Orexin system and new therapeutic possibilites for treatment of insomnia and narcolepsy

Oreksinski (hipokretinski) sustav, otkriven prije svega 20 godina, sudjeluje u regulaciji različitih fizioloških procesa i funkcija u organizmu sisavaca. Povezan je s odgovorom na stres, hranjenjem, homeostazom energije i sustavom nagrađivanja, a zbog svoje uključenosti u regulaciju spavanja i budnosti potencijalna je meta za razvoj novih lijekova za nesanicu i narkolepsiju. Za terapiju nesanice proučavaju se antagonisti oreksina. Prvi odobreni antagonist u SAD-u i Japanu bio je suvoreksant. Trenutno je i jedini na tržištu, ali intenzivno se radi na razvoju novih. Za terapiju narkolepsije istražuje se nadomjesna terapija oreksinom te oreksinski agonisti. Ukoliko ispitivanja pokažu učinkovitost, uz prihvatljiv sigurnosni profil, to će biti prvi terapijski pristup koji djeluje na uzrok, a ne primarno na simptome bolesti.The orexin system, discovered twenty years ago, has multiple roles in human body. It is associated with stress responese, feeding behaviour, energy homeostasis and reward system, but because of its important role in sleep and arousal regulation, it is a potential target for the development of new drugs for insomnia and narcolepsy. For insomnia therapy, orexin antagonists are being studied. The first approved orexin antagonist in the USA and Japan was suvorexant. It´s currently the only one on the market, but others are being intensively worked on. For narcolepsy therapy, orexin supstitution and orexin agonists are being observed. If the tests show effectivnes, along with acceptable safety profile, this would be the first therapeutical approach for narcolepsy that would act on the cause and not only the symptoms