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Das V, Miller JH, Alladi CG, Annadurai N, De Sanctis JB, Hrubá L, Hajdúch M. Antineoplastics for treating Alzheimer's disease and dementia: Evidence from preclinical and observational studies. Med Res Rev 2024; 44:2078-2111. [PMID: 38530106 DOI: 10.1002/med.22033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 02/15/2024] [Accepted: 03/04/2024] [Indexed: 03/27/2024]
Abstract
As the world population ages, there will be an increasing need for effective therapies for aging-associated neurodegenerative disorders, which remain untreatable. Dementia due to Alzheimer's disease (AD) is one of the leading neurological diseases in the aging population. Current therapeutic approaches to treat this disorder are solely symptomatic, making the need for new molecular entities acting on the causes of the disease extremely urgent. One of the potential solutions is to use compounds that are already in the market. The structures have known pharmacokinetics, pharmacodynamics, toxicity profiles, and patient data available in several countries. Several drugs have been used successfully to treat diseases different from their original purposes, such as autoimmunity and peripheral inflammation. Herein, we divulge the repurposing of drugs in the area of neurodegenerative diseases, focusing on the therapeutic potential of antineoplastics to treat dementia due to AD and dementia. We briefly touch upon the shared pathological mechanism between AD and cancer and drug repurposing strategies, with a focus on artificial intelligence. Next, we bring out the current status of research on the development of drugs, provide supporting evidence from retrospective, clinical, and preclinical studies on antineoplastic use, and bring in new areas, such as repurposing drugs for the prion-like spreading of pathologies in treating AD.
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Affiliation(s)
- Viswanath Das
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University and University Hospital Olomouc, Olomouc, Czech Republic
- Czech Advanced Technologies and Research Institute (CATRIN), Institute of Molecular and Translational Medicine, Palacký University Olomouc, Olomouc, Czech Republic
| | - John H Miller
- School of Biological Sciences and Centre for Biodiscovery, Victoria University of Wellington, Wellington, New Zealand
| | - Charanraj Goud Alladi
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Narendran Annadurai
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Juan Bautista De Sanctis
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University and University Hospital Olomouc, Olomouc, Czech Republic
- Czech Advanced Technologies and Research Institute (CATRIN), Institute of Molecular and Translational Medicine, Palacký University Olomouc, Olomouc, Czech Republic
| | - Lenka Hrubá
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University and University Hospital Olomouc, Olomouc, Czech Republic
- Czech Advanced Technologies and Research Institute (CATRIN), Institute of Molecular and Translational Medicine, Palacký University Olomouc, Olomouc, Czech Republic
| | - Marián Hajdúch
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University and University Hospital Olomouc, Olomouc, Czech Republic
- Czech Advanced Technologies and Research Institute (CATRIN), Institute of Molecular and Translational Medicine, Palacký University Olomouc, Olomouc, Czech Republic
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Hu Y, Oleshko S, Firmani S, Zhu Z, Cheng H, Ulmer M, Arnold M, Colomé-Tatché M, Tang J, Xhonneux S, Marsico A. Path-based reasoning for biomedical knowledge graphs with BioPathNet. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.17.599219. [PMID: 39149355 PMCID: PMC11326122 DOI: 10.1101/2024.06.17.599219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
Understanding complex interactions in biomedical networks is crucial for advancements in biomedicine, but traditional link prediction (LP) methods are limited in capturing this complexity. Representation-based learning techniques improve prediction accuracy by mapping nodes to low-dimensional embeddings, yet they often struggle with interpretability and scalability. We present BioPathNet, a novel graph neural network framework based on the Neural Bellman-Ford Network (NBFNet), addressing these limitations through path-based reasoning for LP in biomedical knowledge graphs. Unlike node-embedding frameworks, BioPathNet learns representations between node pairs by considering all relations along paths, enhancing prediction accuracy and interpretability. This allows visualization of influential paths and facilitates biological validation. BioPathNet leverages a background regulatory graph (BRG) for enhanced message passing and uses stringent negative sampling to improve precision. In evaluations across various LP tasks, such as gene function annotation, drug-disease indication, synthetic lethality, and lncRNA-mRNA interaction prediction, BioPathNet consistently outperformed shallow node embedding methods, relational graph neural networks and task-specific state-of-the-art methods, demonstrating robust performance and versatility. Our study predicts novel drug indications for diseases like acute lymphoblastic leukemia (ALL) and Alzheimer's, validated by medical experts and clinical trials. We also identified new synthetic lethality gene pairs and regulatory interactions involving lncRNAs and target genes, confirmed through literature reviews. BioPathNet's interpretability will enable researchers to trace prediction paths and gain molecular insights, making it a valuable tool for drug discovery, personalized medicine and biology in general.
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Affiliation(s)
- Yue Hu
- Computational Health Center, Helmholtz Center Munich, Ingolstaedter Landstrasse 1, Neuherberg, 85764, Bavaria, Germany
- School of Life Sciences, Technical University of Munich, Alte Akademie 8, Freising, 85354, Bavaria, Germany
| | - Svitlana Oleshko
- Computational Health Center, Helmholtz Center Munich, Ingolstaedter Landstrasse 1, Neuherberg, 85764, Bavaria, Germany
- School of Computation, Information and Technology, Technical University of Munich, Arcisstrasse 21, Munich, 80333, Bavaria, Germany
| | - Samuele Firmani
- Computational Health Center, Helmholtz Center Munich, Ingolstaedter Landstrasse 1, Neuherberg, 85764, Bavaria, Germany
| | - Zhaocheng Zhu
- Department, Mila - Québec AI Institute, 6666 St-Urbain, Montréal, QC H2S 3H1, Quebec, Canada
- Department, Université de Montréal, 2900, boul. Édouard-Montpetit, Montréal, QC H3T 1J4, Quebec, Canada
| | - Hui Cheng
- School of Computation, Information and Technology, Technical University of Munich, Arcisstrasse 21, Munich, 80333, Bavaria, Germany
| | - Maria Ulmer
- Computational Health Center, Helmholtz Center Munich, Ingolstaedter Landstrasse 1, Neuherberg, 85764, Bavaria, Germany
- School of Life Sciences, Technical University of Munich, Alte Akademie 8, Freising, 85354, Bavaria, Germany
| | - Matthias Arnold
- Computational Health Center, Helmholtz Center Munich, Ingolstaedter Landstrasse 1, Neuherberg, 85764, Bavaria, Germany
- Department of Psychiatry and Behavioural Sciences, Duke University, 905 W Main St., Durham, NC 27701, North Carolina, United States
| | - Maria Colomé-Tatché
- Computational Health Center, Helmholtz Center Munich, Ingolstaedter Landstrasse 1, Neuherberg, 85764, Bavaria, Germany
- School of Life Sciences, Technical University of Munich, Alte Akademie 8, Freising, 85354, Bavaria, Germany
- Faculty of Biology, Ludwig-Maximilian University of Munich, Grosshaderner Str. 2, Planegg-Martinsried, 82152, Bavaria, Germany
| | - Jian Tang
- Department, Mila - Québec AI Institute, 6666 St-Urbain, Montréal, QC H2S 3H1, Quebec, Canada
- Department, CIFAR AI Chair, 661 University Ave, Toronto, ON M5G 1M1, Ontario, Canada
- Department, HEC Montréal, 3000 Chem. de la Côte-Sainte-Catherine, Montréal, QC H3T 2A7, Quebec, Canada
| | - Sophie Xhonneux
- Department, Mila - Québec AI Institute, 6666 St-Urbain, Montréal, QC H2S 3H1, Quebec, Canada
- Department, Université de Montréal, 2900, boul. Édouard-Montpetit, Montréal, QC H3T 1J4, Quebec, Canada
| | - Annalisa Marsico
- Computational Health Center, Helmholtz Center Munich, Ingolstaedter Landstrasse 1, Neuherberg, 85764, Bavaria, Germany
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McArthur C, Alizadehsaravi N, Affoo R, Cooke K, Douglas N, Earl M, Flynn T, Ghanouni P, Hunter S, Kalu M, Middleton L, Moody E, Smith C, Verlinden L, Weeks L. Effectiveness of physical rehabilitation for physical functioning and quality of life in long-term care residents with dementia: a systematic review and meta-analysis. JBI Evid Synth 2024; 22:1460-1535. [PMID: 38915237 PMCID: PMC11321609 DOI: 10.11124/jbies-23-00431] [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] [Indexed: 06/26/2024]
Abstract
OBJECTIVE The objective of this review was to evaluate the effectiveness of physical rehabilitation vs non-rehabilitation comparators for physical functioning and quality of life in long-term care (LTC) residents with dementia. INTRODUCTION LTC residents living with dementia often have impaired physical functioning and quality of life. Physical rehabilitation can improve physical functioning and quality of life for individuals living with dementia; however, many LTC residents with dementia do not receive physical rehabilitation and providers are unsure what interventions to employ. A synthesis of studies examining physical rehabilitation will help guide practice in the LTC sector where most residents live with dementia. Previous syntheses have focused on all residents in LTC, specific professions, interventions, or people with dementia in the community. Our review focused on LTC residents with dementia and used a broader definition of physical rehabilitation. INCLUSION CRITERIA This review included studies that evaluated physical rehabilitation in comparison with non-rehabilitation controls among LTC residents with any severity of dementia. We included experimental and quasi-experimental studies that measured the effect on activities of daily living, performance-based physical functioning, and self- or proxy-rated quality of life. METHODS Searches were conducted in APA PsycINFO (EBSCOhost), CINAHL (EBSCOhost), PubMed (National Library of Medicine), Embase, Scopus, and the Cochrane CENTRAL database with no date or language limitations. Two independent reviewers assessed the studies against the inclusion criteria. Two independent reviewers extracted data and conducted a methodological quality assessment using standardized checklists from JBI. Certainty of evidence was ascertained using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Where possible, studies were pooled in meta-analyses; otherwise, a narrative synthesis was presented. RESULTS Thirty-three studies were included (n=3072 participants); 27 were randomized controlled trials and (RCTs) the remaining 6 were non-randomized trials. The overall risk of bias of the included studies was low to unclear. Many of the included studies focused on increasing activity or walking, while few were individually tailored or at an intensity appropriate to induce therapeutic effects on physical function. Physical function was measured via several outcome measures, limiting our ability to pool results. There was low-certainty evidence that physical rehabilitation improved activities of daily living assessed with multiple instruments (12 RCTs, 1348 participants, standardized mean difference [SMD] 0.78; 95% CI 0.27 to 1.30) and lower extremity function assessed with the Short Physical Performance Battery Score (3 RCTs, 258 participants, mean difference [MD] 3.01 points; 95% CI 1.37 to 4.66), compared with non-rehabilitation interventions. There was very low- to moderate-certainty evidence that physical rehabilitation demonstrated no change in the 30-Second Sit to Stand Test (2 RCTs, 293 participants, MD 0.79 repetitions; 95% CI -0.45 to 2.03), 6-Minute Walk Test (4 RCTs, 363 participants, MD 17.32 meters; 95% CI -29.41 to 64.05), Timed Walk Test (4 RCTs, 400 participants, MD 0.10 meters/seconds; 95% CI -0.02 to 0.22), Timed Up and Go Test (3 RCTs, 275 participants, MD -2.89 seconds; 95% CI -6.62 to 0.84), or quality of life (4 RCTs, 419 participants, SMD 0.20; 95% CI -0.08 to 0.47). CONCLUSIONS This review demonstrates that physical rehabilitation may improve activities of daily living for LTC residents living with dementia, although the evidence is of low certainty. The effect of physical rehabilitation on specific functional tasks, such as gait speed and quality of life, are less clear. Future research should examine the effects of individualized, progressive interventions on outcome measures that reflect the capacity and preferences of LTC residents with more advanced dementia. REVIEW REGISTRATION PROSPERO CRD42022308444.
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Affiliation(s)
- Caitlin McArthur
- School of Physiotherapy, Dalhousie University, Halifax, NS, Canada
| | | | - Rebecca Affoo
- School of Communication Sciences and Disorders, Dalhousie University, Halifax, NS, Canada
| | - Karen Cooke
- Physiotherapy Department, Halifax, NS, Canada
| | - Natalie Douglas
- Deparment of Communicative Disorders, University of Louisiana Lafeyette, Lafeyette, LA, United States
| | - Marie Earl
- School of Physiotherapy, Dalhousie University, Halifax, NS, Canada
| | | | - Parisa Ghanouni
- School of Occupational Therapy, Dalhousie University, Halifax, NS, Canada
| | - Susan Hunter
- School of Physiotherapy, Western University, London, ON, Canada
| | - Michael Kalu
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Laura Middleton
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Schlegel-University of Waterloo Research Institute for Aging, Waterloo, ON, Canada
| | - Elaine Moody
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- Aligning Health Needs with Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
| | | | | | - Lori Weeks
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- Aligning Health Needs with Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Dalhousie University, Halifax, NS, Canada
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Barrera-Ocampo A. Monoclonal antibodies and aptamers: The future therapeutics for Alzheimer's disease. Acta Pharm Sin B 2024; 14:2795-2814. [PMID: 39027235 PMCID: PMC11252463 DOI: 10.1016/j.apsb.2024.03.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/06/2024] [Accepted: 03/14/2024] [Indexed: 07/20/2024] Open
Abstract
Alzheimer's disease (AD) is considered the most common and prevalent form of dementia of adult-onset with characteristic progressive impairment in cognition and memory. The cure for AD has not been found yet and the treatments available until recently were only symptomatic. Regardless of multidisciplinary approaches and efforts made by pharmaceutical companies, it was only in the past two years that new drugs were approved for the treatment of the disease. Amyloid beta (Aβ) immunotherapy is at the core of this therapy, which is one of the most innovative approaches looking to change the course of AD. This technology is based on synthetic peptides or monoclonal antibodies (mAb) to reduce Aβ levels in the brain and slow down the advance of neurodegeneration. Hence, this article reviews the state of the art about AD neuropathogenesis, the traditional pharmacologic treatment, as well as the modern active and passive immunization describing approved drugs, and drug prototypes currently under investigation in different clinical trials. In addition, future perspectives on immunotherapeutic strategies for AD and the rise of the aptamer technology as a non-immunogenic alternative to curb the disease progression are discussed.
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Affiliation(s)
- Alvaro Barrera-Ocampo
- Facultad de Ingeniería, Diseño y Ciencias Aplicadas, Departamento de Ciencias Farmacéuticas y Químicas, Grupo Natura, Universidad Icesi, Cali 760031, Colombia
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Muolokwu CE, Chaulagain B, Gothwal A, Mahanta AK, Tagoe B, Lamsal B, Singh J. Functionalized nanoparticles to deliver nucleic acids to the brain for the treatment of Alzheimer's disease. Front Pharmacol 2024; 15:1405423. [PMID: 38855744 PMCID: PMC11157074 DOI: 10.3389/fphar.2024.1405423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/03/2024] [Indexed: 06/11/2024] Open
Abstract
Brain-targeted gene delivery across the blood-brain barrier (BBB) is a significant challenge in the 21st century for the healthcare sector, particularly in developing an effective treatment strategy against Alzheimer's disease (AD). The Internal architecture of the brain capillary endothelium restricts bio-actives entry into the brain. Additionally, therapy with nucleic acids faces challenges like vulnerability to degradation by nucleases and potential immune responses. Functionalized nanocarrier-based gene delivery approaches have resulted in safe and effective platforms. These nanoparticles (NPs) have demonstrated efficacy in protecting nucleic acids from degradation, enhancing transport across the BBB, increasing bioavailability, prolonging circulation time, and regulating gene expression of key proteins involved in AD pathology. We provided a detailed review of several nanocarriers and targeting ligands such as cell-penetrating peptides (CPPs), endogenous proteins, and antibodies. The utilization of functionalized NPs extends beyond a singular system, serving as a versatile platform for customization in related neurodegenerative diseases. Only a few numbers of bioactive regimens can go through the BBB. Thus, exploring functionalized NPs for brain-targeted gene delivery is of utmost necessity. Currently, genes are considered high therapeutic potential molecules for altering any disease-causing gene. Through surface modification, nanoparticulate systems can be tailored to address various diseases by replacing the target-specific molecule on their surface. This review article presents several nanoparticulate delivery systems, such as lipid NPs, polymeric micelles, exosomes, and polymeric NPs, for nucleic acids delivery to the brain and the functionalization strategies explored in AD research.
