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Burke SM, Avstrikova M, Noviello CM, Mukhtasimova N, Changeux JP, Thakur GA, Sine SM, Cecchini M, Hibbs RE. Structural mechanisms of α7 nicotinic receptor allosteric modulation and activation. Cell 2024; 187:1160-1176.e21. [PMID: 38382524 PMCID: PMC10950261 DOI: 10.1016/j.cell.2024.01.032] [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: 08/31/2023] [Revised: 12/05/2023] [Accepted: 01/22/2024] [Indexed: 02/23/2024]
Abstract
The α7 nicotinic acetylcholine receptor is a pentameric ligand-gated ion channel that plays an important role in cholinergic signaling throughout the nervous system. Its unique physiological characteristics and implications in neurological disorders and inflammation make it a promising but challenging therapeutic target. Positive allosteric modulators overcome limitations of traditional α7 agonists, but their potentiation mechanisms remain unclear. Here, we present high-resolution structures of α7-modulator complexes, revealing partially overlapping binding sites but varying conformational states. Structure-guided functional and computational tests suggest that differences in modulator activity arise from the stable rotation of a channel gating residue out of the pore. We extend the study using a time-resolved cryoelectron microscopy (cryo-EM) approach to reveal asymmetric state transitions for this homomeric channel and also find that a modulator with allosteric agonist activity exploits a distinct channel-gating mechanism. These results define mechanisms of α7 allosteric modulation and activation with implications across the pentameric receptor superfamily.
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Affiliation(s)
- Sean M Burke
- Molecular Biophysics Graduate Program, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; Department of Neurobiology, University of California, San Diego, La Jolla, CA 92093, USA
| | - Mariia Avstrikova
- Institut de Chimie de Strasbourg, UMR7177, CNRS, Université de Strasbourg, 67081 Strasbourg Cedex, France
| | - Colleen M Noviello
- Department of Neurobiology, University of California, San Diego, La Jolla, CA 92093, USA
| | - Nuriya Mukhtasimova
- Receptor Biology Laboratory, Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN 55902, USA; Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic College of Medicine, Rochester, MN 55902, USA
| | - Jean-Pierre Changeux
- Neuroscience Department, Institut Pasteur, Collège de France, 75015 Paris, France
| | - Ganesh A Thakur
- Department of Pharmaceutical Sciences, Northeastern University, Boston, MA 02115, USA
| | - Steven M Sine
- Receptor Biology Laboratory, Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, MN 55902, USA; Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic College of Medicine, Rochester, MN 55902, USA; Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN 55902, USA.
| | - Marco Cecchini
- Institut de Chimie de Strasbourg, UMR7177, CNRS, Université de Strasbourg, 67081 Strasbourg Cedex, France.
| | - Ryan E Hibbs
- Department of Neurobiology, University of California, San Diego, La Jolla, CA 92093, USA; Department of Neuroscience, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
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Present and future antipsychotic drugs: a systematic review of the putative mechanisms of action for efficacy and a critical appraisal under a translational perspective. Pharmacol Res 2022; 176:106078. [PMID: 35026403 DOI: 10.1016/j.phrs.2022.106078] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/23/2021] [Accepted: 01/07/2022] [Indexed: 01/10/2023]
Abstract
Antipsychotics represent the mainstay of schizophrenia pharmacological therapy, and their role has been expanded in the last years to mood disorders treatment. Although introduced in 1952, many years of research were required before an accurate picture of how antipsychotics work began to emerge. Despite the well-recognized characterization of antipsychotics in typical and atypical based on their liability to induce motor adverse events, their main action at dopamine D2R to elicit the "anti-psychotic" effect, as well as the multimodal action at other classes of receptors, their effects on intracellular mechanisms starting with receptor occupancy is still not completely understood. Significant lines of evidence converge on the impact of these compounds on multiple molecular signaling pathways implicated in the regulation of early genes and growth factors, dendritic spine shape, brain inflammation, and immune response, tuning overall the function and architecture of the synapse. Here we present, based on PRISMA approach, a comprehensive and systematic review of the above mechanisms under a translational perspective to disentangle those intracellular actions and signaling that may underline clinically relevant effects and represent potential targets for further innovative strategies in antipsychotic therapy.
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3
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Astakhov AV, Chernenko AY, Kutyrev VV, Ranny GS, Minyaev ME, Chernyshev VM, Ananikov VP. Selective Buchwald–Hartwig arylation of C-amino-1,2,4-triazoles and other coordinating aminoheterocycles enabled by bulky NHC ligands and TPEDO activator. Inorg Chem Front 2022. [DOI: 10.1039/d2qi01832b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A facile method for selective N-(hetero)arylation of coordinating 3(5)-amino-1,2,4-triazoles under Pd/NHC catalysis using TPEDO as a new efficient Pd(ii) to Pd(0) reductant has been developed.
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Affiliation(s)
- Alexander V. Astakhov
- Platov South-Russian State Polytechnic University, (NPI), Prosvescheniya st., 132, Novocherkassk, 346428, Russia
| | - Andrey Yu. Chernenko
- Platov South-Russian State Polytechnic University, (NPI), Prosvescheniya st., 132, Novocherkassk, 346428, Russia
| | - Vadim V. Kutyrev
- Platov South-Russian State Polytechnic University, (NPI), Prosvescheniya st., 132, Novocherkassk, 346428, Russia
| | - Gleb S. Ranny
- Platov South-Russian State Polytechnic University, (NPI), Prosvescheniya st., 132, Novocherkassk, 346428, Russia
| | - Mikhail E. Minyaev
- Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, Leninsky Prospect 47, Moscow, 119991, Russia
| | - Victor M. Chernyshev
- Platov South-Russian State Polytechnic University, (NPI), Prosvescheniya st., 132, Novocherkassk, 346428, Russia
| | - Valentine P. Ananikov
- Platov South-Russian State Polytechnic University, (NPI), Prosvescheniya st., 132, Novocherkassk, 346428, Russia
- Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, Leninsky Prospect 47, Moscow, 119991, Russia
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4
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Davidson M, Levi L, Park J, Nastas I, Ford L, Rassnick S, Canuso C, Davis JM, Weiser M. The effects of JNJ-39393406 a positive allosteric nicotine modulator on mood and cognition in patients with unipolar depression: A double-blind, add-on, placebo-controlled trial. Eur Neuropsychopharmacol 2021; 51:33-42. [PMID: 34023797 DOI: 10.1016/j.euroneuro.2021.04.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/27/2021] [Accepted: 04/29/2021] [Indexed: 12/23/2022]
Abstract
Nicotinic agonists have been shown to improve cognition and mood, but this improvement is inconsistent and short-lived, possibly due to receptor desensitization. Positive Allosteric Modulators (PAMs) of the nicotinic alpha-7 nicotinic-acetyl-choline receptor (a7nAChR) are hypothesized to change the configuration of the nicotinic receptor and delay desensitization, potentially increasing the duration of the activation of the receptor, and improving clinical efficacy. This was a randomized controlled trial (RCT) adding JNJ-39393406 9 (a PAM of the a7nAChR) (n=35) or placebo (n=36) to treatment as usual for two weeks in 71 patients with unipolar depression. Mixed models for repeated measures analyses were performed Primary outcome measures were the Brief Assessment of Cognition in Schizophrenia (BACS) composite and the Montgomery-Asperg Depression Rating Scale (MADRS) scores. The drug was well tolerated, however mixed models for repeated measures comparing JNJ-39393406 to placebo showed no significant difference for MADRS total score (p=0.78), BACS composite score (p=0.34), or any of the secondary outcome measures. There was no significant difference in adverse events between the study groups (p=0.44). In conclusion, this study's findings do not support the hypothesis that a positive nicotinic receptor modulator can improve cognitive or depressive symptomatology in patients with unipolar depression.
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Affiliation(s)
| | - Linda Levi
- Department of Psychiatry, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - Jinyoung Park
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Igor Nastas
- Department of Psychiatry, Narcology and Medical Psychology, State University of Medicine and Pharmacy Nicolae Testemitanu, Moldova
| | - Lisa Ford
- Janssen Research & Development LLC, USA
| | | | | | - John M Davis
- Department of Psychiatry, University of Illinois, Chicago, IL, USA
| | - Mark Weiser
- Department of Psychiatry, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
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5
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Choueiry J, Blais CM, Shah D, Smith D, Fisher D, Illivitsky V, Knott V. CDP-choline and galantamine, a personalized α7 nicotinic acetylcholine receptor targeted treatment for the modulation of speech MMN indexed deviance detection in healthy volunteers: a pilot study. Psychopharmacology (Berl) 2020; 237:3665-3687. [PMID: 32851421 DOI: 10.1007/s00213-020-05646-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 08/18/2020] [Indexed: 02/06/2023]
Abstract
RATIONALE The combination of CDP-choline, an α7 nicotinic acetylcholine receptor (α7 nAChR) agonist, with galantamine, a positive allosteric modulator of nAChRs, is believed to counter the fast desensitization rate of the α7 nAChRs and may be of interest for schizophrenia (SCZ) patients. Beyond the positive and negative clinical symptoms, deficits in early auditory prediction-error processes are also observed in SCZ. Regularity violations activate these mechanisms that are indexed by electroencephalography-derived mismatch negativity (MMN) event-related potentials (ERPs) in response to auditory deviance. OBJECTIVES/METHODS This pilot study in thirty-three healthy humans assessed the effects of an optimized α7 nAChR strategy combining CDP-choline (500 mg) with galantamine (16 mg) on speech-elicited MMN amplitude and latency measures. The randomized, double-blinded, placebo-controlled, and counterbalanced design with a baseline stratification method allowed for assessment of individual response differences. RESULTS Increases in MMN generation mediated by the acute CDP-choline/galantamine treatment in individuals with low baseline MMN amplitude for frequency, intensity, duration, and vowel deviants were revealed. CONCLUSIONS These results, observed primarily at temporal recording sites overlying the auditory cortex, implicate α7 nAChRs in the enhancement of speech deviance detection and warrant further examination with respect to dysfunctional auditory deviance processing in individuals with SCZ.
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Affiliation(s)
- Joelle Choueiry
- Department of Neuroscience, Faculty of Medicine, University of Ottawa, 1145 Carling Ave, Ottawa, ON, K1Z 7K4, Canada.
- Department of Psychiatry, The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada.
- Department of Psychology, University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada.
| | - Crystal M Blais
- Institute of Cognitive Science, Carleton University, Ottawa, ON, Canada
| | - Dhrasti Shah
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Dylan Smith
- Department of Psychiatry, The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
- Department of Psychology, University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Derek Fisher
- Department of Psychology, Faculty of Social Sciences, Mount Saint Vincent University, Halifax, NS, Canada
| | - Vadim Illivitsky
- Department of Psychiatry, The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Verner Knott
- Department of Neuroscience, Faculty of Medicine, University of Ottawa, 1145 Carling Ave, Ottawa, ON, K1Z 7K4, Canada
- Department of Psychiatry, The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
- Department of Psychology, University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
- Institute of Cognitive Science, Carleton University, Ottawa, ON, Canada
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
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6
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Moerke MJ, McMahon LR, Wilkerson JL. More than Smoke and Patches: The Quest for Pharmacotherapies to Treat Tobacco Use Disorder. Pharmacol Rev 2020; 72:527-557. [PMID: 32205338 DOI: 10.1124/pr.119.018028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Tobacco use is a persistent public health issue. It kills up to half its users and is the cause of nearly 90% of all lung cancers. The main psychoactive component of tobacco is nicotine, primarily responsible for its abuse-related effects. Accordingly, most pharmacotherapies for smoking cessation target nicotinic acetylcholine receptors (nAChRs), nicotine's major site of action in the brain. The goal of the current review is twofold: first, to provide a brief overview of the most commonly used behavioral procedures for evaluating smoking cessation pharmacotherapies and an introduction to pharmacokinetic and pharmacodynamic properties of nicotine important for consideration in the development of new pharmacotherapies; and second, to discuss current and potential future pharmacological interventions aimed at decreasing tobacco use. Attention will focus on the potential for allosteric modulators of nAChRs to offer an improvement over currently approved pharmacotherapies. Additionally, given increasing public concern for the potential health consequences of using electronic nicotine delivery systems, which allow users to inhale aerosolized solutions as an alternative to smoking tobacco, an effort will be made throughout this review to address the implications of this relatively new form of nicotine delivery, specifically as it relates to smoking cessation. SIGNIFICANCE STATEMENT: Despite decades of research that have vastly improved our understanding of nicotine and its effects on the body, only a handful of pharmacotherapies have been successfully developed for use in smoking cessation. Thus, investigation of alternative pharmacological strategies for treating tobacco use disorder remains active; allosteric modulators of nicotinic acetylcholine receptors represent one class of compounds currently under development for this purpose.
