
Cabergoline
Description
Cabergoline is a long-acting, ergot-derived dopamine D2 receptor agonist with high selectivity and potency. Its pharmacokinetic profile, characterized by a prolonged half-life (~68 hours), enables infrequent dosing (e.g., twice weekly), improving patient compliance compared to shorter-acting agonists like bromocriptine . Approved for hyperprolactinemia, it is also used off-label in acromegaly, Parkinson’s disease (PD), and peripartum cardiomyopathy (PPCM). This compound suppresses prolactin (PRL) secretion, reduces growth hormone (GH) and insulin-like growth factor 1 (IGF-I) levels, and mitigates dopaminergic deficiency in PD. Its safety profile is favorable at therapeutic doses, though high doses historically raised concerns about cardiac valve fibrosis, a risk mitigated in newer analogs .
Properties
IUPAC Name |
(6aR,9R,10aR)-N-[3-(dimethylamino)propyl]-N-(ethylcarbamoyl)-7-prop-2-enyl-6,6a,8,9,10,10a-hexahydro-4H-indolo[4,3-fg]quinoline-9-carboxamide | |
---|---|---|
Source | PubChem | |
URL | https://pubchem.ncbi.nlm.nih.gov | |
Description | Data deposited in or computed by PubChem | |
InChI |
InChI=1S/C26H37N5O2/c1-5-11-30-17-19(25(32)31(26(33)27-6-2)13-8-12-29(3)4)14-21-20-9-7-10-22-24(20)18(16-28-22)15-23(21)30/h5,7,9-10,16,19,21,23,28H,1,6,8,11-15,17H2,2-4H3,(H,27,33)/t19-,21-,23-/m1/s1 | |
Source | PubChem | |
URL | https://pubchem.ncbi.nlm.nih.gov | |
Description | Data deposited in or computed by PubChem | |
InChI Key |
KORNTPPJEAJQIU-KJXAQDMKSA-N | |
Source | PubChem | |
URL | https://pubchem.ncbi.nlm.nih.gov | |
Description | Data deposited in or computed by PubChem | |
Canonical SMILES |
CCNC(=O)N(CCCN(C)C)C(=O)C1CC2C(CC3=CNC4=CC=CC2=C34)N(C1)CC=C | |
Source | PubChem | |
URL | https://pubchem.ncbi.nlm.nih.gov | |
Description | Data deposited in or computed by PubChem | |
Isomeric SMILES |
CCNC(=O)N(CCCN(C)C)C(=O)[C@@H]1C[C@H]2[C@@H](CC3=CNC4=CC=CC2=C34)N(C1)CC=C | |
Source | PubChem | |
URL | https://pubchem.ncbi.nlm.nih.gov | |
Description | Data deposited in or computed by PubChem | |
Molecular Formula |
C26H37N5O2 | |
Source | PubChem | |
URL | https://pubchem.ncbi.nlm.nih.gov | |
Description | Data deposited in or computed by PubChem | |
Related CAS |
85329-89-1 (diphosphate) | |
Record name | Cabergoline [USAN:USP:INN:BAN] | |
Source | ChemIDplus | |
URL | https://pubchem.ncbi.nlm.nih.gov/substance/?source=chemidplus&sourceid=0081409907 | |
Description | ChemIDplus is a free, web search system that provides access to the structure and nomenclature authority files used for the identification of chemical substances cited in National Library of Medicine (NLM) databases, including the TOXNET system. | |
DSSTOX Substance ID |
DTXSID6022719 | |
Record name | Cabergoline | |
Source | EPA DSSTox | |
URL | https://comptox.epa.gov/dashboard/DTXSID6022719 | |
Description | DSSTox provides a high quality public chemistry resource for supporting improved predictive toxicology. | |
Molecular Weight |
451.6 g/mol | |
Source | PubChem | |
URL | https://pubchem.ncbi.nlm.nih.gov | |
Description | Data deposited in or computed by PubChem | |
Physical Description |
Solid | |
Record name | Cabergoline | |
Source | Human Metabolome Database (HMDB) | |
URL | http://www.hmdb.ca/metabolites/HMDB0014393 | |
Description | The Human Metabolome Database (HMDB) is a freely available electronic database containing detailed information about small molecule metabolites found in the human body. | |
Explanation | HMDB is offered to the public as a freely available resource. Use and re-distribution of the data, in whole or in part, for commercial purposes requires explicit permission of the authors and explicit acknowledgment of the source material (HMDB) and the original publication (see the HMDB citing page). We ask that users who download significant portions of the database cite the HMDB paper in any resulting publications. | |
Solubility |
Insoluble, 6.40e-02 g/L | |
Record name | Cabergoline | |
Source | DrugBank | |
URL | https://www.drugbank.ca/drugs/DB00248 | |