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Affiliation(s)
| | | | | | | | | | | | - Jagdish Singh
- Department of Pharmaceutical Sciences, School of Pharmacy, College of Health and Human Sciences, North Dakota State University, Fargo, ND, United States
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Ott BR, Hollins C, Tjia J, Baek J, Chen Q, Lapane KL, Alcusky M. Antidementia Medication Use in Nursing Home Residents. J Geriatr Psychiatry Neurol 2024; 37:194-205. [PMID: 37715795 PMCID: PMC10947315 DOI: 10.1177/08919887231202948] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/18/2023]
Abstract
BACKGROUND Antidementia medication can provide symptomatic improvements in patients with Alzheimer's disease, but there is a lack of consensus guidance on when to start and stop treatment in the nursing home setting. METHODS We describe utilization patterns of cholinesterase inhibitors (ChEI) and memantine for 3,50,197 newly admitted NH residents with dementia between 2011 and 2018. RESULTS Overall, pre-admission use of antidementia medications declined from 2011 to 2018 (ChEIs: 44.5% to 36.9%; memantine: 27.4% to 23.2%). Older age, use of a feeding tube, and greater functional dependency were associated with lower odds of ChEI initiation. Coronary artery disease, parenteral nutrition, severe aggressive behaviors, severe cognitive impairment, and high functional dependency were associated with discontinuation of ChEIs. Comparison of clinical factors related to anti-dementia drug treatment changes from pre to post NH admission in 2011 and 2018 revealed a change toward lower likelihood of initiation of treatment among residents with more functional dependency and those with indicators of more complex illness as well as a change toward higher likelihood of discontinuation in residents having 2 or more hospital stays. CONCLUSIONS These prescribing trends highlight the need for additional research on the effects of initiating and discontinuing antidementia medications in the NH to provide clear guidance for clinicians when making treatment decisions for individual residents.
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Affiliation(s)
- Brian R. Ott
- Department of Neurology, Brown University Warren Alpert Medical School, Providence, RI
| | - Carl Hollins
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | - Jennifer Tjia
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | - Jonggyu Baek
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | - Qiaoxi Chen
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | - Kate L. Lapane
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | - Matthew Alcusky
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
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Vicente-Zurdo D, Rosales-Conrado N, León-González ME. Unravelling the in vitro and in vivo potential of selenium nanoparticles in Alzheimer's disease: A bioanalytical review. Talanta 2024; 269:125519. [PMID: 38086100 DOI: 10.1016/j.talanta.2023.125519] [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: 07/25/2023] [Revised: 11/30/2023] [Accepted: 12/03/2023] [Indexed: 01/05/2024]
Abstract
Alzheimer's disease (AD) is a devastating neurodegenerative disorder characterized by progressive cognitive decline and the accumulation of beta-amyloid plaques and tau tangles in the brain. Current therapies have limited efficacy, prompting the search for novel treatments. Selenium nanoparticles (SeNPs) have emerged as promising candidates for AD therapy due to their unique physicochemical properties and potential therapeutic effects. This review provides an overview of SeNPs and their potential application in AD treatment, as well as the main bioanalytical techniques applied in this field. SeNPs possess antioxidant and anti-inflammatory properties, making them potential candidates to combat the oxidative stress and neuroinflammation associated with AD. Moreover, SeNPs have shown the ability to cross the blood-brain barrier (BBB), allowing them to target brain regions affected by AD pathology. Various methods for synthesizing SeNPs are explored, including chemical, physical and biological synthesis approaches. Based on the employment of algae, yeast, fungi, and plants, green methods offer a promising and biocompatible alternative for SeNPs production. In vitro studies have demonstrated the potential of SeNPs in reducing beta-amyloid aggregation and inhibiting tau hyperphosphorylation, providing evidence of their neuroprotective effects on neuronal cells. In vivo studies using transgenic mouse models and AD-induced symptoms have shown promising results, with SeNPs treatment leading to cognitive improvements and reduced amyloid plaque burden in the hippocampus. Looking ahead, future trends in SeNPs research involve developing innovative brain delivery strategies to enhance their therapeutic potential, exploring alternative animal models to complement traditional mouse studies, and investigating multi-targeted SeNPs formulations to address multiple aspects of AD pathology. Overall, SeNPs represent a promising avenue for AD treatment, and further research in this field may pave the way for effective and much-needed therapeutic interventions for individuals affected by this debilitating disease.
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Affiliation(s)
- David Vicente-Zurdo
- Dpto. Química Analítica, Facultad de Ciencias Químicas, Universidad Complutense de Madrid, 28040, Madrid, Spain; Centre for Metabolomics and Bioanalysis (CEMBIO), Department of Chemistry and Biochemistry, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660, Boadilla del Monte, Madrid, Spain.
| | - Noelia Rosales-Conrado
- Dpto. Química Analítica, Facultad de Ciencias Químicas, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - María Eugenia León-González
- Dpto. Química Analítica, Facultad de Ciencias Químicas, Universidad Complutense de Madrid, 28040, Madrid, Spain.
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Rybnicek J, Chen Y, Milic M, Tio ES, McLaurin J, Hohman TJ, De Jager PL, Schneider JA, Wang Y, Bennett DA, Tripathy S, Felsky D, Lambe EK. CHRNA5 links chandelier cells to severity of amyloid pathology in aging and Alzheimer's disease. Transl Psychiatry 2024; 14:83. [PMID: 38331937 PMCID: PMC10853183 DOI: 10.1038/s41398-024-02785-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/09/2024] [Accepted: 01/16/2024] [Indexed: 02/10/2024] Open
Abstract
Changes in high-affinity nicotinic acetylcholine receptors are intricately connected to neuropathology in Alzheimer's Disease (AD). Protective and cognitive-enhancing roles for the nicotinic α5 subunit have been identified, but this gene has not been closely examined in the context of human aging and dementia. Therefore, we investigate the nicotinic α5 gene CHRNA5 and the impact of relevant single nucleotide polymorphisms (SNPs) in prefrontal cortex from 922 individuals with matched genotypic and post-mortem RNA sequencing in the Religious Orders Study and Memory and Aging Project (ROS/MAP). We find that a genotype robustly linked to increased expression of CHRNA5 (rs1979905A2) predicts significantly reduced cortical β-amyloid load. Intriguingly, co-expression analysis suggests CHRNA5 has a distinct cellular expression profile compared to other nicotinic receptor genes. Consistent with this prediction, single nucleus RNA sequencing from 22 individuals reveals CHRNA5 expression is disproportionately elevated in chandelier neurons, a distinct subtype of inhibitory neuron known for its role in excitatory/inhibitory (E/I) balance. We show that chandelier neurons are enriched in amyloid-binding proteins compared to basket cells, the other major subtype of PVALB-positive interneurons. Consistent with the hypothesis that nicotinic receptors in chandelier cells normally protect against β-amyloid, cell-type proportion analysis from 549 individuals reveals these neurons show amyloid-associated vulnerability only in individuals with impaired function/trafficking of nicotinic α5-containing receptors due to homozygosity of the missense CHRNA5 SNP (rs16969968A2). Taken together, these findings suggest that CHRNA5 and its nicotinic α5 subunit exert a neuroprotective role in aging and Alzheimer's disease centered on chandelier interneurons.
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Affiliation(s)
- Jonas Rybnicek
- Department of Physiology, University of Toronto, Toronto, ON, Canada
| | - Yuxiao Chen
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Milos Milic
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Earvin S Tio
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - JoAnne McLaurin
- Biological Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Timothy J Hohman
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Philip L De Jager
- Center for Translational & Computational Neuroimmunology, Department of Neurology and the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, NY, USA
| | - Julie A Schneider
- Department of Pathology, Rush University, Chicago, IL, USA
- Department of Neurological Sciences, Rush University, Chicago, IL, USA
| | - Yanling Wang
- Department of Neurological Sciences, Rush University, Chicago, IL, USA
| | - David A Bennett
- Department of Neurological Sciences, Rush University, Chicago, IL, USA
| | - Shreejoy Tripathy
- Department of Physiology, University of Toronto, Toronto, ON, Canada.
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
| | - Daniel Felsky
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
| | - Evelyn K Lambe
- Department of Physiology, University of Toronto, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
- Department of OBGYN, University of Toronto, Toronto, ON, Canada.
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DiBello JR, Lu Y, Swartz J, Bortnichak EA, Liaw KL, Zhong W, Liu X. Patterns of use of symptomatic treatments for Alzheimer's disease dementia (AD). BMC Neurol 2023; 23:400. [PMID: 37946118 PMCID: PMC10634008 DOI: 10.1186/s12883-023-03447-5] [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: 03/14/2023] [Accepted: 10/23/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Symptomatic treatment for Alzheimer's disease (AD) dementia could temporarily slow symptom worsening and improve the quality of life for both AD dementia patients and their caregivers. A comprehensive evaluation of symptomatic treatment patterns using recent data for newly diagnosed AD dementia has not been performed and compared across different countries. METHODS The drug name, time to the first therapy, duration, discontinuation or switches were described in newly diagnosed AD dementia patients in two databases (a major U.S. health plan [US] and UK-Clinical Practice Research Datalink [CPRD GOLD]). This analysis included patients with newly diagnosed AD dementia in 2018-2019, who initiated symptomatic AD drug therapy, with ≥ 1 year baseline period and ≥ 1 year of follow-up. RESULTS Over median follow-ups of 698 and 645 days, 63% and 65% of AD dementia patients used symptomatic treatments, with 34% and 77% newly initiating therapy, constituting analytic samples of 7637 patients in the US database and 4470 patients in the CPRD, respectively. The median time to the first therapy was 14 days for US and 49 days for CPRD; donepezil ranked the as most frequently used (69% vs 61%), followed by memantine (19% vs 28%) in the US database and CPRD, respectively. Median time on first therapy was 213 and 334 days, and 30% and 12% of patients proceeded to a second treatment in the US and CPRD databases, respectively. CONCLUSION Approximately two thirds of newly diagnosed AD dementia patients utilized approved symptomatic treatment. Time on first therapy was relatively short (< 1 year) and the majority did not move to a second therapy, highlighting the need for better adherence and persistence to existing AD symptomatic therapies and the need for additional therapies to alleviate the significant burden of AD dementia.
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Affiliation(s)
- Julia R DiBello
- Epidemiology, Biostatistics and Research Decision Sciences, Merck & Co., Inc., 770 Sumneytown Pike, West Point, PA, 19486, USA
| | - Yifei Lu
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jina Swartz
- Exciva EXCIVA GmbH, Hauptstrasse 25, 69117, Heidelberg, Germany
| | - Edward A Bortnichak
- Epidemiology, Biostatistics and Research Decision Sciences, Merck & Co., Inc., 770 Sumneytown Pike, West Point, PA, 19486, USA
| | - Kai-Li Liaw
- Epidemiology, Biostatistics and Research Decision Sciences, Merck & Co., Inc., 770 Sumneytown Pike, West Point, PA, 19486, USA
| | - Wenjun Zhong
- Epidemiology, Biostatistics and Research Decision Sciences, Merck & Co., Inc., 770 Sumneytown Pike, West Point, PA, 19486, USA
| | - Xinyue Liu
- Epidemiology, Biostatistics and Research Decision Sciences, Merck & Co., Inc., 770 Sumneytown Pike, West Point, PA, 19486, USA.
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10
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Ezzat MAF, Abdelhamid SM, Fouad MA, Abdel-Aziz HA, Allam HA. Design, synthesis, in vitro, and in vivo evaluation of novel phthalazinone-based derivatives as promising acetylcholinesterase inhibitors for treatment of Alzheimer's disease. Drug Dev Res 2023; 84:1231-1246. [PMID: 37243322 DOI: 10.1002/ddr.22082] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/09/2023] [Accepted: 05/14/2023] [Indexed: 05/28/2023]
Abstract
Twenty novel phthalazinone-based compounds were designed as acetylcholinesterase (hAChE) inhibitors. Compounds 7e and 17c demonstrated comparable or superior activity compared to donepezil, respectively, in in vitro enzyme assay. Moreover, both compounds 7e and 17c possess minimal toxicity on hepatic and neuroblastoma cell lines. Besides, it was proved that compounds 7e and 17c have percentage alternations and a transfer latency time comparable to donepezil and can alleviate the cognitive impairment caused by the scopolamine-induced model in mice. The kinetic analysis for compound 17c suggested this compound as a mixed-type inhibitor that could bind to both the peripheral (PAS) and the catalytic site (CAS) of the hAChE enzyme. The synthesized molecules were subjected to in silico analyses, including molecular docking studies, and the outcomes were consistent with the in vitro findings.
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Affiliation(s)
| | | | - Marwa A Fouad
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Cairo University, Cairo, Egypt
- Pharmaceutical Chemistry Department, School of Pharmacy, Newgiza University, Cairo, Egypt
| | - Hatem A Abdel-Aziz
- Department of Applied Organic Chemistry, National Research Center, Dokki, Giza, Egypt
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11
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Richmond V, Falcone BN, Maier MS, Arroyo Máñez P. Putting the Puzzle Together To Get the Whole Picture: Molecular Basis of the Affinity of Two Steroid Derivatives to Acetylcholinesterase. ACS OMEGA 2023; 8:25610-25622. [PMID: 37483177 PMCID: PMC10357547 DOI: 10.1021/acsomega.3c03749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 06/14/2023] [Indexed: 07/25/2023]
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disorder that has no cure because its etiology is still unknown, and its main treatment is the administration of acetylcholinesterase (AChE) inhibitors. The study of the mechanism of action of this family of compounds is critical for the design of new more potent and specific inhibitors. In this work, we study the molecular basis of an uncompetitive inhibitor (compound 1, 2β, 3α-dihydroxy-5α-cholestan-6-one disulfate), which we have proved to be a peripheral anionic site (PAS)-binding AChE inhibitor. The pipeline designed in this work is key to the development of other PAS inhibitors that not only inhibit the esterase action of the enzyme but could also modulate the non-cholinergic functions of AChE linked to the process of amylogenesis. Our studies showed that 1 inhibits the enzyme not simply by blocking the main gate but by an allosteric mechanism. A detailed and careful analysis of the ligand binding position and the protein dynamics, particularly regarding their secondary gates and active site, was necessary to conclude this. The same analysis was executed with an inactive analogue (compound 2, 2β, 3α-dihydroxy-5α-cholestan-6-one). Our first computational results showed no differences in affinity to AChE between both steroids, making further analysis necessary. This work highlights the variables to be considered and develops a refined methodology, for the successful design of new potent dual-action drugs for AD, particularly PAS inhibitors, an attractive strategy to combat AD.
