حمض الكروموگليسيك

حمض الكروموگليسيك

البيانات السريرية
فئة السلامة أثناء الحمل	B
مسارات الدواء	topical: oral, nasal spray, inhaled, eye drops
رمز ATC	A07EB01 (WHO) D11AH03 R01AC01 R03BC01 S01GX01
الحالة القانونية
الحالة القانونية	inhaler POM, eye OTC(UK)
بيانات الحركية الدوائية
التوافر الحيوي	1%
Elimination half-life	1.3 hours
المعرفات
IUPAC name 5,5′-(2-hydroxypropane-1,3-diyl)bis(oxy)bis(4-oxo-4H-chromene-2-carboxylic acid)
رقم CAS	16110-51-3
PubChem CID	2882
DrugBank	APRD00336
ChemSpider	2779
CompTox Dashboard (EPA)	DTXSID4022860
ECHA InfoCard	100.036.602
Chemical and physical data
التركيب	C23H16O11
الكتلة المولية	468.367 g/mol
3D model (JSmol)	Interactive image
SMILES O=C(O)C=4Oc3cccc(OCC(O)COc2cccc1O/C(=C\C(=O)c12)C(=O)O)c3C(=O)C=4
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حمض كرموغليسيك Cromoglicic acid(حسب التسمية الدولية غير المملوكة INN) ويسمى كرمولين cromolyn (حسب الأسماء المعتمدة في الولايات المتحدة USAN) وسابقاً cromoglycate (الاسم البريطاني المعتمد BAN) يوصف عادة كمثبط للخلايا البدينة mast cell stabilizer ويسوق كملح صوديوم ، ويمنع هذا الدواء تحرر الوسائط الإلتهابية كالهيستامين histamine من الخلايا البدينة.

. This drug prevents the release of inflammatory chemicals such as histamine from mast cells.

Because of their convenience (and perceived safety), leukotriene receptor antagonists have largely replaced it as the non-corticosteroid treatment of choice. Cromoglicic acid requires administration four times daily, and does not provide additive benefit in combination with inhaled corticosteroids.

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 التاريخ

Cromolyn sodium was discovered by Dr. Roger Altounyan 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, however, it is mainly effective as a prophylaxis for allergic and exercise induced asthma, not as a treatment for acute attacks. Dr. Altounyan was investigating certain plants and herbs which have bronchodilating properties. One such plant was Khella (Ammi visnaga) which had been used as a muscle relaxant since ancient times in Egypt. Dr. Altounyan deliberately inhaled derivatives of the active ingredient 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.

 التحضير

Cromoglicic acid is available in multiple forms:

• as a nasal spray (Rynacrom(UK), Nasalcrom, Prevalin (Netherlands)) to treat allergic rhinitis.

• in a nebulizer solution for aerosol administration to treat asthma.

• as an inhaler (Intal) for preventive management of asthma. The maker of Intal, King Pharmaceuticals, has discontinued manufacturing the inhaled form, cromolyn sodium inhalation aerosol, due to issues involving CFC-free propellant. As stocks are depleted, this inhaler preparation will no longer be available to patients.

• as eye drops (Opticrom and Optrex Allergy (UK), Crolom) for allergic conjunctivitis

• in an oral form (Gastrocrom) to treat mastocytosis, dermatographic urticaria and ulcerative colitis. Another oral product, Intercron (sodium cromoglicate in distilled water, from Zambon France), is used for food allergies.

 ميكانيكا التفاعل

"Cromolyn works because it prevents the release of mediators that would normally attract inflammatory cells and because it stabilizes the inflammatory cells." 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. 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. 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)

It is known to somewhat inhibit chloride channels (37% +/- 7%) 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.