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Abd El Wahab MM, Saad S, Sheribah ZA, El-Enany N. A green micelle-enhanced first derivative synchronous fluorescence approach for determination of donepezil HCl and trazodone HCl in their pure state, pharmaceutical dosage form and spiked human plasma. LUMINESCENCE 2024; 39:e4797. [PMID: 38837846 DOI: 10.1002/bio.4797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 05/19/2024] [Accepted: 05/25/2024] [Indexed: 06/07/2024]
Abstract
The study's objective is to establish an eco-friendly, sensitive and economical quantitative methodology for the concurrent analysis of donepezil HCl (DPZ) and trazodone HCl (TRZ) in raw materials, tablets and human plasma. The first derivative synchronous fluorescence spectroscopic (FDSFS) technique was applied at constant wavelength difference (∆λ = 120) for assessment of DPZ and TRZ at each other's zero-crossing point at 279 nm and 297 nm, respectively. The submitted technique was validated in accordance with ICH Q2 R1 guidelines and the linearity of the standard calibration curve was observed over the concentration range of 10-500 ng/ml for DPZ and 20-1,000 ng/ml for TRZ. The detection limits (LOD) were found to be 2.65 and 5.4 ng/ml, and the limits of quantitation (LOQ) were 8.05 and 16.3 ng/ml for DPZ and TRZ, respectively. This technique was used further to quantify the studied medications in their laboratory-prepared mixtures, commercial tablets and spiked plasma samples. The results obtained were not significantly different from those acquired from the comparison methods, indicating the high accuracy and precision of the proposed method. Furthermore, the ecological friendliness of the suggested method was evaluated and proven to be excellent using Green Analytical Procedure Index (GAPI) and Analytical GREEnness (AGREE) evaluation tools.
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Affiliation(s)
- Mennah M Abd El Wahab
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Sinai University - Arish Branch, Arish, Egypt
| | - Samar Saad
- Department of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt
| | - Zeinab A Sheribah
- Department of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt
| | - Nahed El-Enany
- Department of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt
- Department of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, New Mansoura University, New Mansoura, Egypt
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Dichiara M, Cosentino G, Giordano G, Pasquinucci L, Marrazzo A, Costanzo G, Amata E. Designing drugs optimized for both blood-brain barrier permeation and intra-cerebral partition. Expert Opin Drug Discov 2024; 19:317-329. [PMID: 38145409 DOI: 10.1080/17460441.2023.2294118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 12/07/2023] [Indexed: 12/26/2023]
Abstract
INTRODUCTION With the increasing incidence and prevalence of neurological disorders globally, there is a paramount need for new pharmacotherapies. BBB effectively protects the brain but raises a profound challenge to drug permeation, with less than 2% of most drugs reaching the CNS. AREAS COVERED This article reviews aspects of the most recent design strategies, providing insights into ideas and concepts in CNS drug discovery. An overview of the products available on the market is given and why clinical trials are continuously failing is discussed. EXPERT OPINION Among the available CNS drugs, small molecules account for most successful CNS therapeutics due to their ability to penetrate the BBB through passive or carrier-mediated mechanisms. The development of new CNS drugs is very difficult. To date, there is a lack of effective drugs for alleviating or even reversing the progression of brain diseases. Particularly, the use of artificial intelligence strategies, together with more appropriate animal models, may enable the design of molecules with appropriate permeation, to elicit a biological response from the neurotherapeutic target.
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Affiliation(s)
- Maria Dichiara
- Dipartimento di Scienze del Farmaco e della Salute, Università degli Studi di Catania, Catania, Italy
| | - Giuseppe Cosentino
- Dipartimento di Scienze del Farmaco e della Salute, Università degli Studi di Catania, Catania, Italy
| | - Giorgia Giordano
- Dipartimento di Scienze del Farmaco e della Salute, Università degli Studi di Catania, Catania, Italy
| | - Lorella Pasquinucci
- Dipartimento di Scienze del Farmaco e della Salute, Università degli Studi di Catania, Catania, Italy
| | - Agostino Marrazzo
- Dipartimento di Scienze del Farmaco e della Salute, Università degli Studi di Catania, Catania, Italy
| | - Giuliana Costanzo
- Dipartimento di Scienze del Farmaco e della Salute, Università degli Studi di Catania, Catania, Italy
| | - Emanuele Amata
- Dipartimento di Scienze del Farmaco e della Salute, Università degli Studi di Catania, Catania, Italy
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Dávila G, Torres-Prioris MJ, López-Barroso D, Berthier ML. Turning the Spotlight to Cholinergic Pharmacotherapy of the Human Language System. CNS Drugs 2023; 37:599-637. [PMID: 37341896 PMCID: PMC10374790 DOI: 10.1007/s40263-023-01017-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/24/2023] [Indexed: 06/22/2023]
Abstract
Even though language is essential in human communication, research on pharmacological therapies for language deficits in highly prevalent neurodegenerative and vascular brain diseases has received little attention. Emerging scientific evidence suggests that disruption of the cholinergic system may play an essential role in language deficits associated with Alzheimer's disease and vascular cognitive impairment, including post-stroke aphasia. Therefore, current models of cognitive processing are beginning to appraise the implications of the brain modulator acetylcholine in human language functions. Future work should be directed further to analyze the interplay between the cholinergic system and language, focusing on identifying brain regions receiving cholinergic innervation susceptible to modulation with pharmacotherapy to improve affected language domains. The evaluation of language deficits in pharmacological cholinergic trials for Alzheimer's disease and vascular cognitive impairment has thus far been limited to coarse-grained methods. More precise, fine-grained language testing is needed to refine patient selection for pharmacotherapy to detect subtle deficits in the initial phases of cognitive decline. Additionally, noninvasive biomarkers can help identify cholinergic depletion. However, despite the investigation of cholinergic treatment for language deficits in Alzheimer's disease and vascular cognitive impairment, data on its effectiveness are insufficient and controversial. In the case of post-stroke aphasia, cholinergic agents are showing promise, particularly when combined with speech-language therapy to promote trained-dependent neural plasticity. Future research should explore the potential benefits of cholinergic pharmacotherapy in language deficits and investigate optimal strategies for combining these agents with other therapeutic approaches.
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Affiliation(s)
- Guadalupe Dávila
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Marqués de Beccaria 3, 29010, Malaga, Spain
- Instituto de Investigación Biomédica de Malaga-IBIMA, Malaga, Spain
- Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
- Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
| | - María José Torres-Prioris
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Marqués de Beccaria 3, 29010, Malaga, Spain
- Instituto de Investigación Biomédica de Malaga-IBIMA, Malaga, Spain
- Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
- Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
| | - Diana López-Barroso
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Marqués de Beccaria 3, 29010, Malaga, Spain
- Instituto de Investigación Biomédica de Malaga-IBIMA, Malaga, Spain
- Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
- Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
| | - Marcelo L Berthier
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Marqués de Beccaria 3, 29010, Malaga, Spain.
- Instituto de Investigación Biomédica de Malaga-IBIMA, Malaga, Spain.
- Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain.