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Affiliation(s)
- Victoria Richmond
- Facultad
de Ciencias Exactas y Naturales, Departamento de Química Orgánica, Universidad de Buenos Aires, Buenos Aires C1428EGA, Argentina
- Unidad
de Microanálisis y Métodos Físicos aplicados
a la Química Orgánica (UMYMFOR), CONICET-Universidad de Buenos Aires, Pabellón 2 de Ciudad Universitaria, Buenos Aires C1428EGA, Argentina
| | - Bruno N. Falcone
- Facultad
de Ciencias Exactas y Naturales, Departamento de Química Orgánica, Universidad de Buenos Aires, Buenos Aires C1428EGA, Argentina
- Unidad
de Microanálisis y Métodos Físicos aplicados
a la Química Orgánica (UMYMFOR), CONICET-Universidad de Buenos Aires, Pabellón 2 de Ciudad Universitaria, Buenos Aires C1428EGA, Argentina
| | - Marta S. Maier
- Facultad
de Ciencias Exactas y Naturales, Departamento de Química Orgánica, Universidad de Buenos Aires, Buenos Aires C1428EGA, Argentina
- Unidad
de Microanálisis y Métodos Físicos aplicados
a la Química Orgánica (UMYMFOR), CONICET-Universidad de Buenos Aires, Pabellón 2 de Ciudad Universitaria, Buenos Aires C1428EGA, Argentina
| | - Pau Arroyo Máñez
- Instituto
Interuniversitario de Investigación de Reconocimiento Molecular
y Desarrollo Tecnológico (IDM), Universitat
Politècnica de València, Universitat de València, Doctor Moliner 50, Burjassot, Valencia 46100, Spain
- Departamento
de Química Orgánica, Universitat
de València, Doctor Moliner 50, Burjassot, Valencia 46100, Spain
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12
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Innovations in the synthesis of graphene nanostructures for bio and gas sensors. BIOMATERIALS ADVANCES 2023; 145:213234. [PMID: 36502548 DOI: 10.1016/j.bioadv.2022.213234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 11/11/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
Sensors play a significant role in modern technologies and devices used in industries, hospitals, healthcare, nanotechnology, astronomy, and meteorology. Sensors based upon nanostructured materials have gained special attention due to their high sensitivity, precision accuracy, and feasibility. This review discusses the fabrication of graphene-based biosensors and gas sensors, which have highly efficient performance. Significant developments in the synthesis routes to fabricate graphene-based materials with improved structural and surface properties have boosted their utilization in sensing applications. The higher surface area, better conductivity, tunable structure, and atom-thick morphology of these hybrid materials have made them highly desirable for the fabrication of flexible and stable sensors. Many publications have reported various modification approaches to improve the selectivity of these materials. In the current work, a compact and informative review focusing on the most recent developments in graphene-based biosensors and gas sensors has been designed and delivered. The research community has provided a complete critical analysis of the most robust case studies from the latest fabrication routes to the most complex challenges. Some significant ideas and solutions have been proposed to overcome the limitations regarding the field of biosensors and hazardous gas sensors.
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13
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de Campos DP, Silva-Barcellos NM, Caldeira TG, Mussel WDN, Silveira V, de Souza J. Donepezil Hydrochloride BCS Class Ambiguity: Relevant Aspects to be Considered in Drug Classification. J Pharm Sci 2022; 111:3064-3074. [PMID: 35787368 DOI: 10.1016/j.xphs.2022.06.023] [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: 04/06/2022] [Revised: 06/27/2022] [Accepted: 06/27/2022] [Indexed: 12/14/2022]
Abstract
Donepezil hydrochloride (DH) is the most used anti-Alzheimer's disease drug, however, its classification according to the Biopharmaceutics Classification System (BCS) is not clear in the literature. BCS is one of the accepted criteria used to grant biowaiver (waiver of in vivo bioequivalence studies) of new drug products. So, the purpose of this work was to elucidate the BCS classification of DH and to raise the discussion about the possibility of biowaiver for new medicines containing it. The polymorphic form was previously identified as form III of DH. The drug showed high solubility in the entire pH range evaluated (1.2 to 6.8, at 37 °C) with a pH-dependent solubility profile. The effective permeability (Peff) values obtained with different DH concentrations, using in situ closed-loop perfusion model were statistically similar (p > 0.05), even when compared to high permeability control used (ketoprofen), demonstrating that DH has high permeability which, associated with its high solubility, allows to classify DH as BCS class 1. Relevant data to evaluate for granting a biowaiver for new medicines were also reviewed from the literature. Based on information reunited new immediate-release drug products containing DH should be eligible for BCS-based biowaiver.
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Affiliation(s)
- Débora Priscila de Campos
- Quality Control Laboratory - Postgraduate Program in Pharmaceutical Sciences. School of Pharmacy, Federal University of Ouro Preto, Ouro Preto, Brazil.
| | - Neila Márcia Silva-Barcellos
- Quality Control Laboratory - Postgraduate Program in Pharmaceutical Sciences. School of Pharmacy, Federal University of Ouro Preto, Ouro Preto, Brazil; Department of Pharmacy. School of Pharmacy, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Tamires Guedes Caldeira
- Quality Control Laboratory - Postgraduate Program in Pharmaceutical Sciences. School of Pharmacy, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Wagner da Nova Mussel
- Department of Chemistry. Institute of Exact Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Virgínia Silveira
- School of Pharmacy, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Jacqueline de Souza
- Quality Control Laboratory - Postgraduate Program in Pharmaceutical Sciences. School of Pharmacy, Federal University of Ouro Preto, Ouro Preto, Brazil; Department of Pharmacy. School of Pharmacy, Federal University of Ouro Preto, Ouro Preto, Brazil
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14
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Alfonsetti M, d’Angelo M, Castelli V. Neurotrophic factor-based pharmacological approaches in neurological disorders. Neural Regen Res 2022; 18:1220-1228. [PMID: 36453397 PMCID: PMC9838155 DOI: 10.4103/1673-5374.358619] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Aging is a physiological event dependent on multiple pathways that are linked to lifespan and processes leading to cognitive decline. This process represents the major risk factor for aging-related diseases such as Alzheimer's disease, Parkinson's disease, and ischemic stroke. The incidence of all these pathologies increases exponentially with age. Research on aging biology has currently focused on elucidating molecular mechanisms leading to the development of those pathologies. Cognitive deficit and neurodegeneration, common features of aging-related pathologies, are related to the alteration of the activity and levels of neurotrophic factors, such as brain-derived neurotrophic factor, nerve growth factor, and glial cell-derived neurotrophic factor. For this reason, treatments that modulate neurotrophin levels have acquired a great deal of interest in preventing neurodegeneration and promoting neural regeneration in several neurological diseases. Those treatments include both the direct administration of neurotrophic factors and the induced expression with viral vectors, neurotrophins' binding with biomaterials or other molecules to increase their bioavailability but also cell-based therapies. Considering neurotrophins' crucial role in aging pathologies, here we discuss the involvement of several neurotrophic factors in the most common brain aging-related diseases and the most recent therapeutic approaches that provide direct and sustained neurotrophic support.
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Affiliation(s)
- Margherita Alfonsetti
- Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
| | - Michele d’Angelo
- Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
| | - Vanessa Castelli
- Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy,Correspondence to: Vanessa Castelli, .
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15
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Buendía D, Guncay T, Oyanedel M, Lemus M, Weinstein A, Ardiles ÁO, Marcos J, Fernandes A, Zângaro R, Muñoz P. The Transcranial Light Therapy Improves Synaptic Plasticity in the Alzheimer’s Disease Mouse Model. Brain Sci 2022; 12:brainsci12101272. [PMID: 36291206 PMCID: PMC9599908 DOI: 10.3390/brainsci12101272] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/10/2022] [Accepted: 09/15/2022] [Indexed: 11/16/2022] Open
Abstract
Alzheimer’s disease (AD) is the main cause of dementia worldwide. Emerging non-invasive treatments such as photobiomodulation target the mitochondria to minimize brain damage, improving cognitive functions. In this work, an experimental design was carried out to evaluate the effect of transcranial light therapy (TLTC) on synaptic plasticity (SP) and cognitive functions in an AD animal model. Twenty-three mice were separated into two general groups: an APP/PS1 (ALZ) transgenic group and a wild-type (WT) group. Each group was randomly subdivided into two subgroups: mice with and without TLTC, depending on whether they would undergo treatment with TLTC. Cognitive function, measured through an object recognition task, showed non-significant improvement after TLTC. SP, on the other hand, was evaluated using four electrophysiological parameters from the Schaffer-CA1 collateral hippocampal synapses: excitatory field potentials (fEPSP), paired pulse facilitation (PPF), long-term depression (LTD), and long-term potentiation (LTP). An improvement was observed in subjects treated with TLTC, showing higher levels of LTP than those transgenic mice that were not exposed to the treatment. Therefore, the results obtained in this work showed that TLTC could be an efficient non-invasive treatment for AD-associated SP deficits.
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Affiliation(s)
- Débora Buendía
- Programa de Engenharia Biomédica, Instituto de Engenharia Biomédica, Universidade Anhembi Morumbi—UAM, Rua Casa do Ator, 294, Sao Paulo 04546-001, Brazil
- Escuela de Ingeniería Civil Biomédica, Facultad de Ingeniería, Universidad de Valparaíso, General Cruz 222, Valparaíso 2362905, Chile
- Centro de Neurología Traslacional, Facultad de Medicina, Universidad de Valparaíso, Valparaíso 2341386, Chile
- Centro de Inovação, Tecnología e Educação—CITÉ, Parque Tecnológico de São José dos Campos, Estrada Dr. Altino Bondesan 500, São José dos Campos 12247-016, Brazil
| | - Tatiana Guncay
- Centro de Neurología Traslacional, Facultad de Medicina, Universidad de Valparaíso, Valparaíso 2341386, Chile
| | - Macarena Oyanedel
- Escuela de Ingeniería Civil Biomédica, Facultad de Ingeniería, Universidad de Valparaíso, General Cruz 222, Valparaíso 2362905, Chile
| | - Makarena Lemus
- Escuela de Ingeniería Civil Biomédica, Facultad de Ingeniería, Universidad de Valparaíso, General Cruz 222, Valparaíso 2362905, Chile
| | - Alejandro Weinstein
- Escuela de Ingeniería Civil Biomédica, Facultad de Ingeniería, Universidad de Valparaíso, General Cruz 222, Valparaíso 2362905, Chile
| | - Álvaro O. Ardiles
- Centro de Neurología Traslacional, Facultad de Medicina, Universidad de Valparaíso, Valparaíso 2341386, Chile
- Centro Interdisciplinario de Neurociencia de Valparaíso, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso 2360102, Chile
- Escuela de Medicina, Facultad de Medicina, Universidad de Valparaíso, Angamos 655, Viña del Mar 2540064, Chile
| | - José Marcos
- Centro de Neurología Traslacional, Facultad de Medicina, Universidad de Valparaíso, Valparaíso 2341386, Chile
- Escuela de Ciencias Agrícolas y Veterinarias, Universidad Viña del Mar, Viña del Mar 2572007, Chile
| | - Adriana Fernandes
- Programa de Engenharia Biomédica, Instituto de Engenharia Biomédica, Universidade Anhembi Morumbi—UAM, Rua Casa do Ator, 294, Sao Paulo 04546-001, Brazil
- Centro de Inovação, Tecnología e Educação—CITÉ, Parque Tecnológico de São José dos Campos, Estrada Dr. Altino Bondesan 500, São José dos Campos 12247-016, Brazil
| | - Renato Zângaro
- Programa de Engenharia Biomédica, Instituto de Engenharia Biomédica, Universidade Anhembi Morumbi—UAM, Rua Casa do Ator, 294, Sao Paulo 04546-001, Brazil
- Centro de Inovação, Tecnología e Educação—CITÉ, Parque Tecnológico de São José dos Campos, Estrada Dr. Altino Bondesan 500, São José dos Campos 12247-016, Brazil
- Correspondence: (R.Z.); (P.M.); Tel.: +55-12-997830843 (R.Z.); +56-969028160 (P.M.)
| | - Pablo Muñoz
- Centro de Neurología Traslacional, Facultad de Medicina, Universidad de Valparaíso, Valparaíso 2341386, Chile
- Escuela de Medicina, Facultad de Medicina, Universidad de Valparaíso, Angamos 655, Viña del Mar 2540064, Chile
- Centro de Investigaciones Biomédicas, Facultad de Medicina, Universidad de Valparaíso, Angamos 655, Viña del Mar 2540064, Chile
- Correspondence: (R.Z.); (P.M.); Tel.: +55-12-997830843 (R.Z.); +56-969028160 (P.M.)
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16
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Elumalai V, Trobec T, Grundner M, Labriere C, Frangež R, Sepčić K, Hansen JH, Svenson J. Development of potent cholinesterase inhibitors based on a marine pharmacophore. Org Biomol Chem 2022; 20:5589-5601. [PMID: 35796650 DOI: 10.1039/d2ob01064j] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The management of neurological disorders such as dementia associated with Alzheimer's or Parkinson's disease includes the use of cholinesterase inhibitors. These compounds can slow down the progression of these diseases and can also be used in the treatment of glaucoma and myasthenia gravis. The majority of the cholinesterase inhibitors used in the clinic are derived from natural products and our current paper describes the use of a small marine pharmacophore to develop potent and selective cholinesterase inhibitors. Fourteen small inhibitors were designed based on recent discoveries about the inhibitory potential of a range of related marine secondary metabolites. The compounds were evaluated, in kinetic enzymatic assays, for their ability to inhibit three different cholinesterase enzymes and it was shown that compounds with a high inhibitory activity towards electric eel and human recombinant acetylcholinesterase (IC50 between 20-70 μM) could be prepared. It was also shown that this compound class was particularly active against horse serum butyrylcholinesterase, with IC50 values between 0.8-16 μM, which is an order of magnitude more potent than the clinically used positive control neostigmine. The compounds were further tested for off-target toxicity against both human umbilical vein endothelial cells and bovine and human erythrocytes and were shown to display a low mammalian cellular toxicity. Overall, the study illustrates how the brominated dipeptide marine pharmacophore can be used as a versatile natural scaffold for the design of potent, and selective cholinesterase inhibitors.
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Affiliation(s)
- Vijayaragavan Elumalai
- Department of Chemistry, Chemical Synthesis and Analysis Group, UiT The Arctic University of Norway, N-9037, Tromsø, Norway.
| | - Tomaž Trobec
- Institute of Preclinical Sciences, Veterinary Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Maja Grundner
- Department of Biology, Biotechnical Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Christophe Labriere
- Department of Chemistry, Chemical Synthesis and Analysis Group, UiT The Arctic University of Norway, N-9037, Tromsø, Norway.
| | - Robert Frangež
- Institute of Preclinical Sciences, Veterinary Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Kristina Sepčić
- Department of Biology, Biotechnical Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Jørn H Hansen
- Department of Chemistry, Chemical Synthesis and Analysis Group, UiT The Arctic University of Norway, N-9037, Tromsø, Norway.
| | - Johan Svenson
- Cawthron Institute, 98 Halifax Street East, Nelson 7010, New Zealand
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17
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Lamptey RNL, Chaulagain B, Trivedi R, Gothwal A, Layek B, Singh J. A Review of the Common Neurodegenerative Disorders: Current Therapeutic Approaches and the Potential Role of Nanotherapeutics. Int J Mol Sci 2022; 23:ijms23031851. [PMID: 35163773 PMCID: PMC8837071 DOI: 10.3390/ijms23031851] [Citation(s) in RCA: 168] [Impact Index Per Article: 84.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 11/16/2022] Open
Abstract
Neurodegenerative disorders are primarily characterized by neuron loss. The most common neurodegenerative disorders include Alzheimer’s and Parkinson’s disease. Although there are several medicines currently approved for managing neurodegenerative disorders, a large majority of them only help with associated symptoms. This lack of pathogenesis-targeting therapies is primarily due to the restrictive effects of the blood–brain barrier (BBB), which keeps close to 99% of all “foreign substances” out of the brain. Since their discovery, nanoparticles have been successfully used for targeted delivery into many organs, including the brain. This review briefly describes the pathophysiology of Alzheimer’s, Parkinson’s disease, and amyotrophic lateral sclerosis, and their current management approaches. We then highlight the major challenges of brain-drug delivery, followed by the role of nanotherapeutics for the diagnosis and treatment of various neurological disorders.