Description | The DrugBank database is a unique bioinformatics and cheminformatics resource that combines detailed drug (i.e. chemical, pharmacological and pharmaceutical) data with comprehensive drug target (i.e. sequence, structure, and pathway) information. | |
Explanation | Creative Common's Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/legalcode) | |
Record name | Cabergoline | |
Source | Human Metabolome Database (HMDB) | |
URL | http://www.hmdb.ca/metabolites/HMDB0014393 | |
Description | The Human Metabolome Database (HMDB) is a freely available electronic database containing detailed information about small molecule metabolites found in the human body. | |
Explanation | HMDB is offered to the public as a freely available resource. Use and re-distribution of the data, in whole or in part, for commercial purposes requires explicit permission of the authors and explicit acknowledgment of the source material (HMDB) and the original publication (see the HMDB citing page). We ask that users who download significant portions of the database cite the HMDB paper in any resulting publications. | |
CAS No. |
81409-90-7 | |
Record name | Cabergoline | |
Source | CAS Common Chemistry | |
URL | https://commonchemistry.cas.org/detail?cas_rn=81409-90-7 | |
Description | CAS Common Chemistry is an open community resource for accessing chemical information. Nearly 500,000 chemical substances from CAS REGISTRY cover areas of community interest, including common and frequently regulated chemicals, and those relevant to high school and undergraduate chemistry classes. This chemical information, curated by our expert scientists, is provided in alignment with our mission as a division of the American Chemical Society. | |
Explanation | The data from CAS Common Chemistry is provided under a CC-BY-NC 4.0 license, unless otherwise stated. | |
Record name | Cabergoline [USAN:USP:INN:BAN] | |
Source | ChemIDplus | |
URL | https://pubchem.ncbi.nlm.nih.gov/substance/?source=chemidplus&sourceid=0081409907 | |
Description | ChemIDplus is a free, web search system that provides access to the structure and nomenclature authority files used for the identification of chemical substances cited in National Library of Medicine (NLM) databases, including the TOXNET system. | |
Record name | Cabergoline | |
Source | DrugBank | |
URL | https://www.drugbank.ca/drugs/DB00248 | |
Description | The DrugBank database is a unique bioinformatics and cheminformatics resource that combines detailed drug (i.e. chemical, pharmacological and pharmaceutical) data with comprehensive drug target (i.e. sequence, structure, and pathway) information. | |
Explanation | Creative Common's Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/legalcode) | |
Record name | Cabergoline | |
Source | EPA DSSTox | |
URL | https://comptox.epa.gov/dashboard/DTXSID6022719 | |
Description | DSSTox provides a high quality public chemistry resource for supporting improved predictive toxicology. | |
Record name | (6aR,9R,10aR)-N-[3-(dimethylamino)propyl]-N-(ethylcarbamoyl)-7-prop-2-enyl-6,6a,8,9,10,10a-hexahydro-4H-indolo[4,3-fg]quinoline-9-carboxamide | |
Source | European Chemicals Agency (ECHA) | |
URL | https://echa.europa.eu/information-on-chemicals | |
Description | The European Chemicals Agency (ECHA) is an agency of the European Union which is the driving force among regulatory authorities in implementing the EU's groundbreaking chemicals legislation for the benefit of human health and the environment as well as for innovation and competitiveness. | |
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Record name | CABERGOLINE | |
Source | FDA Global Substance Registration System (GSRS) | |
URL | https://gsrs.ncats.nih.gov/ginas/app/beta/substances/LL60K9J05T | |
Description | The FDA Global Substance Registration System (GSRS) enables the efficient and accurate exchange of information on what substances are in regulated products. Instead of relying on names, which vary across regulatory domains, countries, and regions, the GSRS knowledge base makes it possible for substances to be defined by standardized, scientific descriptions. | |