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Valis M, Dlabkova A, Hort J, Angelucci F, Pejchal J, Kuca K, Pavelek Z, Karasova JZ, Novotny M. The measured CSF/plasma donepezil concentration ratio but not individually measured CSF and plasma concentrations significantly increase over 24 h after donepezil treatment in patients with Alzheimer's disease. Biomed Pharmacother 2023; 159:114223. [PMID: 36630846 DOI: 10.1016/j.biopha.2023.114223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/01/2023] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The acetylcholinesterase inhibitor donepezil is administered as a treatment for Alzheimer's disease (AD). However, the appropriate donepezil dosage is still a matter of debate. METHODS Forty AD patients receiving 10 mg/day of donepezil were randomly divided into four groups based on the time of plasma and cerebrospinal fluid (CSF) sampling: 6 h (n = 5), 12 h (n = 12), 18 h (n = 6) and 24 h (n = 17) after donepezil administration. High-performance liquid chromatography measured the donepezil concentration in plasma samples and CSF samples collected at 4-time points. RESULTS Plasma and CSF levels among the groups were not significantly different. Conversely, the CSF/plasma donepezil concentration ratio considerably increased in the 24 h group compared to the 6 h (p < 0.005) and 12 h (p < 0.05) groups. CONCLUSION The measurement of the CSF/plasma donepezil concentration ratio could be used to better evaluate the optimal dose of donepezil.
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Affiliation(s)
- Martin Valis
- Department of Neurology, Faculty of Medicine and University Hospital Hradec Kralove, Charles University in Prague, Hradec Kralove, Czech Republic.
| | - Alzbeta Dlabkova
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, the University of Defense in Brno, Hradec Kralove, Czech Republic.
| | - Jakub Hort
- Department of Neurology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic; International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.
| | - Francesco Angelucci
- Department of Neurology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic; International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Jaroslav Pejchal
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, the University of Defense in Brno, Hradec Kralove, Czech Republic
| | - Kamil Kuca
- Department of Neurology, Faculty of Medicine and University Hospital Hradec Kralove, Charles University in Prague, Hradec Kralove, Czech Republic; Biomedical Research Center, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.
| | - Zbysek Pavelek
- Department of Neurology, Faculty of Medicine and University Hospital Hradec Kralove, Charles University in Prague, Hradec Kralove, Czech Republic
| | - Jana Zdarova Karasova
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, the University of Defense in Brno, Hradec Kralove, Czech Republic; Department of Neurology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
| | - Michal Novotny
- Department of Neurology, Faculty of Medicine and University Hospital Hradec Kralove, Charles University in Prague, Hradec Kralove, Czech Republic.
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Ameliorative effects of bromelain on aluminum-induced Alzheimer's disease in rats through modulation of TXNIP pathway. Int J Biol Macromol 2023; 227:1119-1131. [PMID: 36462588 DOI: 10.1016/j.ijbiomac.2022.11.291] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/01/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022]
Abstract
Alzheimer's disease (AD) is known as "type 3 diabetes". As thioredoxin binding protein (TXNIP) has been shown to be involved in brain insulin resistance, the present study evaluated the roles of TXNIP, phospho-insulin receptor substrate 1 (P-IRS-1), and phosphatidyl inositol-3 kinase (PI3K) in the pathogenesis of AD. The potential ameliorative effect of bromelain compared to donepezil was evaluated in an aluminum chloride (AlCl3)-induced AD in rats. Behavioral tests demonstrated similar improvements in exploratory activity, cognitive and spatial memory functions, anxiety, and depression levels between rats treated with bromelain and donepezil. Donepezil was superior to bromelain in improving locomotor activity. Histopathological examinations demonstrated neuronal degeneration in the AlCl3 group that was almost normalized by bromelain and donepezil. Moreover, there was deposition of amyloid plaques in the AlCl3 group that was improved by bromelain and donepezil. Acetylcholine esterase levels were significantly increased in rats treated with AlCl3 group and significantly decreased in rats treated with bromelain and donepezil. Furthermore, AlCl3 group showed a significantly increased TXNIP and P-IRS1 and a significantly reduced PI3K levels. These effects were ameliorated by bromelain and donepezil treatment. The present study demonstrates a previously unreported modulatory effect of bromelain on the TXNIP/P-IRS-1/PI3K axis in AD model.
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Yao W, Che J, Zhao C, Zhang X, Zhou H, Bai F. Treatment of Alzheimer's disease by microcapsule regulates neurotransmitter release via microfluidic technology. ENGINEERED REGENERATION 2023. [DOI: 10.1016/j.engreg.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
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Saleh MAA, Bloemberg JS, Elassaiss-Schaap J, de Lange ECM. Drug Distribution in Brain and Cerebrospinal Fluids in Relation to IC 50 Values in Aging and Alzheimer's Disease, Using the Physiologically Based LeiCNS-PK3.0 Model. Pharm Res 2022; 39:1303-1319. [PMID: 35606598 PMCID: PMC9246802 DOI: 10.1007/s11095-022-03281-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/27/2022] [Indexed: 12/02/2022]
Abstract
Background Very little knowledge exists on the impact of Alzheimer’s disease on the CNS target site pharmacokinetics (PK). Aim To predict the CNS PK of cognitively healthy young and elderly and of Alzheimer’s patients using the physiologically based LeiCNS-PK3.0 model. Methods LeiCNS-PK3.0 was used to predict the PK profiles in brain extracellular (brainECF) and intracellular (brainICF) fluids and cerebrospinal fluid of the subarachnoid space (CSFSAS) of donepezil, galantamine, memantine, rivastigmine, and semagacestat in young, elderly, and Alzheimer’s patients. The physiological parameters of LeiCNS-PK3.0 were adapted for aging and Alzheimer’s based on an extensive literature search. The CNS PK profiles at plateau for clinical dose regimens were related to in vitro IC50 values of acetylcholinesterase, butyrylcholinesterase, N-methyl-D-aspartate, or gamma-secretase. Results The PK profiles of all drugs differed between the CNS compartments regarding plateau levels and fluctuation. BrainECF, brainICF and CSFSAS PK profile relationships were different between the drugs. Aging and Alzheimer’s had little to no impact on CNS PK. Rivastigmine acetylcholinesterase IC50 values were not reached. Semagacestat brain PK plateau levels were below the IC50 of gamma-secretase for half of the interdose interval, unlike CSFSAS PK profiles that were consistently above IC50. Conclusion This study provides insights into the relations between CNS compartments PK profiles, including target sites. CSFSAS PK appears to be an unreliable predictor of brain PK. Also, despite extensive changes in blood-brain barrier and brain properties in Alzheimer’s, this study shows that the impact of aging and Alzheimer’s pathology on CNS distribution of the five drugs is insignificant. Supplementary Information The online version contains supplementary material available at 10.1007/s11095-022-03281-3.