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Affiliation(s)
- M J Moerke
- Division of Preclinical Pharmacology, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland (M.J.M.) and Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, Florida (L.R.M., J.L.W.)
| | - L R McMahon
- Division of Preclinical Pharmacology, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland (M.J.M.) and Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, Florida (L.R.M., J.L.W.)
| | - J L Wilkerson
- Division of Preclinical Pharmacology, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland (M.J.M.) and Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, Florida (L.R.M., J.L.W.)
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7
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Kantrowitz JT, Javitt DC, Freedman R, Sehatpour P, Kegeles LS, Carlson M, Sobeih T, Wall MM, Choo TH, Vail B, Grinband J, Lieberman JA. Double blind, two dose, randomized, placebo-controlled, cross-over clinical trial of the positive allosteric modulator at the alpha7 nicotinic cholinergic receptor AVL-3288 in schizophrenia patients. Neuropsychopharmacology 2020; 45:1339-1345. [PMID: 32015461 PMCID: PMC7298033 DOI: 10.1038/s41386-020-0628-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 01/06/2020] [Accepted: 01/26/2020] [Indexed: 11/09/2022]
Abstract
Despite their theoretical rationale, nicotinic alpha-7 acetylcholine (nα7) receptor agonists, have largely failed to demonstrate efficacy in placebo-controlled trials in schizophrenia. AVL-3288 is a nα7 positive allosteric modulator (PAM), which is only active in the presence of the endogenous ligand (acetylcholine), and thus theoretically less likely to cause receptor desensitization. We evaluated the efficacy of AVL-3288 in a Phase 1b, randomized, double-blind, placebo-controlled, triple cross-over study. Twenty-four non-smoking, medicated, outpatients with schizophrenia or schizoaffective disorder and a Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) ≥62 were randomized. Each subject received 5 days of AVL-3288 (10, 30 mg) and placebo across three separate treatment weeks. The primary outcome measure was the RBANS total scale score, with auditory P50 evoked potential suppression the key target engagement biomarker. Secondary outcome measures include task-based fMRI (RISE task), mismatch negativity, the Scale for the Assessment of Negative Symptoms of Schizophrenia (SANS) and the Brief Psychiatric Rating Scale (BPRS). Twenty-four subjects were randomized and treated without any clinically significant treatment emergent adverse effects. Baseline RBANS (82 ± 17) and BPRS (41 ± 13) scores were consistent with moderate impairment. Primary outcomes were negative, with non-significant worsening for both active groups vs. placebo in the P50 and minimal between group changes on the RBANS. In conclusion, the results did not indicate efficacy of the compound, consistent with most prior results for the nα7 target.
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Affiliation(s)
- Joshua T. Kantrowitz
- 0000000419368729grid.21729.3fColumbia University, New York, USA ,0000 0000 8499 1112grid.413734.6New York State Psychiatric Institute, New York, USA ,0000 0001 2189 4777grid.250263.0Nathan Kline Institute, Orangeburg, USA
| | - Daniel C. Javitt
- 0000000419368729grid.21729.3fColumbia University, New York, USA ,0000 0000 8499 1112grid.413734.6New York State Psychiatric Institute, New York, USA ,0000 0001 2189 4777grid.250263.0Nathan Kline Institute, Orangeburg, USA
| | | | - Pejman Sehatpour
- 0000000419368729grid.21729.3fColumbia University, New York, USA ,0000 0000 8499 1112grid.413734.6New York State Psychiatric Institute, New York, USA ,0000 0001 2189 4777grid.250263.0Nathan Kline Institute, Orangeburg, USA
| | - Lawrence S. Kegeles
- 0000000419368729grid.21729.3fColumbia University, New York, USA ,0000 0000 8499 1112grid.413734.6New York State Psychiatric Institute, New York, USA
| | - Marlene Carlson
- 0000000419368729grid.21729.3fColumbia University, New York, USA ,0000 0000 8499 1112grid.413734.6New York State Psychiatric Institute, New York, USA
| | - Tarek Sobeih
- 0000 0001 2189 4777grid.250263.0Nathan Kline Institute, Orangeburg, USA
| | - Melanie M. Wall
- 0000000419368729grid.21729.3fColumbia University, New York, USA ,0000 0000 8499 1112grid.413734.6New York State Psychiatric Institute, New York, USA
| | - Tse-Hwei Choo
- 0000000419368729grid.21729.3fColumbia University, New York, USA ,0000 0000 8499 1112grid.413734.6New York State Psychiatric Institute, New York, USA
| | - Blair Vail
- 0000 0000 8499 1112grid.413734.6New York State Psychiatric Institute, New York, USA
| | - Jack Grinband
- 0000000419368729grid.21729.3fColumbia University, New York, USA ,0000 0000 8499 1112grid.413734.6New York State Psychiatric Institute, New York, USA
| | - Jeffrey A. Lieberman
- 0000000419368729grid.21729.3fColumbia University, New York, USA ,0000 0000 8499 1112grid.413734.6New York State Psychiatric Institute, New York, USA
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Potasiewicz A, Krawczyk M, Gzielo K, Popik P, Nikiforuk A. Positive allosteric modulators of alpha 7 nicotinic acetylcholine receptors enhance procognitive effects of conventional anti-Alzheimer drugs in scopolamine-treated rats. Behav Brain Res 2020; 385:112547. [DOI: 10.1016/j.bbr.2020.112547] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/06/2020] [Accepted: 02/07/2020] [Indexed: 01/13/2023]
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9
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Terry AV, Callahan PM. α7 nicotinic acetylcholine receptors as therapeutic targets in schizophrenia: Update on animal and clinical studies and strategies for the future. Neuropharmacology 2020; 170:108053. [PMID: 32188568 DOI: 10.1016/j.neuropharm.2020.108053] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/10/2020] [Accepted: 03/11/2020] [Indexed: 10/24/2022]
Abstract
Schizophrenia is a devastating mental illness and its effective treatment is among the most challenging issues in psychiatry. The symptoms of schizophrenia are heterogeneous ranging from positive symptoms (e.g., delusions, hallucinations) to negative symptoms (e.g., anhedonia, social withdrawal) to cognitive dysfunction. Antipsychotics are effective at ameliorating positive symptoms in some patients; however, they are not reliably effective at improving the negative symptoms or cognitive impairments. The inability to address the cognitive impairments is a particular concern since they have the greatest long-term impact on functional outcomes. While decades of research have been devoted to the development of pro-cognitive agents for schizophrenia, to date, no drug has been approved for clinical use. Converging behavioral, neurobiological, and genetic evidence led to the identification of the α7-nicotinic acetylcholine receptor (α7-nAChR) as a therapeutic target several years ago and there is now extensive preclinical evidence that α7-nAChR ligands have pro-cognitive effects and other properties that should be beneficial to schizophrenia patients. However, like the other pro-cognitive strategies, no α7-nAChR ligand has been approved for clinical use in schizophrenia thus far. In this review, several topics are discussed that may impact the success of α7-nAChR ligands as pro-cognitive agents for schizophrenia including the translational value of the animal models used, clinical trial design limitations, confounding effects of polypharmacy, dose-effect relationships, and chronic versus intermittent dosing considerations. Determining the most optimal pharmacologic strategy at α7-nAChRs: agonist, positive allosteric modulator, or potentially even receptor antagonist is also discussed. article is part of the special issue on 'Contemporary Advances in Nicotine Neuropharmacology'.
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Affiliation(s)
- Alvin V Terry
- Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta University, Augusta, 30912, Georgia; Small Animal Behavior Core, Medical College of Georgia, Augusta University, Augusta, 30912, Georgia.
| | - Patrick M Callahan
- Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta University, Augusta, 30912, Georgia; Small Animal Behavior Core, Medical College of Georgia, Augusta University, Augusta, 30912, Georgia
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10
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Wang X, Bell IM, Uslaner JM. Activators of α7 nAChR as Potential Therapeutics for Cognitive Impairment. Curr Top Behav Neurosci 2020; 45:209-245. [PMID: 32451955 DOI: 10.1007/7854_2020_140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The α7 nicotinic acetylcholine receptor (nAChR) is a promising target for the treatment of cognitive deficits associated with psychiatric and neurological disorders, including schizophrenia and Alzheimer's disease (AD). Several α7 nAChR agonists and positive allosteric modulators (PAMs) have demonstrated procognitive effects in preclinical models and early clinical trials. However, despite intense research efforts in the pharmaceutical industry and academia, none of the α7 nAChR ligands has been approved for clinical use. This chapter will focus on the α7 nAChR ligands that have advanced to clinical studies and explore the reasons why these agents have not met with unequivocal clinical success.
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Affiliation(s)
- Xiaohai Wang
- Department of Neuroscience Research, Merck & Co. Inc., West Point, PA, USA
| | - Ian M Bell
- Department of Discovery Chemistry, Merck & Co. Inc., West Point, PA, USA
| | - Jason M Uslaner
- Department of Neuroscience Research, Merck & Co. Inc., West Point, PA, USA.
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11
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Barnes TR, Drake R, Paton C, Cooper SJ, Deakin B, Ferrier IN, Gregory CJ, Haddad PM, Howes OD, Jones I, Joyce EM, Lewis S, Lingford-Hughes A, MacCabe JH, Owens DC, Patel MX, Sinclair JM, Stone JM, Talbot PS, Upthegrove R, Wieck A, Yung AR. Evidence-based guidelines for the pharmacological treatment of schizophrenia: Updated recommendations from the British Association for Psychopharmacology. J Psychopharmacol 2020; 34:3-78. [PMID: 31829775 DOI: 10.1177/0269881119889296] [Citation(s) in RCA: 141] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
These updated guidelines from the British Association for Psychopharmacology replace the original version published in 2011. They address the scope and targets of pharmacological treatment for schizophrenia. A consensus meeting was held in 2017, involving experts in schizophrenia and its treatment. They were asked to review key areas and consider the strength of the evidence on the risk-benefit balance of pharmacological interventions and the clinical implications, with an emphasis on meta-analyses, systematic reviews and randomised controlled trials where available, plus updates on current clinical practice. The guidelines cover the pharmacological management and treatment of schizophrenia across the various stages of the illness, including first-episode, relapse prevention, and illness that has proved refractory to standard treatment. It is hoped that the practice recommendations presented will support clinical decision making for practitioners, serve as a source of information for patients and carers, and inform quality improvement.
