The primary function of CYP46 inhibitors is to impede the activity of Cytochrome P450 46A1, an enzyme crucial for cholesterol metabolism. By inhibiting CYP46, these chemicals can significantly impact cholesterol turnover and homeostasis within the central nervous system. The mechanism of action of CYP46 inhibitors involves the interaction with the active site of the enzyme, thereby hindering its ability to convert cholesterol into 24-hydroxycholesterol. This conversion is essential for the regulation and maintenance of cholesterol levels in the brain, a process vital for normal neuronal function and integrity. The inhibition of CYP46 can have significant implications, particularly in neurological conditions where cholesterol metabolism is disrupted or plays a pathological role.
Among the listed inhibitors, several are antifungal agents such as Ketoconazole, Fluconazole, and Itraconazole. These compounds are primarily known for their ability to interfere with the synthesis of ergosterol, a key component of fungal cell membranes. However, their inhibitory effect on CYP46 reveals a secondary pharmacological action, extending their potential impact beyond antifungal activity. In addition to antifungals, several anticancer agents like Erlotinib, Gefitinib, and Imatinib are also noted for their CYP46 inhibitory effects. Originally designed to target specific cancer-driving kinases, these drugs inadvertently affect cholesterol metabolism.
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