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Bartollino S, Chiosi F, di Staso S, Uva M, Pascotto A, Rinaldi M, Hesselink JMK, Costagliola C. The retinoprotective role of phenytoin. DRUG DESIGN DEVELOPMENT AND THERAPY 2018; 12:3485-3489. [PMID: 30410309 PMCID: PMC6198895 DOI: 10.2147/dddt.s169621] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Phenytoin is a non-sedative barbiturate derivate and has been recently rediscovered as a neuroprotective and retinoprotective compound in patients affected by optic neuritis secondary to multiple sclerosis. However, currently there are still no neuroprotective compounds registered and available in the clinic. We reviewed the literature supporting the retinoprotective properties of phenytoin and analyzed the various approaches and definitions from the first research periods onwards. The retinoprotective role of phenytoin was already known in the 1970s, but only recently has this effect been rediscovered, confirming that it could indeed provide structural protection of the retinal cells.
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Affiliation(s)
- Silvia Bartollino
- Eye Clinic, Department of Medicine and Health Sciences "V. Tiberio," University of Molise, Campobasso, Italy,
| | - Flavia Chiosi
- Eye Clinic, Department of Medicine and Health Sciences "V. Tiberio," University of Molise, Campobasso, Italy,
| | - Silvio di Staso
- Department of Surgical Science, Ophthalmic Clinic, University of L'Aquila, L'Aquila, Italy
| | - Maurizio Uva
- Eye Clinic, University of Catania, Catania, Italy
| | - Arduino Pascotto
- Eye Clinic, Department of Medicine and Health Sciences "V. Tiberio," University of Molise, Campobasso, Italy,
| | - Michele Rinaldi
- Department of Ophthalmology, University della Campania Luigi Vanvitelli, Naples, Italy
| | | | - Ciro Costagliola
- Eye Clinic, Department of Medicine and Health Sciences "V. Tiberio," University of Molise, Campobasso, Italy,
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Dietrich M, Cruz-Herranz A, Yiu H, Aktas O, Brandt AU, Hartung HP, Green A, Albrecht P. Whole-body positional manipulators for ocular imaging of anaesthetised mice and rats: a do-it-yourself guide. BMJ Open Ophthalmol 2016; 1:e000008. [PMID: 29354694 PMCID: PMC5759402 DOI: 10.1136/bmjophth-2016-000008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 09/27/2016] [Indexed: 11/10/2022] Open
Abstract
Background In vivo retinal imaging of rodents has gained a growing interest in ophthalmology and neurology. The bedding of the animals with the possibility to perform adjustments in order to obtain an ideal camera-to-eye angle is challenging. Methods We provide a guide for a cost-effective, do-it-yourself rodent holder for ocular imaging techniques. The set-up was tested and refined in over 2000 optical coherence tomography measurements of mice and rats. Results The recommended material is very affordable, readily available and easily assembled. The holder can be adapted to both mice and rats. A custom-made mouthpiece is provided for the use of inhalant anaesthesia. The holder is highly functional and assures that the rodent’s eye is the centre of rotation for adjustments in both the axial and the transverse planes with a major time benefit over unrestrained positioning of the rodents. Conclusion We believe this guide is very useful for eye researchers focusing on in vivo retinal imaging in rodents as it significantly reduces examination times for ocular imaging.
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Affiliation(s)
- Michael Dietrich
- Department of Neurology, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - Andrés Cruz-Herranz
- Department of Neurology, University of California, San Francisco, San Francisco, California, United States
| | - Hao Yiu
- Department of Neurology, University of California, San Francisco, San Francisco, California, United States
| | - Orhan Aktas
- Department of Neurology, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - Alexander U Brandt
- NeuroCure Clinical Research Center, Charite-Universitätsmedizin Berlin, Berlin, Germany
| | - Hans-Peter Hartung
- Department of Neurology, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - Ari Green
- Department of Neurology, University of California, San Francisco, San Francisco, California, United States
| | - Philipp Albrecht
- Department of Neurology, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
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A Personalized Approach in Progressive Multiple Sclerosis: The Current Status of Disease Modifying Therapies (DMTs) and Future Perspectives. Int J Mol Sci 2016; 17:ijms17101725. [PMID: 27763513 PMCID: PMC5085756 DOI: 10.3390/ijms17101725] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 09/29/2016] [Accepted: 10/02/2016] [Indexed: 12/20/2022] Open
Abstract
Using the term of progressive multiple sclerosis (PMS), we considered a combined population of persons with secondary progressive MS (SPMS) and primary progressive MS (PPMS). These forms of MS cannot be challenged with efficacy by the licensed therapy. In the last years, several measures of risk estimation were developed for predicting clinical course in MS, but none is specific for the PMS forms. Personalized medicine is a therapeutic approach, based on identifying what might be the best therapy for an individual patient, taking into account the risk profile. We need to achieve more accurate estimates of useful predictors in PMS, including unconventional and qualitative markers which are not yet currently available or practicable routine diagnostics. The evaluation of an individual patient is based on the profile of disease activity.Within the neurology field, PMS is one of the fastest-moving going into the future.
