Eritoran
 | |
| Clinical data | |
|---|---|
| Other names | E 5564 |
| Routes of administration | Intravenous injection |
| ATC code |
|
| Legal status | |
| Legal status |
|
| Identifiers | |
| |
| CAS Number |
|
| PubChem CID | |
| UNII | |
| ChEMBL | |
| CompTox Dashboard (EPA) | |
| Chemical and physical data | |
| Formula | C66H126N2O19P2 |
| Molar mass | 1313.656 g/mol g·mol−1 |
| 3D model (JSmol) | |
| |
| |
  (what is this?) (verify) | |
Eritoran is an investigational drug for the treatment of severe sepsis, an excessive inflammatory response to an infection. It is being developed by the Japanese pharmaceutical company Eisai Co. and administered intravenously as the sodium salt eritoran tetrasodium.[1][2]
In a phase III clinical trial,[3] eritoran did not perform better than existing treatments for the treatment of sepsis.[4][5]
Mechanism of action
Toll-like receptors (TLRs) play an important role in the innate immune system. They recognise microbes and activate inflammatory immune responses. Toll-like receptor 4 (TLR4) detects lipopolysaccharides found in most Gram-negative bacteria.[6]
Because of its similarity to the lipopolysaccharide lipid A, eritoran acts as TLR4 antagonist and so blocks the excessive reaction triggered by this receptor.[2][7]
 |
 |
Cytokine storm
While eritoran did not perform well in the treatment of sepsis, it was shown to combat another, related phenomenon called cytokine storm in influenza cases involving certain virus strains (involving preliminary experimentation on mice, not in other animals or humans, led by a University of Maryland School of Medicine researcher). A cytokine storm can help to cause sepsis and can in concert with it or by itself cause serious illness or death if not soon controlled. Mortality rates for sepsis, cytokine storm, and especially septic shock and organ dysfunction are still quite high despite progress made. This is in no small part due to the prevalence of nosocomial (hospital-acquired) infections, as well as ongoing mutations which confer multi-drug resistance in pathological microorganisms such as bacteria and viruses (many strains of flu are resistant to the first two drugs[clarification needed] and some are resistant to oseltamivir), and delays and mistakes in the recognition and treatment of disease.[8] New flu strains, such as the H7N9 strain, are always emerging.
References
- ^ "Eritoran: A Potential Therapeutic Agent In Severe Sepsis". MediNEWS.Direct. 17 October 2007. Retrieved 26 December 2009.
- ^ a b Kiemer, Alexandra K. (2008). "TLR eröffnen neue Möglichkeiten". Pharmazeutische Zeitung online (in German). Govi-Verlag. Retrieved 26 December 2009.
- ^ Clinical trial number NCT00334828 for "ACCESS: A Controlled Comparison of Eritoran Tetrasodium and Placebo in Patients With Severe Sepsis" at ClinicalTrials.gov
- ^ . doi:10.1001/jama.2013.2194.
{{cite journal}}: Cite journal requires|journal=(help); Missing or empty|title=(help) - ^ "Phase III Study for Eritoran Does Not Meet Primary Endpoint". drugs.com.
- ^ "Entrez Gene: TLR4 toll-like receptor 4".
- ^ Tidswell, M; Tillis, W; Larosa, SP; Lynn, M; Wittek, AE; Kao, R; Wheeler, J; Gogate, J; Opal, SM (2010). "Phase 2 trial of eritoran tetrasodium (E5564), a Toll-like receptor 4 antagonist, in patients with severe sepsis". Critical Care Medicine. 38 (1): 72–83. doi:10.1097/CCM.0b013e3181b07b78. PMID 19661804.
- ^ "New drug offers novel approach to taming flu virus". NBC News. 1 May 2013.