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Affiliation(s)
- Thomas Re Barnes
- Emeritus Professor of Clinical Psychiatry, Division of Psychiatry, Imperial College London, and Joint-head of the Prescribing Observatory for Mental Health, Centre for Quality Improvement, Royal College of Psychiatrists, London, UK
| | - Richard Drake
- Clinical Lead for Mental Health in Working Age Adults, Health Innovation Manchester, University of Manchester and Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Carol Paton
- Joint-head of the Prescribing Observatory for Mental Health, Centre for Quality Improvement, Royal College of Psychiatrists, London, UK
| | - Stephen J Cooper
- Emeritus Professor of Psychiatry, School of Medicine, Queen's University Belfast, Belfast, UK
| | - Bill Deakin
- Professor of Psychiatry, Neuroscience & Psychiatry Unit, University of Manchester and Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - I Nicol Ferrier
- Emeritus Professor of Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Catherine J Gregory
- Honorary Clinical Research Fellow, University of Manchester and Higher Trainee in Child and Adolescent Psychiatry, Manchester University NHS Foundation Trust, Manchester, UK
| | - Peter M Haddad
- Honorary Professor of Psychiatry, Division of Psychology and Mental Health, University of Manchester, UK and Senior Consultant Psychiatrist, Department of Psychiatry, Hamad Medical Corporation, Doha, Qatar
| | - Oliver D Howes
- Professor of Molecular Psychiatry, Imperial College London and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ian Jones
- Professor of Psychiatry and Director, National Centre of Mental Health, Cardiff University, Cardiff, UK
| | - Eileen M Joyce
- Professor of Neuropsychiatry, UCL Queen Square Institute of Neurology, London, UK
| | - Shôn Lewis
- Professor of Adult Psychiatry, Faculty of Biology, Medicine and Health, The University of Manchester, UK, and Mental Health Academic Lead, Health Innovation Manchester, Manchester, UK
| | - Anne Lingford-Hughes
- Professor of Addiction Biology and Honorary Consultant Psychiatrist, Imperial College London and Central North West London NHS Foundation Trust, London, UK
| | - James H MacCabe
- Professor of Epidemiology and Therapeutics, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, and Honorary Consultant Psychiatrist, National Psychosis Service, South London and Maudsley NHS Foundation Trust, Beckenham, UK
| | - David Cunningham Owens
- Professor of Clinical Psychiatry, University of Edinburgh. Honorary Consultant Psychiatrist, Royal Edinburgh Hospital, Edinburgh, UK
| | - Maxine X Patel
- Honorary Clinical Senior Lecturer, King's College London, Institute of Psychiatry, Psychology and Neuroscience and Consultant Psychiatrist, Oxleas NHS Foundation Trust, London, UK
| | - Julia Ma Sinclair
- Professor of Addiction Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK
| | - James M Stone
- Clinical Senior Lecturer and Honorary Consultant Psychiatrist, King's College London, Institute of Psychiatry, Psychology and Neuroscience and South London and Maudsley NHS Trust, London, UK
| | - Peter S Talbot
- Senior Lecturer and Honorary Consultant Psychiatrist, University of Manchester and Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Rachel Upthegrove
- Professor of Psychiatry and Youth Mental Health, University of Birmingham and Consultant Psychiatrist, Birmingham Early Intervention Service, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Angelika Wieck
- Honorary Consultant in Perinatal Psychiatry, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Alison R Yung
- Professor of Psychiatry, University of Manchester, School of Health Sciences, Manchester, UK and Centre for Youth Mental Health, University of Melbourne, Australia, and Honorary Consultant Psychiatrist, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
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12
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Tregellas JR, Wylie KP. Alpha7 Nicotinic Receptors as Therapeutic Targets in Schizophrenia. Nicotine Tob Res 2019; 21:349-356. [PMID: 30137618 DOI: 10.1093/ntr/nty034] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/09/2018] [Indexed: 12/12/2022]
Abstract
While current treatments for schizophrenia often provide much relief for positive symptoms such as hallucinations, other symptoms, particularly cognitive deficits, persist and contribute to substantial suffering and reduced quality of life for patients. In searching for novel therapeutic avenues to treat cognitive deficits in schizophrenia, recent work is exploring nicotinic receptor neurobiology. Supported by a large body of evidence, with contributions from studies of smoking behaviors, genetics, receptor distribution and function, animal models and nicotinic effects on illness symptoms, the alpha7 nicotinic receptor has emerged as a potential therapeutic target. Despite promise in early clinical trials, however, no drug targeting nicotinic systems has succeeded in larger phase 3 trials. Following a brief review of nicotinic receptor biology and the evidence that has led to pursuit of alpha7 nicotinic agonism as a therapeutic strategy, this review will provide an update on the status of recent trials, discuss potential issues that may have contributed to negative outcomes, and point to new directions and promising advances in developing alpha7 nicotinic receptor-based treatment for cognitive symptoms in schizophrenia. IMPLICATIONS By examining alpha7 nicotinic receptor biology and recent efforts to target the receptor in clinical trials, it is hoped that investigators will be motivated to explore novel, promising directions focusing on the receptor as a strategy to treat cognitive symptoms in schizophrenia.
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Affiliation(s)
- Jason R Tregellas
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO.,Research Service, Denver VA Medical Center, Denver, CO
| | - Korey P Wylie
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO.,Research Service, Denver VA Medical Center, Denver, CO
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13
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Jackson A, Alkhlaif Y, Papke RL, Brunzell DH, Damaj MI. Impact of modulation of the α7 nicotinic acetylcholine receptor on nicotine reward in the mouse conditioned place preference test. Psychopharmacology (Berl) 2019; 236:3593-3599. [PMID: 31302720 PMCID: PMC6895411 DOI: 10.1007/s00213-019-05331-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 07/08/2019] [Indexed: 12/26/2022]
Abstract
RATIONALE The α7 nicotinic acetylcholine receptor (nAChR) has been implicated as a target in modulating nicotine reward. However, the effect of pharmacological agents that have been shown to alter the channel properties of the α7 nAChR is not well understood in nicotine reward. OBJECTIVES This study aimed to investigate the impact of α7 nAChR pharmacological modulation on nicotine conditioned place preference (CPP) in mice by using positive allosteric modulators (PAMs) and a silent agonist. METHODS The effect of the orthosteric α7 nAChR full agonist PNU282987 (1.3 and 9 mg/kg, s.c.), Type I α7 PAM NS1738 (1 and 10 mg/kg; i.p.), the Type II α7 PAM PNU120596 (0.3, 1, and 3 mg/kg, i.p.), and the α7 silent agonist NS6740 (1 and 3 mg/kg, i.p) on nicotine CPP was measured in mice. Mice were conditioned with either saline or nicotine (0.5 mg/kg) for 3 days in the CPP paradigm. RESULTS The α7 full orthosteric agonist PNU282987 and the Type II α7 nAChR PAM PNU120596 reduced nicotine CPP, while the silent agonist NS6740 and Type I PAM NS1738 had no effect. The effects of PNU282987 and PNU120596 did not have an effect on morphine CPP. CONCLUSIONS Taken together, our results suggest that modulation of the α7 nAChR can play important roles in nicotine CPP in mice. In addition, the Type II α7 nAChR PAM PNU120596 attenuated nicotine reward suggesting that endogenous acetylcholine/choline tone is sufficient to reduce nicotine CPP. These findings highlight a beneficial effect of using α7 nAChR PAMs in nicotine reward.
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Affiliation(s)
- Asti Jackson
- Department of Psychiatry, Yale School of Medicine, 34 Park St., New Haven, CT, 06519, USA.
| | - Y. Alkhlaif
- Department of Pharmacology and Toxicology, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298-0613, USA
| | - R. L. Papke
- Department of Pharmacology and Therapeutics, University of Florida, PO Box 100267, Gainesville, FL 32610-0267, USA
| | - D. H. Brunzell
- Department of Pharmacology and Toxicology, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298-0613, USA
| | - M. I. Damaj
- Department of Pharmacology and Toxicology, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298-0613, USA
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14
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Santos SN, Alves de Souza G, Pereira TM, Franco DP, de Nigris Del Cistia C, Sant'Anna CMR, Lacerda RB, Kümmerle AE. Regioselective microwave synthesis and derivatization of 1,5-diaryl-3-amino-1,2,4-triazoles and a study of their cholinesterase inhibition properties. RSC Adv 2019; 9:20356-20369. [PMID: 35514684 PMCID: PMC9065794 DOI: 10.1039/c9ra04105b] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 06/22/2019] [Indexed: 11/30/2022] Open
Abstract
Herein we describe the development of an efficient one-pot regioselective synthesis protocol to obtain N-protected or N-deprotected 1,5-diaryl-3-amino-1,2,4-triazoles from N-acyl-N-Boc-carbamidothioates. This improved protocol using microwave irradiation and low reaction times (up to 1 h) furnished desired compounds in yields ranging from 50 to 84%. This chemistry is useful for a variety of aromatic groups with electronically diverse substituents. The design and correct derivation of the amino group led to compounds able to inhibit cholinesterases with good IC50 of up to 1 μM. Also, the mode of action (mixed-type) and SAR analysis for this series of compounds was described by means of kinetic and molecular modelling evaluations, showing potential for this class of compounds as new scaffolds for this biological activity.
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Affiliation(s)
- Sabrina Neves Santos
- Laboratório de Diversidade Molecular e Química Medicinal (LaDMol-QM, Molecular Diversity and Medicinal Chemistry Laboratory), Chemistry Institute, Universidade Federal Rural do Rio de Janeiro Seropédica Rio de Janeiro 239897-000 Brazil
- Programa de Pós-Gradução em Química (PPGQ), Universidade Federal Rural do Rio de Janeiro Seropédica Rio de Janeiro 239897-000 Brazil
| | - Gabriela Alves de Souza
- Laboratório de Diversidade Molecular e Química Medicinal (LaDMol-QM, Molecular Diversity and Medicinal Chemistry Laboratory), Chemistry Institute, Universidade Federal Rural do Rio de Janeiro Seropédica Rio de Janeiro 239897-000 Brazil
- Programa de Pós-Gradução em Química (PPGQ), Universidade Federal Rural do Rio de Janeiro Seropédica Rio de Janeiro 239897-000 Brazil
| | - Thiago Moreira Pereira
- Laboratório de Diversidade Molecular e Química Medicinal (LaDMol-QM, Molecular Diversity and Medicinal Chemistry Laboratory), Chemistry Institute, Universidade Federal Rural do Rio de Janeiro Seropédica Rio de Janeiro 239897-000 Brazil
- Programa de Pós-Gradução em Química (PPGQ), Universidade Federal Rural do Rio de Janeiro Seropédica Rio de Janeiro 239897-000 Brazil
| | - Daiana Portella Franco
- Laboratório de Diversidade Molecular e Química Medicinal (LaDMol-QM, Molecular Diversity and Medicinal Chemistry Laboratory), Chemistry Institute, Universidade Federal Rural do Rio de Janeiro Seropédica Rio de Janeiro 239897-000 Brazil
- Programa de Pós-Gradução em Química (PPGQ), Universidade Federal Rural do Rio de Janeiro Seropédica Rio de Janeiro 239897-000 Brazil
| | - Catarina de Nigris Del Cistia
- Programa de Pós-Gradução em Química (PPGQ), Universidade Federal Rural do Rio de Janeiro Seropédica Rio de Janeiro 239897-000 Brazil
| | - Carlos Mauricio R Sant'Anna
- Programa de Pós-Gradução em Química (PPGQ), Universidade Federal Rural do Rio de Janeiro Seropédica Rio de Janeiro 239897-000 Brazil
| | - Renata Barbosa Lacerda
- Laboratório de Diversidade Molecular e Química Medicinal (LaDMol-QM, Molecular Diversity and Medicinal Chemistry Laboratory), Chemistry Institute, Universidade Federal Rural do Rio de Janeiro Seropédica Rio de Janeiro 239897-000 Brazil
- Programa de Pós-Gradução em Química (PPGQ), Universidade Federal Rural do Rio de Janeiro Seropédica Rio de Janeiro 239897-000 Brazil
| | - Arthur Eugen Kümmerle
- Laboratório de Diversidade Molecular e Química Medicinal (LaDMol-QM, Molecular Diversity and Medicinal Chemistry Laboratory), Chemistry Institute, Universidade Federal Rural do Rio de Janeiro Seropédica Rio de Janeiro 239897-000 Brazil
- Programa de Pós-Gradução em Química (PPGQ), Universidade Federal Rural do Rio de Janeiro Seropédica Rio de Janeiro 239897-000 Brazil
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15
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Choueiry J, Blais CM, Shah D, Smith D, Fisher D, Illivitsky V, Knott V. Combining CDP-choline and galantamine: Effects of a selective α7 nicotinic acetylcholine receptor agonist strategy on P50 sensory gating of speech sounds in healthy volunteers. J Psychopharmacol 2019; 33:688-699. [PMID: 30920339 DOI: 10.1177/0269881119836217] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Schizophrenia (SCZ) patients and relatives have deficits in early cortical sensory gating (SG) typically measured by suppression of electroencephalography-derived P50 event-related potentials (ERPs) in a conditioning-testing (S1-S2) paradigm. Associated with alpha 7 nicotinic acetylcholine receptor (α7 nAChR) dysfunction and shown to be improved with nicotine and α7 nAChR agonists, SG has recently been shown to be improved in low P50 suppressing SCZ patients following acute CDP-choline treatment. AIMS This pilot study in healthy humans assessed the SG effects of an α7 nAChR strategy combining CDP-choline with galantamine, a positive allosteric modulator (PAM) of nAChRs, aimed at increasing and prolonging nicotinic receptor activity. METHODS The combined effect of CDP-choline (500 mg) and galantamine (16 mg) on speech P50 gating indices rP50 (S2/S1) and dP50 (S1-S2) was examined in 30 healthy participants stratified into low and high baseline P50 suppressors in a randomized, double-blind, placebo-controlled and counterbalanced design. RESULTS In low suppressors, CDP-choline/galantamine (vs. placebo) improved rP50 and dP50 gating, and reduced S2P50 amplitudes. No P50 gating effects were observed in high suppressors; however, CDP-choline/galantamine (vs. placebo) increased their S2P50 amplitudes. CONCLUSION Findings from this pilot study with CDP-choline/galantamine in a healthy, SCZ-like surrogate deficient gating sample are consistent with the association of α7 nAChR mechanisms in SG impairment in SCZ and support further research trials with CDP-choline and galantamine targeting sensory processes.
