (IOP) in rabbits, monkeys, and humans, with indications of long-term hypotensive effects and neuroprotective benefits. Additionally, melatonin analogues may offer antidepressant and circadian rhythm normalization benefits for glaucoma patients.
Population
Rabbits, monkeys, and humans (glaucoma patients).
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
α(2)-adrenergic agonists, β(2)-adrenergic antagonists, carbonic anhydrase inhibitors and hypotensive lipids | decrease | intraocular pressure | glaucoma patients | - | IOP-lowering | #1 |
Melatonin and its analogues | decrease | IOP | rabbits, monkeys and humans | - | potently reduce | #2 |
melatoninergic substances | increase | neuroprotection | - | - | proven neuroprotective role | #3 |
melatonin analogues | improve | mood and circadian rhythm | glaucoma patients | - | antidepressant and normalizing circadian rhythm actions | #4 |
Glaucoma is a chronic progressive optic neuropathy, which can result in visual impairment and blindness. Elevated intraocular pressure (IOP) is currently the only modifiable risk factor. Several recent studies have shown the benefits of IOP reduction in open-angle glaucoma. Therefore, current glaucoma drugs are IOP-lowering substances such as α(2)-adrenergic agonists, β(2)-adrenergic antagonists, carbonic anhydrase inhibitors and hypotensive lipids, which are used separately or in combination. In spite of the wide variety of antiglaucoma medicines, all therapies have several undesirable side effects. As a consequence, there are constant research attempts on the discovery of novel ocular hypotensive drugs. In the current paper, we review the latest available patents and literature for the pharmacological treatment of glaucoma, focusing on their molecular targets and/or their chemical characteristics and especially directed to melatoninergic drugs. Melatonin is a hormone secreted into the blood mainly from the pineal gland allowing the entrainment of the circadian rhythms of several biological functions. Melatonin and its analogues potently reduce IOP in rabbits, monkeys and humans. In addition, there are indications of long-term hypotensive effects and a proven neuroprotective role of melatoninergic substances. Furthermore, antidepressant and normalizing circadian rhythm actions of melatonin analogues might be beneficial for glaucoma patients. All the above mentioned facts suggest these agents as proper candidates for the glaucoma treatment. Consequently, the scientific research has given new and significant progress on the development of new, potent and selective melatonin ligands.