Explanation | Unless otherwise noted, the contents of the FDA website (www.fda.gov), both text and graphics, are not copyrighted. They are in the public domain and may be republished, reprinted and otherwise used freely by anyone without the need to obtain permission from FDA. Credit to the U.S. Food and Drug Administration as the source is appreciated but not required. | |
Record name | Cabergoline | |
Source | Human Metabolome Database (HMDB) | |
URL | http://www.hmdb.ca/metabolites/HMDB0014393 | |
Description | The Human Metabolome Database (HMDB) is a freely available electronic database containing detailed information about small molecule metabolites found in the human body. | |
Explanation | HMDB is offered to the public as a freely available resource. Use and re-distribution of the data, in whole or in part, for commercial purposes requires explicit permission of the authors and explicit acknowledgment of the source material (HMDB) and the original publication (see the HMDB citing page). We ask that users who download significant portions of the database cite the HMDB paper in any resulting publications. | |
Melting Point |
102-104 °C, 102 - 104 °C | |
Record name | Cabergoline | |
Source | DrugBank | |
URL | https://www.drugbank.ca/drugs/DB00248 | |
Description | The DrugBank database is a unique bioinformatics and cheminformatics resource that combines detailed drug (i.e. chemical, pharmacological and pharmaceutical) data with comprehensive drug target (i.e. sequence, structure, and pathway) information. | |
Explanation | Creative Common's Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/legalcode) | |
Record name | Cabergoline | |
Source | Human Metabolome Database (HMDB) | |
URL | http://www.hmdb.ca/metabolites/HMDB0014393 | |
Description | The Human Metabolome Database (HMDB) is a freely available electronic database containing detailed information about small molecule metabolites found in the human body. | |
Explanation | HMDB is offered to the public as a freely available resource. Use and re-distribution of the data, in whole or in part, for commercial purposes requires explicit permission of the authors and explicit acknowledgment of the source material (HMDB) and the original publication (see the HMDB citing page). We ask that users who download significant portions of the database cite the HMDB paper in any resulting publications. | |
Preparation Methods
Synthetic Routes and Chemical Synthesis
Starting Materials and Initial Protection Steps
Cabergoline synthesis typically begins with ergoline-8β-carboxylic acid esters, such as methyl or ethyl esters, which are derived from ergot alkaloids. The initial step involves protecting the indole nitrogen and secondary amine functionalities to prevent undesired side reactions. A preferred method employs tert-butyl carbamate (Boc) to protect the indole nitrogen, forming a stable intermediate (compound VII). Sodium hexamethyldisilazide (NaHMDS) is used as a strong base to deprotonate the amide nitrogen, enabling subsequent trapping with phenyl chloroformate to yield a phenyl carbamate intermediate (compound VIII). This dual protection strategy ensures regioselectivity during subsequent reactions.
Amidation and Urea Formation
The protected ergoline derivative undergoes amidation with 3-(dimethylamino)propylamine to extend the side chain. This reaction is facilitated by aprotic solvents such as tetrahydrofuran (THF) at temperatures ranging from −50°C to reflux. The resulting amide (compound IV) is then reacted with ethyl isocyanate to form the urea moiety, a critical structural feature of this compound. Silylating agents like trimethylsilyl trifluoromethane sulfonate (TMSOTf) are employed to activate intermediates, enhancing reaction efficiency.
Deprotection and Final Modification
Final deprotection of the Boc group is achieved under acidic conditions, typically using hydrochloric acid in methanol. The liberated secondary amine is subsequently alkylated with an allyl alcohol derivative to introduce the allyl group at position 6 of the ergoline backbone. This step completes the synthesis of this compound’s core structure. The overall process achieves a yield of approximately 78%, significantly higher than earlier methods that reported yields below 50%.