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Affiliation(s)
- Joelle Choueiry
- 1 Department of Neuroscience, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Crystal M Blais
- 2 Institute of Cognitive Science, Carleton University, Ottawa, ON, Canada
| | - Dhrasti Shah
- 3 School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Dylan Smith
- 3 School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Derek Fisher
- 4 Department of Psychology, Faculty of Social Sciences, Mount Saint Vincent University, Halifax, NS, Canada
| | | | - Verner Knott
- 1 Department of Neuroscience, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,2 Institute of Cognitive Science, Carleton University, Ottawa, ON, Canada.,3 School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada.,5 The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada.,6 University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
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16
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Choueiry J, Blais CM, Shah D, Smith D, Fisher D, Labelle A, Knott V. Combining CDP-choline and galantamine, an optimized α7 nicotinic strategy, to ameliorate sensory gating to speech stimuli in schizophrenia. Int J Psychophysiol 2019; 145:70-82. [PMID: 30790597 DOI: 10.1016/j.ijpsycho.2019.02.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 01/04/2019] [Accepted: 02/12/2019] [Indexed: 11/18/2022]
Abstract
Neural α7 nicotinic acetylcholine receptor (nAChR) expression and functioning deficits have been extensively associated with cognitive and early sensory gating (SG) impairments in schizophrenia (SCZ) patients and their relatives. SG, the suppression of irrelevant and redundant stimuli, is measured in a conditioning-testing (S1-S2) paradigm eliciting electroencephalography-derived P50 event-related potentials (ERPs), the S2 amplitudes of which are typically suppressed relative to S1. Despite extensive reports of nicotine-related improvements and several decades of research, an efficient nicotinic treatment has yet to be approved for SCZ. Following reports of SG improvements in low P50 suppressing SCZ patients and healthy participants with the α7 agonist, CDP-choline, this pilot study examined the combined modulatory effect of CDP-choline (500 mg) and galantamine (16 mg), a nAChR positive allosteric modulator and acetylcholinesterase inhibitor, on SG to speech stimuli in twenty-four SCZ patients in a randomized, double-blind and placebo-controlled design. As expected, in low P50 suppressors CDP-choline/galantamine (vs. Placebo) improved rP50 and dP50 scores by increasing inhibitory mechanisms as reflected by S2P50 amplitude reductions. Results also suggest a moderating role for auditory verbal hallucinations in treatment response. These preliminary findings provide supportive evidence for the involvement of α7 nAChR activity in speech gating in SCZ and support additional trials, examining different dose combinations and repeated doses of this optimized and personalized targeted α7 cholinergic treatment for SG dysfunction in subgroups of SCZ patients.
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Affiliation(s)
- Joelle Choueiry
- Department of Neuroscience, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Crystal M Blais
- Institute of Cognitive Science, Carleton University, Ottawa, ON, Canada
| | - Dhrasti Shah
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Dylan Smith
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Derek Fisher
- Department of Psychology, Faculty of Social Sciences, Mount Saint Vincent University, Halifax, NS, Canada
| | - Alain Labelle
- The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Verner Knott
- Department of Neuroscience, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Institute of Cognitive Science, Carleton University, Ottawa, ON, Canada; School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada; Department of Psychology, Faculty of Social Sciences, Mount Saint Vincent University, Halifax, NS, Canada; The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada; University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada.
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17
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Terry AV, Callahan PM. Nicotinic Acetylcholine Receptor Ligands, Cognitive Function, and Preclinical Approaches to Drug Discovery. Nicotine Tob Res 2019; 21:383-394. [PMID: 30137518 PMCID: PMC6379039 DOI: 10.1093/ntr/nty166] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 08/20/2018] [Indexed: 12/15/2022]
Abstract
Interest in nicotinic acetylcholine receptor (nAChR) ligands as potential therapeutic agents for cognitive disorders began more than 30 years ago when it was first demonstrated that the tobacco alkaloid nicotine could improve cognitive function in nicotine-deprived smokers as well as nonsmokers. Numerous animal and human studies now indicate that nicotine and a variety of nAChR ligands have the potential to improve multiple domains of cognition including attention, spatial learning, working memory, recognition memory, and executive function. The purpose of this review is to (1) discuss several pharmacologic strategies that have been developed to enhance nAChR activity (eg, agonist, partial agonist, and positive allosteric modulator) and improve cognitive function, (2) provide a brief overview of some of the more common rodent behavioral tasks with established translational validity that have been used to evaluate nAChR ligands for effects on cognitive function, and (3) briefly discuss some of the topics of debate regarding the development of optimal therapeutic strategies using nAChR ligands. Because of their densities in the mammalian brain and the amount of literature available, the review primarily focuses on ligands of the high-affinity α4β2* nAChR ("*" indicates the possible presence of additional subunits in the complex) and the low-affinity α7 nAChR. The behavioral task discussion focuses on representative methods that have been designed to model specific domains of cognition that are relevant to human neuropsychiatric disorders and often evaluated in human clinical trials. IMPLICATIONS The preclinical literature continues to grow in support of the development of nAChR ligands for a variety of illnesses that affect humans. However, to date, no new nAChR ligand has been approved for any condition other than nicotine dependence. As discussed in this review, the studies conducted to date provide the impetus for continuing efforts to develop new nAChR strategies (ie, beyond simple agonist and partial agonist approaches) as well as to refine current behavioral strategies and create new animal models to address translational gaps in the drug discovery process.
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Affiliation(s)
- Alvin V Terry
- Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta University, Augusta, GA
- Small Animal Behavior Core Laboratory, Augusta University, Augusta, GA
| | - Patrick M Callahan
- Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta University, Augusta, GA
- Small Animal Behavior Core Laboratory, Augusta University, Augusta, GA
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18
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Garai S, Raja KS, Papke RL, Deschamps JR, Damaj MI, Thakur GA. B-973, a Novel α7 nAChR Ago-PAM: Racemic and Asymmetric Synthesis, Electrophysiological Studies, and in Vivo Evaluation. ACS Med Chem Lett 2018; 9:1144-1148. [PMID: 30429960 DOI: 10.1021/acsmedchemlett.8b00407] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 10/11/2018] [Indexed: 02/06/2023] Open
Abstract
We report here the total synthesis of B-973 (five steps), a recently identified α7 nAChR ago-PAM, its enantiomeric resolution, and its electrophysiological characterization in Xenopus oocytes to identify (-)-B-973B as the bioactive enantiomer. The asymmetric synthesis of B-973B was accomplished in 99% ee, and X-ray crystallography studies revealed its absolute "S" stereochemistry. B-973B was effective in attenuating pain behavior and decreasing paw edema (formalin test), and its analgesic effects were mediated through α7 nAChR.
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Affiliation(s)
- Sumanta Garai
- Department of Pharmaceutical Sciences, Bouvé College of Health Science, Northeastern University, 140 The Fenway, 360 Huntington Avenue, Boston, Massachusetts 02115, United States
| | - Krishnamohan S. Raja
- Department of Pharmaceutical Sciences, Bouvé College of Health Science, Northeastern University, 140 The Fenway, 360 Huntington Avenue, Boston, Massachusetts 02115, United States
| | - Roger L. Papke
- Department of Pharmacology and Therapeutics, University of Florida, Gainesville, Florida 32611, United States
| | - Jeffrey R. Deschamps
- Naval Research Laboratory, Code 6930, 4555 Overlook Avenue, Washington, D.C. 20375, United States
| | - M. Imad Damaj
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, Virginia 23284, United States
| | - Ganesh A. Thakur
- Department of Pharmaceutical Sciences, Bouvé College of Health Science, Northeastern University, 140 The Fenway, 360 Huntington Avenue, Boston, Massachusetts 02115, United States
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19
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Aidelbaum R, Labelle A, Baddeley A, Knott V. Assessing the acute effects of CDP-choline on sensory gating in schizophrenia: A pilot study. J Psychopharmacol 2018; 32:541-551. [PMID: 29338621 DOI: 10.1177/0269881117746903] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Deficient sensory gating (SG) in schizophrenia is associated with functional outcome and offers a therapeutic target as it is linked to the altered function/expression of the α7 nicotinic acetylcholine receptors (nAChRs). This study analyzed the effects of citicoline (CDP-choline), a supplement with α7 nAChRs agonist properties, on SG in a sample of schizophrenia (SZ) patients. Using a randomized, placebo-controlled, double-blind design the dose-dependent (500 mg, 1000 mg, 2000 mg) and baseline-dependent (deficient versus normal suppressors) effects of CDP-choline on SG were examined using the P50 event-related potential (ERP) index of SG. Overall analysis failed to demonstrate treatment effects but CDP-choline improved SG (500 mg) in the deficient SZ subgroup by increasing suppression of the S2 P50 amplitude. These findings tentatively support α7 nAChR dysfunction in the expression of SG deficits and suggest further trials to assess the effects of sustained α7 nAChR activation on SG with low doses of CDP-choline.
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Affiliation(s)
- Robert Aidelbaum
- 1 Clinical Neuroelectrophysiology and Cognitive Research Laboratory, University of Ottawa Institute of Mental Health Research, ON, Canada.,2 Department of Psychology, Carleton University, ON, Canada
| | - Alain Labelle
- 3 Schizophrenia Program, Royal Ottawa Mental Health Centre, ON, Canada
| | - Ashley Baddeley
- 1 Clinical Neuroelectrophysiology and Cognitive Research Laboratory, University of Ottawa Institute of Mental Health Research, ON, Canada
| | - Verner Knott
- 1 Clinical Neuroelectrophysiology and Cognitive Research Laboratory, University of Ottawa Institute of Mental Health Research, ON, Canada
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20
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Perkins KA, Roy Chengappa KN, Karelitz JL, Boldry MC, Michael V, Herb T, Gannon J, Brar J, Ford L, Rassnick S, Brunzell DH. Initial Cross-Over Test of A Positive Allosteric Modulator of Alpha-7 Nicotinic Receptors to Aid Cessation in Smokers With Or Without Schizophrenia. Neuropsychopharmacology 2018; 43:1334-1342. [PMID: 29185480 PMCID: PMC5916362 DOI: 10.1038/npp.2017.292] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 10/20/2017] [Accepted: 11/20/2017] [Indexed: 12/20/2022]
Abstract
Preclinical research shows that compounds acting at α7 nicotinic receptors (nAChRs) can reduce nicotine self-administration, suggesting that a positive allosteric modulator (PAM) of α7 receptors, JNJ-39393406, may aid smoking cessation. Moreover, individuals with schizophrenia, who have very high rates of smoking, have reduced expression of α7 nAChRs and may particularly benefit from this compound. In two parallel studies using a within-subject cross-over design, 36 healthy smokers (Study 1) and 62 smokers with schizophrenia (Study 2), both groups high in quit interest, attempted to initiate quitting temporarily during each of two 3-week phases. Treatments were the α7 nicotinic receptor PAM JNJ-39393406 (100 mg b.i.d.) or placebo (double-blind, counter-balanced). In each phase, all smoked ad lib with no drug on week 1 or during dose run-up on week 2, and then tried to quit every day during week 3. Abstinence (confirmed by CO <5 p.p.m.) and smoking reduction (CO <8), as well as cigarettes/day (in Study 1), were assessed daily (Monday-Friday) each quit week and compared between conditions. Secondary outcomes included abstinence symptoms (withdrawal and craving) and cognitive test responding (N-back; continuous performance task). In both studies, compared with placebo, active JNJ-39393406 did not increase the number of abstinent days nor reduce total smoking exposure. We also found no significant improvements in craving, withdrawal, or cognitive function. With this dose and study duration, our findings do not support further testing of this α7 nAChR PAM compound for possible efficacy in smoking cessation, in smokers with or without schizophrenia.
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Affiliation(s)
- Kenneth A Perkins
- Department of Psychiatry, WPIC, University of Pittsburgh School of Medicine, Pittsburgh PA, USA,Department of Psychiatry, WPIC, University of Pittsburgh School of Medicine, 3811 O’Hara Street, Pittsburgh, PA 15213, USA, Tel: +1 412 246 5395, Fax: +1 412 246 5390, E-mail:
| | - K N Roy Chengappa
- Department of Psychiatry, WPIC, University of Pittsburgh School of Medicine, Pittsburgh PA, USA
| | - Joshua L Karelitz
- Department of Psychiatry, WPIC, University of Pittsburgh School of Medicine, Pittsburgh PA, USA
| | - Margaret C Boldry
- Department of Psychiatry, WPIC, University of Pittsburgh School of Medicine, Pittsburgh PA, USA
| | - Valerie Michael
- Department of Psychiatry, WPIC, University of Pittsburgh School of Medicine, Pittsburgh PA, USA
| | - Taylor Herb
- Department of Psychiatry, WPIC, University of Pittsburgh School of Medicine, Pittsburgh PA, USA
| | - Jessica Gannon
- Department of Psychiatry, WPIC, University of Pittsburgh School of Medicine, Pittsburgh PA, USA
| | - Jaspreet Brar
- Department of Psychiatry, WPIC, University of Pittsburgh School of Medicine, Pittsburgh PA, USA
| | - Lisa Ford
- Janssen Research and Development, Janssen Pharmaceuticals, Titusville NJ, USA
| | - Stefanie Rassnick
- Janssen Research and Development, Janssen Pharmaceuticals, Titusville NJ, USA
| | - Darlene H Brunzell
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond VA, USA
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21
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Designing selective modulators for the nicotinic receptor subtypes: challenges and opportunities. Future Med Chem 2018; 10:433-459. [PMID: 29451400 DOI: 10.4155/fmc-2017-0169] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Nicotinic receptors are membrane proteins involved in several physiological processes. They are considered suitable drug targets for various CNS disorders or conditions, as shown by the large number of compounds which have entered clinical trials. In recent years, nonconventional agonists have been discovered: positive allosteric modulators, allosteric agonists, site-specific agonists and silent desensitizers are compounds able to modulate the receptor interacting at sites different from the orthodox one, or to desensitize the receptor without prior opening. While these new findings can further complicate the pharmacology of these proteins and the design and optimization of ligands, they undoubtedly offer new opportunities to find drugs for the many therapeutic indications involving nicotinic receptors.