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Villoslada P. Neuroprotective therapies for multiple sclerosis and other demyelinating diseases. ACTA ACUST UNITED AC 2016. [DOI: 10.1186/s40893-016-0004-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Shirani A, Okuda DT, Stüve O. Therapeutic Advances and Future Prospects in Progressive Forms of Multiple Sclerosis. Neurotherapeutics 2016; 13:58-69. [PMID: 26729332 PMCID: PMC4720678 DOI: 10.1007/s13311-015-0409-z] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Identifying effective therapies for the treatment of progressive forms of multiple sclerosis (MS) is a highly relevant priority and one of the greatest challenges for the global MS community. Better understanding of the mechanisms involved in progression of the disease, novel trial designs, drug repurposing strategies, and new models of collaboration may assist in identifying effective therapies. In this review, we discuss various therapies under study in phase II or III trials, including antioxidants (idebenone); tyrosine kinase inhibitors (masitinib); sphingosine receptor modulators (siponimod); monoclonal antibodies (anti-leucine-rich repeat and immunoglobulin-like domain containing neurite outgrowth inhibitor receptor-interacting protein-1, natalizumab, ocrelizumab, intrathecal rituximab); hematopoetic stem cell therapy; statins and other possible neuroprotective agents (amiloride, riluzole, fluoxetine, oxcarbazepine); lithium; phosphodiesterase inhibitors (ibudilast); hormone-based therapies (adrenocorticotrophic hormone and erythropoietin); T-cell receptor peptide vaccine (NeuroVax); autologous T-cell immunotherapy (Tcelna); MIS416 (a microparticulate immune response modifier); dopamine antagonists (domperidone); and nutritional supplements, including lipoic acid, biotin, and sunphenon epigallocatechin-3-gallate (green tea extract). Given ongoing and planned clinical trial initiatives, and the largest ever focus of the global research community on progressive MS, future prospects for developing targeted therapeutics aimed at reducing disability in progressive forms of MS appear promising.
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Affiliation(s)
- Afsaneh Shirani
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Darin T Okuda
- Department of Neurology and Neurotherapeutics, Clinical Center for Multiple Sclerosis, Multiple Sclerosis and Neuroimmunology Imaging Program, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Olaf Stüve
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA.
- Neurology Section, VA North Texas Health Care System, Medical Service, Dallas VA Medical Center, Dallas, TX, 75216, USA.
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Singman EL, Daphalapurkar N, White H, Nguyen TD, Panghat L, Chang J, McCulley T. Indirect traumatic optic neuropathy. Mil Med Res 2016; 3:2. [PMID: 26759722 PMCID: PMC4709956 DOI: 10.1186/s40779-016-0069-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 01/04/2016] [Indexed: 01/12/2023] Open
Abstract
Indirect traumatic optic neuropathy (ITON) refers to optic nerve injury resulting from impact remote to the optic nerve. The mechanism of injury is not understood, and there are no confirmed protocols for prevention, mitigation or treatment. Most data concerning this condition comes from case series of civilian patients suffering blunt injury, such as from sports- or motor vehicle-related concussion, rather than military-related ballistic or blast damage. Research in this field will likely require the development of robust databases to identify patients with ITON and follow related outcomes, in addition to both in-vivo animal and virtual human models to study the mechanisms of damage and potential therapies.