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Affiliation(s)
- Mohammed A A Saleh
- Division of Systems Pharmacology and Pharmacy, Leiden Academic Center for Drug Research, Leiden University, Leiden, The Netherlands
| | - Julia S Bloemberg
- Division of Systems Pharmacology and Pharmacy, Leiden Academic Center for Drug Research, Leiden University, Leiden, The Netherlands
| | - Jeroen Elassaiss-Schaap
- Division of Systems Pharmacology and Pharmacy, Leiden Academic Center for Drug Research, Leiden University, Leiden, The Netherlands
- PD-value B.V., Houten, The Netherlands
| | - Elizabeth C M de Lange
- Division of Systems Pharmacology and Pharmacy, Leiden Academic Center for Drug Research, Leiden University, Leiden, The Netherlands.
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Bakker C, van der Aart J, Labots G, Liptrot J, Cross DM, Klaassen ES, Dickinson S, Tasker T, Groeneveld GJ. Safety and Pharmacokinetics of HTL0018318, a Novel M 1 Receptor Agonist, Given in Combination with Donepezil at Steady State: A Randomized Trial in Healthy Elderly Subjects. Drugs R D 2021; 21:295-304. [PMID: 34164794 PMCID: PMC8363684 DOI: 10.1007/s40268-021-00352-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2021] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION HTL0018318 is a selective muscarinic M1 receptor partial agonist under development for the symptomatic treatment of dementias, including Alzheimer's disease. Clinically, HTL0018318 would likely be used alone or in conjunction with cholinesterase inhibitors (e.g. donepezil). OBJECTIVE We investigated the safety, tolerability, and pharmacokinetics of HTL0018318 given alone and in combination with donepezil. METHODS This was a randomized, double-blind, placebo-controlled trial in 42 (to deliver 36 with combination treatment) healthy elderly subjects investigating the effects of oral HTL0018318 15 and 25 mg given alone and combined with donepezil 10 mg at steady state on adverse events (AEs), vital signs, saliva production, sleep quality, pulmonary function, subjective feelings, and pharmacokinetics. RESULTS AEs were reported by lower percentages of subjects after HTL0018318 alone than after donepezil alone. There was no increase in the percentage of subjects reporting AEs after co-administration than after donepezil alone. Supine systolic blood pressure was 1.6 mmHg (95% confidence interval [CI] -3.1 to -0.1) lower after HTL0018318 alone than after combination treatment. This was comparable with results from placebo alone: 1.7 mmHg (95% CI -3.2 to 0.2) lower than with combination treatment. Supine pulse rate was 3.3 bpm (95% CI 1.5-5.1) higher after HTL0018318 alone than with co-administration. HTL0018318 and donepezil did not meaningfully affect each other's pharmacokinetics. CONCLUSION HTL0018318 was well tolerated when given alone and in combination with donepezil. HTL0018318 and donepezil do not demonstrate pharmacokinetic or pharmacodynamic interactions, indicating that HTL0018318 can be safely administered in combination with donepezil. CLINICAL TRIAL REGISTRATION Netherlands Trial register identifier NL5915, registered on 28 October 2016.
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Affiliation(s)
- Charlotte Bakker
- Centre for Human Drug Research (CDHR), Leiden, The Netherlands.
- Leids Universitair Medisch Centrum, Leiden, The Netherlands.
| | | | - Geert Labots
- Centre for Human Drug Research (CDHR), Leiden, The Netherlands
| | | | | | | | | | | | - Geert Jan Groeneveld
- Centre for Human Drug Research (CDHR), Leiden, The Netherlands
- Leids Universitair Medisch Centrum, Leiden, The Netherlands
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Kassa J, Karasova JZ. Memantine and Its Combination with Acetylcholinesterase Inhibitors in Pharmacological Pretreatment of Soman Poisoning in Mice. Neurotox Res 2021; 39:1487-1494. [PMID: 34292503 DOI: 10.1007/s12640-021-00394-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/18/2021] [Accepted: 07/07/2021] [Indexed: 10/20/2022]
Abstract
Nerve agents pose a real threat to both the military and civil populations, but the current treatment of the poisoning is unsatisfactory. Thus, we studied the efficacy of prophylactic use of memantine alone or in combination with clinically used reversible acetylcholinesterase inhibitors (pyridostigmine, donepezil, rivastigmine) against soman. In addition, we tested their influence on post-exposure therapy consisting of atropine and asoxime. Pyridostigmine alone failed to decrease the acute toxicity of soman. But all clinically used acetylcholinesterase inhibitors administered alone reduced the acute toxicity, with donepezil showing the best efficacy. The combination of memantine with reversible acetylcholinesterase inhibitors attenuated soman acute toxicity significantly. The pretreatment administered alone or in combinations influenced the efficacy of post-exposure treatment in a similar fashion: (i) pyridostigmine or memantine alone did not affect the antidotal treatment, (ii) centrally acting reversible acetylcholinesterase inhibitors alone increased the antidotal treatment slightly, (iii) combination of memantine with reversible acetylcholinesterase inhibitors increased the antidotal treatment more markedly. In conclusion, memantine alone failed to decrease the acute toxicity of soman or increase post-exposure antidotal treatment efficacy. The combination of memantine with donepezil significantly increased post-exposure effectiveness (together 5.12, pretreatment alone 1.72). Both drugs, when applied together, mitigate soman toxicity and boost post-exposure treatment.
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Affiliation(s)
- Jiri Kassa
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, Trebesska 1575, 500 01, Hradec Králové, Czech Republic
| | - Jana Zdarova Karasova
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, Trebesska 1575, 500 01, Hradec Králové, Czech Republic.
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Yin W, Mamashli F, Buhl DL, Khudyakov P, Volfson D, Martenyi F, Gevorkyan H, Rosen L, Simen AA. Safety, pharmacokinetics and quantitative EEG modulation of TAK-071, a novel muscarinic M1 receptor positive allosteric modulator, in healthy subjects. Br J Clin Pharmacol 2021; 88:600-612. [PMID: 34240455 PMCID: PMC9291057 DOI: 10.1111/bcp.14975] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 06/06/2021] [Accepted: 06/19/2021] [Indexed: 12/26/2022] Open
Abstract
Aims TAK‐071 is a muscarinic M1 receptor positive allosteric modulator designed to have low cooperativity with acetylcholine. This was a first‐in‐human study to evaluate the safety, pharmacokinetics, and pharmacodynamics of TAK‐071. Methods TAK‐071 was administered as single and multiple doses in a randomized, double‐blind, placebo‐controlled, parallel‐group design in healthy volunteers alone and in combination with donepezil. Laboratory, electrocardiogram (ECG) and electroencephalogram (EEG) evaluations were performed. Cerebrospinal fluid and blood samples were taken to evaluate the pharmacokinetics (PK), relative bioavailability and food effect. Results TAK‐071 was safe and well tolerated, and no deaths or serious adverse events occurred. TAK‐071 demonstrated a long mean (% coefficient of variation) half‐life of 46.3 (25.2%) to 60.5 (51.5%) hours and excellent brain penetration following oral dosing. Coadministration with donepezil had no impact on the PK of either drug. There was no food effect on systemic exposure. Quantitative EEG analysis revealed that TAK‐071 40‐80 mg increased power in the 7‐9 Hz range in the posterior electrode group with eyes open and 120‐160 mg doses increased power in the 16‐18 Hz range and reduced power in the 2‐4 Hz range in central‐posterior areas with eyes open and eyes closed. Functional connectivity was significantly reduced after TAK‐071 at high doses and was enhanced with coadministration of donepezil under the eyes‐closed condition. Conclusions PK and safety profiles of TAK‐071 were favorable, including those exceeding expected pharmacologically active doses based on preclinical data. When administered without donepezil TAK‐071 was largely free of cholinergic adverse effects. Further clinical evaluation of TAK‐071 is warranted.