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22
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Smucny J, Tregellas JR. Targeting neuronal dysfunction in schizophrenia with nicotine: Evidence from neurophysiology to neuroimaging. J Psychopharmacol 2017; 31:801-811. [PMID: 28441884 PMCID: PMC5963521 DOI: 10.1177/0269881117705071] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Patients with schizophrenia self-administer nicotine at rates higher than is self-administered for any other psychiatric illness. Although the reasons are unclear, one hypothesis suggests that nicotine is a form of 'self-medication' in order to restore normal levels of nicotinic signaling and target abnormalities in neuronal function associated with cognitive processes. This brief review discusses evidence from neurophysiological and neuroimaging studies in schizophrenia patients that nicotinic agonists may effectively target dysfunctional neuronal circuits in the illness. Evidence suggests that nicotine significantly modulates a number of these circuits, although relatively few studies have used modern neuroimaging techniques (e.g. functional magnetic resonance imaging (fMRI)) to examine the effects of nicotinic drugs on disease-related neurobiology. The neuronal effects of nicotine and other nicotinic agonists in schizophrenia remain a priority for psychiatry research.
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Affiliation(s)
- Jason Smucny
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jason R Tregellas
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA,Research Service, Denver VA Medical Center, Denver, CO, USA
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Talpos JC. Symptomatic thinking: the current state of Phase III and IV clinical trials for cognition in schizophrenia. Drug Discov Today 2017; 22:1017-1026. [PMID: 28461223 DOI: 10.1016/j.drudis.2017.04.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 04/19/2017] [Accepted: 04/21/2017] [Indexed: 12/20/2022]
Abstract
Research indicates that relieving the cognitive and negative symptoms of schizophrenia is crucial for improving patient quality of life. However effective pharmacotherapies for cognitive and negative symptoms do not currently exist. A review of ongoing Phase III clinical trials indicates that, despite numerous compounds being investigated for cognition in schizophrenia, few are actually novel and most are not backed by empirically driven preclinical research efforts. Based on these trials, and a general disinvestment in development of novel therapies for schizophrenia, the likelihood of a major advancement in treating cognitive differences in schizophrenia does not look promising. Possible ways in which the remaining resources for development of novel treatment for schizophrenia can best be leveraged are discussed.
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Affiliation(s)
- John C Talpos
- National Center for Toxicological Research, 3900 NCTR Rd, Jefferson, AR 72079, USA.
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24
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Gee KW, Olincy A, Kanner R, Johnson L, Hogenkamp D, Harris J, Tran M, Edmonds SA, Yoshimura R, Johnstone T, Freedman R. First in human trial of a type I positive allosteric modulator of alpha7-nicotinic acetylcholine receptors: Pharmacokinetics, safety, and evidence for neurocognitive effect of AVL-3288. J Psychopharmacol 2017; 31:434-441. [PMID: 28196430 PMCID: PMC11012235 DOI: 10.1177/0269881117691590] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Type I positive allosteric modulators (PAMs) of the alpha7-nicotinic receptor enhance its cholinergic activation while preserving the spatiotemporal features of synaptic transmission and the receptor's characteristic rapid desensitization kinetics. Alpha7-nicotinic receptor agonists have shown promise for improving cognition in schizophrenia, but longer-term trials have been disappointing. Therefore, the type I PAM AVL-3288 was evaluated for safety and preliminary evidence of neurocognitive effect in healthy human subjects. Single-dose oral administration in ascending doses was conducted in a double-blind, placebo-controlled Phase I trial in non-smokers. The trial found indication of positive but non-significant effects on neurocognition at 10 and 30 mg, two doses that produced overlapping peak levels. There was also some evidence for effects on inhibition of the P50 auditory evoked potential to repeated stimuli, a biomarker that responds to alpha7-nicotinic receptor activation. The pharmacokinetic characteristics were consistent between subjects, and there were no safety concerns. The effects and safety profile were also assessed at 3 mg in a cohort of smokers, in whom concurrent nicotine administration did not alter either effects or safety. The trial demonstrates that a type I PAM can be safely administered to humans and that it has potential positive neurocognitive effects in central nervous system (CNS) disorders.
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Affiliation(s)
- Kelvin W. Gee
- Department of Pharmacology, School of Medicine, University of California Irvine, Irvine, CA 92697
| | - Ann Olincy
- Department of Psychiatry, University of Colorado School of Medicine, Aurora CO 80045
| | - Richard Kanner
- Anvyl LLC, 18092 Sky Park South, Suite F, Irvine, CA 92614
| | - Lynn Johnson
- Department of Psychiatry, University of Colorado School of Medicine, Aurora CO 80045
| | - Derk Hogenkamp
- Department of Pharmacology, School of Medicine, University of California Irvine, Irvine, CA 92697
| | - Josette Harris
- Department of Psychiatry, University of Colorado School of Medicine, Aurora CO 80045
| | - Minhtam Tran
- Department of Pharmacology, School of Medicine, University of California Irvine, Irvine, CA 92697
| | - Stephen A. Edmonds
- Department of Psychiatry, University of Colorado School of Medicine, Aurora CO 80045
| | - Ryan Yoshimura
- Department of Pharmacology, School of Medicine, University of California Irvine, Irvine, CA 92697
| | - Timothy Johnstone
- Department of Pharmacology, School of Medicine, University of California Irvine, Irvine, CA 92697
| | - Robert Freedman
- Department of Psychiatry, University of Colorado School of Medicine, Aurora CO 80045
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25
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Post-Munson DJ, Pieschl RL, Molski TF, Graef JD, Hendricson AW, Knox RJ, McDonald IM, Olson RE, Macor JE, Weed MR, Bristow LJ, Kiss L, Ahlijanian MK, Herrington J. B-973, a novel piperazine positive allosteric modulator of the α7 nicotinic acetylcholine receptor. Eur J Pharmacol 2017; 799:16-25. [PMID: 28132910 DOI: 10.1016/j.ejphar.2017.01.037] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 01/23/2017] [Accepted: 01/25/2017] [Indexed: 11/18/2022]
Abstract
The alpha7 (α7) nicotinic acetylcholine receptor is a therapeutic target for cognitive disorders. Here we describe 3-(3,4-difluorophenyl)-N-(1-(6-(4-(pyridin-2-yl)piperazin-1-yl)pyrazin-2-yl)ethyl)propanamide (B-973), a novel piperazine-containing molecule that acts as a positive allosteric modulator of the α7 receptor. We characterize the action of B-973 on the α7 receptor using electrophysiology and radioligand binding. At 0.1mM acetylcholine, 1μM B-973 potentiated peak acetylcholine-induced currents 6-fold relative to maximal acetylcholine (3mM) and slowed channel desensitization, resulting in a 6900-fold increase in charge transfer. The EC50 of B-973 was approximately 0.3μM at acetylcholine concentrations ranging from 0.03 to 3mM. At a concentration of 1μM, B-973 shifted the acetylcholine EC50 of peak currents from 0.30mM in control to 0.007mM. B-973 slowed channel deactivation upon acetylcholine removal (τ=50s) and increased the affinity of the α7 agonist [3H]A-585539. In the absence of exogenously added acetylcholine, application of B-973 at concentrations >1μM induced large methyllycaconitine-sensitive currents, suggesting B-973 can function as an Ago-PAM at high concentrations. B-973 will be a useful probe for investigating the biological consequences of increasing α7 receptor activity through allosteric modulation.
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Affiliation(s)
- Debra J Post-Munson
- Discovery Biology, Bristol-Myers Squibb, Inc., 5 Research Parkway, Wallingford, CT 06492 USA
| | - Rick L Pieschl
- Discovery Biology, Bristol-Myers Squibb, Inc., 5 Research Parkway, Wallingford, CT 06492 USA
| | - Thaddeus F Molski
- Discovery Biology, Bristol-Myers Squibb, Inc., 5 Research Parkway, Wallingford, CT 06492 USA
| | - John D Graef
- Discovery Biology, Bristol-Myers Squibb, Inc., 5 Research Parkway, Wallingford, CT 06492 USA
| | - Adam W Hendricson
- Lead Discovery and Optimization, Bristol-Myers Squibb, Inc., 5 Research Parkway, Wallingford, CT 06492 USA
| | - Ronald J Knox
- Lead Discovery and Optimization, Bristol-Myers Squibb, Inc., 5 Research Parkway, Wallingford, CT 06492 USA
| | - Ivar M McDonald
- Discovery Chemistry, Bristol-Myers Squibb, Inc., 5 Research Parkway, Wallingford, CT 06492 USA
| | - Richard E Olson
- Discovery Chemistry, Bristol-Myers Squibb, Inc., 5 Research Parkway, Wallingford, CT 06492 USA
| | - John E Macor
- Discovery Chemistry, Bristol-Myers Squibb, Inc., 5 Research Parkway, Wallingford, CT 06492 USA
| | - Michael R Weed
- Discovery Biology, Bristol-Myers Squibb, Inc., 5 Research Parkway, Wallingford, CT 06492 USA
| | - Linda J Bristow
- Discovery Biology, Bristol-Myers Squibb, Inc., 5 Research Parkway, Wallingford, CT 06492 USA
| | - Laszlo Kiss
- Lead Discovery and Optimization, Bristol-Myers Squibb, Inc., 5 Research Parkway, Wallingford, CT 06492 USA
| | - Michael K Ahlijanian
- Discovery Biology, Bristol-Myers Squibb, Inc., 5 Research Parkway, Wallingford, CT 06492 USA
| | - James Herrington
- Discovery Biology, Bristol-Myers Squibb, Inc., 5 Research Parkway, Wallingford, CT 06492 USA.
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26
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What is the promise of nicotinergic compounds in schizophrenia treatment? Future Med Chem 2016; 8:2009-2012. [DOI: 10.4155/fmc-2016-0154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Echeverria V, Yarkov A, Aliev G. Positive modulators of the α7 nicotinic receptor against neuroinflammation and cognitive impairment in Alzheimer's disease. Prog Neurobiol 2016; 144:142-57. [DOI: 10.1016/j.pneurobio.2016.01.002] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 11/07/2015] [Accepted: 01/06/2016] [Indexed: 01/08/2023]
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Abstract
Although there has been more than 50 years of development, there remains a great need for better antipsychotic medications. This article looks at the recent advances in treatment of schizophrenia. New hypotheses have been suggested that may replace or complement the dopamine hypotheses. The article explores the different novel drugs that impact some of the key neurotransmitter systems currently. Phosphodiesterase 10A inhibitors and α-7 neuronal nicotinic acetylcholine receptor modulators constitute the majority. The marketing of these medications eventually may result in change about how schizophrenia is treated.
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Cholinergic modulation of auditory P3 event-related potentials as indexed by CHRNA4 and CHRNA7 genotype variation in healthy volunteers. Neurosci Lett 2016; 623:36-41. [PMID: 27109789 DOI: 10.1016/j.neulet.2016.04.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 03/24/2016] [Accepted: 04/18/2016] [Indexed: 11/23/2022]
Abstract
Schizophrenia (SZ) is a psychiatric disorder characterized by cognitive dysfunction within the realm of attentional processing. Reduced P3a and P3b event-related potentials (ERPs), indexing involuntary and voluntary attentional processing respectively, have been consistently observed in SZ patients who also express prominent cholinergic deficiencies. The involvement of the brain's cholinergic system in attention has been examined for several decades; however, further inquiry is required to further comprehend how abnormalities in this system affect neighbouring neurotransmitter systems and contribute to neurocognitive deficits. The objective of this pilot study was to examine the moderating role of the CHRNA4 (rs1044396), CHRNA7 (rs3087454), and SLC5A7 (rs1013940) genes on ERP indices of attentional processing in healthy volunteers (N=99; Caucasians and non-Caucasians) stratified by genotype and assessed using the auditory P300 "oddball" paradigm. Results indicated significantly greater P3a and P3b-indexed attentional processing for CT (vs. CC) CHRNA4 carriers and greater P3b for AA (vs. CC) CHRNA7 carriers. SLC5A7 allelic variants did not show significant differences in P3a and P3b processing. These findings expand our knowledge on the moderating effect of cholinergic genes on attention and could help inform targeted drug developments aimed at restoring attention deficits in SZ patients.