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Affiliation(s)
- Eric L Singman
- Wilmer Eye Institute at Johns Hopkins Hospital, Baltimore, Maryland USA
| | | | - Helen White
- Director of Informatics and Information Management, Vision Center of Excellence [VCE], Office of the Assistant Secretary of Defense for Health Affairs [ASD-HA], United States Department of Defense [DOD], Walter Reed National Military Medical Center, Bethesda, MD USA
| | - Thao D Nguyen
- Whiting School of Engineering, Johns Hopkins University, Baltimore, MD USA
| | - Lijo Panghat
- Whiting School of Engineering, Johns Hopkins University, Baltimore, MD USA
| | - Jessica Chang
- Wilmer Eye Institute at Johns Hopkins Hospital, Baltimore, Maryland USA
| | - Timothy McCulley
- Wilmer Eye Institute at Johns Hopkins Hospital, Baltimore, Maryland USA
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Brownlee WJ, Miller DH. Clinically isolated syndromes and the relationship to multiple sclerosis. J Clin Neurosci 2014; 21:2065-71. [PMID: 25027666 DOI: 10.1016/j.jocn.2014.02.026] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 02/02/2014] [Indexed: 11/27/2022]
Abstract
The most common presentation of multiple sclerosis (MS) is with a clinically isolated syndrome (CIS) affecting the optic nerves, brainstem or spinal cord. Two thirds of patients with CIS will have further episodes of neurological dysfunction and convert to relapsing-remitting MS, while the remaining patients have a monophasic illness, at least clinically. Abnormalities on a baseline MRI scan predict the subsequent development of MS in patients with CIS. In the long term, about 80% of patients with an abnormal MRI convert to MS compared with 20% with a normal MRI. For patients who develop MS the long term prognosis is varied. After 20 years, almost half will have developed secondary progressive MS, while around one third have a benign disease course with little physical disability. Disease-modifying treatments delay conversion to MS in selected CIS patients with abnormal MRI but an effect on long term disability has not been demonstrated. In this review we discuss recent advances in the diagnosis, management and prognostication of patients with CIS.
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Affiliation(s)
- Wallace J Brownlee
- Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, London, United Kingdom.
| | - David H Miller
- Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, London, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, London, United Kingdom
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Amor S, Peferoen LAN, Vogel DYS, Breur M, van der Valk P, Baker D, van Noort JM. Inflammation in neurodegenerative diseases--an update. Immunology 2014; 142:151-66. [PMID: 24329535 DOI: 10.1111/imm.12233] [Citation(s) in RCA: 360] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 12/09/2013] [Accepted: 12/11/2013] [Indexed: 12/12/2022] Open
Abstract
Neurodegeneration, the progressive dysfunction and loss of neurons in the central nervous system (CNS), is the major cause of cognitive and motor dysfunction. While neuronal degeneration is well-known in Alzheimer's and Parkinson's diseases, it is also observed in neurotrophic infections, traumatic brain and spinal cord injury, stroke, neoplastic disorders, prion diseases, multiple sclerosis and amyotrophic lateral sclerosis, as well as neuropsychiatric disorders and genetic disorders. A common link between these diseases is chronic activation of innate immune responses including those mediated by microglia, the resident CNS macrophages. Such activation can trigger neurotoxic pathways leading to progressive degeneration. Yet, microglia are also crucial for controlling inflammatory processes, and repair and regeneration. The adaptive immune response is implicated in neurodegenerative diseases contributing to tissue damage, but also plays important roles in resolving inflammation and mediating neuroprotection and repair. The growing awareness that the immune system is inextricably involved in mediating damage as well as regeneration and repair in neurodegenerative disorders, has prompted novel approaches to modulate the immune system, although it remains whether these approaches can be used in humans. Additional factors in humans include ageing and exposure to environmental factors such as systemic infections that provide additional clues that may be human specific and therefore difficult to translate from animal models. Nevertheless, a better understanding of how immune responses are involved in neuronal damage and regeneration, as reviewed here, will be essential to develop effective therapies to improve quality of life, and mitigate the personal, economic and social impact of these diseases.
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Affiliation(s)
- Sandra Amor
- Department of Pathology, VU University Medical Centre, Amsterdam, the Netherlands; Neuroimmunology Unit, Blizard Institute of Cell and Molecular Science, Barts and The London School of Medicine and Dentistry, London, UK
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Baker D, Amor S. Experimental autoimmune encephalomyelitis is a good model of multiple sclerosis if used wisely. Mult Scler Relat Disord 2014; 3:555-64. [PMID: 26265267 DOI: 10.1016/j.msard.2014.05.002] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 05/01/2014] [Accepted: 05/05/2014] [Indexed: 02/07/2023]
Abstract
Although multiple sclerosis is a uniquely human disease, many pathological features can be induced in experimental autoimmune encephalomyelitis (EAE) models following induction of central nervous system-directed autoimmunity. Whilst it is an imperfect set of models, EAE can be used to identify pathogenic mechanisms and therapeutics. However, the failure to translate many treatments from EAE into human benefit has led some to question the validity of the EAE model. Whilst differences in biology between humans and other species may account for this, it is suggested here that the failure to translate may be considerably influenced by human activity. Basic science contributes to failings in aspects of experimental design and over-interpretation of results and lack of transparency and reproducibility of the studies. Importantly issues in trial design by neurologists and other actions of the pharmaceutical industry destine therapeutics to failure and terminate basic science projects. However animal, particularly mechanism-orientated, studies have increasingly identified useful treatments and provided mechanistic ideas on which most hypothesis-led clinical research is based. Without EAE and other animal studies, clinical investigations will continue to be "look-see" exercises, which will most likely provide more misses than hits and will fail the people with MS that they aim to serve.
