The effects of amiflamine on cerebrospinal fluid amine metabolites in the rhesus monkey

The new generation of monoamine oxidase inhibitors

Irreversible and unspecific inhibitors of MAO were the first modern antidepressants, but after an initial success they fell into discredit due to adverse side effects. In the past two decades interest in MAO inhibitors has been renewed because of progress in basic research, a milestone being the finding that there are two subtypes of MAO, MAO-A and MAO-B. These are distinct proteins with high amino acid homology, coded by separate genes both located on the short arm of the human chromosome X. The enzyme subforms show different substrate specificities in vitro and different distributions within the central nervous system and in peripheral organs. In the central nervous system of man MAO-A seems to be mainly involved in the metabolism of 5 HT and noradrenaline, whereas 2-phenylethylamine and probably dopamine are predominantly deaminated by MAO-B. In the intestinal tract tyramine is mainly metabolized by MAO-A. These characteristics indicate distinct physiological functions of the two MAO-subforms. Several irreversible and reversible non-hydrazine inhibitors with relative selectivities for one of the MAO-subforms have been developed. They belong to various chemical classes with different modes of enzyme inhibition. These range from covalent mechanism based interaction (e.g. by propargyl- and allylamine derivatives) to pseudosubstrate inhibition (e.g. by 2-aminoethyl-carboxamides) and non-covalent interaction (e.g. by brofaromine, toloxatone and possibly moclobemide). The most important pharmacological effects of the new types of MAO inhibitors are those observed in neuropsychiatric disorders. The inhibitors of MAO-A show a favorable action in various forms of mental depression. The drugs seem to have about the same activity as other types of antidepressants, including tricyclic and related compounds as well as classical MAO inhibitors. The onset of action of the MAO-A inhibitors is claimed to be relatively fast. Other possible indications of these drugs include disorders with cognitive impairment, e.g. dementia of the Alzheimer type. In subjects with Parkinson's disease the MAO-B inhibitor L-deprenyl exerts a L-dopa-sparing effect, prolongs L-dopa action and seems to have a favorable influence regarding on-off disabilities. The action is in general transitory (months to several years). In addition L-deprenyl has been shown to delay the necessity for L-dopa treatment in patients with early parkinsonism. Whether the drug influence the progression of the disease is still a matter of debate. L-deprenyl also appears to have some antidepressant effect (especially in higher doses) and to exert a beneficial influence in other disorders, e.g. dementia of the Alzheimer type.(ABSTRACT TRUNCATED AT 400 WORDS)

Amine oxidases and their endogenous substrates (with special reference to monoamine oxidase and the brain)

The roles of MAO, BzO, DAO and PAO in the metabolism of endogenous substrates and the functional implications of their action and inhibition is reviewed, the emphasis being on MAO on one hand and on brain on the other. The major issues are the following: There is no discrete subdivision into substrates selective for MAO-A, MAO-B, or mixed ones, but rather a continuum. Tissue differences in substrate specificity are not likely to be due to molecular variability of MAO. For the deamination of DA, 5-HT and PEA at least, the relative participation of either MAO form in a given tissue is primarily determined by the relative abundance of the two forms; only at 10(-5) M and above, substrate concentration begins to matter also. In vivo, compartmentation is of paramount importance: since there seems to be more MAO-A than B inside monoaminergic neurons, DA, 5-HT and NA are predominantly metabolized by MAO-A if metabolism occurs mainly intraneuronally. Conversely, since MAO-B is more abundant extraneuronally, e.g. in glia cells, the relative participation of this form increases if a significant portion of these amines is deaminated outside monoaminergic neurons. In vivo, monoamine deamination is reduced concomitantly with the degree of MAO inhibition, whereas signs of increased transmitter function are only observed if enzyme inhibition is at least 80%. This is likely to be the result of the action of compensatory mechanisms such as feedback inhibition of transmitter release and synthesis. BzO is particularly abundant in vascular tissue, lung and bone. Low levels are found in brain. Endogenous substrates and physiological function are not known. DAO also occurs only in minimal amount in brain, if at all. Its principal substrates are histamine and the polyamines, and the disposal of these amines is probably its main function. Of the PAO's, the type of enzyme found in the rat liver attacks the secondary amino groups and may have a more prominent role in the metabolism of polyamines in the brain than in the periphery. Bovine plasma PAO, which attacks primary amino groups, is only found in the serum of ruminants, but not other species. Its function in the metabolism of polyamines is not known.

Rhesus monkey cerebrospinal fluid amine metabolite changes following treatment with the reversible monoamine oxidase type-A inhibitor cimoxatone

The effects of cimoxatone, a reversible inhibitor of monoamine oxidase type A (MAO-A), on the deaminated metabolites of norepinephrine, dopamine, and serotonin were examined in continuously collected rhesus monkey cerebrospinal fluid (CSF). Cimoxatone, 0.5-8 mg/kg given PO, produced dose-proportionate reductions of 24-h mean CSF 3-methoxy, 4-hydroxy phenylglycol (MHPG) concentrations of 21%-52%. Homovanillic acid (HVA) concentrations also decreased 27%-55%, while CSF 5-hydroxyindoleacetic acid (5-HIAA) decreases were somewhat smaller (7%-32% from baseline). All three metabolite concentrations reached a nadir approximately 6-10 h after drug administration, and required over 40 h to gradually return towards baseline following drug discontinuation. HVA concentration reductions in particular persisted during the entire 24-h period following treatment and were the slowest to return to baseline values. CSF concentrations of cimoxatone and its MAO-inhibiting O-demethyl metabolite showed a parallel time course, peaking 6-10 h after treatment and persisting for up to 24 h in the case of cimoxatone and over 48 h for its metabolite. Single simultaneous time point determinations revealed 10-to 20-fold lower concentrations of cimoxatone and its metabolite in CSF compared to plasma 2 h after treatment. MAO-B activity in platelet-rich plasma was not inhibited by 8 mg/kg cimoxatone, indicating that this drug maintains MAO-A selectivity in vivo.(ABSTRACT TRUNCATED AT 250 WORDS)