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30
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Parikh V, Kutlu MG, Gould TJ. nAChR dysfunction as a common substrate for schizophrenia and comorbid nicotine addiction: Current trends and perspectives. Schizophr Res 2016; 171:1-15. [PMID: 26803692 PMCID: PMC4762752 DOI: 10.1016/j.schres.2016.01.020] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 01/07/2016] [Accepted: 01/10/2016] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The prevalence of tobacco use in the population with schizophrenia is enormously high. Moreover, nicotine dependence is found to be associated with symptom severity and poor outcome in patients with schizophrenia. The neurobiological mechanisms that explain schizophrenia-nicotine dependence comorbidity are not known. This study systematically reviews the evidence highlighting the contribution of nicotinic acetylcholine receptors (nAChRs) to nicotine abuse in schizophrenia. METHODS Electronic data bases (Medline, Google Scholar, and Web of Science) were searched using the selected key words that match the aims set forth for this review. A total of 276 articles were used for the qualitative synthesis of this review. RESULTS Substantial evidence from preclinical and clinical studies indicated that dysregulation of α7 and β2-subunit containing nAChRs account for the cognitive and affective symptoms of schizophrenia and nicotine use may represent a strategy to remediate these symptoms. Additionally, recent meta-analyses proposed that early tobacco use may itself increase the risk of developing schizophrenia. Genetic studies demonstrating that nAChR dysfunction that may act as a shared vulnerability factor for comorbid tobacco dependence and schizophrenia were found to support this view. The development of nAChR modulators was considered an effective therapeutic strategy to ameliorate psychiatric symptoms and to promote smoking cessation in schizophrenia patients. CONCLUSIONS The relationship between schizophrenia and smoking is complex. While the debate for the self-medication versus addiction vulnerability hypothesis continues, it is widely accepted that a dysfunction in the central nAChRs represent a common substrate for various symptoms of schizophrenia and comorbid nicotine dependence.
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Affiliation(s)
- Vinay Parikh
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA 19112, United States.
| | - Munir Gunes Kutlu
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA 19112, United States
| | - Thomas J Gould
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA 19112, United States
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31
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Ouach A, Pin F, Bertrand E, Vercouillie J, Gulhan Z, Mothes C, Deloye JB, Guilloteau D, Suzenet F, Chalon S, Routier S. Design of α7 nicotinic acetylcholine receptor ligands using the (het)Aryl-1,2,3-triazole core: Synthesis, in vitro evaluation and SAR studies. Eur J Med Chem 2016; 107:153-64. [DOI: 10.1016/j.ejmech.2015.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 10/30/2015] [Accepted: 11/01/2015] [Indexed: 10/22/2022]
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32
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Tregellas JR, Smucny J, Legget KT, Stevens KE. Effects of a ketogenic diet on auditory gating in DBA/2 mice: A proof-of-concept study. Schizophr Res 2015; 169:351-354. [PMID: 26453015 PMCID: PMC4827327 DOI: 10.1016/j.schres.2015.09.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 09/18/2015] [Accepted: 09/21/2015] [Indexed: 11/20/2022]
Abstract
Although the ketogenic diet has shown promise in a pilot study and case report in schizophrenia, its effects in animal models of hypothesized disease mechanisms are unknown. This study examined effects of treatment with the ketogenic diet on hippocampal P20/N40 gating in DBA/2 mice, a translational endophenotype that mirrors inhibitory deficits in P50 sensory gating in schizophrenia patients. As expected, the diet increased blood ketone levels. Animals with the highest ketone levels showed the lowest P20/N40 gating ratios. These preliminary results suggest that the ketogenic diet may effectively target sensory gating deficits and is a promising area for additional research in schizophrenia.
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Affiliation(s)
- Jason R Tregellas
- Research Service, Denver VA Medical Center, Denver, CO, USA; Neuroscience Program, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Jason Smucny
- Neuroscience Program, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kristina T Legget
- Neuroscience Program, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Karen E Stevens
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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33
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Featherstone RE, Siegel SJ. The Role of Nicotine in Schizophrenia. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2015; 124:23-78. [PMID: 26472525 DOI: 10.1016/bs.irn.2015.07.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Schizophrenia is associated with by severe disruptions in thought, cognition, emotion, and behavior. Patients show a marked increase in rates of smoking and nicotine dependence relative to nonaffected individuals, a finding commonly ascribed to the potential ameliorative effects of nicotine on symptom severity and cognitive impairment. Indeed, many studies have demonstrated improvement in patients following the administration of nicotine. Such findings have led to an increased emphasis on the development of therapeutic agents to target the nicotinic system as well as increasing the impetus to understand the genetic basis for nicotinic dysfunction in schizophrenia. The goal of this review article is to provide a critical summary of evidence for the role of the nicotinic system in schizophrenia. The first part will review the role of nicotine in normalization of primary dysfunctions and endophenotypical changes found in schizophrenia. The second part will provide a summary of genetic evidence linking polymorphisms in nicotinic receptor genes to smoking and schizophrenia. The third part will summarize attempts to treat schizophrenia using agents specifically targeting nicotinic and nicotinic receptor subtypes. Although currently available antipsychotic treatments are generally able to manage some aspects of schizophrenia (e.g., positive symptoms) they fail to address several other critically effected aspects of the disease. As such, the search for novel mechanisms to treat this disease is necessary.
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Affiliation(s)
- Robert E Featherstone
- Translational Neuroscience Program, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
| | - Steven J Siegel
- Translational Neuroscience Program, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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34
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Mata D, Linn DM, Linn CL. Retinal ganglion cell neuroprotection induced by activation of alpha7 nicotinic acetylcholine receptors. Neuropharmacology 2015; 99:337-46. [PMID: 26239818 DOI: 10.1016/j.neuropharm.2015.07.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 07/28/2015] [Accepted: 07/29/2015] [Indexed: 10/23/2022]
Abstract
The α7nAChR agonist, PNU-282987, has previously been shown to have a neuroprotective effect against loss of retinal ganglion cells (RGCs) in an in vivo glaucoma model when the agent was injected into the vitreous chamber of adult Long Evans rat eyes. Here, we characterized the neuroprotective effect of PNU-282987 at the nerve fiber and retinal ganglion cell layer, determined that neuroprotection occurred when the agonist was applied as eye drops and verified detection of the agonist in the retina, using LC/MS/MS. To induce glaucoma-like conditions in adult Long Evans rats, hypertonic saline was injected into the episcleral veins to induce scar tissue and increase intraocular pressure. Within one month, this procedure produced significant loss of RGCs compared to untreated conditions. RGCs were quantified after immunostaining with an antibody against Thy 1.1 and imaged using a confocal microscope. In dose-response studies, concentrations of PNU-282987 were applied to the animal's right eye two times each day, while the left eye acted as an internal control. Eye drops of PNU-282987 resulted in neuroprotection against RGC loss in a dose-dependent manner using concentrations between 100 μM and 2 mM PNU-282987. LC/MS/MS results demonstrated that PNU-282987 was detected in the retina when applied as eye drops, relatively small amounts of PNU-282987 were measured in blood plasma and no PNU-282987 was detected in cardiac tissue. These results support the hypothesis that eye drop application of PNU-282987 can prevent loss of RGCs associated with glaucoma, which can lead to neuroprotective treatments for diseases that involve α7nAChRs.
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Affiliation(s)
- David Mata
- Western Michigan University, Department of Biological Sciences, Kalamazoo, MI 49008, USA.
| | - David M Linn
- Grand Valley State University, Department of Biomedical Sciences, Allendale, MI 49401, USA.
| | - Cindy L Linn
- Western Michigan University, Department of Biological Sciences, Kalamazoo, MI 49008, USA.
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35
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Nicotinic ligands as multifunctional agents for the treatment of neuropsychiatric disorders. Biochem Pharmacol 2015; 97:388-398. [PMID: 26231940 DOI: 10.1016/j.bcp.2015.07.027] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 07/24/2015] [Indexed: 02/08/2023]
Abstract
The challenges associated with developing more effective treatments for neurologic and psychiatric illness such as Alzheimer's disease and schizophrenia are considerable. Both the symptoms and the pathophysiology of these conditions are complex and poorly understood and the clinical presentations across different patients can be very heterogeneous. Moreover, it has become apparent that the reductionist approach to drug discovery for these illnesses that has dominated the field for decades (i.e., the development of highly selective compounds or other treatment modalities focused on a very specific pathophysiologic target) has not been widely successful. Accordingly, a variety of new strategies have emerged including the development of "multitarget-directed ligands" (MTDLs), the development and/or identification of compounds that exhibit "multifunctional" activity (e.g., pro-cognitive plus neuroprotective, pro-cognitive plus antipsychotic activity), "repurposing" strategies for existing compounds that have other clinical indications, and novel "adjunctive" treatment strategies that might enhance the efficacy of the currently available treatments. Interestingly, a variety of ligands at nicotinic acetylcholine receptors (nAChRs) appear to have the potential to fulfill one or more of these desirable properties (i.e., multifunctional, repurposing, or adjunctive treatment potential). The purpose of this review (while not all-inclusive) is to provide an overview of a variety of nAChR ligands that demonstrate potential in these categories, particularly, "multifunctional" properties. Due to their densities in the mammalian brain and the amount of literature available, the review will focus on ligands of the high affinity α4β2 nAChR and the low affinity α7 nAChR.
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36
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Beinat C, Banister SD, Herrera M, Law V, Kassiou M. The therapeutic potential of α7 nicotinic acetylcholine receptor (α7 nAChR) agonists for the treatment of the cognitive deficits associated with schizophrenia. CNS Drugs 2015; 29:529-42. [PMID: 26242477 DOI: 10.1007/s40263-015-0260-0] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Homomeric α7 nicotinic acetylcholine receptors (α7 nAChRs) have implications in the regulation of cognitive processes such as memory and attention, and have shown promise as a therapeutic target for the treatment of the cognitive deficits associated with schizophrenia. Multiple α7 nAChR agonists have entered human trials; however, unfavorable side effects and pharmacokinetic issues have hindered the development of a clinical α7 nAChR agonist. Currently, EVP-6124 is in phase III clinical trials, and several other α7 nAChR agonists (GTS-21 and AQW051) are in earlier stages of development. This review will summarize the recent advances and failures of α7 nAChR agonists in clinical trials for the treatment of the aforementioned pathology.
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Affiliation(s)
- Corinne Beinat
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, 94305, USA
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37
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Smucny J, Stevens KE, Olincy A, Tregellas JR. Translational utility of rodent hippocampal auditory gating in schizophrenia research: a review and evaluation. Transl Psychiatry 2015; 5:e587. [PMID: 26101850 PMCID: PMC4490287 DOI: 10.1038/tp.2015.77] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 04/14/2015] [Accepted: 05/04/2015] [Indexed: 01/15/2023] Open
Abstract
Impaired gating of the auditory evoked P50 potential is one of the most pharmacologically well-characterized features of schizophrenia. This deficit is most commonly modeled in rodents by implanted electrode recordings from the hippocampus of the rodent analog of the P50, the P20-N40. The validity and effectiveness of this tool, however, has not been systematically reviewed. Here, we summarize findings from studies that have examined the effects of pharmacologic modulation on gating of the rodent hippocampal P20-N40 and the human P50. We show that drug effects on the P20-N40 are highly predictive of human effects across similar dose ranges. Furthermore, mental status (for example, anesthetized vs alert) does not appear to diminish the predictive capacity of these recordings. We then discuss hypothesized neuropharmacologic mechanisms that may underlie gating effects for each drug studied. Overall, this review supports continued use of hippocampal P20-N40 gating as a translational tool for schizophrenia research.
