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Epalrestat is an inhibitor of aldose reductase (IC50s = 0.01 and 0.26 µM for rat lens and human placenta aldose reductase, respectively).1 It inhibits glucose-induced sorbitol accumulation in isolated rat lens, rat sciatic nerve, and human erythrocytes (IC50s = 1.5, 5, and 1.5 µM, respectively). It decreases high glucose-induced proliferation of vascular smooth muscle cells when used at a concentration of 10 nM and prevents high glucose-induced intracellular NADH/NAD+ increases and membrane-bound PKC activation at 100 nM.2,3 Epalrestat (20 and 40 mg/kg) improves motor nerve conduction velocity and decreases sorbitol content in the sciatic nerve and erythrocytes in a rat model of streptozotocin-induced diabetic neuropathy.4 It also prevents capillary strand formation in a rat model of diabetes-induced retinal microangiopathy when administered at a dose of 50 mg/kg.5
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1. Effects of a new aldose reductase inhibitor on various tissues in vitro. J. Pharmacol. Exp. Ther. 229(1), 226-230 (1984).
2. Aldose reductase inhibitor improves insulin-
3. Aldose reductase inhibitor prevents hyperproliferation and hypertrophy of cultured rat vascular smooth muscle cells induced by high glucose. Arterioscler. Thromb. Vasc. Biol. 15(12), 2207-2212 (1995).
4. Effect of a new aldose reductase inhibitor, (E)-
5. Experimentally induced diabetic retinal microangiopathy and polyol pathway. II. Effect of aldose reductase inhibitors on microangiopathy. Nippon Ganka Gakkai Zasshi 89(2), 247-256 (1985).