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Hennis K, Piantoni C, Biel M, Fenske S, Wahl-Schott C. Pacemaker Channels and the Chronotropic Response in Health and Disease. Circ Res 2024; 134:1348-1378. [PMID: 38723033 PMCID: PMC11081487 DOI: 10.1161/circresaha.123.323250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2024]
Abstract
Loss or dysregulation of the normally precise control of heart rate via the autonomic nervous system plays a critical role during the development and progression of cardiovascular disease-including ischemic heart disease, heart failure, and arrhythmias. While the clinical significance of regulating changes in heart rate, known as the chronotropic effect, is undeniable, the mechanisms controlling these changes remain not fully understood. Heart rate acceleration and deceleration are mediated by increasing or decreasing the spontaneous firing rate of pacemaker cells in the sinoatrial node. During the transition from rest to activity, sympathetic neurons stimulate these cells by activating β-adrenergic receptors and increasing intracellular cyclic adenosine monophosphate. The same signal transduction pathway is targeted by positive chronotropic drugs such as norepinephrine and dobutamine, which are used in the treatment of cardiogenic shock and severe heart failure. The cyclic adenosine monophosphate-sensitive hyperpolarization-activated current (If) in pacemaker cells is passed by hyperpolarization-activated cyclic nucleotide-gated cation channels and is critical for generating the autonomous heartbeat. In addition, this current has been suggested to play a central role in the chronotropic effect. Recent studies demonstrate that cyclic adenosine monophosphate-dependent regulation of HCN4 (hyperpolarization-activated cyclic nucleotide-gated cation channel isoform 4) acts to stabilize the heart rate, particularly during rapid rate transitions induced by the autonomic nervous system. The mechanism is based on creating a balance between firing and recently discovered nonfiring pacemaker cells in the sinoatrial node. In this way, hyperpolarization-activated cyclic nucleotide-gated cation channels may protect the heart from sinoatrial node dysfunction, secondary arrhythmia of the atria, and potentially fatal tachyarrhythmia of the ventricles. Here, we review the latest findings on sinoatrial node automaticity and discuss the physiological and pathophysiological role of HCN pacemaker channels in the chronotropic response and beyond.
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Affiliation(s)
- Konstantin Hennis
- Institute of Cardiovascular Physiology and Pathophysiology, Biomedical Center Munich, Walter Brendel Centre of Experimental Medicine, Faculty of Medicine (K.H., C.P., C.W.-S.), Ludwig-Maximilians-Universität München, Germany
| | - Chiara Piantoni
- Institute of Cardiovascular Physiology and Pathophysiology, Biomedical Center Munich, Walter Brendel Centre of Experimental Medicine, Faculty of Medicine (K.H., C.P., C.W.-S.), Ludwig-Maximilians-Universität München, Germany
| | - Martin Biel
- Department of Pharmacy, Center for Drug Research (M.B., S.F.), Ludwig-Maximilians-Universität München, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Germany (M.B., S.F.)
| | - Stefanie Fenske
- Department of Pharmacy, Center for Drug Research (M.B., S.F.), Ludwig-Maximilians-Universität München, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Germany (M.B., S.F.)
