Prostaglandin F receptor

The FP receptor is the least selective of the prostenoid receptors in that it is responsive to PGD2 and to a lesser extent PGE2 at concentrations close to those of PGF_2α. Standard prostanoids have the following relative efficacies as receptor ligands in binding to and activating FP: PGF_2α>PGD2>PGE2>PGI2=TXA2. In typical binding studies, PGF_2α has one-half maximal binding and cell stimulating actions at ~1 nanomolar whereas PGD2 and PGE2 are ~5- to 10-fold and 10-100-fold weaker than this. The synthetic analogs that like PGF_2α act as selective receptor agonists of FP viz., cloprostenol, flupostenol, latanoprost, and tafluprost (acid form) have FP binding affinities and stimulating potencies similar to PGF_2α while others as enprostil, sulprostone, U46619, carbacyclin, and iloprost are considerably weaker FP agonists. Fluprostenol is a widely used clinically as a selective FP receptor agonist; latanoprost is a suitable substitute.[9]

Currently, there are no selective receptor antagonists for FP.[9]

Animal and human studies have found that the stimulation of FP receptors located on Ciliary muscle and trabecular meshwork cells of the eye widens the drainage channels (termed the uveoscleral pathway) that they form. This increases the outflow of aqueous humor from the anterior chamber of the eye through Schlemm's canal to outside of the eyeball. The increase in aqueous humor outflow triggered by FP receptor activation reduces Intraocular pressure and underlies the widespread usage of FP receptor agonists to treat glaucoma. László Z. Bitó is credited with making critical studies to define this intraocular pressure-relieving pathway.[12] Three FP receptor agonists are approved for clinical use in the USA viz., travoprost, latanoprost, and bimatoprost, and two additional agonists are prescribed in Europe and Asia viz., unoprostone and tafluprost.[13]

Since FP receptors are expresses in human dermal papillae and the use of FP agonists to treat glaucoma has as a side-effect an increase in eyelash growth, it has been suggested that FP agonists may be useful for treating baldness. This is supported by studies in the stump-tailed Macaque primate model of androgen-induced scalp alopecia which have found that the FP agonist, latanoprost, promotes scalp hair growth. These studies have not yet been translated into baldness therapy in humans.[12]

FP receptor activation contributes to the regression of the corpus luteum and thereby the estrus cycle in many species of farm animals. However, it does not make these contributions in mice and its contribution to these functions in humans is controversial. The receptor has been in use as a target for decades to regulate the estrus cycle as well as to induce labor in pregnant farm animals[14][15] FP gene knockout in female mice blocks parturition. That is, these FP-/- mice fail to enter labor even if induced by oxytocin due to a failure in copus luteum regression and consequential failure to stop secreting progesterone (declining progesterone levels trigger labor).[14][15][16] Studies with monkey and human tissues allow that FP receptors may have a similar function in humans.[10]

One side effect of applying FP receptor agonists to eyelashes in humans is the development of hyperpigmentation at nearby skin sites. Follow-up studies of this side effect indicated than human skin pigment-forming melanocyte cells express FP receptors and respond to FP receptor agonists by increasing their dendricites (projections to other cells) as well as to increase their tyrosinase activity. Since skin melanocytes use their dendrites to transfer the skin pigment melanin to skin keratinocytes thereby darkening skin and since tyrosinase is the rate-limiting enzyme in the synthesis of melanin, these studies suggest that FP receptor activation may be a useful means to increase skin pigmentation.[17]

PGF_2α triggers the NFATC2 pathway stimulating skeletal muscle cell growth.[18] PGF_2α, shown or presumed to operate by activating FP receptors, has complex effects on bone osteoclasts and osteoblasts to regulate Bone remodeling. However, further studies on the impact of the PGF_2α-FP axis on bone are needed to better understand the pathophysiology underlying bone turnover and to identify this axis as a novel pharmacological target for the treatment of bone disorders and diseases.[12][19]

