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What is Inhibitors & Agonists?
An enzyme inhibitor is a molecule that binds to an enzyme and blocks its activity. Enzymes are proteins that speed up chemical reactions necessary for life, in which substrate molecules are converted into products.
An agonist is a substance that binds to a receptor and causes a response, similar to the response that would be caused by the substance that normally binds to the receptor. Agonists can be endogenous molecules, such as neurotransmitters, or exogenous molecules, such as drugs.
How Effective Are Both Agonist And Inhibitor?
Both agonists and inhibitors play significant roles in the world of pharmacology, acting on various biological receptors to elicit or block certain responses. Agonists are substances that bind to specific receptors and trigger a response in the cell. They mimic the action of naturally occurring substances and enhance their effects, such as morphine mimicking endorphins to provide pain relief.
On the other hand, inhibitors disrupt normal interactions between molecules, often by attaching themselves to proteins or enzymes and reducing or preventing their regular function. An example is beta-blockers (inhibitors) which attach themselves to beta-receptors on heart cells, inhibiting adrenaline from binding there - hence slowing heart rate.
The effectiveness of both agonists and inhibitors have been studied extensively across different fields of medicine for many years; these two classes of drugs exhibit efficacy in managing symptoms across a wide range of conditions depending upon where they act within the body's systems. A 1999 study compared opioid agonist methadone with antagonist naltrexone showing that methadone (agonist) was more effective at retaining patients in treatment and suppressing heroin use.
A 2005 review highlighted that ACE Inhibitors are considered first-line therapy for chronic heart failure due to their proven benefits including reduction in mortality rates among those with symptomatic left ventricular dysfunction.
Agonists might be chosen over inhibitors under circumstances where enhancing bodily functions would be beneficial such as Parkinson’s Disease where dopamine agonists help replenish low levels of dopamine. On contrast, an inhibitor may be prescribed when it is necessary to reduce overactivity like proton pump inhibitors used for acid reflux disease.
Types of Agonists




Endogenous and Exogenous Agonists
Endogenous agonists constitute internal factors which induce a biological response. Some examples of endogenous agonists include hormones and neurotransmitters, which bind to defined receptors and induce a desired response. In contrast, exogenous agonists are external factors which bind to various receptors and induce a biological response. An example of an exogenous agonist is a drug, such as synthetic dopamine, which binds to the dopamine receptor and elicits a response analogous to endogenous dopamine signaling.
Physiological Agonists
Physiological agonists are agonists which can induce the same biological response; however, they do not bind to the same receptor. An example of this type of agonist is the activation of NF-kappa B by both cytokines (Interleukin [IL]-6, IL-1, and tumor necrosis factor) and environmental stimuli (e.g., bacterial lipopolysaccharides) via signaling through the associated cytokine receptors and pathogen recognition receptors, respectively.
Superagonists
A superagonist is an agonist capable of eliciting a biological response that is greater than the effect generated when the endogenous agonist binds to the receptor. The most common form of superagonists are drugs. For example, TGN1412 is a superagonist of CD28, resulting in the polyclonal activation of T cells and is associated with the risk of pathogenic cytokine production if used at a high dose.
Full versus Partial Agonists
Full agonists are able to fully bind to and activate their cognate receptor, thereby inducing the complete response capable of that receptor. In contrast, partial agonists also bind to the cognate receptor; however, they only induce a partial response. Partial agonists are useful for the treatment and avoidance of drug dependencies, as they induce a similar effect, albeit less potent and addictive. An example is the use of buprenorphine as an alternative for opiates (e.g., morphine) as it only partially engages the opioid receptor, thus reducing the likelihood of opiate addiction.
Inverse Agonists
An inverse agonist binds to the same receptor as an agonist; however, it exerts the opposite biological response of an agonist. An inverse agonist differs from an antagonist in that rather than simply inhibiting the response of the agonist, the opposing response is induced.
Irreversible Agonists
Irreversible agonists are agonists that form a permanent association with a receptor via the formation of covalent bonds. Some of the most well-characterized irreversible agonists are μ-opioid receptor agonists, such as naloxazone and oxymorphazone.