Crystallization and Polymorphic Forms
Solvent-Dependent Polymorphism
This compound exhibits multiple crystalline forms, each with distinct physicochemical properties. Form I, the most thermodynamically stable polymorph, is industrially preferred due to its consistent bioavailability. Patent literature describes two primary methods for obtaining Form I:
- Toluene/Diethyl Ether Solvate Route : Crystallization from a toluene-diethyl ether mixture at −20°C yields Form V, a toluene solvate, which is subsequently desolvated under vacuum to produce Form I. This method, however, suffers from a low yield (45%) and requires prolonged drying.
- Ethylbenzene-Based Crystallization : Dissolving this compound in ethylbenzene at 25–30°C followed by cooling to −23°C produces a solvate that is easily converted to Form I via nitrogen drying. This approach improves yields to 86% and reduces particle size variability (Table 1).
Table 1: Comparison of Crystallization Methods for this compound Form I
Method | Solvent System | Temperature (°C) | Yield (%) | Particle Size (X₅₀, µm) |
---|---|---|---|---|
Toluene/Diethyl Ether | Toluene + Ether | −20 | 45 | 15–20 |
Ethylbenzene | Ethylbenzene | −23 | 86 | 5–10 |
Alternative Polymorphs and Their Applications
Form II, characterized by a melting point of 108°C, is obtained by stirring this compound in diethyl ether for several days. Form VII, a metastable polymorph, is generated by suspending Form I in n-heptane or 1,4-dioxane for 48 hours. While these forms are less common in pharmaceutical products, they serve as intermediates in purity optimization.
Industrial-Scale Production and Yield Optimization
Solvent Selection and Process Efficiency
The shift from toluene to ethylbenzene as the primary crystallization solvent addresses key industrial challenges. Ethylbenzene’s higher volatility facilitates faster drying, reducing processing time from 29 hours to under 15 hours. Additionally, its low toxicity profile aligns with modern green chemistry principles.
Particle Size Control
Milling, a traditional method for particle size reduction, often induces polymorphic transitions. The ethylbenzene-derived Form I exhibits a median particle size (X₅₀) of 5–10 µm without milling, compared to 15–20 µm for toluene-based methods. This finer particle size enhances dissolution rates, critical for oral bioavailability.
Formulation Considerations
Oral Liquid Preparation
This compound’s poor aqueous solubility necessitates specialized formulations. A standard oral liquid (500 µg/mL) is prepared by dissolving this compound in propylene glycol (10 mL) and adding tutti frutti flavoring agents. The solution is homogenized to ensure uniformity, with stability studies confirming a shelf life of 30 days under refrigeration.
Analytical Characterization
Chromatographic Purity
High-performance liquid chromatography (HPLC) analyses reveal that ethylbenzene-derived Form I achieves 99.9% purity, surpassing the 98.5% purity of toluene-based methods. Impurities predominantly include residual solvents (<0.1%) and des-allyl metabolites (<0.05%).
Thermal Stability
Differential scanning calorimetry (DSC) of Form I shows a single endothermic peak at 101.5°C, indicative of high crystalline purity. In contrast, Form II exhibits dual melting events due to polymorphic contamination.
Chemical Reactions Analysis
Cabergoline undergoes various chemical reactions, including hydrolysis and oxidation. It is highly sensitive to hydrolysis, particularly at the urea moiety and amide group. The alkene bond in this compound is susceptible to oxidation. Common reagents used in these reactions include water for hydrolysis and oxidizing agents for oxidation. The major products formed from these reactions are degradation products identified using infrared and mass spectrometry analyses.
Scientific Research Applications
Treatment of Hyperprolactinemia
Overview : Cabergoline is the first-line treatment for hyperprolactinemia, effectively normalizing prolactin levels in a significant percentage of patients.
Key Findings :
- In a study involving 455 patients, this compound normalized serum prolactin levels in 86% of cases. Specifically, normalization was achieved in 92% of patients with idiopathic hyperprolactinemia or microprolactinoma and 77% in those with macroadenomas.
- Tumor shrinkage was observed in 67% of patients, while visual field abnormalities improved in 70% .
Treatment of Pituitary Adenomas
Overview : this compound not only suppresses hormone production but also induces tumor shrinkage in prolactinomas.
Research Insights :
Acromegaly Management
Overview : this compound is also utilized in managing acromegaly, particularly in patients who have not undergone radiation therapy.