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Affiliation(s)
| | | | | | | | - Buddhadev Layek
- Correspondence: (B.L.); (J.S.); Tel.: +1-701-231-7906 (B.L.); +1-701-231-7943 (J.S.); Fax: +1-701-231-8333 (B.L. & J.S.)
| | - Jagdish Singh
- Correspondence: (B.L.); (J.S.); Tel.: +1-701-231-7906 (B.L.); +1-701-231-7943 (J.S.); Fax: +1-701-231-8333 (B.L. & J.S.)
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18
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Zeng Y, Nie L, Liu L, Niu C, Li Y, Bozorov K, Zhao J, Shen J, Aisa HA. Design, Synthesis, in vitro Evaluation of a New Pyrrolo[1,2‐
a
]thiazolo[5,4‐
d
]pyrimidinone Derivatives as Cholinesterase Inhibitors Against Alzheimer's Disease. J Heterocycl Chem 2022. [DOI: 10.1002/jhet.4452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Yan Zeng
- State Key Laboratory Basis of Xinjiang Indigenous Medicinal Plants Resource Utilization Xinjiang Technical Institute of Physics and Chemistry, Chinese Academy of Sciences Urumqi China
- University of Chinese Academy of Sciences Beijing China
| | - Lifei Nie
- State Key Laboratory Basis of Xinjiang Indigenous Medicinal Plants Resource Utilization Xinjiang Technical Institute of Physics and Chemistry, Chinese Academy of Sciences Urumqi China
| | - Liu Liu
- State Key Laboratory Basis of Xinjiang Indigenous Medicinal Plants Resource Utilization Xinjiang Technical Institute of Physics and Chemistry, Chinese Academy of Sciences Urumqi China
| | - Chao Niu
- State Key Laboratory Basis of Xinjiang Indigenous Medicinal Plants Resource Utilization Xinjiang Technical Institute of Physics and Chemistry, Chinese Academy of Sciences Urumqi China
- University of Chinese Academy of Sciences Beijing China
| | - Yi Li
- State Key Laboratory Basis of Xinjiang Indigenous Medicinal Plants Resource Utilization Xinjiang Technical Institute of Physics and Chemistry, Chinese Academy of Sciences Urumqi China
- University of Chinese Academy of Sciences Beijing China
| | - Khurshed Bozorov
- State Key Laboratory Basis of Xinjiang Indigenous Medicinal Plants Resource Utilization Xinjiang Technical Institute of Physics and Chemistry, Chinese Academy of Sciences Urumqi China
- Faculty of Chemistry Samarkand State University Samarkand Uzbekistan
| | - Jiangyu Zhao
- State Key Laboratory Basis of Xinjiang Indigenous Medicinal Plants Resource Utilization Xinjiang Technical Institute of Physics and Chemistry, Chinese Academy of Sciences Urumqi China
- University of Chinese Academy of Sciences Beijing China
| | - Jingshan Shen
- State Key Laboratory Basis of Xinjiang Indigenous Medicinal Plants Resource Utilization Xinjiang Technical Institute of Physics and Chemistry, Chinese Academy of Sciences Urumqi China
- Shanghai Institute of Materia Medica Chinese Academy of Sciences Shanghai China
| | - Haji Akber Aisa
- State Key Laboratory Basis of Xinjiang Indigenous Medicinal Plants Resource Utilization Xinjiang Technical Institute of Physics and Chemistry, Chinese Academy of Sciences Urumqi China
- University of Chinese Academy of Sciences Beijing China
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19
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Çakmak R, Başaran E, Şentürk M. Synthesis, characterization, and biological evaluation of some novel Schiff bases as potential metabolic enzyme inhibitors. Arch Pharm (Weinheim) 2022; 355:e2100430. [PMID: 34994010 DOI: 10.1002/ardp.202100430] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/09/2021] [Accepted: 12/21/2021] [Indexed: 01/02/2023]
Abstract
In this study, a series of novel Schiff base derivatives containing a pyrazolone ring (2a-e) were designed, successfully synthesized for the first time, and characterized by elemental analysis and some spectroscopic methods. These compounds were tested for their inhibitory activities on acetylcholinesterase (AChE), butyrylcholinesterase (BChE), and the human carbonic anhydrase isoenzymes I and II (hCA I and II). All synthesized molecules indicated significant inhibition effects with IC50 values ranging from 14.15 to 107.62 nM against these enzymes. Compound 2d showed the most potent inhibitory activity among the tested molecules toward AChE and BChE (IC50 = 15.07 and 14.15 nM) compared to the standard drug neostigmine. We determined that the IC50 values of the tested molecules ranged between 16.86 and 57.96 nM for hCA I and 15.24-46.21 nM for hCA II. As a consequence, we may say that some of the Schiff base derivatives may be used as potential drug candidates in later studies.
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Affiliation(s)
- Reşit Çakmak
- Medical Laboratory Techniques Program, Vocational School of Health Services, Batman University, Batman, Turkey
| | - Eyüp Başaran
- Department of Chemistry and Chemical Processing Technologies, Vocational School of Technical Sciences, Batman University, Batman, Turkey
| | - Murat Şentürk
- Department of Biochemistry, Pharmacy Faculty, Ağrı Ibrahim Çecen University, Ağrı, Turkey
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20
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OUP accepted manuscript. Brain 2022; 145:2250-2275. [DOI: 10.1093/brain/awac096] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 01/21/2022] [Accepted: 01/23/2022] [Indexed: 11/13/2022] Open
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21
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Liu CS, Herrmann N, Song BX, Ba J, Gallagher D, Oh PI, Marzolini S, Rajji TK, Charles J, Papneja P, Rapoport MJ, Andreazza AC, Vieira D, Kiss A, Lanctôt KL. Exercise priming with transcranial direct current stimulation: a study protocol for a randomized, parallel-design, sham-controlled trial in mild cognitive impairment and Alzheimer's disease. BMC Geriatr 2021; 21:677. [PMID: 34863115 PMCID: PMC8645072 DOI: 10.1186/s12877-021-02636-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/16/2021] [Indexed: 12/14/2022] Open
Abstract
Background Transcranial direct current stimulation (tDCS) is a non-invasive type of brain stimulation that uses electrical currents to modulate neuronal activity. A small number of studies have investigated the effects of tDCS on cognition in patients with Mild Cognitive Impairment (MCI) and Alzheimer’s disease (AD), and have demonstrated variable effects. Emerging evidence suggests that tDCS is most effective when applied to active brain circuits. Aerobic exercise is known to increase cortical excitability and improve brain network connectivity. Exercise may therefore be an effective, yet previously unexplored primer for tDCS to improve cognition in MCI and mild AD. Methods Participants with MCI or AD will be randomized to receive 10 sessions over 2 weeks of either exercise primed tDCS, exercise primed sham tDCS, or tDCS alone in a blinded, parallel-design trial. Those randomized to an exercise intervention will receive individualized 30-min aerobic exercise prescriptions to achieve a moderate-intensity dosage, equivalent to the ventilatory anaerobic threshold determined by cardiopulmonary assessment, to sufficiently increase cortical excitability. The tDCS protocol consists of 20 min sessions at 2 mA, 5 times per week for 2 weeks applied through 35 cm2 bitemporal electrodes. Our primary aim is to assess the efficacy of exercise primed tDCS for improving global cognition using the Montreal Cognitive Assessment (MoCA). Our secondary aims are to evaluate the efficacy of exercise primed tDCS for improving specific cognitive domains using various cognitive tests (n-back, Word Recall and Word Recognition Tasks from the Alzheimer’s Disease Assessment Scale-Cognitive subscale) and neuropsychiatric symptoms (Neuropsychiatric Inventory). We will also explore whether exercise primed tDCS is associated with an increase in markers of neurogenesis, oxidative stress and angiogenesis, and if changes in these markers are correlated with cognitive improvement. Discussion We describe a novel clinical trial to investigate the effects of exercise priming before tDCS in patients with MCI or mild AD. This proof-of-concept study may identify a previously unexplored, non-invasive, non-pharmacological combination intervention that improves cognitive symptoms in patients. Findings from this study may also identify potential mechanistic actions of tDCS in MCI and mild AD. Trial registration Clinicaltrials.gov, NCT03670615. Registered on September 13, 2018.
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Affiliation(s)
- Celina S Liu
- Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 3K1, Canada.,Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Nathan Herrmann
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
| | - Bing Xin Song
- Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 3K1, Canada.,Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Joycelyn Ba
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.,Department of Biology, Faculty of Science, The University of Western Ontario, London, ON, Canada
| | - Damien Gallagher
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
| | - Paul I Oh
- Cardiovascular Prevention and Rehabilitation Program, KITE - Toronto Rehabilitation Institute, University Health Network, 347 Rumsey Road, Toronto, ON, M5G 1R7, Canada
| | - Susan Marzolini
- Cardiovascular Prevention and Rehabilitation Program, KITE - Toronto Rehabilitation Institute, University Health Network, 347 Rumsey Road, Toronto, ON, M5G 1R7, Canada
| | - Tarek K Rajji
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Adult Neurodevelopment and Geriatric Psychiatry Division, Centre for Addiction & Mental Health, 80 Workman Way, Toronto, ON, M6J 1H4, Canada.,Toronto Dementia Research Alliance, University of Toronto, Toronto, ON, Canada
| | - Jocelyn Charles
- Family & Community Medicine, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Purti Papneja
- Family & Community Medicine, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Mark J Rapoport
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
| | - Ana C Andreazza
- Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 3K1, Canada
| | - Danielle Vieira
- Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Alex Kiss
- Institute for Clinical Evaluative Sciences, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Krista L Lanctôt
- Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 3K1, Canada. .,Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada. .,Department of Psychiatry, University of Toronto, Toronto, ON, Canada. .,Department of Psychiatry, Division of Geriatric Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada. .,Cardiovascular Prevention and Rehabilitation Program, KITE - Toronto Rehabilitation Institute, University Health Network, 347 Rumsey Road, Toronto, ON, M5G 1R7, Canada.
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22
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Shaikh S, Dhavan P, Uparkar J, Singh P, Vaidya SP, Jadhav BL, Ramana MMV. Synthesis, characterization, in vitro cholinesterase and hRBCs hemolysis assay and computational evaluation of novel 2,3,4,5-tetrahydrobenzothiazepine appended α-aminophosphonates. Bioorg Chem 2021; 116:105397. [PMID: 34628223 DOI: 10.1016/j.bioorg.2021.105397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/11/2021] [Accepted: 09/28/2021] [Indexed: 12/30/2022]
Abstract
A series of novel 2,3,4,5-tetrahydrobenzothiazepine appended α-aminophosphonate derivatives were synthesized by subjecting 2,3-dihydrobenzothiazepine to Pudovik reaction using diethyl phosphite. Tested derivatives exhibited better AChE inhibition (0.86-12.85 µM) when compared to BuChE (3.13-19.36 µM). Derivative 5f (IC50 = 0.86 ± 0.08 µM), 5g (IC50 = 1.05 ± 0.06 µM) and 5d (IC50 = 1.64 ± 0.06 µM) exhibited higher AChE inhibitory activity as compared to standard drug galantamine (IC50 = 2.15 ± 0.05 µM). Similarly, derivative 5e (IC50 = 3.13 ± 0.11 µM) and 5f (IC50 = 3.64 ± 0.06 µM) demonstrated comparable BuChE inhibitory activity to reference drug galantamine (IC50 = 3.86 ± 0.03 µM). Further, enzyme kinetic studies were carried out for the most active molecule i.e. derivative 5f (for AChE) and derivative 5e (for BuChE) and the results imply that derivatives 5f and 5e show mixed-type inhibition with Ki values of 1.779 µM and 3.851 µM respectively. Enzyme reversibility inhibition studies demonstrated that all the tested derivatives possess reversible inhibitor characteristics. In addition, % hemolysis studies were carried out using human red blood cells (hRBCs) and the results demonstrated that the synthesized derivatives were biocompatible in nature as they impart very less cytotoxicity to hRBCs (CC50 > 1000 μg/mL). Also, cell viability studies for tested derivatives revealed no cytotoxicity in N2a cells. Moreover, molecular docking studies revealed that derivative 5e and 5f bind to the PAS and CAS of the AChE. ADME predictions suggested that synthesized derivatives have high possibility of being drug-like.
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Affiliation(s)
- Sarfaraz Shaikh
- Department of Chemistry, University of Mumbai, Santacruz (E), Mumbai 400 098, India
| | - Pratik Dhavan
- Department of Life Sciences, University of Mumbai, Santacruz (E), Mumbai 400 098, India
| | - Jasmin Uparkar
- Department of Chemistry, University of Mumbai, Santacruz (E), Mumbai 400 098, India
| | - Pinky Singh
- Department of Microbiology, Haffkine Institute, Parel, Mumbai 400 012, India
| | - S P Vaidya
- Department of Microbiology, Haffkine Institute, Parel, Mumbai 400 012, India
| | - B L Jadhav
- Department of Life Sciences, University of Mumbai, Santacruz (E), Mumbai 400 098, India
| | - M M V Ramana
- Department of Chemistry, University of Mumbai, Santacruz (E), Mumbai 400 098, India.
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23
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Ruangritchankul S, Chantharit P, Srisuma S, Gray LC. Adverse Drug Reactions of Acetylcholinesterase Inhibitors in Older People Living with Dementia: A Comprehensive Literature Review. Ther Clin Risk Manag 2021; 17:927-949. [PMID: 34511919 PMCID: PMC8427072 DOI: 10.2147/tcrm.s323387] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 08/16/2021] [Indexed: 12/30/2022] Open
Abstract
The rising of global geriatric population has contributed to increased prevalence of dementia. Dementia is a neurodegenerative disease, which is characterized by progressive deterioration of cognitive functions, such as judgment, language, memory, attention and visuospatial ability. Dementia not only has profoundly devastating physical and psychological health outcomes, but it also poses a considerable healthcare expenditure and burdens. Acetylcholinesterase inhibitors (AChEIs), or so-called anti-dementia medications, have been developed to delay the progression of neurocognitive disorders and to decrease healthcare needs. AChEIs have been widely prescribed in clinical practice for the treatment of Alzheimer's disease, which account for 70% of dementia. The rising use of AChEIs results in increased adverse drug reactions (ADRs) such as cardiovascular and gastrointestinal adverse effects, resulting from overstimulation of peripheral cholinergic activity and muscarinic receptor activation. Changes in pharmacokinetics (PK), pharmacodynamics (PD) and pharmacogenetics (PGx), and occurrence of drug interactions are said to be major risk factors of ADRs of AChEIs in this population. To date, comprehensive reviews in ADRs of AChEIs have so far been scarcely studied. Therefore, we aimed to recapitulate and update the diverse aspects of AChEIs, including the mechanisms of action, characteristics and risk factors of ADRs, and preventive strategies of their ADRs. The collation of this knowledge is essential to facilitate efforts to reduce ADRs of AChEIs.