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Affiliation(s)
- Wei Yin
- Takeda Pharmaceutical Company Ltd, Cambridge, MA, USA
| | - Fahimeh Mamashli
- Takeda Pharmaceutical Company Ltd, Cambridge, MA, USA.,Signal Insights, LLC, Cambridge, MA, USA
| | - Derek L Buhl
- Takeda Pharmaceutical Company Ltd, Cambridge, MA, USA
| | | | | | | | - Hakop Gevorkyan
- California Clinical Trials Medical Group, in affiliation with Parexel International, Glendale, CA, USA
| | - Laura Rosen
- Takeda Pharmaceutical Company Ltd, Cambridge, MA, USA
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Bures J, Tacheci I, Kvetina J, Radochova V, Prchal L, Kohoutova D, Valis M, Novak M, Dolezal R, Kopacova M, Rejchrt S, Sestak V, Knoblochova V, Peterova E, Zdarova Karasova J. The Impact of Dextran Sodium Sulfate-Induced Gastrointestinal Injury on the Pharmacokinetic Parameters of Donepezil and Its Active Metabolite 6- O-desmethyldonepezil, and Gastric Myoelectric Activity in Experimental Pigs. Molecules 2021; 26:2160. [PMID: 33918638 PMCID: PMC8070437 DOI: 10.3390/molecules26082160] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 04/05/2021] [Accepted: 04/07/2021] [Indexed: 02/07/2023] Open
Abstract
Gastrointestinal side effects of donepezil, including dyspepsia, nausea, vomiting or diarrhea, occur in 20-30% of patients. The pathogenesis of these dysmotility associated disorders has not been fully clarified yet. Pharmacokinetic parameters of donepezil and its active metabolite 6-O-desmethyldonepezil were investigated in experimental pigs with and without small intestinal injury induced by dextran sodium sulfate (DSS). Morphological features of this injury were evaluated by a video capsule endoscopy. The effect of a single and repeated doses of donepezil on gastric myoelectric activity was assessed. Both DSS-induced small intestinal injury and prolonged small intestinal transit time caused higher plasma concentrations of donepezil in experimental pigs. This has an important implication for clinical practice in humans, with a need to reduce doses of the drug if an underlying gastrointestinal disease is present. Donepezil had an undesirable impact on porcine myoelectric activity. This effect was further aggravated by DSS-induced small intestinal injury. These findings can explain donepezil-associated dyspepsia in humans.
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Affiliation(s)
- Jan Bures
- 2nd Department of Internal Medicine-Gastroenterology, Charles University Faculty of Medicine in Hradec Kralove and University Hospital, 500 03 Hradec Kralove, Czech Republic; (I.T.); (J.K.); (D.K.); (M.K.); (S.R.); (V.K.); (E.P.)
| | - Ilja Tacheci
- 2nd Department of Internal Medicine-Gastroenterology, Charles University Faculty of Medicine in Hradec Kralove and University Hospital, 500 03 Hradec Kralove, Czech Republic; (I.T.); (J.K.); (D.K.); (M.K.); (S.R.); (V.K.); (E.P.)
| | - Jaroslav Kvetina
- 2nd Department of Internal Medicine-Gastroenterology, Charles University Faculty of Medicine in Hradec Kralove and University Hospital, 500 03 Hradec Kralove, Czech Republic; (I.T.); (J.K.); (D.K.); (M.K.); (S.R.); (V.K.); (E.P.)
| | - Vera Radochova
- Animal Laboratory, Faculty of Military Health Sciences, University of Defence, 500 01 Hradec Kralove, Czech Republic;
| | - Lukas Prchal
- Centre of Biomedical Research, University Hospital, 500 05 Hradec Kralove, Czech Republic; (L.P.); (M.N.); (R.D.); (J.Z.K.)
| | - Darina Kohoutova
- 2nd Department of Internal Medicine-Gastroenterology, Charles University Faculty of Medicine in Hradec Kralove and University Hospital, 500 03 Hradec Kralove, Czech Republic; (I.T.); (J.K.); (D.K.); (M.K.); (S.R.); (V.K.); (E.P.)
- The Royal Marsden Hospital NHS Foundation Trust, London SW3 6JJ, UK
| | - Martin Valis
- Department of Neurology, Charles University Faculty of Medicine in Hradec Kralove and University Hospital, 500 03 Hradec Kralove, Czech Republic;
| | - Martin Novak
- Centre of Biomedical Research, University Hospital, 500 05 Hradec Kralove, Czech Republic; (L.P.); (M.N.); (R.D.); (J.Z.K.)
- Department of Pharmaceutical Chemistry and Pharmaceutical Analysis, Charles University Faculty of Pharmacy, 500 05 Hradec Kralove, Czech Republic
| | - Rafael Dolezal
- Centre of Biomedical Research, University Hospital, 500 05 Hradec Kralove, Czech Republic; (L.P.); (M.N.); (R.D.); (J.Z.K.)
| | - Marcela Kopacova
- 2nd Department of Internal Medicine-Gastroenterology, Charles University Faculty of Medicine in Hradec Kralove and University Hospital, 500 03 Hradec Kralove, Czech Republic; (I.T.); (J.K.); (D.K.); (M.K.); (S.R.); (V.K.); (E.P.)
| | - Stanislav Rejchrt
- 2nd Department of Internal Medicine-Gastroenterology, Charles University Faculty of Medicine in Hradec Kralove and University Hospital, 500 03 Hradec Kralove, Czech Republic; (I.T.); (J.K.); (D.K.); (M.K.); (S.R.); (V.K.); (E.P.)
| | - Vit Sestak
- Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Kralove, 500 05 Hradec Kralove, Czech Republic;
| | - Veronika Knoblochova
- 2nd Department of Internal Medicine-Gastroenterology, Charles University Faculty of Medicine in Hradec Kralove and University Hospital, 500 03 Hradec Kralove, Czech Republic; (I.T.); (J.K.); (D.K.); (M.K.); (S.R.); (V.K.); (E.P.)
| | - Eva Peterova
- 2nd Department of Internal Medicine-Gastroenterology, Charles University Faculty of Medicine in Hradec Kralove and University Hospital, 500 03 Hradec Kralove, Czech Republic; (I.T.); (J.K.); (D.K.); (M.K.); (S.R.); (V.K.); (E.P.)
| | - Jana Zdarova Karasova
- Centre of Biomedical Research, University Hospital, 500 05 Hradec Kralove, Czech Republic; (L.P.); (M.N.); (R.D.); (J.Z.K.)