Clinical Efficacy :
Potential Use in Other Tumors
Recent research has explored this compound's broader applications in oncology:
- Breast Cancer : Studies suggest that this compound may have anti-tumor effects on breast cancer cells, potentially offering a new therapeutic avenue for treatment.
- Neuroendocrine Tumors : Its efficacy has been investigated for pancreatic neuroendocrine tumors, indicating possible benefits in tumor management.
Case Studies and Clinical Trials
Several case studies illustrate the efficacy and safety profile of this compound:
Study Type | Patient Population | Outcome |
---|---|---|
Retrospective Cohort Study | 455 patients with hyperprolactinemia | 86% normalization of prolactin levels |
Clinical Trial | Non-irradiated acromegaly patients | 32% normalization of IGF-1 levels |
Case Series | Patients with breast cancer | Indications of tumor growth suppression |
Mechanism of Action
Cabergoline exerts its effects by stimulating dopamine D2 receptors, which are G-protein coupled receptors associated with Gi proteins. In lactotrophs, stimulation of dopamine D2 receptors inhibits adenylyl cyclase, decreasing intracellular cyclic adenosine monophosphate (cAMP) concentrations and blocking inositol triphosphate (IP3)-dependent release of calcium from intracellular stores. This results in the inhibition of prolactin secretion .
Comparison with Similar Compounds
Cabergoline is compared to bromocriptine, somatostatin analogs (SSA), and pegvisomant (PEG) across indications. Key findings are summarized below:
Hyperprolactinemia
Comparison with Bromocriptine
Key Findings :
- This compound achieves faster PRL normalization and higher efficacy with fewer side effects .
- A randomized trial (n=94) showed this compound improved LH, FSH, and estradiol levels more effectively than bromocriptine, enhancing menstrual regularity .
Acromegaly
Comparison with Bromocriptine and SSA
Key Findings :
- This compound monotherapy is effective in one-third of patients, particularly with mild IGF-I elevation .
- When added to SSA, this compound normalizes IGF-I in 50% of SSA-resistant cases, regardless of prolactin levels .
- Superior to bromocriptine in tolerability and efficacy, though less potent than SSA or PEG .
Parkinson’s Disease
Comparison with Bromocriptine and Levodopa
Key Findings :
- This compound and bromocriptine show comparable motor improvement, but this compound’s once-daily dosing improves adherence .
- Confusion is more frequent with this compound, while bromocriptine has higher gastrointestinal toxicity .
Peripartum Cardiomyopathy (PPCM)
Comparison with Bromocriptine
Parameter | This compound | Bromocriptine | Evidence Source |
---|---|---|---|
HF Prevention | 100% recovery in small series | Effective in preclinical models | |
Safety | No major adverse events reported | Risk of thrombosis |
Key Findings :
- Both agents prevent postpartum heart failure in mouse models, but this compound’s safety in humans requires validation in larger trials .
Metabolic Effects
Comparison with Placebo (Obesity/Prediabetes)
Parameter | This compound | Placebo | Evidence Source |
---|---|---|---|
Glucose Tolerance | Improved postprandial glucose/insulin | No change | |
Weight Loss | 1.2% body weight | 1.0% body weight |
Key Findings :
- This compound improves glucose metabolism independent of weight loss, suggesting dopaminergic modulation of insulin sensitivity .
Biological Activity
Therapeutic Applications
This compound is utilized in various clinical contexts, including:
-
Hyperprolactinemia :
- A retrospective study involving 455 patients showed that this compound normalized prolactin levels in 86% of cases, with significant improvements noted in visual field abnormalities and tumor shrinkage.
- The median starting dose was 1.0 mg/week, which could be reduced to 0.5 mg/week upon achieving control.
- Acromegaly :
- Cushing's Disease :
Neuroprotective Effects
Recent research suggests that this compound may also possess neuroprotective properties:
- A study indicated that this compound prevents oxidative stress-induced neuronal cell death by reducing extracellular glutamate accumulation and inhibiting ERK1/2 signaling pathways. This suggests potential applications beyond endocrine disorders, possibly extending into neurodegenerative conditions.
Case Studies and Research Findings
Q & A
Basic Research Questions
Q. What experimental models are appropriate for investigating Cabergoline’s dopamine receptor selectivity and mechanism of action?