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Affiliation(s)
- Sirasa Ruangritchankul
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Prawat Chantharit
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sahaphume Srisuma
- Ramathibodi Poison Center and Division of Clinical Pharmacology and Toxicology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Leonard C Gray
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
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24
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Vilela AFL, Narciso Dos Reis VE, Cardoso CL. Co-Immobilized Capillary Enzyme Reactor Based on Beta-Secretase1 and Acetylcholinesterase: A Model for Dual-Ligand Screening. Front Chem 2021; 9:708374. [PMID: 34307303 PMCID: PMC8295500 DOI: 10.3389/fchem.2021.708374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 06/23/2021] [Indexed: 11/13/2022] Open
Abstract
We have developed a dual enzymatic system assay involving liquid chromatography-mass spectrometry (LC–MS) to screen AChE and BACE1 ligands. A fused silica capillary (30 cm × 0.1 mm i.d. × 0.362 mm e.d.) was used as solid support. The co-immobilization procedure encompassed two steps and random immobilization. The resulting huAChE+BACE1-ICER/MS was characterized by using acetylcholine (ACh) and JMV2236 as substrates. The best conditions for the dual enzymatic system assay were evaluated and compared to the conditions of the individual enzymatic system assays. Analysis was performed in series for each enzyme. The kinetic parameters (KMapp) and inhibition assays were evaluated. To validate the system, galantamine and a β-secretase inhibitor were employed as standard inhibitors, which confirmed that the developed screening assay was able to identify reference ligands and to provide quantitative parameters. The combination of these two enzymes in a single on-line system allowed possible multi-target inhibitors to be screened and identified. The innovative huAChE+BACE1-ICER/MS dual enzymatic system reported herein proved to be a reliable tool to identify and to characterize hit ligands for AChE and BACE1 in an enzymatic competitive environment. This innovative system assay involved lower costs; measured the product from enzymatic hydrolysis directly by MS; enabled immediate recovery of the enzymatic activity; showed specificity, selectivity, and sensitivity; and mimicked the cellular process.
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Affiliation(s)
- Adriana Ferreira Lopes Vilela
- Departamento de Química, Grupo de Cromatografia de Bioafinidade e Produtos Naturais, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Vitor Eduardo Narciso Dos Reis
- Departamento de Química, Grupo de Cromatografia de Bioafinidade e Produtos Naturais, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Carmen Lúcia Cardoso
- Departamento de Química, Grupo de Cromatografia de Bioafinidade e Produtos Naturais, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
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25
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Gascon S, Jann J, Langlois-Blais C, Plourde M, Lavoie C, Faucheux N. Peptides Derived from Growth Factors to Treat Alzheimer's Disease. Int J Mol Sci 2021; 22:ijms22116071. [PMID: 34199883 PMCID: PMC8200100 DOI: 10.3390/ijms22116071] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 05/30/2021] [Accepted: 06/01/2021] [Indexed: 12/13/2022] Open
Abstract
Alzheimer's disease (AD) is a devastating neurodegenerative disease characterized by progressive neuron losses in memory-related brain structures. The classical features of AD are a dysregulation of the cholinergic system, the accumulation of amyloid plaques, and neurofibrillary tangles. Unfortunately, current treatments are unable to cure or even delay the progression of the disease. Therefore, new therapeutic strategies have emerged, such as the exogenous administration of neurotrophic factors (e.g., NGF and BDNF) that are deficient or dysregulated in AD. However, their low capacity to cross the blood-brain barrier and their exorbitant cost currently limit their use. To overcome these limitations, short peptides mimicking the binding receptor sites of these growth factors have been developed. Such peptides can target selective signaling pathways involved in neuron survival, differentiation, and/or maintenance. This review focuses on growth factors and their derived peptides as potential treatment for AD. It describes (1) the physiological functions of growth factors in the brain, their neuronal signaling pathways, and alteration in AD; (2) the strategies to develop peptides derived from growth factor and their capacity to mimic the role of native proteins; and (3) new advancements and potential in using these molecules as therapeutic treatments for AD, as well as their limitations.
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Affiliation(s)
- Suzanne Gascon
- Laboratory of Cell-Biomaterial Biohybrid Systems, Department of Chemical and Biotechnological Engineering, 2500 Boulevard Université, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada; (S.G.); (J.J.)
| | - Jessica Jann
- Laboratory of Cell-Biomaterial Biohybrid Systems, Department of Chemical and Biotechnological Engineering, 2500 Boulevard Université, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada; (S.G.); (J.J.)
| | - Chloé Langlois-Blais
- Département de Pharmacologie-Physiologie, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada;
| | - Mélanie Plourde
- Centre de Recherche sur le Vieillissement, Centre Intégré Universitaire de Santé et Services Sociaux de l’Estrie–Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC J1G 1B1, Canada;
- Département de Médecine, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
| | - Christine Lavoie
- Département de Pharmacologie-Physiologie, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada;
- Institut de Pharmacologie de Sherbrooke, 3001 12th Avenue, N., Sherbrooke, QC J1H 5N4, Canada
- Correspondence: (C.L.); (N.F.); Tel.: +1-819-821-8000 (ext. 72732) (C.L.); +1-819-821-8000 (ext. 61343) (N.F.)
| | - Nathalie Faucheux
- Laboratory of Cell-Biomaterial Biohybrid Systems, Department of Chemical and Biotechnological Engineering, 2500 Boulevard Université, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada; (S.G.); (J.J.)
- Institut de Pharmacologie de Sherbrooke, 3001 12th Avenue, N., Sherbrooke, QC J1H 5N4, Canada
- Correspondence: (C.L.); (N.F.); Tel.: +1-819-821-8000 (ext. 72732) (C.L.); +1-819-821-8000 (ext. 61343) (N.F.)
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Chen Z, Zhang H, Guo Y, George TJ, Prosperi M, Hogan WR, He Z, Shenkman EA, Wang F, Bian J. Exploring the feasibility of using real-world data from a large clinical data research network to simulate clinical trials of Alzheimer's disease. NPJ Digit Med 2021; 4:84. [PMID: 33990663 PMCID: PMC8121837 DOI: 10.1038/s41746-021-00452-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 04/06/2021] [Indexed: 02/06/2023] Open
Abstract
In this study, we explored the feasibility of using real-world data (RWD) from a large clinical research network to simulate real-world clinical trials of Alzheimer’s disease (AD). The target trial (i.e., NCT00478205) is a Phase III double-blind, parallel-group trial that compared the 23 mg donepezil sustained release with the 10 mg donepezil immediate release formulation in patients with moderate to severe AD. We followed the target trial’s study protocol to identify the study population, treatment regimen assignments and outcome assessments, and to set up a number of different simulation scenarios and parameters. We considered two main scenarios: (1) a one-arm simulation: simulating a standard-of-care (SOC) arm that can serve as an external control arm; and (2) a two-arm simulation: simulating both intervention and control arms with proper patient matching algorithms for comparative effectiveness analysis. In the two-arm simulation scenario, we used propensity score matching controlling for baseline characteristics to simulate the randomization process. In the two-arm simulation, higher serious adverse event (SAE) rates were observed in the simulated trials than the rates reported in original trial, and a higher SAE rate was observed in the 23 mg arm than in the 10 mg SOC arm. In the one-arm simulation scenario, similar estimates of SAE rates were observed when proportional sampling was used to control demographic variables. In conclusion, trial simulation using RWD is feasible in this example of AD trial in terms of safety evaluation. Trial simulation using RWD could be a valuable tool for post-market comparative effectiveness studies and for informing future trials’ design. Nevertheless, such an approach may be limited, for example, by the availability of RWD that matches the target trials of interest, and further investigations are warranted.
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Affiliation(s)
- Zhaoyi Chen
- Health Outcomes & Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Hansi Zhang
- Health Outcomes & Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Yi Guo
- Health Outcomes & Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Thomas J George
- Hematology & Oncology, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Mattia Prosperi
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, FL, USA
| | - William R Hogan
- Health Outcomes & Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Zhe He
- School of Information, Florida State University, Tallahassee, FL, USA
| | - Elizabeth A Shenkman
- Health Outcomes & Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Fei Wang
- Department of Healthcare Policy and Research, Cornell University, New York, NY, USA
| | - Jiang Bian
- Health Outcomes & Biomedical Informatics, University of Florida, Gainesville, FL, USA.
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Pohanka M. Inhibitors of Cholinesterases in Pharmacology: the Current Trends. Mini Rev Med Chem 2021; 20:1532-1542. [PMID: 31656151 DOI: 10.2174/1389557519666191018170908] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 03/30/2018] [Accepted: 05/27/2018] [Indexed: 12/20/2022]
Abstract
Inhibitors of cholinesterases are a wide group of low molecular weight compounds with a significant role in the current pharmacology. Besides the pharmacological importance, they are also known as toxic compounds like military nerve agents. In the pharmacology, drugs for Alzheimer disease, myasthenia gravis and prophylaxis of poisoning by nerve agents can be mentioned as the relevant applications. Besides this, anti-inflammation and antiphrastic drugs are other pharmacological applications of these inhibitors. This review is focused on a survey of cholinesterase inhibitors with known or expected pharmacological impact and indications of their use. Recent literature with comments is provided here as well.
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Affiliation(s)
- Miroslav Pohanka
- Faculty of Military Health Sciences, University of Defense, Trebesska 1575, Hradec Kralove, Czech Republic
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28
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Noori T, Dehpour AR, Sureda A, Sobarzo-Sanchez E, Shirooie S. Role of natural products for the treatment of Alzheimer's disease. Eur J Pharmacol 2021; 898:173974. [PMID: 33652057 DOI: 10.1016/j.ejphar.2021.173974] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 02/09/2021] [Accepted: 02/19/2021] [Indexed: 12/19/2022]
Abstract
Negative psychological and physiological consequences of neurodegenerative disorders represent a high social and health cost. Among the neurodegenerative disorders Alzheimer's disease (AD) is recognized as a leading neurodegenerative condition and a primary cause of dementia in the elderlys. AD is considered as neurodegenerative disorder that progressively impairs cognitive function and memory. According to current epidemiological data, about 50 milLion people worldwide are suffering from AD. The primary symptoms of AD are almost inappreciable and usually comprise forgetfulness of recent events. Numerous processes are involved in the development of AD, for example oxidative stress (OS) mainly due to mitochondrial dysfunction, intracellular the accumulation of hyperphosphorylated tau (τ) proteins in the form of neurofibrillary tangles, excessive the accumulation of extracellular plaques of beta-amyloid (Aβ), genetic and environmental factors. Running treatments only attenuate symptoms and temporarily reduce the rate of cognitive progression associated with AD. This means that most treatments focus only on controlLing symptoms, particularly in the initial stages of the disease. In the past, the first choice of treatment was based on natural ingredients. In this sense, diverse natural products (NPs) are capable to decrease the symptoms and alleviate the development of several diseases including AD attracting the attention of the scientific community and the pharmaceutical industry. Specifically, numerous NPs including flavonoids, gingerols, tannins, anthocyanins, triterpenes and alkaloids have been shown anti-inflammatory, antioxidant, anti-amyloidogenic, and anti-choLinesterase properties. This review provide a summary of the pathogenesis and the therapeutic goals of AD. It also discusses the available data on various plants and isolated natural compounds used to prevent and diminish the symptoms of AD.
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Affiliation(s)
- Tayebeh Noori
- Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ahmad Reza Dehpour
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Experimental Medicine Research Center, TUMS, Tehran, Iran
| | - Antoni Sureda
- Research Group on Community Nutrition and Oxidative Stress (NUCOX), University Research Institute of Health Sciences (IUNICS), and Health Research Institute of Balearic Islands (IdISBa), University of Balearic Islands, Palma de Mallorca E-07122, Balearic Islands, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
| | - Eduardo Sobarzo-Sanchez
- Instituto de Investigación y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago, Chile; Department of Organic Chemistry, Faculty of Pharmacy, University of Santiago de Compostela, Spain
| | - Samira Shirooie
- Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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29
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Das M, Devi KP. Dihydroactinidiolide regulates Nrf2/HO-1 expression and inhibits caspase-3/Bax pathway to protect SH-SY5Y human neuroblastoma cells from oxidative stress induced neuronal apoptosis. Neurotoxicology 2021; 84:53-63. [PMID: 33617922 DOI: 10.1016/j.neuro.2021.02.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 12/21/2020] [Accepted: 02/17/2021] [Indexed: 02/07/2023]
Abstract
Alzheimer's disease (AD) etiology has been studied for a long time and it is found to be multifaceted involving the accumulation of amyloid β and tau protein. Oxidative stress is an early event in AD associated neurodegeneration provoking neuronal death through mitochondrial dysfunction and activation of caspase-3. Therefore we tested the efficacy of dihydroactinidiolide (DHAc), a monoterpene lactone against the oxidative load involved in AD like pathological conditions induced by sodium dithionite, glutamate, amyloid β and colchicine in SH-SY5Y cells. Some of the indicators of neurotoxicity like acetylcholinesterase activity, intracellular reactive oxygen species (ROS), nitrite content, lipid peroxidation, protein carbonylation, nuclear and membrane damage were found to be significantly high in the toxicant treated cells when compared to the control cells while DHAc pretreatment significantly restored the toxicant induced neuronal damage signatures. Caspase-3 activity was found to be increased in the toxicant treated cells while DHAc significantly reduced it. Western blotting and RT-PCR revealed that DHAc significantly increased anti-apoptotic Bcl-2 expression and mRNA levels of Nrf2 and HO-1. Therefore DHAc was found to protect SH-SY5Y cells from neurotoxicant induced oxidative stress and apoptosis by regulating cellular antioxidant defenses and apoptosis related genes.
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Affiliation(s)
- Mamali Das
- Department of Biotechnology, Alagappa University (Science Campus), Karaikudi, 630003, India
| | - Kasi Pandima Devi
- Department of Biotechnology, Alagappa University (Science Campus), Karaikudi, 630003, India.