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, 500 01 Hradec Kralove, Czech Republic
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12
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Karasova JZ, Hrabinova M, Krejciova M, Jun D, Kuca K. Donepezil and Rivastigmine: Pharmacokinetic Profile and Brain-targeting After Intramuscular Administration in Rats. IRANIAN JOURNAL OF PHARMACEUTICAL RESEARCH : IJPR 2021; 19:95-102. [PMID: 33680013 PMCID: PMC7758017 DOI: 10.22037/ijpr.2019.1100723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Current palliative pharmacotherapy of Alzheimer's disease based on the cholinergic hypothesis led to the development of four cholinesterase inhibitors. These compounds can bring prolongation of the symptom-free period in some patients. This is the first report directly comparing donepezil and rivastigmine plasma and brain levels in in-vivo study. Donepezil and rivastigmine were applied i.m. to rats; the dose was calculated from clinical recommendations. The samples were analysed on an Agilent 1260 Series LC with UV/VIS detector. An analytical column (Waters Spherisorb S5 W (250 mm × 4.6 i.d.; 5 μm particle size)) with guard column (Waters Spherisorb S5 W (30 mm × 4.6 mm i.d.)) was used. The mobile phase contained acetonitrile and 50 mM sodium dihydrogen phosphate (17:83; v/v); pH 3.1. The LLOQ in rat plasma was 0.5 ng/mL for donepezil and 0.8 ng/mL for rivastigmine, and the LLOQ in rat brain was 1.0 ng/mL for donepezil and 1.1 ng/mL for rivastigmine. Both compounds showed ability to target the central nervous system, with brain concentrations exceeding those in plasma. Maximum brain concentration after i.m. administration was reached in the 36 (8.34 ± 0.34 ng/mL) and 17 minute (6.18 ± 0.40 ng/mL), respectively for donepezil and rivastigmine. The differences in brain profile can be most easily expressed by plasma/brain AUCtotal ratios: donepezil ratio in the brain was nine-times higher than in plasma and rivastigmine ratio was less than two-times higher than in plasma.
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Affiliation(s)
- Jana Zdarova Karasova
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic.,Biomedical Research Centre, University Hospital, Hradec Kralove, Czech Republic
| | - Martina Hrabinova
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic
| | - Marketa Krejciova
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic
| | - Daniel Jun
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic.,Biomedical Research Centre, University Hospital, Hradec Kralove, Czech Republic
| | - Kamil Kuca
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, Hradec Kralove, Czech Republic
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13
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Bakker C, Tasker T, Liptrot J, Hart EP, Klaassen ES, Prins S, van der Doef TF, Brown GA, Brown A, Congreve M, Weir M, Marshall FH, Cross DM, Groeneveld GJ, Nathan PJ. First-in-man study to investigate safety, pharmacokinetics and exploratory pharmacodynamics of HTL0018318, a novel M 1 -receptor partial agonist for the treatment of dementias. Br J Clin Pharmacol 2021; 87:2945-2955. [PMID: 33351971 PMCID: PMC8359307 DOI: 10.1111/bcp.14710] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/09/2020] [Accepted: 12/16/2020] [Indexed: 12/23/2022] Open
Abstract
AIMS HTL0018318 is a selective M1 receptor partial agonist currently under development for the symptomatic treatment of cognitive and behavioural symptoms in Alzheimer's disease and other dementias. We investigated safety, tolerability, pharmacokinetics and exploratory pharmacodynamics (PD) of HTL0018318 following single ascending doses. METHODS This randomized, double-blind, placebo-controlled study in 40 healthy younger adult and 57 healthy elderly subjects, investigated oral doses of 1-35 mg HTL0018318. Pharmacodynamic assessments were performed using a battery of neurocognitive tasks and electrophysiological measurements. Cerebrospinal fluid concentrations of HTL0018318 and food effects on pharmacokinetics of HTL0018318 were investigated in an open label and partial cross-over design in 14 healthy subjects. RESULTS Pharmacokinetics of HTL0018318 were well-characterized showing dose proportional increases in exposure from 1-35 mg. Single doses of HTL0018318 were associated with mild dose-related adverse events of low incidence in both younger adult and elderly subjects. The most frequently reported cholinergic AEs included hyperhidrosis and increases in blood pressure up to 10.3 mmHg in younger adults (95% CI [4.2-16.3], 35-mg dose) and up to 11.9 mmHg in elderly subjects (95% CI [4.9-18.9], 15-mg dose). There were no statistically significant effects on cognitive function but the study was not powered to detect small to moderate effect sizes of clinical relevance. CONCLUSION HTL0018318 showed well-characterized pharmacokinetics and following single doses were generally well tolerated in the dose range studied. These provide encouraging data in support of the development for HTL0018318 for Alzheimer's disease and other dementias.
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Affiliation(s)
| | | | | | - Ellen P Hart
- Centre for Human Drug Research (CDHR), Leiden, Netherlands
| | | | - Samantha Prins
- Centre for Human Drug Research (CDHR), Leiden, Netherlands
| | | | | | | | | | | | | | | | - Geert Jan Groeneveld
- Centre for Human Drug Research (CDHR), Leiden, Netherlands.,Leiden University Medical Centre, Leiden, The Netherlands
| | - Pradeep J Nathan
- Sosei Heptares, Cambridge, UK.,Department of Psychiatry, University of Cambridge, UK.,School of Psychological Sciences, Monash University, Australia
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14
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Influence of Acetylcholine Esterase Inhibitors and Memantine, Clinically Approved for Alzheimer's Dementia Treatment, on Intestinal Properties of the Mouse. Int J Mol Sci 2021; 22:ijms22031015. [PMID: 33498392 PMCID: PMC7864027 DOI: 10.3390/ijms22031015] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/11/2021] [Accepted: 01/19/2021] [Indexed: 02/07/2023] Open
Abstract
Four drugs are currently approved for the treatment of Alzheimer’s disease (AD) by the FDA. Three of these drugs—donepezil, rivastigmine, and galantamine—belong to the class of acetylcholine esterase inhibitors. Memantine, a NMDA receptor antagonist, represents the fourth and a combination of donepezil and memantine the fifth treatment option. Recently, the gut and its habitants, its microbiome, came into focus of AD research and added another important factor to therapeutic considerations. While the first data provide evidence that AD patients might carry an altered microbiome, the influence of administered drugs on gut properties and commensals have been largely ignored so far. However, the occurrence of digestive side effects with these drugs and the knowledge that cholinergic transmission is crucial for several gut functions enforces the question if, and how, this medication influences the gastrointestinal system and its microbial stocking. Here, we investigated aspects such as microbial viability, colonic propulsion, and properties of enteric neurons, affected by assumed intestinal concentration of the four drugs using the mouse as a model organism. All ex vivo administered drugs revealed no direct effect on fecal bacteria viability and only a high dosage of memantine resulted in reduced biofilm formation of E. coli. Memantine was additionally the only compound that elevated calcium influx in enteric neurons, while all acetylcholine esterase inhibitors significantly reduced esterase activity in colonic tissue specimen and prolonged propulsion time. Both, acetylcholine esterase inhibitors and memantine, had no effect on general viability and neurite outgrowth of enteric neurons. In sum, our findings indicate that all AD symptomatic drugs have the potential to affect distinct intestinal functions and with this—directly or indirectly—microbial commensals.
