1. Secreted by one cell & acts upon adjacent cells or surrounding extracellular matrix [ECM] Secreted from a cell and acts on the same cell

2. Chemically they are classified into MONOAMINES Histamine Serotonin …etc PEPTIDES Contractants Angiotensin Endothelin NPY Vasopressin Relaxants Kinines ANP Tachykinins [SP] VIP ….etc EICOSANOIDS Prostaglandins Prostacyclines Thromboxane A 2 Leukotrienes …etc PURINES ATP / ADP Adenosine NO OTHERS Cytokines Chemokine Growth Factors ….etc.     

3. MONOAMINE (HISTAMINE )

4. Storage Sites Highest amounts in mast cells BasophilsSkinLung Intestinal mucosa StomachBrain

5. RELEASE

6. Storage and release:  Histamine is usually found in storage granules as complex with sulfated polysacharides, heparin and released (locally) by: a) immunologicl Mechanism (During Allergic Reaction (see Fig 56-5) b)Tissue injury Mast cell degranulation c) Chemical and physical Conditions ( see table 51-2)

8. Chemical and Physical Agents that Release Histamine Physical AgentsChemical Agents Mechanical trauma, Radiant energy, Thermal energy Chymotrypsin, Compound 48/80, Detergents, Dextran, DMSO (dimethyl- sulfoxide), Morphine and other Opiods, Pentamidine, Polymyxin B, Polyvinyl pyrrolidine, Propamidine, eserpine, Surface active agents, Stilbamidine, Toxins, Tubocurarine, venoms, X-ray contrast media

9. SYNTHESIS & INACTIVATIONTION

10. H 2 H 1 H 3 H istamine Mediator Neurotransmitter CNS ANS H 3 + + + H 1 -ve presynaptic autoregulation

11. Receptor Type Major Tissue Locations Major Biologic Effects H1H1 smooth muscle, endothelial cells acute allergic responses H2H2 gastric parietal cellssecretion of gastric acid H3H3 central nervous systemmodulating neurotransmission H4H4 mast cells, eosinophils, T cells regulating immune responses Histamine receptors

12. Histamine receptors antagonists What is the physiological Antagonist of Histamine?

13. First generation Diphenhydramin, Promethazine etc (Sedating and Pass Blood Brain Barriers) Clinical uses : Antinausia and Vomiting Insomnia Cough Motion sickness Allergy H 1 antagonists

14. Second generation. Loratadine Non-sedating Clinical uses Allergic conditions Allergic rhinitis Conjunctivitis Urticaria H 1 antagonists

15. Ranitidine Ranitidine Inhibitor of gastric acid secretion Used in the treatment of peptic ulcers H 2 antagonists

16. BETAHISTINE (Betaserc) Used in treatment of vertigo in middle ear H 3 antagonists

17. EICOSANOIDS (PROSTAGLANDINS)

19. INHIBITORS OF EICOSANOIDS

20. Phospholipids Phospholipase A 2 Arachidonic Acid Prostaglandins PGE2, PGD2, PGF2  Thromboxane (TXA2) Prostacyclin (PGI2) COX1 & COX2 Leukotrienes LTA4, B4, D4, C4 ( Zafirlukast Zafirlukast as Antagonist) Lipoxygenase Drugs NSAIDs Corticosteroids Zileuton

21. ACTIONS

22. Vascular smooth muscles: Potent vasoconstrictor. PGE 2 and PGI 2 Thromboxane A 2 Potent vasodilators.

23. Blood: PGE 2 and PGI 2 inhibit platelet aggregation TXA2 a potent inducer of platelet aggregation.

24.  One of the chemical mediators in inflammatory reactions. Inflammation:

25. -PGF 2  -LTs and thromboxane are potent bronchoconstrictors in man → allergic bronchospasm. Bronchial smooth muscle: - PGE 2 cause dilatation.

26. Uterine smooth muscle: PGE 2 and PGF 2  → Menstruation/ Dysmenorrhea/ Labor contractions

27. - PGE 2 and PGF 2  GIT smooth muscle:  GIT motility

28. GIT secretions: PGE 2, PGE 1 PGI 2 ↓ acid and pepsinogen secretion.  mucin, water and bicarbonate & Blood flow. Thus, it is cytoprotective

29. PGE2 and PGI2 increase renal blood flow and diuresis. Kideny

30. Central and peripheral nervous systems  Fever: PGE 1 and PGE 2 increase body temperature.

31. CLINICAL USES OF PGS ANALOGS

32. Carboprost PGF 2 α ( analog) 1)Abortifacient: Trigger abortion in first trimester.

33. 2) For postpartum haemorrhage vasoconstriction

34. (PGF 2 α analog ) eye drops in open angle glaucoma. ↓ IOP by enhancing outflow of the aqueous humar. Latanoprost

35. Alprostadil (PGE 1 analog) 1- Injected in corpus cavernosum of the penis for some forms of male impotence.

36. 2- In congenital heart anomalies to keep the patent ductus arteriosus until surgery.

37. Misoprostol  (PGE 1 analog) Peptic ulcer

38. Clinical Uses :  Oxytocis agents: (e.g.: Dinoprostone PGE2)  Asthma: Leukotrien antagonists (Zafirleukast; Montelukast); Zileuton  Impotance: Alprostadil PGE2  Glaucoma: Latanoprost PGF2  Anti-inflammatory and RA (NSAIDs)  Antiplatelet action (Aspirin)   Peptic Ulcer (Minoprostol PGE1)(Cytotec)

39. Thank you & Good Luck