| | - Christian Wahl-Schott
- Institute of Cardiovascular Physiology and Pathophysiology, Biomedical Center Munich, Walter Brendel Centre of Experimental Medicine, Faculty of Medicine (K.H., C.P., C.W.-S.), Ludwig-Maximilians-Universität München, Germany
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Coleman M, Pinares-Garcia P, Stephenson SE, Lee WS, Kooshavar D, Mclean CA, Howell KB, Leventer RJ, Reid CA, Lockhart PJ. Ectopic HCN4 Provides a Target Biomarker for the Genetic Spectrum of mTORopathies. Neurol Genet 2024; 10:e200135. [PMID: 38496361 PMCID: PMC10940058 DOI: 10.1212/nxg.0000000000200135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/05/2024] [Indexed: 03/19/2024]
Abstract
Background and Objectives Pathogenic variants in PI3K-AKT-mTOR pathway and GATOR1 complex genes resulting in hyperactivation of mechanistic target of rapamycin (mTOR) complex 1 are a major cause of drug-resistant epilepsy and focal cortical malformations (FCM). Resective neurosurgery is often required to achieve seizure control in patients with mTORopathies due to lack of effectiveness of nonsurgical therapies, including antiseizure medication and mTOR inhibitors. Elevated hyperpolarization-activated cyclic nucleotide-gated potassium channel isoform 4 (HCN4) has been proposed as a key marker in some mTOR-related brain malformations. This study aimed to investigate HCN4 as a biomarker in the brain across the genetic spectrum of mTORopathies in humans. Methods Our study investigated the relative steady-state levels and cellular localization of HCN4 in resected human brain tissue from 18 individuals with mTORopathies (3 individuals with tuberous sclerosis complex (TSC) due to TSC2 variants, 5 individuals with focal cortical dysplasia type IIA (FCD IIA) due to genetic variants in MTOR, AKT3, and PIK3CA, and 10 individuals with FCD IIB due to variants in TSC1, MTOR, RHEB, DEPDC5, or NPRL3). Results Elevated HCN4 was observed to be highly restricted to abnormal cell types (dysmorphic neurons and balloon cells) in brain tissue from all mTORopathy tissues (p < 0.0001) compared with those in controls, regardless of genetic cause or variant allele frequency. Elevated HCN4 was not observed in controls or individuals with non-mTOR-related focal epilepsy due to pathogenic variants in ATP1A3, SLC35A2, or FGFR1. Discussion HCN4 provides a biomarker for the genetic spectrum of mTORopathies and may present a potential therapeutic target for seizure control in mTOR-related epilepsy.
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Affiliation(s)
- Matthew Coleman
- From the Murdoch Children's Research Institute (M.C., S.E.S., W.S.L., D.K., K.B.H., R.J.L., P.J.L.); Department of Paediatrics (M.C., S.E.S., D.K., K.B.H., R.J.L., P.J.L.), University of Melbourne; The Florey Institute of Neuroscience and Mental Health (P.P.-G., C.A.R.), Parkville; Alfred Hospital (C.A.M.), Prahran; Department of Neurology (K.B.H., R.J.L.), The Royal Children's Hospital, Parkville; and Epilepsy Research Centre (C.A.R.), Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victory, Australia
| | - Paulo Pinares-Garcia
- From the Murdoch Children's Research Institute (M.C., S.E.S., W.S.L., D.K., K.B.H., R.J.L., P.J.L.); Department of Paediatrics (M.C., S.E.S., D.K., K.B.H., R.J.L., P.J.L.), University of Melbourne; The Florey Institute of Neuroscience and Mental Health (P.P.-G., C.A.R.), Parkville; Alfred Hospital (C.A.M.), Prahran; Department of Neurology (K.B.H., R.J.L.), The Royal Children's Hospital, Parkville; and Epilepsy Research Centre (C.A.R.), Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victory, Australia
| | - Sarah E Stephenson
- From the Murdoch Children's Research Institute (M.C., S.E.S., W.S.L., D.K., K.B.H., R.J.L., P.J.L.); Department of Paediatrics (M.C., S.E.S., D.K., K.B.H., R.J.L., P.J.L.), University of Melbourne; The Florey Institute of Neuroscience and Mental Health (P.P.-G., C.A.R.), Parkville; Alfred Hospital (C.A.M.), Prahran; Department of Neurology (K.B.H., R.J.L.), The Royal Children's Hospital, Parkville; and Epilepsy Research Centre (C.A.R.), Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victory, Australia
| | - Wei Shern Lee