- Methodological Answer : Utilize in vitro competitive binding assays with radiolabeled dopamine receptors (D2 and D5 subtypes) to measure this compound’s affinity and intrinsic activity. Dose-response curves can quantify receptor activation thresholds. In vivo models (e.g., rodent prolactinoma) should measure serum prolactin suppression as a functional endpoint. Ensure assays include controls for cross-reactivity with other receptors (e.g., serotonin) to confirm specificity .
Q. How can researchers determine the optimal this compound dose for prolactin suppression in hyperprolactinemia?
- Methodological Answer : Conduct dose-escalation studies in animal models or clinical cohorts, measuring serum prolactin levels weekly. Use nonlinear mixed-effects modeling (NONMEM) to correlate dose with hormonal response, adjusting for covariates like body weight and baseline prolactin. Validate findings with pharmacokinetic/pharmacodynamic (PK/PD) simulations to identify minimal effective and maximal tolerated doses .
Q. What biomarkers are validated for monitoring this compound’s therapeutic efficacy in endocrine disorders?
- Methodological Answer : IGF-I normalization (for acromegaly) and prolactin suppression (for hyperprolactinemia) are primary biomarkers. Secondary endpoints include tumor volume reduction (MRI) and patient-reported outcomes (e.g., headache resolution). Ensure assays meet CLIA/CAP certification standards to minimize variability .
Advanced Research Questions
Q. How can researchers reconcile contradictory findings on this compound’s association with valvular heart disease?
- Methodological Answer : Apply multivariate Cox regression in large-scale cohort studies to adjust for confounders (e.g., age, hypertension, cumulative dose). Stratify analyses by dose thresholds (e.g., <3 mg/week vs. ≥3 mg/week) and validate echocardiographic endpoints (e.g., valve thickening) with blinded adjudication. Meta-analyses should assess publication bias via funnel plots and Egger’s test .
Q. What statistical approaches are suitable for analyzing this compound’s synergistic effects with somatostatin analogs in acromegaly?
- Methodological Answer : Use interaction terms in mixed-effects regression models to evaluate additive vs. synergistic effects on IGF-I suppression. Individual patient data (IPD) meta-analyses can pool data from heterogeneous studies, adjusting for baseline IGF-I, tumor size, and prolactin levels. Sensitivity analyses should exclude outliers to ensure robustness .
Q. How to design longitudinal studies evaluating this compound’s long-term neuroendocrine and cardiovascular outcomes?
- Methodological Answer : Implement a prospective, matched cohort design with annual echocardiography and hormonal profiling. Use time-dependent covariates in survival analysis to account for cumulative exposure. Power calculations should assume a 5% annual incidence of subclinical valvulopathy, requiring ≥500 patient-years of follow-up .
Q. Methodological Considerations
- Contradiction Analysis : When studies report conflicting results (e.g., valvulopathy risk), perform subgroup analyses by dose, duration, and population characteristics. Use the Bradford Hill criteria to assess causality .
- Research Design : For preclinical studies, adhere to ARRIVE guidelines for experimental rigor. In clinical research, prioritize randomized adaptive trials for dose-finding and PROBE designs for long-term safety .
Retrosynthesis Analysis
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Strategy Settings
Precursor scoring | Relevance Heuristic |
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Min. plausibility | 0.01 |
Model | Template_relevance |
Template Set | Pistachio/Bkms_metabolic/Pistachio_ringbreaker/Reaxys/Reaxys_biocatalysis |
Top-N result to add to graph | 6 |
Feasible Synthetic Routes
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Please be aware that all articles and product information presented on BenchChem are intended solely for informational purposes. The products available for purchase on BenchChem are specifically designed for in-vitro studies, which are conducted outside of living organisms. In-vitro studies, derived from the Latin term "in glass," involve experiments performed in controlled laboratory settings using cells or tissues. It is important to note that these products are not categorized as medicines or drugs, and they have not received approval from the FDA for the prevention, treatment, or cure of any medical condition, ailment, or disease. We must emphasize that any form of bodily introduction of these products into humans or animals is strictly prohibited by law. It is essential to adhere to these guidelines to ensure compliance with legal and ethical standards in research and experimentation.