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Affiliation(s)
- J Smucny
- Neuroscience Program, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Research Service, Denver VA Medical Center, Denver, CO, USA
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - K E Stevens
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - A Olincy
- Research Service, Denver VA Medical Center, Denver, CO, USA
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - J R Tregellas
- Neuroscience Program, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Research Service, Denver VA Medical Center, Denver, CO, USA
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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38
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Chapleau RR, McElroy CA, Ruark CD, Fleming EJ, Ghering AB, Schlager JJ, Poeppelman LD, Gearhart JM. High-Throughput Screening for Positive Allosteric Modulators Identified Potential Therapeutics against Acetylcholinesterase Inhibition. JOURNAL OF BIOMOLECULAR SCREENING 2015; 20:1142-9. [PMID: 26078409 DOI: 10.1177/1087057115591006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 05/20/2015] [Indexed: 11/16/2022]
Abstract
The current standard of care for treatment of organophosphate (OP) poisoning includes pretreatment with the weak reversible acetylcholinesterase (AChE) inhibitor pyridostigmine bromide. Because this drug is an AChE inhibitor, similar side effects exist as with OP poisoning. In an attempt to provide a therapeutic capable of mitigating AChE inhibition without such side effects, high-throughput screening was performed to identify a compound capable of increasing the catalytic activity of AChE. Herein, two such novel positive allosteric modulators (PAMs) of AChE are presented. These PAMs increase AChE activity threefold, but they fail to upshift the apparent IC50 of a variety of OPs. Further development and optimization of these compounds may lead to pre- and/or postexposure therapeutics with broad-spectrum efficacy against pesticide and nerve agent poisoning. In addition, they could be used to complement the current therapeutic standard of care to increase the activity of uninhibited AChE, potentially increasing the efficacy of current therapeutics in addition to altering the therapeutic window.
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Affiliation(s)
- Richard R Chapleau
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Wright Patterson AFB, OH, USA Molecular Bioeffects Branch, Bioeffects Division, Human Effectiveness Directorate, 711th Human Performance Wing, Air Force Research Laboratory (711 HPW/RHDJ), Wright Patterson AFB, OH, USA
| | - Craig A McElroy
- College of Pharmacy, Ohio State University, Columbus, OH, USA
| | - Christopher D Ruark
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Wright Patterson AFB, OH, USA Molecular Bioeffects Branch, Bioeffects Division, Human Effectiveness Directorate, 711th Human Performance Wing, Air Force Research Laboratory (711 HPW/RHDJ), Wright Patterson AFB, OH, USA
| | - Emily J Fleming
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Wright Patterson AFB, OH, USA Molecular Bioeffects Branch, Bioeffects Division, Human Effectiveness Directorate, 711th Human Performance Wing, Air Force Research Laboratory (711 HPW/RHDJ), Wright Patterson AFB, OH, USA
| | - Amy B Ghering
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Wright Patterson AFB, OH, USA Molecular Bioeffects Branch, Bioeffects Division, Human Effectiveness Directorate, 711th Human Performance Wing, Air Force Research Laboratory (711 HPW/RHDJ), Wright Patterson AFB, OH, USA
| | - John J Schlager
- Molecular Bioeffects Branch, Bioeffects Division, Human Effectiveness Directorate, 711th Human Performance Wing, Air Force Research Laboratory (711 HPW/RHDJ), Wright Patterson AFB, OH, USA
| | - Lee D Poeppelman
- Molecular Bioeffects Branch, Bioeffects Division, Human Effectiveness Directorate, 711th Human Performance Wing, Air Force Research Laboratory (711 HPW/RHDJ), Wright Patterson AFB, OH, USA
| | - Jeffery M Gearhart
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Wright Patterson AFB, OH, USA Molecular Bioeffects Branch, Bioeffects Division, Human Effectiveness Directorate, 711th Human Performance Wing, Air Force Research Laboratory (711 HPW/RHDJ), Wright Patterson AFB, OH, USA
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Knott V, Impey D, Choueiry J, Smith D, de la Salle S, Saghir S, Smith M, Beaudry E, Ilivitsky V, Labelle A. An acute dose, randomized trial of the effects of CDP-Choline on Mismatch Negativity (MMN) in healthy volunteers stratified by deviance detection level. ACTA ACUST UNITED AC 2015. [DOI: 10.1186/s40810-014-0002-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Stevens KE, Zheng L, Floyd KL, Stitzel JA. Maximizing the effect of an α7 nicotinic receptor PAM in a mouse model of schizophrenia-like sensory inhibition deficits. Brain Res 2015; 1611:8-17. [PMID: 25744161 DOI: 10.1016/j.brainres.2015.02.044] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 02/20/2015] [Accepted: 02/21/2015] [Indexed: 12/30/2022]
Abstract
Positive allosteric modulators (PAMs) for the α7 nicotinic receptor hold promise for the treatment of sensory inhibition deficits observed in schizophrenia patients. Studies of these compounds in the DBA/2 mouse, which models the schizophrenia-related deficit in sensory inhibition, have shown PAMs to be effective in improving the deficit. However, the first published clinical trial of a PAM for both sensory inhibition deficits and related cognitive difficulties failed, casting a shadow on this therapeutic approach. The present study used both DBA/2 mice, and C3H Chrna7 heterozygote mice to assess the ability of the α7 PAM, PNU-120596, to improve sensory inhibition. Both of these strains of mice have reduced hippocampal α7 nicotinic receptor numbers and deficient sensory inhibition similar to schizophrenia patients. Low doses of PNU-120596 (1 or 3.33mg/kg) were effective in the DBA/2 mouse but not the C3H Chrna7 heterozygote mouse. Moderate doses of the selective α7 nicotinic receptor agonist, choline chloride (10 or 33mg/kg), were also ineffective in improving sensory inhibition in the C3H Chrna7 heterozygote mouse. However, combining the lowest doses of both PNU-120596 and choline chloride in this mouse model did improve sensory inhibition. We propose here that the difference in efficacy of PNU-120596 between the 2 mouse strains is driven by differences in hippocampal α7 nicotinic receptor numbers, such that C3H Chrna7 heterozygote mice require additional direct stimulation of the α7 receptors. These data may have implications for further clinical testing of putative α7 nicotinic receptor PAMs.
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Affiliation(s)
- Karen E Stevens
- Department of Psychiatry, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA.
| | - Lijun Zheng
- Department of Psychiatry, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA
| | - Kirsten L Floyd
- Department of Psychiatry, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA
| | - Jerry A Stitzel
- Institute for Behavioral Genetics, University of Colorado, Boulder, Boulder, CO, USA
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41
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Rowe AR, Mercer L, Casetti V, Sendt KV, Giaroli G, Shergill SS, Tracy DK. Dementia praecox redux: a systematic review of the nicotinic receptor as a target for cognitive symptoms of schizophrenia. J Psychopharmacol 2015; 29:197-211. [PMID: 25567553 DOI: 10.1177/0269881114564096] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Most individuals with schizophrenia suffer some cognitive dysfunction: such deficits are predictive of longer-term functioning; and current dopamine-blocking antipsychotics have made little impact on this domain. There is a pressing need to develop novel pharmacological agents to tackle this insidious but most disabling of problems. The acetylcholinergic system is involved in cognitive and attentional processing, and its metabotropic and nicotinic receptors are widespread throughout the brain. Deficits in acetylcholinergic functioning occur in schizophrenia, and high rates of tobacco smoking have been posited to represent a form of self-medication. The nicotinic acetylcholine receptor (nAChR) has emerged as a putative target to improve cognitive deficits in schizophrenia, and this study systematically reviewed the emerging data. Nineteen studies were identified, covering three compound classes: agonists at the α7 and α 4β2 nAChRs, and positive allosteric modulators. Overall data are underwhelming: some studies showed significant improvements in cognition but as many studies had negative findings. It remains unclear if this represents drug limitations or nascent study methodology problems. The literature is particularly hindered by variability in inclusion of smokers, generally small sample sizes, and a lack of consensus on cognitive test batteries. Future work should evaluate longer-term outcomes, and, particularly, the effects of concomitant cognitive training.
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Affiliation(s)
- Arann R Rowe
- The Institute of Psychiatry, King's College London, London, UK
| | - Louise Mercer
- The Institute of Psychiatry, King's College London, London, UK
| | - Valentina Casetti
- The Institute of Psychiatry, King's College London, London, UK Oxleas NHS Foundation Trust, London, UK
| | | | | | - Sukhwinder S Shergill
- The Institute of Psychiatry, King's College London, London, UK South London and Maudsley NHS Foundation Trust, London, UK
| | - Derek K Tracy
- The Institute of Psychiatry, King's College London, London, UK Oxleas NHS Foundation Trust, London, UK
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Feuerbach D, Pezous N, Weiss M, Shakeri-Nejad K, Lingenhoehl K, Hoyer D, Hurth K, Bilbe G, Pryce CR, McAllister K, Chaperon F, Kucher K, Johns D, Blaettler T, Lopez Lopez C. AQW051, a novel, potent and selective α7 nicotinic ACh receptor partial agonist: pharmacological characterization and phase I evaluation. Br J Pharmacol 2015; 172:1292-304. [PMID: 25363835 DOI: 10.1111/bph.13001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 10/14/2014] [Accepted: 10/27/2014] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND AND PURPOSE Activation of the α7 nicotinic ACh receptor (nACh receptor) is considered an attractive target for the treatment of cognitive impairment associated with neurological disorders. Here we describe the novel α7-nACh receptor agonist AQW051 as a promising drug candidate for this indication. EXPERIMENTAL APPROACH AQW051 was functionally characterized in vitro and cognitive effects evaluated in rodent behavioural models. Pharmacokinetics and tolerability were evaluated in three phase I placebo-controlled studies in 180 healthy subjects. KEY RESULTS In vitro, AQW051 bound with high affinity to α7-nACh receptors and stimulated calcium influx in cells recombinantly expressing the human α7-nACh receptor. In vivo, AQW051 demonstrated good oral bioavailability and rapid penetration into the rodent brain. AQW051 administered over a broad dose range facilitated learning/memory performance in the object recognition and social recognition test in mice and the water maze model in aged rats. Clinically, AQW051 was well tolerated in healthy young and elderly subjects, with an adverse event (AE) profile comparable with placebo. No serious AEs were reported and all AEs were either mild or moderate in severity at single oral doses up to 200 mg and multiple daily doses up to 75 mg. Once-daily oral administration of AQW051 resulted in continuous exposure and a two- to threefold accumulation compared with steady state was achieved by 1 week. CONCLUSIONS AND IMPLICATIONS These data support further development of AQW051 as a cognitive-enhancing agent, as a therapeutic, for example, in Alzheimer's disease or schizophrenia.
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43
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Hashimoto K. Targeting of α7 Nicotinic Acetylcholine Receptors in the Treatment of Schizophrenia and the Use of Auditory Sensory Gating as a Translational Biomarker. Curr Pharm Des 2015; 21:3797-806. [PMID: 26044974 PMCID: PMC5024727 DOI: 10.2174/1381612821666150605111345] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 06/04/2015] [Indexed: 11/22/2022]
Abstract
Accumulating evidence suggests that the α7 subtype of nicotinic acetylcholine receptors (nAChRs) plays a key role in inflammatory processes, thought to be involved in the pathophysiology of neuropsychiatric diseases, such as schizophrenia and Alzheimer's disease. Preclinical and clinical studies showed that the diminished suppression of P50 auditory evoked potentials in patients with schizophrenia may be associated with a decreased density of α7 nAChRs in the brain. This points to a role for auditory sensory gating (P50) as a translational biomarker. A number of agonists and positive allosteric modulators (PAMs) for α7 nAChR promoted beneficial effects in animal models with sensory gating and cognitive deficits. Additionally, several clinical studies showed that α7 nAChR agonists could improve suppression in auditory P50 evoked potentials, as well as cognitive deficits, and negative symptoms in patients with schizophrenia. Taken together, α7 nAChR presents as an extremely attractive therapeutic target for schizophrenia. In this article, the author discusses recent findings on α7 nAChR agonists such as DMXB-A, RG3487, TC-5619, tropisetron, EVP-6124 (encenicline), ABT-126, AQW051 and α7 nAChR PAMs such as JNJ-39393406, PNU- 120596 and AVL-3288 (also known as UCI-4083), and their potential as therapeutic drugs for neuropsychiatric diseases, such as schizophrenia.
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Affiliation(s)
- Kenji Hashimoto
- Division of Clinical Neuroscience, Chiba University Center for Forensic, Mental Health, 1-8-1 Inohana, Chiba 260-8670, Japan.