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Affiliation(s)
- David Baker
- Neuroimmunology Unit, Blizard Institute, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, 4 Newark Street, London E1 2AT, United Kingdom.
| | - Sandra Amor
- Neuroimmunology Unit, Blizard Institute, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, 4 Newark Street, London E1 2AT, United Kingdom; Pathology Department, VU Medical Centre, Free University of Amsterdam, The Netherlands
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Browne L, Lidster K, Al-Izki S, Clutterbuck L, Posada C, Chan AWE, Riddall D, Garthwaite J, Baker D, Selwood DL. Imidazol-1-ylethylindazole voltage-gated sodium channel ligands are neuroprotective during optic neuritis in a mouse model of multiple sclerosis. J Med Chem 2014; 57:2942-52. [PMID: 24601592 PMCID: PMC4010550 DOI: 10.1021/jm401881q] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A series of imidazol-1-ylethylindazole sodium channel ligands were developed and optimized for sodium channel inhibition and in vitro neuroprotective activity. The molecules exhibited displacement of a radiolabeled sodium channel ligand and selectivity for blockade of the inactivated state of cloned neuronal Nav channels. Metabolically stable analogue 6 was able to protect retinal ganglion cells during optic neuritis in a mouse model of multiple sclerosis.
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Affiliation(s)
- Lorcan Browne
- Biological and Medicinal Chemistry, Wolfson Institute for Biomedical Science, University College London , Gower Street, London WC1E 6BT, United Kingdom
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Al-Izki S, Pryce G, Hankey DJR, Lidster K, von Kutzleben SM, Browne L, Clutterbuck L, Posada C, Edith Chan AW, Amor S, Perkins V, Gerritsen WH, Ummenthum K, Peferoen-Baert R, van der Valk P, Montoya A, Joel SP, Garthwaite J, Giovannoni G, Selwood DL, Baker D. Lesional-targeting of neuroprotection to the inflammatory penumbra in experimental multiple sclerosis. ACTA ACUST UNITED AC 2013; 137:92-108. [PMID: 24287115 DOI: 10.1093/brain/awt324] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Progressive multiple sclerosis is associated with metabolic failure of the axon and excitotoxicity that leads to chronic neurodegeneration. Global sodium-channel blockade causes side effects that can limit its use for neuroprotection in multiple sclerosis. Through selective targeting of drugs to lesions we aimed to improve the potential therapeutic window for treatment. This was assessed in the relapsing-progressive experimental autoimmune encephalomyelitis ABH mouse model of multiple sclerosis using conventional sodium channel blockers and a novel central nervous system-excluded sodium channel blocker (CFM6104) that was synthesized with properties that selectively target the inflammatory penumbra in experimental autoimmune encephalomyelitis lesions. Carbamazepine and oxcarbazepine were not immunosuppressive in lymphocyte-driven autoimmunity, but slowed the accumulation of disability in experimental autoimmune encephalomyelitis when administered during periods of the inflammatory penumbra after active lesion formation, and was shown to limit the development of neurodegeneration during optic neuritis in myelin-specific T cell receptor transgenic mice. CFM6104 was shown to be a state-selective, sodium channel blocker and a fluorescent p-glycoprotein substrate that was traceable. This compound was >90% excluded from the central nervous system in normal mice, but entered the central nervous system during the inflammatory phase in experimental autoimmune encephalomyelitis mice. This occurs after the focal and selective downregulation of endothelial p-glycoprotein at the blood-brain barrier that occurs in both experimental autoimmune encephalomyelitis and multiple sclerosis lesions. CFM6104 significantly slowed down the accumulation of disability and nerve loss in experimental autoimmune encephalomyelitis. Therapeutic-targeting of drugs to lesions may reduce the potential side effect profile of neuroprotective agents that can influence neurotransmission. This class of agents inhibit microglial activity and neural sodium loading, which are both thought to contribute to progressive neurodegeneration in multiple sclerosis and possibly other neurodegenerative diseases.
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Affiliation(s)
- Sarah Al-Izki
- 1 Neuroimmunology Unit, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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