Khanna Vivek, Arumugam Surendar, Roy Subhasis, Mittra Shivani, Bansal Vinay S
Ranbaxy Research Laboratories, Department of Pharmacology, New Drug Discovery Research, R&D III, Plot No. 20, Sector 18, Udyog Vihar Industrial Area, Gurgaon-122015, Haryana, India.
Expert Opin Ther Targets. 2008 Jan;12(1):81-90. doi: 10.1517/14728222.12.1.81.
Topiramate, a marketed antiepileptic drug, has been used to treat seizures and allied neurological problems since 1999. Recently, a series of newer findings for the use of topiramate have cropped up, which include Type 2 diabetes and obesity. In a series of clinical studies, a subset of neurological patients with Type 2 diabetes mellitus (T2DM) serendipitously showed better glycaemic control when treated with topiramate. It has since been demonstrated that topiramate can act both as an insulin secretagogue and sensitiser in T2DM animal models. Pathogenesis of Type 2 diabetes involves both beta-cell dysfunction and insulin resistance. Therefore, an agent that has dual action (insulin secretagougue and sensitisation) is preferred for T2DM. Topiramate seems to act through multiple mechanisms to ameliorate diabetic symptoms, some of them unknown. Hence, it becomes imperative to discuss its probable modes of action. Topiramate raises new hope as an antidiabetic agent or a potential new chemotype with a better safety profile for the treatment of T2DM.
托吡酯是一种已上市的抗癫痫药物，自1999年以来一直用于治疗癫痫发作及相关神经问题。最近，出现了一系列关于托吡酯用途的新发现，其中包括2型糖尿病和肥胖症。在一系列临床研究中，一部分患有2型糖尿病（T2DM）的神经科患者在接受托吡酯治疗时意外地显示出血糖控制情况有所改善。此后已证实，在T2DM动物模型中托吡酯既可以作为胰岛素促分泌剂，也可以作为胰岛素增敏剂发挥作用。2型糖尿病的发病机制涉及β细胞功能障碍和胰岛素抵抗。因此，对于T2DM而言，具有双重作用（胰岛素促分泌和增敏作用）的药物更为可取。托吡酯似乎通过多种机制来改善糖尿病症状，其中一些机制尚不清楚。因此，讨论其可能的作用方式变得至关重要。作为一种抗糖尿病药物或具有更好安全性的潜在新化学类型，托吡酯为T2DM的治疗带来了新希望。