- From the Murdoch Children's Research Institute (M.C., S.E.S., W.S.L., D.K., K.B.H., R.J.L., P.J.L.); Department of Paediatrics (M.C., S.E.S., D.K., K.B.H., R.J.L., P.J.L.), University of Melbourne; The Florey Institute of Neuroscience and Mental Health (P.P.-G., C.A.R.), Parkville; Alfred Hospital (C.A.M.), Prahran; Department of Neurology (K.B.H., R.J.L.), The Royal Children's Hospital, Parkville; and Epilepsy Research Centre (C.A.R.), Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victory, Australia
| | - Daniz Kooshavar
- From the Murdoch Children's Research Institute (M.C., S.E.S., W.S.L., D.K., K.B.H., R.J.L., P.J.L.); Department of Paediatrics (M.C., S.E.S., D.K., K.B.H., R.J.L., P.J.L.), University of Melbourne; The Florey Institute of Neuroscience and Mental Health (P.P.-G., C.A.R.), Parkville; Alfred Hospital (C.A.M.), Prahran; Department of Neurology (K.B.H., R.J.L.), The Royal Children's Hospital, Parkville; and Epilepsy Research Centre (C.A.R.), Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victory, Australia
| | - Catriona A Mclean
- From the Murdoch Children's Research Institute (M.C., S.E.S., W.S.L., D.K., K.B.H., R.J.L., P.J.L.); Department of Paediatrics (M.C., S.E.S., D.K., K.B.H., R.J.L., P.J.L.), University of Melbourne; The Florey Institute of Neuroscience and Mental Health (P.P.-G., C.A.R.), Parkville; Alfred Hospital (C.A.M.), Prahran; Department of Neurology (K.B.H., R.J.L.), The Royal Children's Hospital, Parkville; and Epilepsy Research Centre (C.A.R.), Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victory, Australia
| | - Katherine B Howell
- From the Murdoch Children's Research Institute (M.C., S.E.S., W.S.L., D.K., K.B.H., R.J.L., P.J.L.); Department of Paediatrics (M.C., S.E.S., D.K., K.B.H., R.J.L., P.J.L.), University of Melbourne; The Florey Institute of Neuroscience and Mental Health (P.P.-G., C.A.R.), Parkville; Alfred Hospital (C.A.M.), Prahran; Department of Neurology (K.B.H., R.J.L.), The Royal Children's Hospital, Parkville; and Epilepsy Research Centre (C.A.R.), Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victory, Australia
| | - Richard J Leventer
- From the Murdoch Children's Research Institute (M.C., S.E.S., W.S.L., D.K., K.B.H., R.J.L., P.J.L.); Department of Paediatrics (M.C., S.E.S., D.K., K.B.H., R.J.L., P.J.L.), University of Melbourne; The Florey Institute of Neuroscience and Mental Health (P.P.-G., C.A.R.), Parkville; Alfred Hospital (C.A.M.), Prahran; Department of Neurology (K.B.H., R.J.L.), The Royal Children's Hospital, Parkville; and Epilepsy Research Centre (C.A.R.), Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victory, Australia
| | - Christopher A Reid
- From the Murdoch Children's Research Institute (M.C., S.E.S., W.S.L., D.K., K.B.H., R.J.L., P.J.L.); Department of Paediatrics (M.C., S.E.S., D.K., K.B.H., R.J.L., P.J.L.), University of Melbourne; The Florey Institute of Neuroscience and Mental Health (P.P.-G., C.A.R.), Parkville; Alfred Hospital (C.A.M.), Prahran; Department of Neurology (K.B.H., R.J.L.), The Royal Children's Hospital, Parkville; and Epilepsy Research Centre (C.A.R.), Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victory, Australia
| | - Paul J Lockhart
- From the Murdoch Children's Research Institute (M.C., S.E.S., W.S.L., D.K., K.B.H., R.J.L., P.J.L.); Department of Paediatrics (M.C., S.E.S., D.K., K.B.H., R.J.L., P.J.L.), University of Melbourne; The Florey Institute of Neuroscience and Mental Health (P.P.-G., C.A.R.), Parkville; Alfred Hospital (C.A.M.), Prahran; Department of Neurology (K.B.H., R.J.L.), The Royal Children's Hospital, Parkville; and Epilepsy Research Centre (C.A.R.), Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victory, Australia
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Sun M, Yin F, Wu X, Sun S, An Y, Zhu M, Li X, Liu W. Effects of ivabradine on myocardial autophagia and apoptosis in isoprenaline-induced heart failure in mice. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2024; 27:107-113. [PMID: 38164488 PMCID: PMC10722486 DOI: 10.22038/ijbms.2023.70060.15236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 08/12/2023] [Indexed: 01/03/2024]
Abstract