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15
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Preparation, characterization, and in vivo pharmacokinetics of thermosensitive in situ nasal gel of donepezil hydrochloride. ACTA PHARMACEUTICA (ZAGREB, CROATIA) 2020; 70:411-422. [PMID: 32074067 DOI: 10.2478/acph-2020-0032] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/18/2019] [Indexed: 01/19/2023]
Abstract
Donepezil hydrochloride thermosensitive in situ gel for nasal delivery was prepared by using Poloxamer 407 and Poloxamer 188 as thermoreversible polymers, hydroxypropyl-β-cyclodextrin and ethylparaben as permeation enhancer and preservative, respectively. The gelation temperature and time, pH value of the gel formulation were found to meet the requirements for nasal administration. The in vitro erosion and in vitro release tests exhibited obvious drug sustained release behavior. Meantime, main pharmacokinetic parameters such as tmax, cmax and AUC in plasma as well as in brain were significantly different between the nasal gel formulation and intragastric drug solution in rats (p < 0.01). The relative bioavailability and drug targeting efficiency of the gel formulation were calculated to be 385.6 and 151.2 %, respectively. Thus, the drug gel formulation might be a potential new delivery system for treatment of Alzheimer's disease due to its higher bioavailability and better distribution to brain when compared to oral route.
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16
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Valis M, Herman D, Vanova N, Masopust J, Vysata O, Hort J, Pavelek Z, Klimova B, Kuca K, Misik J, Zdarova Karasova J. The Concentration of Memantine in the Cerebrospinal Fluid of Alzheimer's Disease Patients and Its Consequence to Oxidative Stress Biomarkers. Front Pharmacol 2019; 10:943. [PMID: 31555132 PMCID: PMC6722429 DOI: 10.3389/fphar.2019.00943] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 07/24/2019] [Indexed: 01/01/2023] Open
Abstract
Memantine is a noncompetitive N-methyl-d-aspartate (NMDA) receptor antagonist utilized as a palliative cure for Alzheimer’s disease. This is the second study examining the memantine concentrations in cerebrospinal fluid. The previously published study enrolled six patients, and three of them were theoretically in a steady state. In our study, we enrolled 22 patients who regularly used a standard therapeutic dose of memantine (20 mg/day, oral administration) before the sample collection. Patients were divided into four groups, according to the time of plasma and cerebrospinal fluid collection: 6, 12, 18, and 24 h after memantine administration. The cerebrospinal fluid samples were also assessed for selected oxidative stress parameters (malondialdehyde, 3-nitrotyrosine, glutathione, non-protein thiols, and non-protein disulfides). The plasma/cerebrospinal fluid (CSF) ratio for all time intervals were within the range of 45.89% (6 h) to 55.60% (18 h), which corresponds with previously published findings in most patients. The other aim of our study was to deduce whether the achieved “real” memantine concentration in the central compartment was sufficient to block NMDA receptors. The IC50 value of memantine as an NMDA antagonist is in micromolar range; the lowest limit is 112 ng/ml (GluN2C), and this value was achieved only in three cases. The memantine cerebrospinal fluid concentration did not reach one quarter of the IC50 value in five cases (one patient was excluded for noncompliance); therefore, the potency of memantine as a therapeutic effect in patients may be questionable. However, it appears that memantine therapy positively affected the levels of some oxidative stress parameters, especially non-protein thiols and 3-nitrotyrosine.
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Affiliation(s)
- Martin Valis
- Department of Neurology, Faculty of Medicine and University Hospital Hradec Kralove, Charles University in Prague, Hradec Kralove, Czechia
| | - David Herman
- Biomedical Research Center, University Hospital Hradec Kralove, Hradec Kralove, Czechia.,Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defense in Brno, Hradec Kralove, Czechia
| | - Nela Vanova
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defense in Brno, Hradec Kralove, Czechia.,Department of Pharmaceutical Chemistry and Pharmaceutical Analysis, Faculty of Pharmacy in Hradec Kralove, Charles University, Czechia
| | - Jiri Masopust
- Department of Neurology, Faculty of Medicine and University Hospital Hradec Kralove, Charles University in Prague, Hradec Kralove, Czechia.,Department of Psychiatry, Faculty of Medicine and University Hospital Hradec Kralove, Charles University in Prague, Hradec Kralove, Czechia
| | - Oldrich Vysata
- Department of Neurology, Faculty of Medicine and University Hospital Hradec Kralove, Charles University in Prague, Hradec Kralove, Czechia
| | - Jakub Hort
- Department of Neurology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czechia.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czechia
| | - Zbysek Pavelek
- Department of Neurology, Faculty of Medicine and University Hospital Hradec Kralove, Charles University in Prague, Hradec Kralove, Czechia
| | - Blanka Klimova
- Department of Neurology, Faculty of Medicine and University Hospital Hradec Kralove, Charles University in Prague, Hradec Kralove, Czechia
| | - Kamil Kuca
- Biomedical Research Center, University Hospital Hradec Kralove, Hradec Kralove, Czechia
| | - Jan Misik
- Biomedical Research Center, University Hospital Hradec Kralove, Hradec Kralove, Czechia.,Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defense in Brno, Hradec Kralove, Czechia
| | - Jana Zdarova Karasova
- Biomedical Research Center, University Hospital Hradec Kralove, Hradec Kralove, Czechia.,Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defense in Brno, Hradec Kralove, Czechia
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17
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Duggal P, Mehan S. Neuroprotective Approach of Anti-Cancer Microtubule Stabilizers Against Tauopathy Associated Dementia: Current Status of Clinical and Preclinical Findings. J Alzheimers Dis Rep 2019; 3:179-218. [PMID: 31435618 PMCID: PMC6700530 DOI: 10.3233/adr-190125] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Neuronal microtubule (MT) tau protein provides cytoskeleton to neuronal cells and plays a vital role including maintenance of cell shape, intracellular transport, and cell division. Tau hyperphosphorylation mediates MT destabilization resulting in axonopathy and neurotransmitter deficit, and ultimately causing Alzheimer’s disease (AD), a dementing disorder affecting vast geriatric populations worldwide, characterized by the existence of extracellular amyloid plaques and intracellular neurofibrillary tangles in a hyperphosphorylated state. Pre-clinically, streptozotocin stereotaxically mimics the behavioral and biochemical alterations similar to AD associated with tau pathology resulting in MT assembly defects, which proceed neuropathological cascades. Accessible interventions like cholinesterase inhibitors and NMDA antagonist clinically provides only symptomatic relief. Involvement of microtubule stabilizers (MTS) prevents tauopathy particularly by targeting MT oriented cytoskeleton and promotes polymerization of tubulin protein. Multiple in vitro and in vivo research studies have shown that MTS can hold substantial potential for the treatment of AD-related tauopathy dementias through restoration of tau function and axonal transport. Moreover, anti-cancer taxane derivatives and epothiolones may have potential to ameliorate MT destabilization and prevent the neuronal structural and functional alterations associated with tauopathies. Therefore, this current review strictly focuses on exploration of various clinical and pre-clinical features available for AD to understand the neuropathological mechanisms as well as introduce pharmacological interventions associated with MT stabilization. MTS from diverse natural sources continue to be of value in the treatment of cancer, suggesting that these agents have potential to be of interest in the treatment of AD-related tauopathy dementia in the future.