Unlike other prostaglandin receptors which have been shown in numerous studies to contribute to inflammatory and allergic responses in animal models, there are few studies on the function of FP receptors in these responses. Gene knockout studies in mice clearly show that FP mediates the late phase (thromboxane receptor mediates the early phase) of the tachycardia response to the pro-inflammatory agent, lipopolysaccharide.[16][20] PTGFR knockout mice also show a reduction in the development of pulmonary fibrosis normally caused by microbial invasion or bleomycin treatment. Finally, administration of PGF_2α to mice causes an acute inflammatory response and elevated biosynthesis of PGF_2α has been found in the tissues of patients with rheumatoid arthritis, psoriatic arthritis, and other forms of arthritis. While much further work is needed, these studies indicate that PGF_2α-FP axis has some pro-inflammatory and anti-inflammatory effects in animals that may translate to humans.[7] The axis may likewise play role in human allergic responses: PGF_2α causes airway constriction in normal and asthmatic humans and its presence in human sputum is related to sputum eosinophil levels.[21]

PGF_2α simulates an increase in systolic blood pressure in wild type but not FP(−/−) mice. Furthermore, FP(-/-) mice have significantly lower blood pressure, lower plasma renin levels, and lower plasma angiotensin-1 levels than wild-type mice, and FP agonists have a negative inotropic effect to weaken the strength of heart beating in rats. Finally, FP(−/−) mice deficient in the LDL receptor exhibit significantly less atherosclerosis than FP(+/+) LDL receptor-deficient mice. Activation of FP thus has pathophysiological consequences for the cardiovascular system relative to blood pressure, cardiac function, and atherosclerosis in animal models. The mechanism behind these FP effects and their relevancy to humans have not been elucidated.[12]

FP receptor agonists, specifically latanoprost, travoprost, bimatoprost, and tafluprost, are currently used as first-line drugs to treat glaucoma and other causes of intra-ocular hypertension (see Glaucoma#Medication).[22]

The FP receptor agonist, bimatoprost, in the form of an 0.03% ophthalmic solution termed Latisse, is approved by the US Food and Drug Administration to treat hypotrichosis of the eyelashes, in particular to darken and lengthen eyelashes for cosmetic purposes. Eyelid hypotrichosis caused by[17]

FP receptor agonists are used as highly effective agents to synchronize the oestrus cycles of farm animals and thereby to facilitate animal husbandry.[23]

Eyelash hypotrichosis due to the autoimmune disease, Alopecia areata, or to chemotherapy have been successfully treated with FP agonists in small Translational research studies. In a randomized, double-blind, placebo-controlled pilot study of 16 men with male pattern baldness (also termed androgenetic alopecia) topical application of the FP agonist, latanoprost, for 24 weeks produced a significant increase in scalp hair density. Despite these findings, however, a case report of one woman with female pattern hair loss found that injection of FP agonist bimatoprost failed to influence hair growth.[17]

In preliminary studies, 3 Korean patients with periorbital vitiligo (i.e. skin blanching) were treated topically with the FP receptor agonist, latanoprost, for two months; the three patients experienced 20%, 50%, and >90% re-pigmentation of their vitiligo lesions. Fourteen patients with hypopigmented in their scarreed tissues were treated with the FP receptor agonist, bimatoprost, applied topically plus laser therapy and topical tretinoin or pimecrolimus. Most patients demonstrated significant improvement in their hypopigmentation, but the isolated effect of topical bimatoprost was not evaluated. These studies allow that FP receptor agonists may be useful for treating hypopigmentation such as occurs in scar tissue as well as diseases like vitiligo, tinea versicolor, and pityriasis alba.[17]

The single-nucleotide polymorphism (SNP) A/G variant, rs12731181, located in the Three prime untranslated region of PTGFR has been associated with increased risk for hypertension in individuals from southern Germany; while this association was not replicated in other European populations, it was found in a Korean population. This SNP variant reduces the binging of MicroRNA miR-590-3p to PTGFR; since this binding represses translation of this gene, the rs127231181 variant acts to increase expression of the FP receptor.[8] PTGFR SNP variants rs6686438 and rs10786455s were associated with positive and SNP variants rs3753380, rs6672484, and rs11578155 in PTGFR were associated with negative responses to latanoprost for the treatment of Open-Angle Glaucoma in a Spanish population.[24] PTGFR SNP variants rs3753380 and rs3766355 were associated with a reduce response to latanoprost in a Chinese population study.[25]