Selective Agonists
Selective agonists are specific to a particular receptor. For example, IFN-gamma is a selective agonist of the IFN-gamma receptor.
Co-agonists
A co-agonist requires the combination of two or more agonists to elicit a particular biological response. For example, the activation of infected macrophages to produce nitric oxide is dependent on the binding of bacterial ligands, IFN-gamma, and TNF, to their respective receptors.

Agonists are drugs that activate specific receptors in the brain, leading to a therapeutic response. The dosage of an agonist varies widely depending on the specific drug and individual patient factors. On the other hand, inhibitors work by blocking or slowing down certain processes within the body. Similarly to agonists, their dosages can also vary greatly depending on numerous aspects such as the type of inhibitor and patient's condition. As with all medications, it is important to begin at a lower dose which can be adjusted upwards if necessary under medical supervision. In any case, exceeding maximum recommended dosages for both agonists and inhibitors should be strictly avoided.
Inhibitor treatment typically starts at a moderate dosage, which can be carefully adjusted based on the individual's response to the medication. The dose may then be increased incrementally over time, usually divided into two doses taken 8 hours apart. The maximum dosage varies depending on the specific inhibitor and patient needs but is generally administered in three evenly spaced doses throughout the day. If there is no noticeable improvement in symptoms after several weeks on this regimen, your healthcare provider might consider adjusting your daily intake of the inhibitor further or exploring alternative treatments.
Agonist Drugs Their Functions
Morphine – An opioid agonist used for pain relief, particularly in severe or chronic pain conditions.
Albuterol – A beta-2 adrenergic agonist prescribed as a bronchodilator to alleviate symptoms of asthma and chronic obstructive pulmonary disease (COPD).
Diazepam – A GABA-A receptor agonist with anxiolytic, sedative, and anticonvulsant properties, commonly prescribed to manage anxiety disorders and seizures.
Levothyroxine – A thyroid hormone receptor agonist used to treat hypothyroidism by supplementing deficient thyroid hormone levels.
Dopamine agonists – Employed in the treatment of Parkinson's disease and restless legs syndrome, dopamine agonist medication mimics the action of dopamine to improve motor symptoms and reduce restless leg sensations.
Serotonin agonists – Utilized in migraine management, serotonin agonists help constrict blood vessels and block pain pathways, alleviating migraine symptoms.
GLP-1 agonists – GLP-1 receptor agonists mimic the action of GLP-1, a hormone that regulates blood sugar levels and appetite. This makes GLP-1 agonists valuable in the management of type 2 diabetes and obesity.
Nicotine – A nicotinic acetylcholine receptor agonist found in tobacco products, responsible for addiction and the reinforcing effects of smoking.
Epinephrine – An alpha and beta adrenergic agonist used in emergency medicine to treat anaphylaxis, cardiac arrest, and severe asthma attacks.
Why Are Enzyme Inhibitors Important?
This is the most common use for enzyme inhibitors because they target human enzymes and try to correct a pathological condition. Sildenafil strongly inhibits the enzyme (cGMP specific phosphodiesterase type 5) that denatures the signalling molecule called cyclic guanosine monophosphate. Cyclic guanosine monophosphate activates smooth muscle relaxation by allowing blow flow into the corpus cavernosum which leads to an erection. The drug works by decreasing enzyme activity which halts the signal and makes it last longers. Inhibitors are also often used in chemotherapy for cancer. This is because the inhibitor, methotrexate blocks the action of dihydrofolate reductase which is an enzyme implicated in the production of nucleotides. Blocking the biosynthesis of nucleotides is toxic to rapidly growing cells but not toxic to non-dividing cells.
Enzyme inhibitors are also used to control metabolism. Uncontrolled enzyme reactions can be fatal. In the disease multiple sclerosis, destructive enzymes attack nerve cells because of the immune system starts to destroy the nerves which causes paralysis. Metabolites inhibit metabolic pathways in the cell. Metabolites regulate enzyme activity by allosteric regulation of substrate inhibition. One example of this is the allosteric regulation of the glycolytic pathway which consumes glucose to produce ATP, pyruvate and NADH. A crucial step for controlling glycolysis is a previous reaction in the pathway which is catalysed by phosphofructokinase-1 (PFK1).