Objectives To investigate the effects and mechanisms of ivabradine (IVA) on isoprenaline-induced cardiac injury. Materials and Methods Forty male C57BL/6 mice were randomly divided into control group, model group, high-dose IVA group, and low-dose IVA group. The control group was given saline, other groups were given subcutaneous injections of isoproterenol (ISO) 5 mg/kg/d to make the myocardial remodeling model. A corresponding dose of IVA (high dose 50 mg/kg/d, low dose 10 mg/kg/d) was given by gavage (30 days). A transthoracic echocardiogram was obtained to detect the structure and function of the heart. An electron microscope was used to explore the cardiomyocytes' apoptosis and autophagy. HE staining and Masson's trichrome staining were performed to explore myocardial hypertrophy and fibrosis. Western blot was used to detect Bax, Bcl-2, cleaved caspase-3, Becline-1, LC3, phosphorylated p38 mitogen-activated protein kinase (p-p38MAPK), phosphorylated extracellular regulated protein kinases1/2 (p-ERK1/2), phosphorylated c-Jun N-terminal kinase (p-JNK), and α-smooth muscle actin (α-SMA) in the myocardium. Results Heart rate in the IVA groups was reduced, and the trend of heart rate reduction was more obvious in the high-dose group. Echocardiography showed that IVA improved the cardiac structure and function compared to the model group. IVA attenuated cardiac fibrosis, decreased cardiomyocyte apoptosis, and increased autophagy. The phosphorylated MAPK in the ISO-induced groups was increased. IVA treatment decreased the p-p38MAPK level. There were no differences in p-ERK and p-JNK levels. Conclusion The beneficial effects of IVA on myocardial injury are related to blocking the p38MAPK signal pathway, decreasing cardiomyocyte apoptosis, and increasing cardiomyocyte autophagy.
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Affiliation(s)
- Menghua Sun
- Department of Cardiology, Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
- These authors contributed equally to this work
| | - Feiya Yin
- The University of Sydney, Newtown, NSW 2042, Australia
- These authors contributed equally to this work
| | - Xinrong Wu
- Department of Cardiology, Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
- These authors contributed equally to this work
| | - Shaoer Sun
- Department of Geriatric Cardiology, Guangdong Provincial People’s Hospital, Guangzhou, PR. China, 510080
| | - Yongqiang An
- Department of Cardiology, Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Manlin Zhu
- Department of Cardiology, Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Xiaomin Li
- Department of Cardiology, Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Wei Liu
- Department of Cardiology, Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, China
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Crunelli V, David F, Morais TP, Lorincz ML. HCN channels and absence seizures. Neurobiol Dis 2023; 181:106107. [PMID: 37001612 DOI: 10.1016/j.nbd.2023.106107] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/20/2023] [Accepted: 03/25/2023] [Indexed: 03/31/2023] Open
Abstract
Hyperpolarization-activation cyclic nucleotide-gated (HCN) channels were for the first time implicated in absence seizures (ASs) when an abnormal Ih (the current generated by these channels) was reported in neocortical layer 5 neurons of a mouse model. Genetic studies of large cohorts of children with Childhood Absence Epilepsy (where ASs are the only clinical symptom) have identified only 3 variants in HCN1 (one of the genes that code for the 4 HCN channel isoforms, HCN1-4), with one (R590Q) mutation leading to loss-of-function. Due to the multi-faceted effects that HCN channels exert on cellular excitability and neuronal network dynamics as well as their modulation by environmental factors, it has been difficult to identify the detailed mechanism by which different HCN isoforms modulate ASs. In this review, we systematically and critically analyze evidence from established AS models and normal non-epileptic animals with area- and time-selective ablation of HCN1, HCN2 and HCN4. Notably, whereas knockout of rat HCN1 and mouse HCN2 leads to the expression of ASs, the pharmacological block of all HCN channel isoforms abolishes genetically determined ASs. These seemingly contradictory results could be reconciled by taking into account the well-known opposite effects of Ih on cellular excitability and network function. Whereas existing evidence from mouse and rat AS models indicates that pan-HCN blockers may provide a novel approach for the treatment of human ASs, the development of HCN isoform-selective drugs would greatly contribute to current research on the role for these channels in ASs generation and maintenance as well as offer new potential clinical applications.