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Parsons C, Lim WY, Loy C, McGuinness B, Passmore P, Ward SA, Hughes C. Withdrawal or continuation of cholinesterase inhibitors or memantine or both, in people with dementia. Cochrane Database Syst Rev 2021; 2:CD009081. [PMID: 35608903 PMCID: PMC8094886 DOI: 10.1002/14651858.cd009081.pub2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Dementia is a progressive syndrome characterised by deterioration in memory, thinking and behaviour, and by impaired ability to perform daily activities. Two classes of drug - cholinesterase inhibitors (donepezil, galantamine and rivastigmine) and memantine - are widely licensed for dementia due to Alzheimer's disease, and rivastigmine is also licensed for Parkinson's disease dementia. These drugs are prescribed to alleviate symptoms and delay disease progression in these and sometimes in other forms of dementia. There are uncertainties about the benefits and adverse effects of these drugs in the long term and in severe dementia, about effects of withdrawal, and about the most appropriate time to discontinue treatment. OBJECTIVES To evaluate the effects of withdrawal or continuation of cholinesterase inhibitors or memantine, or both, in people with dementia on: cognitive, neuropsychiatric and functional outcomes, rates of institutionalisation, adverse events, dropout from trials, mortality, quality of life and carer-related outcomes. SEARCH METHODS We searched the Cochrane Dementia and Cognitive Improvement Group's Specialised Register up to 17 October 2020 using terms appropriate for the retrieval of studies of cholinesterase inhibitors or memantine. The Specialised Register contains records of clinical trials identified from monthly searches of a number of major healthcare databases, numerous trial registries and grey literature sources. SELECTION CRITERIA We included all randomised, controlled clinical trials (RCTs) which compared withdrawal of cholinesterase inhibitors or memantine, or both, with continuation of the same drug or drugs. DATA COLLECTION AND ANALYSIS Two review authors independently assessed citations and full-text articles for inclusion, extracted data from included trials and assessed risk of bias using the Cochrane risk of bias tool. Where trials were sufficiently similar, we pooled data for outcomes in the short term (up to 2 months after randomisation), medium term (3-11 months) and long term (12 months or more). We assessed the overall certainty of the evidence for each outcome using GRADE methods. MAIN RESULTS We included six trials investigating cholinesterase inhibitor withdrawal, and one trial investigating withdrawal of either donepezil or memantine. No trials assessed withdrawal of memantine only. Drugs were withdrawn abruptly in five trials and stepwise in two trials. All participants had dementia due to Alzheimer's disease, with severities ranging from mild to very severe, and were taking cholinesterase inhibitors without known adverse effects at baseline. The included trials randomised 759 participants to treatment groups relevant to this review. Study duration ranged from 6 weeks to 12 months. There were too few included studies to allow planned subgroup analyses. We considered some studies to be at unclear or high risk of selection, performance, detection, attrition or reporting bias. Compared to continuing cholinesterase inhibitors, discontinuing treatment may be associated with worse cognitive function in the short term (standardised mean difference (SMD) -0.42, 95% confidence interval (CI) -0.64 to -0.21; 4 studies; low certainty), but the effect in the medium term is very uncertain (SMD -0.40, 95% CI -0.87 to 0.07; 3 studies; very low certainty). In a sensitivity analysis omitting data from a study which only included participants who had shown a relatively poor prior response to donepezil, inconsistency was reduced and we found that cognitive function may be worse in the discontinuation group in the medium term (SMD -0.62; 95% CI -0.94 to -0.31). Data from one longer-term study suggest that discontinuing a cholinesterase inhibitor is probably associated with worse cognitive function at 12 months (mean difference (MD) -2.09 Standardised Mini-Mental State Examination (SMMSE) points, 95% CI -3.43 to -0.75; moderate certainty). Discontinuation may make little or no difference to functional status in the short term (SMD -0.25, 95% CI -0.54 to 0.04; 2 studies; low certainty), and its effect in the medium term is uncertain (SMD -0.38, 95% CI -0.74 to -0.01; 2 studies; very low certainty). After 12 months, discontinuing a cholinesterase inhibitor probably results in greater functional impairment than continuing treatment (MD -3.38 Bristol Activities of Daily Living Scale (BADLS) points, 95% CI -6.67 to -0.10; one study; moderate certainty). Discontinuation may be associated with a worsening of neuropsychiatric symptoms over the short term and medium term, although we cannot exclude a minimal effect (SMD - 0.48, 95% CI -0.82 to -0.13; 2 studies; low certainty; and SMD -0.27, 95% CI -0.47 to -0.08; 3 studies; low certainty, respectively). Data from one study suggest that discontinuing a cholinesterase inhibitor may result in little to no change in neuropsychiatric status at 12 months (MD -0.87 Neuropsychiatric Inventory (NPI) points; 95% CI -8.42 to 6.68; moderate certainty). We found no clear evidence of an effect of discontinuation on dropout due to lack of medication efficacy or deterioration in overall medical condition (odds ratio (OR) 1.53, 95% CI 0.84 to 2.76; 4 studies; low certainty), on number of adverse events (OR 0.85, 95% CI 0.57 to 1.27; 4 studies; low certainty) or serious adverse events (OR 0.80, 95% CI 0.46 to 1.39; 4 studies; low certainty), and on mortality (OR 0.75, 95% CI 0.36 to 1.55; 5 studies; low certainty). Institutionalisation was reported in one trial, but it was not possible to extract data for the groups relevant to this review. AUTHORS' CONCLUSIONS This review suggests that discontinuing cholinesterase inhibitors may result in worse cognitive, neuropsychiatric and functional status than continuing treatment, although this is supported by limited evidence, almost all of low or very low certainty. As all participants had dementia due to Alzheimer's disease, our findings are not transferable to other dementia types. We were unable to determine whether the effects of discontinuing cholinesterase inhibitors differed with baseline dementia severity. There is currently no evidence to guide decisions about discontinuing memantine. There is a need for further well-designed RCTs, across a range of dementia severities and settings. We are aware of two ongoing registered trials. In making decisions about discontinuing these drugs, clinicians should exercise caution, considering the evidence from existing trials along with other factors important to patients and their carers.
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Affiliation(s)
- Carole Parsons
- School of Pharmacy, Queen's University Belfast, Belfast, UK
| | - Wei Yin Lim
- Centre for Clinical Epidemiology, Institute for Clinical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Clement Loy
- Brain and Mind Centre and Sydney School of Public Health, Faculty of Medicine, University of Sydney, Sydney, Australia
| | | | - Peter Passmore
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Stephanie A Ward
- Monash Aging Research Center, The Kingston Centre, Cheltenham, Australia
| | - Carmel Hughes
- School of Pharmacy, Queen's University Belfast, Belfast, UK
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Viayna E, Coquelle N, Cieslikiewicz-Bouet M, Cisternas P, Oliva CA, Sánchez-López E, Ettcheto M, Bartolini M, De Simone A, Ricchini M, Rendina M, Pons M, Firuzi O, Pérez B, Saso L, Andrisano V, Nachon F, Brazzolotto X, García ML, Camins A, Silman I, Jean L, Inestrosa NC, Colletier JP, Renard PY, Muñoz-Torrero D. Discovery of a Potent Dual Inhibitor of Acetylcholinesterase and Butyrylcholinesterase with Antioxidant Activity that Alleviates Alzheimer-like Pathology in Old APP/PS1 Mice. J Med Chem 2020; 64:812-839. [PMID: 33356266 DOI: 10.1021/acs.jmedchem.0c01775] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The combination of the scaffolds of the cholinesterase inhibitor huprine Y and the antioxidant capsaicin results in compounds with nanomolar potencies toward human acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) that retain or improve the antioxidant properties of capsaicin. Crystal structures of their complexes with AChE and BChE revealed the molecular basis for their high potency. Brain penetration was confirmed by biodistribution studies in C57BL6 mice, with one compound (5i) displaying better brain/plasma ratio than donepezil. Chronic treatment of 10 month-old APP/PS1 mice with 5i (2 mg/kg, i.p., 3 times per week, 4 weeks) rescued learning and memory impairments, as measured by three different behavioral tests, delayed the Alzheimer-like pathology progression, as suggested by a significantly reduced Aβ42/Aβ40 ratio in the hippocampus, improved basal synaptic efficacy, and significantly reduced hippocampal oxidative stress and neuroinflammation. Compound 5i emerges as an interesting anti-Alzheimer lead with beneficial effects on cognitive symptoms and on some underlying disease mechanisms.
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Affiliation(s)
- Elisabet Viayna
- Laboratory of Medicinal Chemistry (CSIC Associated Unit), Faculty of Pharmacy and Food Sciences, and Institute of Biomedicine (IBUB), University of Barcelona, Av. Joan XXIII 27-31, E-08028 Barcelona, Spain
| | - Nicolas Coquelle
- Institut de Biologie Structurale, Université Grenoble Alpes, CEA, CNRS UMR 5075, F-38054 Grenoble, France.,Large Scale Structures Group, Institut Laue-Langevin, F-38042 Grenoble Cedex 9, France
| | | | - Pedro Cisternas
- Center of Aging and Regeneration UC (CARE-UC), Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O'Higgins 340, P.O. Box 114, 8331150 Santiago, Chile
| | - Carolina A Oliva
- Center of Aging and Regeneration UC (CARE-UC), Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O'Higgins 340, P.O. Box 114, 8331150 Santiago, Chile
| | - Elena Sánchez-López
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, and Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, Av. Joan XXIII 27-31, E-08028 Barcelona, Spain.,Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Institute of Health Carlos III, E-28031 Madrid, Spain
| | - Miren Ettcheto
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Institute of Health Carlos III, E-28031 Madrid, Spain.,Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Sciences, and Institute of Neuroscience, University of Barcelona, Av. Joan XXIII 27-31, E-08028 Barcelona, Spain.,Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, University Rovira i Virgili, E-43201 Reus, Spain
| | - Manuela Bartolini
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum University of Bologna, Via Belmeloro 6, I-40126 Bologna, Italy
| | - Angela De Simone
- Department of Drug Science and Technology, University of Turin, I-10125 Torino, Italy
| | - Mattia Ricchini
- Laboratory of Medicinal Chemistry (CSIC Associated Unit), Faculty of Pharmacy and Food Sciences, and Institute of Biomedicine (IBUB), University of Barcelona, Av. Joan XXIII 27-31, E-08028 Barcelona, Spain
| | - Marisa Rendina
- Laboratory of Medicinal Chemistry (CSIC Associated Unit), Faculty of Pharmacy and Food Sciences, and Institute of Biomedicine (IBUB), University of Barcelona, Av. Joan XXIII 27-31, E-08028 Barcelona, Spain
| | - Mégane Pons
- Normandie University, UNIROUEN, INSA Rouen, CNRS, COBRA (UMR 6014), 76000 Rouen, France
| | - Omidreza Firuzi
- Medicinal and Natural Products Chemistry Research Center, Shiraz University of Medical Sciences, PO Box 3288, 71345 Shiraz, Iran
| | - Belén Pérez
- Department of Pharmacology, Therapeutics and Toxicology, Autonomous University of Barcelona, E-08193 Bellaterra, Barcelona, Spain
| | - Luciano Saso
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, P.le Aldo Moro 5, 00185 Rome, Italy
| | - Vincenza Andrisano
- Department for Life Quality Studies, University of Bologna, Corso d'Augusto 237, I-47921 Rimini, Italy
| | - Florian Nachon
- Département de Toxicologie et Risques Chimiques, Institut de Recherche Biomédicale des Armées BP73, 91993 Brétigny sur Orge, France
| | - Xavier Brazzolotto
- Département de Toxicologie et Risques Chimiques, Institut de Recherche Biomédicale des Armées BP73, 91993 Brétigny sur Orge, France
| | - Maria Luisa García
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, and Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, Av. Joan XXIII 27-31, E-08028 Barcelona, Spain.,Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Institute of Health Carlos III, E-28031 Madrid, Spain
| | - Antoni Camins
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Institute of Health Carlos III, E-28031 Madrid, Spain.,Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Sciences, and Institute of Neuroscience, University of Barcelona, Av. Joan XXIII 27-31, E-08028 Barcelona, Spain
| | - Israel Silman
- Department of Neurobiology, Weizmann Institute of Science, 76100 Rehovot, Israel
| | - Ludovic Jean
- Normandie University, UNIROUEN, INSA Rouen, CNRS, COBRA (UMR 6014), 76000 Rouen, France
| | - Nibaldo C Inestrosa
- Center of Aging and Regeneration UC (CARE-UC), Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O'Higgins 340, P.O. Box 114, 8331150 Santiago, Chile.,Centro de Excelencia en Biomedicina de Magallanes (CEBIMA), Universidad de Magallanes, 6200000 Punta Arenas, Chile
| | - Jacques-Philippe Colletier
- Institut de Biologie Structurale, Université Grenoble Alpes, CEA, CNRS UMR 5075, F-38054 Grenoble, France
| | - Pierre-Yves Renard
- Normandie University, UNIROUEN, INSA Rouen, CNRS, COBRA (UMR 6014), 76000 Rouen, France
| | - Diego Muñoz-Torrero
- Laboratory of Medicinal Chemistry (CSIC Associated Unit), Faculty of Pharmacy and Food Sciences, and Institute of Biomedicine (IBUB), University of Barcelona, Av. Joan XXIII 27-31, E-08028 Barcelona, Spain
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Shaikh S, Dhavan P, Singh P, Uparkar J, Vaidya SP, Jadhav BL, Ramana MV. Synthesis of carbazole based α-aminophosphonate derivatives: design, molecular docking and in vitro cholinesterase activity. J Biomol Struct Dyn 2020; 40:4801-4814. [PMID: 33345710 DOI: 10.1080/07391102.2020.1861981] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
A series of novel carbazole based α-aminophosphonate derivatives were synthesized under solvent-free condition, characterized and evaluated for their cholinesterase inhibition, enzyme kinetic inhibition, in-vitro cell viability using N2a cells, neuroprotective studies against H2O2-induced stress using N2a cells and antioxidant studies using DPPH radical activity. Test compounds displayed better AChE activity (0.475 to 7.781 µM) than BuChE (3.306 to 21.32 µM). Compound 4j was most potent derivative against AChE as well as BuChE with IC50=0.475 ± 0.12 µM and IC50=3.306 ± 0.21 µM respectively. Kinetic inhibition studies indicate that compound 4j exhibits mixed type inhibition against both enzymes which was supported by molecular docking studies. Cell viability studies showed that compounds did not induce any cytotoxic effect against N2a cells using MTT assay. Also, compound 4j, 4 s and 4r were subjected to H2O2-induced stress using N2a cells and were found to be protective in nature. ADME predictions were carried out to understand the pharmacokinetics behaviour.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Sarfaraz Shaikh
- Department of Chemistry, University of Mumbai, Mumbai, India
| | - Pratik Dhavan
- Department of Life sciences, University of Mumbai, Mumbai, India
| | - Pinky Singh
- Biology Department, Haffkine Institute, Parel, Mumbai, India
| | - Jasmin Uparkar
- Department of Chemistry, University of Mumbai, Mumbai, India
| | - S P Vaidya
- Biology Department, Haffkine Institute, Parel, Mumbai, India
| | - B L Jadhav
- Department of Life sciences, University of Mumbai, Mumbai, India
| | - M V Ramana
- Department of Chemistry, University of Mumbai, Mumbai, India
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Farouk FM, Ooi L, Law CSW, Yeong KY. Dual‐Target‐Directed Ligand Displaying Selective Butyrylcholinesterase Inhibitory and Neurite Promoting Activities as a Potential Therapeutic for Alzheimer's Disease. ChemistrySelect 2020. [DOI: 10.1002/slct.202001202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Fathima Manaal Farouk
- School of Science Monash University Malaysia Campus Jalan Lagoon Selatan, Bandar Sunway 47500 Selangor Malaysia
| | - Luyi Ooi
- School of Science Monash University Malaysia Campus Jalan Lagoon Selatan, Bandar Sunway 47500 Selangor Malaysia
| | - Christine Shing Wei Law
- School of Science Monash University Malaysia Campus Jalan Lagoon Selatan, Bandar Sunway 47500 Selangor Malaysia
| | - Keng Yoon Yeong
- School of Science Monash University Malaysia Campus Jalan Lagoon Selatan, Bandar Sunway 47500 Selangor Malaysia
- Tropical Medicine and Biology (TMB) multidisciplinary platform Monash University Malaysia 47500 Bandar Sunway Selangor Malaysia
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Purgatorio R, Kulikova LN, Pisani L, Catto M, Candia M, Carrieri A, Cellamare S, De Palma A, Beloglazkin AA, Reza Raesi G, Voskressensky LG, Altomare CD. Scouting around 1,2,3,4‐Tetrahydrochromeno[3,2‐
c
]pyridin‐10‐ones for Single‐ and Multitarget Ligands Directed towards Relevant Alzheimer's Targets. ChemMedChem 2020; 15:1947-1955. [DOI: 10.1002/cmdc.202000468] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Indexed: 01/03/2023]
Affiliation(s)
- Rosa Purgatorio
- Department of Pharmacy-Drug Sciences University of Bari Aldo Moro Via E. Orabona 4 70125 Bari Italy
| | - Larisa N. Kulikova
- Organic Chemistry Department Peoples' Friendship University of Russia (RUDN) 6 Miklukho-Maklaya St. Moscow 117198 Russia
| | - Leonardo Pisani
- Department of Pharmacy-Drug Sciences University of Bari Aldo Moro Via E. Orabona 4 70125 Bari Italy
| | - Marco Catto
- Department of Pharmacy-Drug Sciences University of Bari Aldo Moro Via E. Orabona 4 70125 Bari Italy
| | - Modesto Candia
- Department of Pharmacy-Drug Sciences University of Bari Aldo Moro Via E. Orabona 4 70125 Bari Italy
| | - Antonio Carrieri
- Department of Pharmacy-Drug Sciences University of Bari Aldo Moro Via E. Orabona 4 70125 Bari Italy
| | - Saverio Cellamare
- Department of Pharmacy-Drug Sciences University of Bari Aldo Moro Via E. Orabona 4 70125 Bari Italy
| | - Annalisa De Palma
- Department of Biosciences, Biotechnologies and Biopharmaceutics University of Bari Aldo Moro Via E. Orabona 4 70125 Bari Italy
| | - Andrey A. Beloglazkin
- Organic Chemistry Department Peoples' Friendship University of Russia (RUDN) 6 Miklukho-Maklaya St. Moscow 117198 Russia
| | - Ghulam Reza Raesi
- Organic Chemistry Department Peoples' Friendship University of Russia (RUDN) 6 Miklukho-Maklaya St. Moscow 117198 Russia
| | - Leonid G. Voskressensky
- Organic Chemistry Department Peoples' Friendship University of Russia (RUDN) 6 Miklukho-Maklaya St. Moscow 117198 Russia
| | - Cosimo D. Altomare
- Department of Pharmacy-Drug Sciences University of Bari Aldo Moro Via E. Orabona 4 70125 Bari Italy
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Pohanka M. Diagnoses of Pathological States Based on Acetylcholinesterase and Butyrylcholinesterase. Curr Med Chem 2020; 27:2994-3011. [PMID: 30706778 DOI: 10.2174/0929867326666190130161202] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 12/15/2022]
Abstract
Two cholinesterases exist: Acetylcholinesterase (AChE) and butyrylcholinesterase (BChE). While AChE plays a crucial role in neurotransmissions, BChE has no specific function apart from the detoxification of some drugs and secondary metabolites from plants. Thus, both AChE and BChE can serve as biochemical markers of various pathologies. Poisoning by nerve agents like sarin, soman, tabun, VX, novichok and overdosing by drugs used in some neurodegenerative disorders like Alzheimer´s disease and myasthenia gravis, as well as poisoning by organophosphorus pesticides are relevant to this issue. But it appears that changes in these enzymes take place in other processes including oxidative stress, inflammation, some types of cancer and genetically conditioned diseases. In this review, the cholinesterases are introduced, the mechanism of inhibitors action is explained and the relations between the cholinesterases and pathologies are explained.