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Affiliation(s)
- Pallavi Duggal
- Neuropharmacology Division, ISF College of Pharmacy, Moga, Punjab, India
| | - Sidharth Mehan
- Neuropharmacology Division, ISF College of Pharmacy, Moga, Punjab, India
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18
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Zdarova Karasova J, Soukup O, Korabecny J, Hroch M, Krejciova M, Hrabinova M, Misik J, Novotny L, Hepnarova V, Kuca K. Tacrine and its 7-methoxy derivate; time-change concentration in plasma and brain tissue and basic toxicological profile in rats. Drug Chem Toxicol 2019; 44:207-214. [PMID: 31257938 DOI: 10.1080/01480545.2019.1566350] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The search for tacrine derivatives, as potential Alzheimer´s disease treatment, is still being at the forefront of scientific efforts. 7-MEOTA was found to be a potent, centrally active acetylcholinesterase inhibitor free of the serious side effects observed for tacrine. Unfortunately, a relevant argumentation about pharmacokinetics and potential toxicity is incomplete; information about tacrine derivatives absorption and especially CNS penetration are still rare as well as detailed toxicological profile in vivo. Although the structural changes between these compounds are not so distinctive, differences in plasma profile and CNS targeting were found. The maximum plasma concentration were attained at 18th min (tacrine; 38.20 ± 3.91 ng/ml and 7-MEOTA; 88.22 ± 15.19 ng/ml) after i.m. application in rats. Although the brain profiles seem to be similar; tacrine achieved 19.34 ± 0.71 ng/ml in 27 min and 7-MEOTA 15.80 ± 1.13 ng/ml in 22 min; the tacrine Kp (AUCbrain/AUCplasma) fit 1.20 and was significantly higher than 7-MEOTA Kp 0.10. Administration of tacrine and 7-MEOTA showed only mild elevation of some biochemical markers following single p.o. application in 24 hours and 7 days. Also histopathology revealed only mild-to-moderate changes following repeated p.o. administration for 14 days. It seems that small change in tacrine molecule leads to lower ability to penetrate through the biological barriers. The explanation that lower p.o. acute toxicity of 7-MEOTA depends only on differences in metabolic pathways may be now revised to newly described differences in pharmacokinetic and toxicological profiles.
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Affiliation(s)
- Jana Zdarova Karasova
- Faculty of Military Health Sciences, Department of Toxicology and Military Pharmacy, University of Defence, Hradec Kralove, Czech Republic.,Biomedical Research Centre, University Hospital, Hradec Kralove, Czech Republic
| | - Ondrej Soukup
- Faculty of Military Health Sciences, Department of Toxicology and Military Pharmacy, University of Defence, Hradec Kralove, Czech Republic.,Biomedical Research Centre, University Hospital, Hradec Kralove, Czech Republic
| | - Jan Korabecny
- Faculty of Military Health Sciences, Department of Toxicology and Military Pharmacy, University of Defence, Hradec Kralove, Czech Republic.,Biomedical Research Centre, University Hospital, Hradec Kralove, Czech Republic
| | - Milos Hroch
- Faculty of Medicine, Department of Medicinal Biochemistry, Charles University in Prague, Hradec Kralove, Czech Republic
| | - Marketa Krejciova
- Faculty of Military Health Sciences, Department of Toxicology and Military Pharmacy, University of Defence, Hradec Kralove, Czech Republic
| | - Martina Hrabinova
- Faculty of Military Health Sciences, Department of Toxicology and Military Pharmacy, University of Defence, Hradec Kralove, Czech Republic.,Biomedical Research Centre, University Hospital, Hradec Kralove, Czech Republic
| | - Jan Misik
- Faculty of Military Health Sciences, Department of Toxicology and Military Pharmacy, University of Defence, Hradec Kralove, Czech Republic.,Biomedical Research Centre, University Hospital, Hradec Kralove, Czech Republic
| | | | - Vendula Hepnarova
- Faculty of Military Health Sciences, Department of Toxicology and Military Pharmacy, University of Defence, Hradec Kralove, Czech Republic.,Biomedical Research Centre, University Hospital, Hradec Kralove, Czech Republic
| | - Kamil Kuca
- Biomedical Research Centre, University Hospital, Hradec Kralove, Czech Republic.,Faculty of Science, Department of Chemistry, University of Hradec Kralove, Hradec Kralove, Czech Republic.,Department of Cellular Biology and Pharmacology, Florida International University, Miami, FL, USA
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19
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Brewster JT, Dell’Acqua S, Thach DQ, Sessler JL. Classics in Chemical Neuroscience: Donepezil. ACS Chem Neurosci 2019; 10:155-167. [PMID: 30372021 DOI: 10.1021/acschemneuro.8b00517] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
The discovery of acetylcholine and acetylcholinesterase provided the first insight into the intricacies of chemical signal transduction and neuronal communication. Further elucidation of the underlying mechanisms led to an attendant leveraging of this knowledge via the synthesis of new therapeutics designed to control aberrant biochemical processes. The central role of the cholinergic system within human memory and learning, as well as its implication in Alzheimer's disease, has made it a point of focus within the neuropharmacology and medicinal chemistry communities. This review is focused on donepezil and covers the background, synthetic routes, structure-activity relationships, binding interactions with acetylcholinesterase, pharmacokinetics and metabolism, efficacy, adverse effects, and historical importance of this leading therapeutic in the treatment of Alzheimer's disease and true Classic in Chemical Neuroscience.
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Affiliation(s)
- James T. Brewster
- Department of Chemistry, The University of Texas at Austin, Austin, Texas 78712-1224, United States
| | - Simone Dell’Acqua
- Department of Chemistry, University of Pavia, Via Taramelli 12, 27100 Pavia, Italy
| | - Danny Q. Thach
- Department of Chemistry, University of California—Berkeley, Berkeley, California 94720, United States
| | - Jonathan L. Sessler
- Department of Chemistry, The University of Texas at Austin, Austin, Texas 78712-1224, United States
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20
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Srinivas N, Maffuid K, Kashuba ADM. Clinical Pharmacokinetics and Pharmacodynamics of Drugs in the Central Nervous System. Clin Pharmacokinet 2018; 57:1059-1074. [PMID: 29464550 PMCID: PMC6062484 DOI: 10.1007/s40262-018-0632-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Despite contributing significantly to the burden of global disease, the translation of new treatment strategies for diseases of the central nervous system (CNS) from animals to humans remains challenging, with a high attrition rate in the development of CNS drugs. The failure of clinical trials for CNS therapies can be partially explained by factors related to pharmacokinetics/pharmacodynamics (PK/PD), such as lack of efficacy or improper selection of the initial dosage. A focused assessment is needed for CNS-acting drugs in first-in-human studies to identify the differences in PK/PD from animal models, as well as to choose the appropriate dose. In this review, we summarize the available literature from human studies on the PK and PD in brain tissue, cerebrospinal fluid, and interstitial fluid for drugs used in the treatment of psychosis, Alzheimer's disease and neuro-HIV, and address critical questions in the field. We also explore newer methods to characterize PK/PD relationships that may lead to more efficient dose selection in CNS drug development.
