Sertraline slows disease progression and increases neurogenesis in N171-82Q mouse model of Huntington's disease

The pathogenic mechanisms of polyglutamine diseases and current therapeutic strategies

Expansion of CAG trinucleotide repeat within the coding region of several genes results in the production of proteins with expanded polyglutamine (PolyQ) stretch. The expression of these pathogenic proteins leads to PolyQ diseases, such as Huntington's disease or several types of spinocerebellar ataxias. This family of neurodegenerative disorders is characterized by constant progression of the symptoms and molecularly, by the accumulation of mutant proteins inside neurons causing their dysfunction and eventually death. So far, no effective therapy actually preventing the physical and/or mental decline has been developed. Experimental therapeutic strategies either target the levels or processing of mutant proteins in an attempt to prevent cellular deterioration, or they are aimed at the downstream pathologic effects to reverse or ameliorate the caused damages. Certain pathomechanistic aspects of PolyQ disorders are discussed here. Relevance of disease models and recent knowledge of therapeutic possibilities is reviewed and updated.

Nonallele-specific silencing of mutant and wild-type huntingtin demonstrates therapeutic efficacy in Huntington's disease mice

Huntington's disease (HD) is a fatal neurodegenerative disease caused by mutant huntingtin (htt) protein, and there are currently no effective treatments. Recently, we and others demonstrated that silencing mutant htt via RNA interference (RNAi) provides therapeutic benefit in HD mice. We have since found that silencing wild-type htt in adult mouse striatum is tolerated for at least 4 months. However, given the role of htt in various cellular processes, it remains unknown whether nonallele-specific silencing of both wild-type and mutant htt is a viable therapeutic strategy for HD. Here, we tested whether cosilencing wild-type and mutant htt provides therapeutic benefit and is tolerable in HD mice. After treatment, HD mice showed significant reductions in wild-type and mutant htt, and demonstrated improved motor coordination and survival. We performed transcriptional profiling to evaluate the effects of reducing wild-type htt in adult mouse striatum. We identified gene expression changes that are concordant with previously described roles for htt in various cellular processes. Also, several abnormally expressed transcripts associated with early-stage HD were differentially expressed in our studies, but intriguingly, those involved in neuronal function changed in opposing directions. Together, these encouraging and surprising findings support further testing of nonallele-specific RNAi therapeutics for HD.

From neurotransmitters to neurotrophic factors to neurogenesis

New neurons continue to be produced in adult mammals, including humans, predominantly in the anterior subventricular zone of the lateral ventricle and the subgranular zone of the dentate gyrus. This update focuses on the emerging concept that adult CNS neurogenesis can be regulated by targeting neurotransmitter receptors, which, in turn, drive expression of crucial neurotrophic and growth factors. Such an approach might enable the development of pharmacological treatments that harness the endogenous potential of the CNS to replace lost cells in neurological disorders such as stroke and Alzheimer's and Huntington's diseases. This review samples in vivo studies in adult mammals from 2006 to mid-2008. It also provides some considerations for navigating toward translation to human disorders. Among them are the formidable problems of scaling up production of new neurons within the two "niches" of the brain and delivering sufficient numbers to distant degenerating regions for cell replacement. However, an expedition can only succeed if started.

Possible role of sertraline against 3-nitropropionic acid induced behavioral, oxidative stress and mitochondrial dysfunctions in rat brain

Oxidative stress and disrupted energy metabolism are major events leading to nerve cell death. Oxidative stress and related reactive oxygen species is one of the common cooperative sharing pathways involved in neurodegenerative disorders including Huntington's disease. The present study evaluated the possible role of sertraline on the 3-nitropropionic acid induced behavioral, biochemical, and mitochondrial alterations in discrete areas of rat brain. 3-Nitropropionic acid (10 mg/kg) administration for 14 days significantly induced Huntington's disease like symptoms in rats as indicated by change in locomotor activity, body weight, rotarod activity performance, oxidative damage (elevated levels of lipid peroxidation, nitrite concentration, depletion of antioxidant enzyme levels) and mitochondrial dysfunction (Complexes-I, II, II and IV) in striatum, cortex and hippocampal region of brain. Treatment with sertraline (5 and 10 mg/kg) significantly reversed behavioral, biochemical and mitochondrial enzyme dysfunctions in 3-nitropropionic acid treated group. Further, combination of yohimbine (2 mg/kg) (non selective serotonin with the higher dose of sertraline (10 mg/kg) did not influence the protective action of sertraline. The present study suggests the possible antioxidant role of sertraline against 3-nitropropionic acid induced alterations in animals.

Pharmacotherapy to enhance arousal: what is known and what is not

Severe brain injury results in a disturbance among a wide range of critical neurotransmitter systems. Each neurotransmitter system places its own functional role while being interconnected to a multitude of other systems and functions. This chapter seeks to review the major neurotransmitter systems involved after severe acquired brain injury. While limited in their construct, animal models of brain injury have demonstrated agents that may assist in the recovery process and those that may further slow recovery. We review further the issue of laboratory evidence and what is transferable to the clinic. Lastly, this chapter reviews published clinical pharmacotherapy studies or trials in the arena of arousal for those with clinical severe brain injury. We discuss limitations as well as findings and present the available evidence in a table-based format. While no clear evidence exists to suggest a defined and rigid pharmacotherapeutic approach, interesting data does suggest that several medications have been associated with enhanced arousal. Several studies are underway or about to begin that will shed more light on the utility of such agents in improving function after severe brain injury. For now, clinicians must employ their own judgment and what has been learned from the limited literature to the care of a challenging group of persons.

The R6 lines of transgenic mice: a model for screening new therapies for Huntington's disease

Huntington's disease (HD) is a hereditary neurodegenerative disorder caused by an expanded CAG repeat in the HD gene that results in cortical and striatal degeneration, and mutant huntingtin aggregation. Current treatments are unsatisfactory. R6 transgenic mice replicate many features of the human condition, show early onset of symptoms and fast disease progression, being one of the most used models for therapy screening. Here we review the therapies that have been tested in these mice: environmental enrichment, inhibition of histone deacetylation and methylation, inhibition of misfolding and oligomerization, transglutaminase inhibition, rescue of metabolic impairment, amelioration of the diabetic phenotype, use of antioxidants, inhibition of excitotoxicity, caspase inhibition, transplantation, genetic manipulations, and restoration of neurogenesis. Although many of these treatments were beneficial in R6 mice, they may not be as effective in HD patients, and thus the search for a combination of therapies that will rescue the human condition continues.