An ACTH 4-9 analog (Org 2766) and cognitive performance: high-dose efficacy and safety in dementia of the Alzheimer's type

Advances in the pharmacotherapy of Alzheimer's disease

The authors reviewed the literature on the agents proposed for the treatment of Alzheimer's disease (AD). Different classes of drugs have been tested for this indication including psychostimulants, anticoagulants, vasodilators, hyperbaric oxygen, hormones, nootropics, cholinomimetics, monoaminergics and neuropeptides without conclusive evidence of being beneficial for the treatment of this condition. Among the cholinomimetics recent research data seems to indicate that they might produce modest benefits in mild-to-moderate AD patients. Recently, other drugs have also been proposed including neurotrophic factors, phosphatidylserine, angiotension [corrected] converting enzyme (ACE) inhibitors, calcium channel blockers, acetyl-L-carnitine, xanthine derivatives, anti-inflammatory agents, aluminum chelate agents, and D-cycloserine. Of these new strategies few hold promise of more substantial benefits for AD, with the possibility of altering the course of the disease, but these drugs await confirmatory trials.

An ACTH analog minimizes cerebrovascular damage in an animal model of moderate brain injury

An ACTH1-14-related analog (GMM2) was tested for efficacy in reducing the cerebrovascular pathology that follows moderate, closed-head injury in our rat model. Posttraumatic subcutaneous administration of nanomolar amounts of GMM2 significantly minimized both the hypoperfusion and the increased blood-brain permeability observed 2 h following a concussion. Posttraumatic administration of the peptide also reduced the elevated brain water content observed at 24 and 48 h postinjury to nonsignificant levels. These findings complement previously described observations that GMM2 treatment prevents dangerous elevations of ICP (> 25 mm Hg) at 24 to 72 h in this model of head injury. In view of the potency and low toxicity of GMM2 these observation suggest that the peptide may have considerable clinical application in interrupting pathologic sequelae of traumatic brain injury.