Protein inhibitors can also produce physiological enzyme inhibition. This kind of inhibition occurs in the pancreas which produces many zymogens (digestive precursor enzymes). A significant amount of zymogens are triggered by the trypsin protease and hence it is vital to inhibit trypsin activity to prevent the pancreas from digesting themselves. This can be done by regulation the synthesis of a strong trypsin inhibitor which tightly binds to trypsin and decreases trypsin activity that could destroy the organ.
Medicines are also used in enzyme inhibition i.e. the enzyme required for the survival of pathogens. An example of this is the antibiotics penicillin and vancomycin which inhibit the enzymes that produce the polymer peptidoglycan. This net-like polymer is the cell wall that surrounds bacteria. If the enzyme is inhibited, the cell wall’s strength will decrease and cause the bacteria to burst. Antibiotics are designed when enzymes that are crucial to the survival of the pathogens are either absent or in a different form in humans.
Evolution of plants and animals has to lead to them producing a variety of poisonous substances like peptides, proteins and secondary metabolites that act as inhibitors. Natural poisons are typically small molecules which are so diverse that almost every metabolic process has natural inhibitors. These natural inhibitors not only target enzymes but can also target structural protein functions and receptor channels. Another use for natural poisons, as mentioned above, is for defence against predators or capturing prey.
Enzyme inhibitors can also act as pesticides. Animals contain an enzyme called Acetylcholinesterase (AChE) which is crucial to nerve cell functioning. This is because it breaks down the neurotransmitter acetylcholine to form its constituents i.e. acetate and choline. Medicine and agriculture both use AChE inhibitors. An example of this is the carbamate pesticides which are reversible AChE inhibitors. Acetylcho linesterase is also irreversibly inhibited by malathion, parathion and chlorpyrifos which are organophosphate pesticides. Glyphosate which is a herbicide inhibits 3-phosphoshikimate 1-carboxyvinyltransferase. This enzyme is used to make branched-chain amino acids in plants. Other enzymes that are inhibited by herbicides include the enzymes needed for the production of carotenoids and lipids, the enzymes used in the process of photosynthesis and oxidative phosphorylation
What Are Inhibitors Used For?
Alzheimer's Disease and Other Cognitive Disorders: One of the most significant areas of interest for inhibitors is their potential use in neurodegenerative diseases like Alzheimer’s. Alzheimer’s is characterized by the loss of cholinergic neurons, leading to decreased levels of acetylcholine. Although most current treatments aim to increase acetylcholine levels by inhibiting acetylcholinesterase (the enzyme that breaks down acetylcholine), there’s growing interest in targeting to modulate acetylcholine levels more precisely. Some researchers believe that finely tuning acetylcholine synthesis could offer a more nuanced approach to managing symptoms and potentially slowing disease progression.
Muscular Disorders: Inhibitors have also been explored for their role in treating certain neuromuscular disorders. Conditions like myasthenia gravis, characterized by weakened muscles due to impaired acetylcholine transmission, could potentially benefit from a more targeted approach to modulating acetylcholine levels. By inhibiting, it may be possible to achieve a better balance in neurotransmitter levels, thus improving muscle function.
Anti-inflammatory and Analgesic Properties: Emerging research suggests that inhibitors may possess anti-inflammatory and analgesic properties. Acetylcholine is not only a neurotransmitter in the nervous system but also plays a role in the immune response. By modulating acetylcholine levels, inhibitors could potentially influence inflammatory pathways and provide relief from pain. However, this area of research is still in its infancy, and more studies are needed to validate these claims.
Psychiatric Disorders: Another promising avenue for inhibitors is in the treatment of certain psychiatric conditions like schizophrenia and bipolar disorder. Dysregulated acetylcholine signaling has been implicated in these disorders, and modulating its levels through inhibition could offer a new therapeutic strategy. Preliminary studies have shown that altering acetylcholine synthesis may affect mood, cognition, and behavior, opening up new possibilities for treatment.
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