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Affiliation(s)
- Miroslav Pohanka
- Faculty of Military Health Sciences, University of Defence, Trebesska 1575, 50001 Hradec Kralove, Czech Republic
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36
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Droguerre M, Duchêne A, Picoli C, Portal B, Lejards C, Guiard BP, Meunier J, Villard V, Déglon N, Hamon M, Mouthon F, Charvériat M. Efficacy of THN201, a Combination of Donepezil and Mefloquine, to Reverse Neurocognitive Deficits in Alzheimer's Disease. Front Neurosci 2020; 14:563. [PMID: 32612499 PMCID: PMC7309601 DOI: 10.3389/fnins.2020.00563] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 05/07/2020] [Indexed: 01/15/2023] Open
Abstract
Donepezil (DPZ) is an acetylcholinesterase inhibitor used in Alzheimer’s disease to restore cognitive functions but is endowed with limited efficacy. Recent studies pointed out the implication of astroglial networks in cognitive processes, notably via astrocyte connexins (Cxs), proteins involved in gap junction intercellular communications. Hence, we investigated the impact on cognition of pharmacological or genetic modulations of those astrocyte Cxs during DPZ challenge in two rodent models of Alzheimer’s disease–like memory deficits. We demonstrated that the Cx modulator mefloquine (MEF) significantly enhanced the procognitive effect of DPZ in both models. In parallel, we determined that MEF potentiated DPZ-induced release of acetylcholine in hippocampus. Finally, local genetic silencing of astrocyte Cxs in the hippocampus was also found to enhance the procognitive effect of DPZ, pointing out the importance of Cx-dependent astrocyte networks in memory processes.
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Affiliation(s)
| | | | | | - Benjamin Portal
- Centre de Recherches sur la Cognition Animale (CRCA), Centre de Biologie Intégrative (CBI), CNRS, UPS, Université de Toulouse, Toulouse, France
| | - Camille Lejards
- Centre de Recherches sur la Cognition Animale (CRCA), Centre de Biologie Intégrative (CBI), CNRS, UPS, Université de Toulouse, Toulouse, France
| | - Bruno P Guiard
- Centre de Recherches sur la Cognition Animale (CRCA), Centre de Biologie Intégrative (CBI), CNRS, UPS, Université de Toulouse, Toulouse, France
| | | | | | - Nicole Déglon
- Laboratory of Neurotherapies and NeuroModulation, Neuroscience Research Center (CRN), University of Lausanne, Lausanne, Switzerland.,Laboratory of Neurotherapies and NeuroModulation, Department of Clinical Neuroscience (DNC), Lausanne University Hospital (CHUV), Lausanne, Switzerland
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37
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Wang J, Hu WW, Jiang Z, Feng MJ. Advances in treatment of neurodegenerative diseases: Perspectives for combination of stem cells with neurotrophic factors. World J Stem Cells 2020; 12:323-338. [PMID: 32547681 PMCID: PMC7280867 DOI: 10.4252/wjsc.v12.i5.323] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/31/2020] [Accepted: 04/07/2020] [Indexed: 02/06/2023] Open
Abstract
Neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease, Huntington's disease and amyotrophic lateral sclerosis, are a group of incurable neurological disorders, characterized by the chronic progressive loss of different neuronal subtypes. However, despite its increasing prevalence among the ever-increasing aging population, little progress has been made in the coincident immense efforts towards development of therapeutic agents. Research interest has recently turned towards stem cells including stem cells-derived exosomes, neurotrophic factors, and their combination as potential therapeutic agents in neurodegenerative diseases. In this review, we summarize the progress in therapeutic strategies based on stem cells combined with neurotrophic factors and mesenchymal stem cells-derived exosomes for neurodegenerative diseases, with an emphasis on the combination therapy.
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Affiliation(s)
- Jie Wang
- Department of Geriatrics, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China
- Department of Neurology, the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing 211100, Jiangsu Province, China
| | - Wei-Wei Hu
- Department of Geriatrics, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China
| | - Zhi Jiang
- Department of Geriatrics, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China
| | - Mei-Jiang Feng
- Department of Geriatrics, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China
- Key Laboratory for Aging & Disease, Nanjing Medical University, Nanjing 210011, Jiangsu Province, China.
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Hameed S, Fuh JL, Senanarong V, Ebenezer EGM, Looi I, Dominguez JC, Park KW, Karanam AK, Simon O. Role of Fluid Biomarkers and PET Imaging in Early Diagnosis and its Clinical Implication in the Management of Alzheimer's Disease. J Alzheimers Dis Rep 2020; 4:21-37. [PMID: 32206755 PMCID: PMC7081089 DOI: 10.3233/adr-190143] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2020] [Indexed: 12/13/2022] Open
Abstract
Clinical diagnosis of Alzheimer's disease (AD) is based on symptoms; however, the challenge is to diagnose AD at the preclinical stage with the application of biomarkers and initiate early treatment (still not widely available). Currently, cerebrospinal fluid (CSF) amyloid-β 42 (Aβ42) and tau are used in the clinical diagnosis of AD; nevertheless, blood biomarkers (Aβ42 and tau) are less predictive. Amyloid-positron emission tomography (PET) imaging is an advancement in technology that uses approved radioactive diagnostic agents (florbetapir, flutemetamol, or florbetaben) to estimate Aβ neuritic plaque density in adults with cognitive impairment evaluated for AD and other causes of cognitive decline. There is no cure for AD to date-the disease progression cannot be stopped or reversed; approved pharmacological agents (donepezil, galantamine, and rivastigmine; memantine) provide symptomatic treatment. However, the disease-modifying therapies are promising; aducanumab and CAD106 are in phase III trials for the early stages of AD. In conclusion, core CSF biomarkers reflect pathophysiology of AD in the early and late stages; the application of approved radiotracers have potential in amyloid-PET brain imaging to detect early AD.
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Affiliation(s)
- Shahul Hameed
- Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Singapore
- Duke NUS Medical School, Singapore
| | - Jong-Ling Fuh
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Vorapun Senanarong
- Division of Neurology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Irene Looi
- Clinical Research Centre, Hospital Seberang Jaya, Penang, Malaysia
- Department of Medicine, Hospital Seberang Jaya, Penang, Malaysia
| | | | - Kyung Won Park
- Department of Neurology and Cognitive Disorders and Dementia Center, Institute of Convergence Bio-Health, Dong-A University College of Medicine, Busan, Republic of Korea
| | | | - Oliver Simon
- Novartis (Singapore) Pte. Ltd., Singapore, Singapore
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Nicotinic Receptors Underlying Nicotine Dependence: Evidence from Transgenic Mouse Models. Curr Top Behav Neurosci 2020; 45:101-121. [PMID: 32468493 DOI: 10.1007/7854_2020_134] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Nicotine underlies the reinforcing properties of tobacco cigarettes and e-cigarettes. After inhalation and absorption, nicotine binds to various nicotinic acetylcholine receptor (nAChR) subtypes localized on the pre- and postsynaptic membranes of cells, which subsequently leads to the modulation of cellular function and neurotransmitter signaling. In this chapter, we begin by briefly reviewing the current understanding of nicotine's actions on nAChRs and highlight considerations regarding nAChR subtype localization and pharmacodynamics. Thereafter, we discuss the seminal discoveries derived from genetically modified mouse models, which have greatly contributed to our understanding of nicotine's effects on the reward-related mesolimbic pathway and the aversion-related habenulo-interpeduncular pathway. Thereafter, emerging areas of research focusing on modulation of nAChR expression and/or function are considered. Taken together, these discoveries have provided a foundational understanding of various genetic, neurobiological, and behavioral factors underlying the motivation to use nicotine and related dependence processes, which are thereby advancing drug discovery efforts to promote long-term abstinence.
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El-Sayed NAE, Farag AES, Ezzat MAF, Akincioglu H, Gülçin İ, Abou-Seri SM. Design, synthesis, in vitro and in vivo evaluation of novel pyrrolizine-based compounds with potential activity as cholinesterase inhibitors and anti-Alzheimer's agents. Bioorg Chem 2019; 93:103312. [DOI: 10.1016/j.bioorg.2019.103312] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 09/09/2019] [Accepted: 09/23/2019] [Indexed: 01/17/2023]
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Unique coated neusilin pellets with a more distinct and fast visual detection of nerve agents and other cholinesterase inhibitors. J Pharm Biomed Anal 2019; 179:113004. [PMID: 31791835 DOI: 10.1016/j.jpba.2019.113004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 10/25/2019] [Accepted: 11/20/2019] [Indexed: 01/22/2023]
Abstract
Pellets with an immobilized enzyme (acetyl- or butyrylcholinesterase) are the up-to-date type of carriers used for the detection of nerve agents (soman, sarin, tabun, VX, Novichok) and other cholinesterase inhibitors such as organophosphate and carbamate insecticides (parathion, malathion). They are used in the glass detection tubes as a layer containing the enzyme together with the second layer, which contains a colorimetric reagent and substrate. The detection method is based on the visually or spectrophotometrically observable Ellman's reaction, which develops a yellow color in the absence of the cholinesterase inhibitor; otherwise, the detector preserves its original color (preferably white). This reaction occurs very fast and has a high sensitivity to nerve agents but it suffers from an indistinctive color transition from white to yellow. In the presented study, a new approach with the use of the synergic effect of magnesium aluminometasilicate with a high surface area marketed as Neusilin®US2 and a protective semipermeable Eudragit® RL layer was utilized. The prepared pellets have been evaluated for their properties such as the activity of the enzyme, intensity of the developed yellow color, sensitivity to cholinesterase inhibitor physostigmine, which acts as a nerve agent simulant, and physical parameters such as hardness, pycnometric density and sphericity. After the initial evaluation, all samples underwent a stability test under three different storage conditions for 24 months during which they were evaluated at given time points (0, 3, 6, 12 and 24 months). It was found that the prepared samples achieved a much higher intensity of developed yellow color than in the published studies while maintaining similar or better sensitivity, speed of detection and suitable physico-chemical properties.
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Trends in the Use of Medications and Supplements to Treat or Prevent Dementia: A Population-based Study. Alzheimer Dis Assoc Disord 2019; 34:148-155. [PMID: 31633558 DOI: 10.1097/wad.0000000000000357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To examine older adults' use over time of agents to treat or prevent dementia or enhance memory. DESIGN Longitudinal community study with 10-year annual follow-up (2006-2017). SETTING Population-based cohort. PARTICIPANTS A total of 1982 individuals with a mean (SD) age of 77 (7.4) years at baseline. MEASUREMENTS Demographics, self-report, direct inspection of prescription antidementia drugs and nonprescription supplements, cognitive and functional assessments, Clinical Dementia Rating (CDR®) Dementia Staging Instrument. RESULTS Supplement use was reported by 27% to 42% of participants over 10 years. Use was associated with younger age, high school or greater education, good to excellent self-reported health, higher memory test scores, and absence of cognitive impairment or dementia (CDR=0). Over the same period, about 2% to 6% of participants took prescription dementia medications over 10 years. Use was associated with lower memory test scores, at least mild cognitive impairment (CDR≥0.5), fair to poor self-rated health, and high school or lesser education. CONCLUSIONS The use of both prescription drugs and supplements increased over time, except for decreases in ginkgo and vitamin E. Prescription drug use appeared in line with prescribing guidelines. Supplement use was associated with higher education and better self-rated health; it persists despite a lack of supportive evidence.