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Affiliation(s)
- Nithya Srinivas
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina, 1094 Genetic Medicine Building, CB# 7361, 120 Mason Farm Road, Chapel Hill, NC, 27599, USA
| | - Kaitlyn Maffuid
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina, 1094 Genetic Medicine Building, CB# 7361, 120 Mason Farm Road, Chapel Hill, NC, 27599, USA
| | - Angela D M Kashuba
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina, 1094 Genetic Medicine Building, CB# 7361, 120 Mason Farm Road, Chapel Hill, NC, 27599, USA.
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21
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Zdarova Karasova J, Sestak V, Korabecny J, Mezeiova E, Palicka V, Kuca K, Mzik M. 1-Benzyl-4-methylpiperidinyl moiety in donepezil: The priority ticket across the blood-brain-barrier in rats. J Chromatogr B Analyt Technol Biomed Life Sci 2018; 1092:350-358. [PMID: 29936371 DOI: 10.1016/j.jchromb.2018.06.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 06/14/2018] [Accepted: 06/15/2018] [Indexed: 01/01/2023]
Affiliation(s)
- Jana Zdarova Karasova
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic; Biomedical Research Centre, University Hospital, Hradec Kralove, Czech Republic
| | - Vit Sestak
- Department of Clinical Biochemistry, University Hospital, Hradec Kralove, Czech Republic
| | - Jan Korabecny
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic; Biomedical Research Centre, University Hospital, Hradec Kralove, Czech Republic
| | - Eva Mezeiova
- Biomedical Research Centre, University Hospital, Hradec Kralove, Czech Republic
| | - Vladimir Palicka
- Department of Clinical Biochemistry, University Hospital, Hradec Kralove, Czech Republic
| | - Kamil Kuca
- Biomedical Research Centre, University Hospital, Hradec Kralove, Czech Republic; Department of Chemistry, Faculty of Science, University of Hradec Kralove, Hradec Kralove, Czech Republic; Department of Cellular Biology and Pharmacology, Florida International University, Miami, FL, USA
| | - Martin Mzik
- Department of Clinical Biochemistry, University Hospital, Hradec Kralove, Czech Republic.
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22
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Zdarova Karasova J, Mzik M, Hroch M, Korabecny J, Nepovimova E, Vorisek V, Palicka V, Kuca K. The New Acetylcholinesterase Inhibitors PC-37 and PC-48 (7-Methoxytacrine-Donepezil-Like Compounds): Characterization of Their Metabolites in Human Liver Microsomes, Pharmacokinetics and In Vivo Formation of the Major Metabolites in Rats. Basic Clin Pharmacol Toxicol 2017; 122:373-382. [PMID: 29067789 DOI: 10.1111/bcpt.12922] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 10/16/2017] [Indexed: 12/22/2022]
Abstract
The objective of this study was to elucidate the pharmacokinetics and metabolite formation of newly developed non-selective AChE/BChE 7-MEOTA-donepezil-like inhibitors for potential therapeutic use in Alzheimer's disease (AD) patients. The chemical structures of metabolites were defined during incubation with human liver microsomes, and subsequently, the metabolization was verified in in vivo study. In vitro metabolic profiling revealed the formation of nine major metabolites in the case of PC-37 and eight metabolites of PC-48. Hydroxylation and the enzymatic hydrolysis of bonds close to the piperazine ring appeared to be the principal metabolic pathways in vitro. Of these metabolites, M1-M7 of PC-37 and M1-M6 of PC-48 were confirmed under in vivo conditions. Pilot pharmacokinetic experiments in rats were focused on the absorption, distribution and elimination of these compounds. Absorption after i.m. application was relatively fast; the bioavailability expressed as AUCtotal was 28179 ± 4691 min.ng/mL for PC-37 and 23374 ± 4045 min.ng/mL for PC-48. Both compounds showed ability to target the central nervous system, with brain concentrations exceeding those in plasma. The maximal brain concentrations are approximately two times higher than the plasma concentrations. The relatively high brain concentrations persisted throughout the experiment until 24 hr after application. Elimination via the kidneys (urine) significantly exceeded elimination via the liver (bile). All these characteristics are crucial for new candidates intended for AD treatment. The principle metabolic pathways that were verified in the in vivo study do not show any evidence for formation of extremely toxic metabolites, but this needs to be confirmed by further studies.
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Affiliation(s)
- Jana Zdarova Karasova
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defense, Hradec Kralove, Brno, Czech Republic.,Biomedical Research Center, University Hospital, Hradec Kralove, Czech Republic
| | - Martin Mzik
- Institute of Clinical Biochemistry and Diagnostic, University Hospital, Hradec Kralove, Czech Republic
| | - Milos Hroch
- Department of Medical Biochemistry, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Jan Korabecny
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defense, Hradec Kralove, Brno, Czech Republic.,Biomedical Research Center, University Hospital, Hradec Kralove, Czech Republic
| | - Eugenie Nepovimova
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defense, Hradec Kralove, Brno, Czech Republic
| | - Viktor Vorisek
- Institute of Clinical Biochemistry and Diagnostic, University Hospital, Hradec Kralove, Czech Republic
| | - Vladimir Palicka
- Institute of Clinical Biochemistry and Diagnostic, University Hospital, Hradec Kralove, Czech Republic
| | - Kamil Kuca
- Biomedical Research Center, University Hospital, Hradec Kralove, Czech Republic.,Department of Cellular Biology and Pharmacology, Florida International University, Miami, FL, USA
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23
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Anti-Parkinson Drug Biperiden Inhibits Enzyme Acetylcholinesterase. BIOMED RESEARCH INTERNATIONAL 2017; 2017:2532764. [PMID: 28785576 PMCID: PMC5530453 DOI: 10.1155/2017/2532764] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 05/24/2017] [Accepted: 06/19/2017] [Indexed: 01/16/2023]
Abstract
Biperiden is a drug used in Parkinson disease treatment and it serves also as an antiseizures compound in organophosphates poisoning. It acts as antagonist of muscarinic receptor activated by acetylcholine while the enzyme acetylcholinesterase (AChE) cleaves acetylcholine in synaptic junction into choline and acetic acid. This enzyme is inhibited by various compounds; however there has not been proposed evidence about interaction with biperiden molecule. We investigated this interaction using standard Ellman's assay and experimental findings were critically completed with an in silico prediction by SwissDock docking software. Uncompetitive mechanism of action was revealed from Dixon plot and inhibition constant (Ki) was calculated to be 1.11 mmol/l. The lowest predicted binding energy was −7.84 kcal/mol corresponding to H-bond between biperiden molecule and Tyr 341 residuum in protein structure of AChE. This interaction seems to be further stabilized by π-π interaction with Tyr 72, Trp 286, and Tyr 341. In conclusion, biperiden appears as a very weak inhibitor but it can serve as a lead structure in a pharmacological research.
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