Sandbox 45673

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Function

Disease

Relevance

Structural highlights

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Mechanism

Finasteride is a 5-alpha reductase inhibitor. There are two isoforms of the 5alpha-reductase enzyme, type I and II, and while the drug has a higher affinity for the type II enzyme, it also inhibits the function of the type I. (.....) Typically 5 alpha-redcutase turns testosterone into Dihydrotestosterone(DHT), but the enzyme will accept Finasteride as an alternate substrate; turning it into dihydrofinasteride through an enzyme bound, NADP-dihydrofinasteride adduct. Finasteride is similar in structure to testosterone and 5alpha-reductase has almost the same affinity for both molecules. However, Finasteride , having a high affinity for 5 alpha-reductase, covalently binds to the enzyme as a Michael acceptor, through a functionally irreversible reaction. However, the NADP-dihydrofinasteride complex breaks down with a half life of about 1 month at 37˚C., which is why patients must continue taking the drug.(.....) http://pubs.acs.org/doi/pdf/10.1021/ja953069t

Medical

Finasteride is used to shrink an enlarged prostate, also known as benign prostatic hyperplasia (BPH), in adult men. This medication works by inhibiting 5a-reductase, which prevents conversion of testosterone to the natural body hormone, dihydrosestosterone (DHT) that causes growth of the prostate. Finasteride is specific for type II isoenzymes, resulting in a decline in serum DHT levels by 65-70% and in prostate DHT levels by up to 80-90% (source).

Finasteride can also lead to improvements in Androgenetic alopecia, male pattern baldness (MPB), which is caused by an androgen-dependent miniaturization of scalp hair follicles. Testosterone is the major flow of androgen, but to be maximally active in scalp hair follicles it must be converted to dihydrotestosterone (DHT) by the enzyme 5a- reductase. DHT is an important factor in MPB by the absence of the condition in males with a insufficiency of type II 5a-reductase, and by small amounts of hair regrowth in men with MPB (Olsen, et al., 2006). Finasteride acts as an inhibitor for the type II 5a-reductase enzyme, which has shown to reduce both serum and scalp skin dihydrotestosterone levels in balding men (Leyden, et al., 1999). Side effects from Finasteride include but are not limited to, decreased sexual ability and desire.