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Cognitive Function and Consumption of Fruit and Vegetable Polyphenols in a Young Population: Is There a Relationship? Foods 2019; 8:foods8100507. [PMID: 31627296 PMCID: PMC6836211 DOI: 10.3390/foods8100507] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 09/30/2019] [Accepted: 10/02/2019] [Indexed: 12/13/2022] Open
Abstract
Scientific evidence has shown the relationship between consumption of fruits and vegetables and their polyphenols with the prevention or treatment of diseases. The aim of this review was to find out whether the same relationship exists between fruits and vegetables and cognitive function, especially memory, in a young population. The mechanisms by which polyphenols of fruits and vegetables can exert cognitive benefits were also evaluated. These compounds act to improve neuronal plasticity through the protein CREB (Camp Response Element Binding) in the hippocampus, modulating pathways of signaling and transcription factors (ERK/Akt). In the same way, brain-derived neurotrophic factor (BDNF) is implicated in the maintenance, survival, growth, and differentiation of neurons. All these effects are produced by an increase of cerebral blood flow and an increase of the blood’s nitric oxide levels and oxygenation.
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Thancharoen O, Limwattananon C, Waleekhachonloet O, Rattanachotphanit T, Limwattananon P, Limpawattana P. Ginkgo biloba Extract (EGb761), Cholinesterase Inhibitors, and Memantine for the Treatment of Mild-to-Moderate Alzheimer's Disease: A Network Meta-Analysis. Drugs Aging 2019; 36:435-452. [PMID: 30937879 DOI: 10.1007/s40266-019-00648-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Cholinesterase inhibitors (ChEIs) and memantine have been reported to provide modest benefits for cognition and aspects of functioning in Alzheimer's disease (AD). Ginkgo biloba extract (EGb761), a phytomedicine, is widely used and expected to be well-tolerated. A few trials have compared EGb761 with ChEIs, and the results were inconclusive. OBJECTIVE A network meta-analysis was conducted to evaluate the therapeutic benefits and tolerability of EGb761, three ChEIs (donepezil, galantamine, and rivastigmine), and memantine in mild-to-moderate AD patients. METHODS Electronic databases were searched through 30 June 2017. We included randomized double-blinded trials with a minimum treatment duration of 22 weeks for EGb761 240 mg/day and 12 weeks for ChEIs or memantine. The study patients included AD or probable AD patients without other types of dementia or neurological disorders. Cognition, function, and behavior symptoms were compared between treatments using the standardized mean difference (SMD). Clinical global impression, treatment discontinuation, and adverse events were compared between treatments using the relative risk (RR). Statistical pooling of the individual trial results was conducted using a frequentist approach. The probability of being the best for a treatment was estimated using surface under the cumulative ranking. RESULTS EGb761 and memantine showed no therapeutic benefits in all study outcomes. For cognition, all ChEIs were significantly better than placebo (SMD from - 0.52 to - 0.26), and galantamine was better than rivastigmine in the oral and patch forms, EGb761, and memantine (SMD [95% confidence interval (CI)]: - 0.22 [- 0.40 to - 0.05]; - 0.26 [- 0.45 to - 0.07]; - 0.34 [- 0.56 to - 0.12]; and - 0.42 [- 0.71 to - 0.13], respectively). Compared to placebo, galantamine, the rivastigmine patch, and oral rivastigmine provided modest functional benefits (SMD, from 0.21 to 0.24), and galantamine provided behavioral benefits (SMD [95% CI]: - 0.15 [- 0.26 to - 0.04]). All ChEIs provided a better improvement in clinical global impression than placebo (RR from 1.20 to 1.69). The global impression ratings were more improved with donepezil than with galantamine (RR [95% CI]: 1.40 [1.09-1.80]) or with EGb761 (RR [95% CI]: 1.40 [1.06-1.85]), with a 96% probability of donepezil being more effective than the other study agents. Rivastigmine in oral and patch forms, galantamine, and donepezil had a higher risk of being discontinued than placebo (RR [95% CI]: 2.14 [1.49-3.06]; 2.04 [1.30-3.20]; 1.79 [1.28-2.49]; 1.49 [1.03-2.17], respectively). Discontinuation of EGb761 was not statistically lower than that of the ChEIs, in which donepezil had the lowest probability (38%) of being discontinued. CONCLUSION EGb761 and memantine showed no treatment benefits compared to placebo and ChEIs. Galantamine provided the highest beneficial effect on cognition and behavioral symptoms. Donepezil provided a better clinical global impression and tolerability than the other ChEIs and EGb761, with a similar benefit for cognition as galantamine.
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Affiliation(s)
- Onnita Thancharoen
- Pharmacy and Health System Graduate Program, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Chulaporn Limwattananon
- Division of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, 123 Moo 16 Mittraphap Road, Muang District, Khon Kaen, 40002, Thailand.
| | - Onanong Waleekhachonloet
- Department of Clinical Pharmacy, Faculty of Pharmacy, Mahasarakham University, Maha Sarakham, Thailand
| | | | | | - Panita Limpawattana
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Weise L, Töpfer NF, Deux J, Wilz G. Feasibility and effects of individualized recorded music for people with dementia: A pilot RCT study. NORDIC JOURNAL OF MUSIC THERAPY 2019. [DOI: 10.1080/08098131.2019.1661507] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Lisette Weise
- Department of Counseling and Clinical Intervention, Friedrich Schiller University of Jena, Jena, Germany
| | - Nils F. Töpfer
- Department of Counseling and Clinical Intervention, Friedrich Schiller University of Jena, Jena, Germany
| | - Juliane Deux
- Department of Counseling and Clinical Intervention, Friedrich Schiller University of Jena, Jena, Germany
| | - Gabriele Wilz
- Department of Counseling and Clinical Intervention, Friedrich Schiller University of Jena, Jena, Germany
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Liu PP, Xie Y, Meng XY, Kang JS. History and progress of hypotheses and clinical trials for Alzheimer's disease. Signal Transduct Target Ther 2019; 4:29. [PMID: 31637009 PMCID: PMC6799833 DOI: 10.1038/s41392-019-0063-8] [Citation(s) in RCA: 346] [Impact Index Per Article: 69.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 07/07/2019] [Accepted: 07/17/2019] [Indexed: 12/20/2022] Open
Abstract
Alzheimer's disease (AD) is a neurodegenerative disease characterized by progressive memory loss along with neuropsychiatric symptoms and a decline in activities of daily life. Its main pathological features are cerebral atrophy, amyloid plaques, and neurofibrillary tangles in the brains of patients. There are various descriptive hypotheses regarding the causes of AD, including the cholinergic hypothesis, amyloid hypothesis, tau propagation hypothesis, mitochondrial cascade hypothesis, calcium homeostasis hypothesis, neurovascular hypothesis, inflammatory hypothesis, metal ion hypothesis, and lymphatic system hypothesis. However, the ultimate etiology of AD remains obscure. In this review, we discuss the main hypotheses of AD and related clinical trials. Wealthy puzzles and lessons have made it possible to develop explanatory theories and identify potential strategies for therapeutic interventions for AD. The combination of hypometabolism and autophagy deficiency is likely to be a causative factor for AD. We further propose that fluoxetine, a selective serotonin reuptake inhibitor, has the potential to treat AD.
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Affiliation(s)
- Pei-Pei Liu
- Clinical Systems Biology Laboratories, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 Henan China
| | - Yi Xie
- Clinical Systems Biology Laboratories, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 Henan China
| | - Xiao-Yan Meng
- Clinical Systems Biology Laboratories, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 Henan China
| | - Jian-Sheng Kang
- Clinical Systems Biology Laboratories, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 Henan China
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An update on the interactions between Alzheimer's disease, autophagy and inflammation. Gene 2019; 705:157-166. [DOI: 10.1016/j.gene.2019.04.040] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 04/14/2019] [Accepted: 04/15/2019] [Indexed: 12/20/2022]
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Chen XQ, Mobley WC. Exploring the Pathogenesis of Alzheimer Disease in Basal Forebrain Cholinergic Neurons: Converging Insights From Alternative Hypotheses. Front Neurosci 2019; 13:446. [PMID: 31133787 PMCID: PMC6514132 DOI: 10.3389/fnins.2019.00446] [Citation(s) in RCA: 111] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 04/18/2019] [Indexed: 01/01/2023] Open
Abstract
Alzheimer disease (AD) represents an oncoming epidemic that without an effective treatment promises to exact extraordinary financial and emotional burdens (Apostolova, 2016). Studies of pathogenesis are essential for defining critical molecular and cellular events and for discovering therapies to prevent or mitigate their effects. Through studies of neuropathology, genetic and cellular, and molecular biology recent decades have provided many important insights. Several hypotheses have been suggested. Documentation in the 1980s of selective loss of cholinergic neurons of the basal forebrain, followed by clinical improvement in those treated with inhibitors of acetylycholinesterase, supported the "cholinergic hypothesis of age-related cognitive dysfunction" (Bartus et al., 1982). A second hypothesis, prompted by the selective loss of cholinergic neurons and the discovery of central nervous system (CNS) neurotrophic factors, including nerve growth factor (NGF), prompted the "deficient neurotrophic hypothesis" (Chen et al., 2018). The most persuasive hypothesis, the amyloid cascade hypothesis first proposed more than 25 years ago (Selkoe and Hardy, 2016), is supported by a wealth of observations. Genetic studies were exceptionally important, pointing to increased dose of the gene for the amyloid precursor protein (APP) in Down syndrome (DS) and a familial AD (FAD) due to duplication of APP and to mutations in APP and in the genes for Presenilin 1 and 2 (PSEN1, 2), which encode the γ-secretase enzyme that processes APP (Dorszewska et al., 2016). The "tau hypothesis" noted the prominence of tau-related pathology and its correlation with dementia (Kametani and Hasegawa, 2018). Recent interest in induction of microglial activation in the AD brain, as well as other manifestations of inflammation, supports the "inflammatory hypothesis" (Mcgeer et al., 2016). We place these findings in the context of the selective, but by no means unique, involvement of BFCNs and their trophic dependence on NGF signaling and speculate as to how pathogenesis in these neurons is initiated, amplified and ultimately results in their dysfunction and death. In so doing we attempt to show how the different hypotheses for AD may interact and reinforce one another. Finally, we address current attempts to prevent and/or treat AD in light of advances in understanding pathogenetic mechanisms and suggest that studies in the DS population may provide unique insights into AD pathogenesis and treatment.
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Affiliation(s)
- Xu-Qiao Chen
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, United States
| | - William C. Mobley
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, United States
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Vila-Castelar C, Ly JJ, Kaplan L, Van Dyk K, Berger JT, Macina LO, Stewart JL, Foldi NS. Attention Measures of Accuracy, Variability, and Fatigue Detect Early Response to Donepezil in Alzheimer's Disease: A Randomized, Double-blind, Placebo-Controlled Pilot Trial. Arch Clin Neuropsychol 2019; 34:277-289. [PMID: 29635383 PMCID: PMC6487534 DOI: 10.1093/arclin/acy032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 03/03/2018] [Accepted: 03/20/2018] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE Donepezil is widely used to treat Alzheimer's disease (AD), but detecting early response remains challenging for clinicians. Acetylcholine is known to directly modulate attention, particularly under high cognitive conditions, but no studies to date test whether measures of attention under high load can detect early effects of donepezil. We hypothesized that load-dependent attention tasks are sensitive to short-term treatment effects of donepezil, while global and other domain-specific cognitive measures are not. METHOD This longitudinal, randomized, double-blind, placebo-controlled pilot trial (ClinicalTrials.gov Identifier: NCT03073876) evaluated 23 participants newly diagnosed with AD initiating de novo donepezil treatment (5 mg). After baseline assessment, participants were randomized into Drug (n = 12) or Placebo (n = 11) groups, and retested after approximately 6 weeks. Cognitive assessment included: (a) attention tasks (Foreperiod Effect, Attentional Blink, and Covert Orienting tasks) measuring processing speed, top-down accuracy, orienting, intra-individual variability, and fatigue; (b) global measures (Alzheimer's Disease Assessment Scale-Cognitive Subscale, Mini-Mental Status Examination, Dementia Rating Scale); and (c) domain-specific measures (memory, language, visuospatial, and executive function). RESULTS The Drug but not the Placebo group showed benefits of treatment at high-load measures by preserving top-down accuracy, improving intra-individual variability, and averting fatigue. In contrast, other global or cognitive domain-specific measures could not detect treatment effects over the same treatment interval. CONCLUSIONS The pilot-study suggests that attention measures targeting accuracy, variability, and fatigue under high-load conditions could be sensitive to short-term cholinergic treatment. Given the central role of acetylcholine in attentional function, load-dependent attentional measures may be valuable cognitive markers of early treatment response.
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Affiliation(s)
- Clara Vila-Castelar
- Department of Psychology, Queens College and The Graduate Center, City University of New York, New York, NY, USA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jenny J Ly
- eResearch Technology, Inc., Boston, MA, USA
| | - Lillian Kaplan
- Department of Occupational Therapy, York College, City University of New York, New York, NY, USA
| | - Kathleen Van Dyk
- Department of Psychiatry, UCLA - Semel Institute for Neuroscience & Human Behavior and Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Jeffrey T Berger
- Division of Palliative Medicine and Bioethics, Department of Medicine, NYU Winthrop Hospital, Mineola, NY, USA
| | - Lucy O Macina
- Division of Geriatrics, Department of Medicine, NYU Winthrop Hospital, Mineola, NY, USA
| | - Jennifer L Stewart
- Department of Psychology, Queens College and The Graduate Center, City University of New York, New York, NY, USA
| | - Nancy S Foldi
- Department of Psychology, Queens College and The Graduate Center, City University of New York, New York, NY, USA
- Division of Geriatrics, Department of Medicine, NYU Winthrop Hospital, Mineola, NY, USA
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TAK-071, a novel M 1 positive allosteric modulator with low cooperativity, improves cognitive function in rodents with few cholinergic side effects. Neuropsychopharmacology 2019; 44:950-960. [PMID: 30089885 PMCID: PMC6461781 DOI: 10.1038/s41386-018-0168-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 06/29/2018] [Accepted: 07/20/2018] [Indexed: 12/15/2022]
Abstract
The muscarinic M1 receptor (M1R) is a promising target for treating cognitive impairment associated with cholinergic deficits in disorders such as Alzheimer's disease and schizophrenia. We previously reported that cooperativity (α-value) was key to lowering the risk of diarrhea by M1R positive allosteric modulators (M1 PAMs). Based on this, we discovered a low α-value M1 PAM, TAK-071 (α-value: 199), and characterized TAK-071 using T-662 as a reference M1 PAM with high α-value of 1786. Both TAK-071 and T-662 were potent and highly selective M1 PAMs, with inflection points of 2.7 and 0.62 nM, respectively. However, T-662 but not TAK-071 augmented isolated ileum motility. TAK-071 and T-662 increased hippocampal inositol monophosphate production through M1R activation and improved scopolamine-induced cognitive deficits in rats at 0.3 and 0.1 mg/kg, respectively. TAK-071 and T-662 also induced diarrhea at 10 and 0.1 mg/kg, respectively, in rats. Thus, taking into consideration the fourfold lower brain penetration ratio of T-662, TAK-071 had a wider margin between cognitive improvement and diarrhea induction than T-662. Activation of M1R increases neural excitability via membrane depolarization, reduced afterhyperpolarization, and generation of afterdepolarization in prefrontal cortical pyramidal neurons. T-662 induced all three processes, whereas TAK-071 selectively induced afterdepolarization. Combining sub-effective doses of TAK-071, but not T-662, with an acetylcholinesterase inhibitor, significantly ameliorated scopolamine-induced cognitive deficits in rats. TAK-071 may therefore provide therapeutic opportunities for cognitive dysfunction related to cholinergic deficits or reduced M1R expression, while minimizing peripheral cholinergic side effects.
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