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Knott V, Smith D, de la Salle S, Impey D, Choueiry J, Beaudry E, Smith M, Saghir S, Ilivitsky V, Labelle A. CDP-choline: effects of the procholine supplement on sensory gating and executive function in healthy volunteers stratified for low, medium and high P50 suppression. J Psychopharmacol 2014; 28:1095-108. [PMID: 25315828 DOI: 10.1177/0269881114553254] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Diminished auditory sensory gating and associated neurocognitive deficits in schizophrenia have been linked to altered expression and function of the alpha-7 nicotinic acetycholinergic receptor (α7 nAChR), the targeting of which may have treatment potential. Choline is a selective α7 nAChR agonist and the aim of this study was to determine whether cytidine 5'-diphosphocholine (CDP-choline), or citicoline, a dietary source of choline, increases sensory gating and cognition in healthy volunteers stratified for gating level. In a randomized, placebo-controlled, double-blind design involving acute administration of low, moderate doses (500 mg, 1000 mg) of CDP-choline, 24 healthy volunteers were assessed for auditory gating as indexed by suppression of the P50 event-related potential (ERP) in a paired-stimulus (S1, S2) paradigm, and for executive function as measured by the Groton Maze Learning Task (GMLT) of the CogState Schizophrenia Battery. CDP-choline improved gating (1000 mg) and suppression of the S2 P50 response (500 mg, 1000 mg), with the effects being selective for individuals with low gating (suppression) levels. Tentative support was also shown for increased GMLT performance (500 mg) in low suppressors. These preliminary findings with CDP-choline in a healthy, schizophrenia-like surrogate sample are consistent with a α7 nAChR mechanism and support further trials with choline as a pro-cognitive strategy.
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Affiliation(s)
- Verner Knott
- Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada School of Psychology, University of Ottawa, Ottawa, ON, Canada Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
| | - Dylan Smith
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | | | - Danielle Impey
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Joelle Choueiry
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Elise Beaudry
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Meaghan Smith
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Salman Saghir
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Vadim Ilivitsky
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
| | - Alain Labelle
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
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Tan SP, Fan FM, Zhao YL, Chen N, Fan HZ, Zhang JG, Wang YH, Yoon JH, Soares JC, Zou YZ, Zhang XY. Smoking, MATRICS consensus cognitive battery and P50 sensory gating in a Han Chinese population. Drug Alcohol Depend 2014; 143:51-7. [PMID: 25124304 DOI: 10.1016/j.drugalcdep.2014.06.045] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 06/25/2014] [Accepted: 06/27/2014] [Indexed: 01/18/2023]
Abstract
BACKGROUND The effects of smoking on cognitive performance have long been studied, with mixed results. P50 sensory gating has been used as endophenotype for studying nicotinic systems genetics, and P50 gating deficits have been reported to be a sensitive biomarker for cognitive impairment in schizophrenia. This study examined the inter-relationship between P50 suppression, cognitive function, and smoking in a healthy Han Chinese population, which has not been reported before. METHODS We recruited 82 healthy male subjects, including 48 smokers and 34 non-smokers who were matched for age and education. The authors measured P50 sensory gating and administered the Chinese-language version of the MATRICS consensus cognitive battery (MCCB) and Stroop tests. RESULTS The results showed that the smokers scored lower than nonsmokers on the MCCB brief visuospatial memory test (BVMT) index and the STROOP test. Furthermore, the MCCB total score was negatively associated with number of cigarettes smoked per day in the smoker group. However, P50 sensory gating was not associated with either smoking status or any cognitive performance. CONCLUSIONS Our results show that smoking is associated with cognitive impairment, but not with P50 sensory gating.
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Affiliation(s)
- Shu-Ping Tan
- Psychiatry Research Center, Beijing Hui-Long-Guan Hospital., Peking University, Beijing, China
| | - Feng-Mei Fan
- Psychiatry Research Center, Beijing Hui-Long-Guan Hospital., Peking University, Beijing, China
| | - Yan-Li Zhao
- Psychiatry Research Center, Beijing Hui-Long-Guan Hospital., Peking University, Beijing, China
| | - Nan Chen
- Psychiatry Research Center, Beijing Hui-Long-Guan Hospital., Peking University, Beijing, China
| | - Hong-Zhen Fan
- Psychiatry Research Center, Beijing Hui-Long-Guan Hospital., Peking University, Beijing, China
| | - Jin-Guo Zhang
- Psychiatry Research Center, Beijing Hui-Long-Guan Hospital., Peking University, Beijing, China
| | - Yun-Hui Wang
- Psychiatry Research Center, Beijing Hui-Long-Guan Hospital., Peking University, Beijing, China
| | - Jin H Yoon
- Department of Psychiatry and Behavioral Sciences, Center for Neurobehavioral Research on Addiction, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, Harris County Psychiatric Center, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Yi-Zhuang Zou
- Psychiatry Research Center, Beijing Hui-Long-Guan Hospital., Peking University, Beijing, China
| | - Xiang Yang Zhang
- Psychiatry Research Center, Beijing Hui-Long-Guan Hospital., Peking University, Beijing, China; Department of Psychiatry and Behavioral Sciences, Harris County Psychiatric Center, The University of Texas Health Science Center at Houston, Houston, TX, USA.
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46
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Nathou C, Etard O, Simon G, Dollfus S. How do high- and low-frequency repetitive transcranial magnetic stimulations modulate the temporal cortex. Psychophysiology 2014; 52:192-8. [PMID: 25223883 DOI: 10.1111/psyp.12323] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 07/30/2014] [Indexed: 11/27/2022]
Abstract
Few studies have examined the impact of repetitive transcranial magnetic stimulation (rTMS) on the cortical excitability of nonmotor cortices; current treatments often target the temporal or prefrontal cortex. We used auditory evoked potentials recorded in 24 healthy subjects to evaluate the neuromodulatory effects of low- and high-frequency rTMS in the temporal lobe. Both auditory evoked potential P50 amplitude, a marker of cortical excitability, and P50 ratio, a marker of sensory gating known to be impaired in patients with auditory verbal hallucinations, were compared before and after rTMS. We observed a similar effect after both stimulation frequencies, with a decrease in P50 amplitude and no significant effect on P50 ratio. Low- and high-frequency rTMS applied to the temporal lobe seemed to exert the same cortical neuromodulation effect, while auditory sensory gating may not be modulated by temporal rTMS.
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Affiliation(s)
- Clement Nathou
- CHU de Caen, Service de psychiatrie, Centre Esquirol, Caen, France; UCBN, UFR de Médecine, Caen, France; CNRS, UMR 6301, ISTCT, ISTS Group, GIP Cyceron, Caen, France
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47
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Knott V, Impey D, Philippe T, Smith D, Choueiry J, de la Salle S, Dort H. Modulation of auditory deviance detection by acute nicotine is baseline and deviant dependent in healthy nonsmokers: a mismatch negativity study. Hum Psychopharmacol 2014; 29:446-58. [PMID: 25196041 DOI: 10.1002/hup.2418] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 03/19/2014] [Accepted: 05/19/2014] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Cognitive enhancement resulting from nicotinic acetylcholine receptor stimulation may be evidenced by increased efficiency of the auditory-frontal cortex network of auditory discrimination, which is impaired in schizophrenia, a cognitive disorder associated with excessive tobacco use. Investigating automatic (preattentive) detection of acoustic change with the mismatch negativity (MMN) brain event-related potential in response to nicotine in individuals with varying baseline levels of auditory discrimination may provide useful insight into the cholinergic regulation of this neural network and its potential amelioration with novel nicotinic agents. METHODS Sixty healthy, non-smoking male volunteers were presented with an 'optimal' multi-feature MMN paradigm in a randomized, placebo controlled double-blind design with 6 mg of nicotine gum. RESULTS Participants with low, medium, and high baseline amplitudes responded differently to nicotine (vs. placebo), and nicotine response was feature specific. Whereas MMN in individuals with high amplitudes was diminished by nicotine, MMN increased in those with low amplitudes. Nicotine effects were not shown in medium amplitude participants. CONCLUSIONS These findings provide preliminary support for the role of nicotinic neurotransmission in sensory memory processing of auditory change and suggest that nicotinic receptor modulation can both enhance and diminish change detection, depending on baseline MMN and its eliciting stimulus feature.
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Affiliation(s)
- Verner Knott
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada; School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Neuroscience Program, Department of Cellular and Molecular Medicine, University of Ottawa, Ontario, Canada
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48
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Design of α7 nicotinic acetylcholine receptor ligands in quinuclidine, tropane and quinazoline series. Chemistry, molecular modeling, radiochemistry, in vitro and in rats evaluations of a [18F] quinuclidine derivative. Eur J Med Chem 2014; 82:214-24. [DOI: 10.1016/j.ejmech.2014.04.057] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 04/17/2014] [Accepted: 04/19/2014] [Indexed: 12/23/2022]
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49
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Brunzell DH, McIntosh JM, Papke RL. Diverse strategies targeting α7 homomeric and α6β2* heteromeric nicotinic acetylcholine receptors for smoking cessation. Ann N Y Acad Sci 2014; 1327:27-45. [PMID: 24730978 DOI: 10.1111/nyas.12421] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Preclinical studies suggest that a diversity of nicotinic acetylcholine receptors (nAChRs) with different sensitivities to nicotine may contribute to tobacco addiction. Using rodent intravenous nicotine self-administration as a preclinical model with good predictive validity for therapeutic efficacy for tobacco cessation, investigators have identified heteromeric α6β2* and homomeric α7 nAChRs as promising novel therapeutic targets to promote smoking abstinence (*denotes possible assembly with other subunits). The data suggest that diverse strategies that target these subclasses of nAChRs, namely inhibition of α6β2* nAChRs and stimulation of α7 nAChRs, will support tobacco cessation. α6β2* nAChRs, members of the high-affinity family of β2* nAChRs, function similarly to α4β2* nAChRs, the primary target of the FDA-approved drug varenicline, but have a much more selective neuroanatomical pattern of expression in catecholaminergic nuclei. Although activation of β2* nAChRs facilitates nicotine self-administration, stimulation of α7 nAChRs appears to negatively modulate both nicotine reinforcement and β2* nAChR function in the mesolimbic dopamine system. Although challenges and caveats must be considered in the development of therapeutics that target these nAChR subpopulations, an accumulation of data suggests that α7 nAChR agonists, partial agonists, or positive allosteric modulators and α6β2* nAChR antagonists, partial agonists, or negative allosteric modulators may prove to be effective therapeutics for tobacco cessation.
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Affiliation(s)
- Darlene H Brunzell
- Department of Pharmacology and Toxicology, Interdisciplinary Neuroscience Program and Institute for Drug and Alcohol Studies, Virginia Commonwealth University School of Medicine, Richmond, Virginia
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50
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Grupe M, Grunnet M, Laursen B, Bastlund JF. Neuropharmacological modulation of the P3-like event-related potential in a rat two-tone auditory discrimination task with modafinil and NS9283, a positive allosteric modulator of α4β2 nAChRs. Neuropharmacology 2013; 79:444-55. [PMID: 24361451 DOI: 10.1016/j.neuropharm.2013.12.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 12/05/2013] [Accepted: 12/06/2013] [Indexed: 11/19/2022]
Abstract
The P300 (P3) event-related potential (ERP) is a neurophysiological signal believed to reflect cognitive processing of salient cues, and is thus used as a measure of attention and working memory. Additionally, P3 amplitude and latency is altered in neurological diseases and can be pharmacologically modulated. As P3-like ERPs can be recorded in rodents, it may serve as a potential translational biomarker of value for drug discovery. Here we investigated whether a positive allosteric modulator of α4β2 nicotinic acetylcholine receptors, NS9283, and the psychostimulant modafinil could modulate P3-like ERPs in healthy adult rats performing an auditory oddball discrimination task. ERPs were recorded with electroencephalography electrodes implanted into mediodorsal (MD) thalamus, medial prefrontal cortex, hippocampus and auditory cortex (AC). P3-like ERPs were detected in all brain regions, displaying larger amplitudes in target trials compared to non-target trials. Administration of modafinil (64 mg/kg) decreased P3-like ERP latency in MD thalamus and AC, whereas NS9283 augmented P3-like ERP amplitude in MD thalamus at 0.3 mg/kg and in AC at 3.0 mg/kg. Additionally, N1 pre-attention peak amplitude in MD thalamus was increased with 0.3 mg/kg NS9283. Neither of the compounds enhanced task performance. Rather, modafinil lowered correct rejections in non-target trials. In summary, our findings reveal pharmacological modulation of the rat P3-like ERP in cortical and subcortical regions by modafinil and NS9283. These findings encourage further exploration of the rat P3-like ERP in order to promote the understanding of its meaning within cognition, as well as its applicability as a translatable biomarker in drug development.
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Affiliation(s)
- Morten Grupe
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen, Denmark; Synaptic Transmission 1, H. Lundbeck A/S, Ottiliavej 9, 2500 Valby, Denmark.
| | - Morten Grunnet
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen, Denmark; Synaptic Transmission 1, H. Lundbeck A/S, Ottiliavej 9, 2500 Valby, Denmark.
| | - Bettina Laursen
- Synaptic Transmission 1, H. Lundbeck A/S, Ottiliavej 9, 2500 Valby, Denmark; Mech-Sense, Department of Gastroenterology, Aalborg University Hospital, Moelleparkvej 4, 9100 Aalborg, Denmark.
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