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Acarbose is a complex oligosaccharide isolated from actinomycetes culture fluid, it is the first-line oral hypoglycemic drug commonly used in clinical practice, mainly by combining with intestinal mucosal α-glucosidase, inhibiting the activity of the enzyme, reducing the degradation rate of carbohydrates such as starch, sucrose, lactose, maltose, dextrin and other carbohydrates in the food, thus delaying glucose absorption, and achieving the purpose of lowering postprandial glucose, and indirectly through the improvement of postprandial blood glucose Lower fasting blood sugar, reduce urinary glucose, in addition, acarbose can also reduce body weight, lower blood pressure and triglycerides, long-term use can reduce the risk of cardiovascular disease, suitable for patients with type 2 diabetes mellitus who take carbohydrates as the main food components or postprandial glucose increase.
Uses and functions of Acarbose.
Acarbose is an oligosaccharide that reversibly inhibits alpha-glucosidase activity on the brush border of the small intestinal mucosa, slowly reduces the rate of digestion of complex polysaccharides and sucrose, and subsequently retards glucose absorption, and is commonly used in the treatment of both insulin-dependent and non-insulin-dependent diabetes mellitus.
Physiological Effect of Acarbose.
Gastrointestinal dysfunction. Gastrointestinal flatulence such as bloating, diarrhoea and abdominal pain due to impaired breakdown and absorption of sugars in the small intestine and bacterial action on unabsorbed sugars in the colon. This product has been reported to cause hepatocellular liver injury. It is accompanied by jaundice and elevated aminotransferases, and is relieved by discontinuation of the drug. Allergic reactions, skin reactions are rare.
Side Effect of Bulk Acarbose.
Its biosynthetic pathway can be summarised in the following 3 processes:
1. Synthesis of aminocyclic alcohols: 7-P-heptulose (sedo-heptulose-7-phosphate) is gradually produced as NDP-1-epi-valienol-7-phosphate through a series of enzymatic reactions including intramolecular cyclisation, differential isomerisation, dehydrogenation, dehydration, phosphorylation, and nucleotidylation;
2. Synthesis of 4-amino-4,6-dideoxyglucose: D-1-phosphate glucose (D-glucose-1-phosphate) undergoes a series of enzymatic reactions including nucleotidylation, dehydration, and transamination to produce dTDP-4-amino-4,6-dideoxy-D-glucose (dTDP-4-amino-4,6-dideoxy-D-glucose);
3. Synthesis of acarbose: NDP-1-epi-valienol-7-phosphate and dTDP-4-amino-4,6-dideoxyglucose undergo a glycosyltransfer reaction under the action of glycosyltransferase to produce dTDP-acarvicose-7-phosphate, then dTDPacarvicose-7- phosphate then binds directly to the maltose molecule to produce acarbose-7-phosphate.
The synthesis of acarbose-7-phosphate is completed in the intracellular compartment of the bacterium, but for the final production of acarbose, it is necessary to further transport acarbose-7-phosphate to the extracellular compartment through the transmembrane of transporter proteins AcbWXY/GacWXY to undergo dephosphorylation to ultimately produce acarbose.
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