Safety assessment of Apoaequorin, a protein preparation: subchronic toxicity study in rats

Prevagen®: Analysis of Clinical Evidence and Its Designation as a “#1 Pharmacist Recommended Brand”

Prevagen® is a dietary supplement that is marketed to help with mild memory loss associated with older people. The manufacturer of the product notes that clinical evidence supports this use. Furthermore, the manufacturer notes that Prevagen® is a “#1 Pharmacist Recommended Brand.” The authors’ search of the literature identified one clinical study that evaluated the efficacy and safety of Prevagen®; however, this study possesses significant limitations and therefore one must question the merits of such clinical evidence. Prevagen®’s designation as a “#1 Pharmacist Recommended Brand” is based on a survey facilitated by Pharmacy Times® that is designed to identify the brand name over-the-counter products that pharmacists recommend most frequently. Because of the limited clinical data supporting Prevagen®’s efficacy, it is likely that the survey results reflect pharmacists’ familiarity with this product, which may be influenced by extensive advertising techniques. As practitioners of evidence-based medicine, pharmacists should not recommend a product with limited evidence to support its use. Furthermore, pharmacists should proactively educate their patients, especially those who are most vulnerable, about the rational use of all pharmacologically active substances, including dietary supplements.

Subchronic toxicity of lyophilized apoaequorin protein powder in Sprague-Dawley rats

Apoaequorin is a bioluminescent calcium-binding apoprotein endogenous to the Aequorea species of jellyfish and is commercially available in a dietary supplement in support of brain and cognitive health. Results from a previous 90-day subchronic oral gavage study established the no-observed-adverse-effect-level (NOAEL) of lyophilized apoaequorin protein powder (LAPP) at 666.7 mg/kg/day. The current 90-day oral gavage study in Sprague-Dawley rats administered dose levels of 1000, 2000, and 4000 mg/kg/day of test substance as received. These doses are expressed as milligram of supplement with the amounts of apoaequorin based on the analysis of the percentage of active ingredient. The corresponding amounts of apoaequorin protein are 603, 1206, and 2412 mg/kg/day. These dose levels target approximately 4221, 8442, and 16,844 times more than the expected human oral intake. There were no mortalities, clinical observations, ophthalmological, clinical pathology, or histopathological changes attributable to LAPP administration. Changes in mean body weight and feed efficiency, without other correlating clinical or pathological or other toxicologically relevant findings, were considered to be of little toxicological significance. Therefore, the NOAEL for LAPP administered orally up to 90 days was 4000 mg/kg/day (2412 mg/kg/day based on 603 mg/g or 60.3% active ingredient, apoaequorin protein), the highest dose tested in male and female rats.

Pretreatment with apoaequorin protects hippocampal CA1 neurons from oxygen-glucose deprivation

Ischemic stroke affects ∼795,000 people each year in the U.S., which results in an estimated annual cost of $73.7 billion. Calcium is pivotal in a variety of neuronal signaling cascades, however, during ischemia, excess calcium influx can trigger excitotoxic cell death. Calcium binding proteins help neurons regulate/buffer intracellular calcium levels during ischemia. Aequorin is a calcium binding protein isolated from the jellyfish Aequorea victoria, and has been used for years as a calcium indicator, but little is known about its neuroprotective properties. The present study used an in vitro rat brain slice preparation to test the hypothesis that an intra-hippocampal infusion of apoaequorin (the calcium binding component of aequorin) protects neurons from ischemic cell death. Bilaterally cannulated rats received an apoaequorin infusion in one hemisphere and vehicle control in the other. Hippocampal slices were then prepared and subjected to 5 minutes of oxygen-glucose deprivation (OGD), and cell death was assayed by trypan blue exclusion. Apoaequorin dose-dependently protected neurons from OGD--doses of 1% and 4% (but not 0.4%) significantly decreased the number of trypan blue-labeled neurons. This effect was also time dependent, lasting up to 48 hours. This time dependent effect was paralleled by changes in cytokine and chemokine expression, indicating that apoaequorin may protect neurons via a neuroimmunomodulatory mechanism. These data support the hypothesis that pretreatment with apoaequorin protects neurons against ischemic cell death, and may be an effective neurotherapeutic.