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Affiliation(s)
- Vincenzo Crunelli
- Neuroscience Division, School of Bioscience, Cardiff University, Cardiff, UK.
| | - Francois David
- Integrative Neuroscience and Cognition Center, Paris University, Paris, France
| | - Tatiana P Morais
- Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, Malta University, Msida, Malta
| | - Magor L Lorincz
- Neuroscience Division, School of Bioscience, Cardiff University, Cardiff, UK; Department of Physiology, Szeged University, Szeged, Hungary.
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Pinares-Garcia P, Spyrou J, McKenzie CE, Forster IC, Soh MS, Mohamed Syazwan E, Atif M, Reid CA. Antidepressant-like activity of a brain penetrant HCN channel inhibitor in mice. Front Pharmacol 2023; 14:1159527. [PMID: 37234718 PMCID: PMC10206048 DOI: 10.3389/fphar.2023.1159527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023] Open
Abstract
Changes in Hyperpolarization-Activated Cyclic Nucleotide-Gated (HCN) channel function have been linked to depressive-like traits, making them potential drug targets. However, there is currently no peer-reviewed data supporting the use of a small molecule modulator of HCN channels in depression treatment. Org 34167, a benzisoxazole derivative, has been patented for the treatment of depression and progressed to Phase I trials. In the current study, we analysed the biophysical effects of Org 34167 on HCN channels in stably transfected human embryonic kidney 293 (HEK293) cells and mouse layer V neurons using patch-clamp electrophysiology, and we utilised three high-throughput screens for depressive-like behaviour to assess the activity of Org 34167 in mice. The impact of Org 34167 on locomotion and coordination were measured by performing rotarod and ledged beam tests. Org 34167 is a broad-spectrum inhibitor of HCN channels, slowing activation and causing a hyperpolarising shift in voltage-dependence of activation. It also reduced I h-mediated sag in mouse neurons. Org 34167 (0.5 mg/kg) reduced marble burying and increased the time spent mobile in the Porsolt swim and tail suspension tests in both male and female BALB/c mice, suggesting reduced depressive-like behaviour. Although no adverse effects were seen at 0.5 mg/kg, an increase in dose to 1 mg/kg resulted in visible tremors and impaired locomotion and coordination. These data support the premise that HCN channels are valid targets for anti-depressive drugs albeit with a narrow therapeutic index. Drugs with higher HCN subtype selectivity are needed to establish if a wider therapeutic window can be obtained.
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Affiliation(s)
- Paulo Pinares-Garcia
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - James Spyrou
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Chaseley E. McKenzie
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Ian C. Forster
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Ming S. Soh
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Erlina Mohamed Syazwan
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Mohammed Atif
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Christopher A. Reid
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
- Epilepsy Research Centre, Department of Medicine, University of Melbourne, Heidelberg, VIC, Australia
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Zhao K, Li Y, Yang X, Zhou L. The Impact of Altered HCN1 Expression on Brain Function and Its Relationship with Epileptogenesis. Curr Neuropharmacol 2023; 21:2070-2078. [PMID: 37366350 PMCID: PMC10556362 DOI: 10.2174/1570159x21666230214110333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/13/2022] [Accepted: 12/06/2022] [Indexed: 03/08/2023] Open
Abstract
Hyperpolarization-activated cyclic nucleotide-gated cation channel 1 (HCN1) is predominantly expressed in neurons from the neocortex and hippocampus, two important regions related to epilepsy. Both animal models for epilepsy and epileptic patients show decreased HCN1 expression and HCN1-mediated Ih current. It has been shown in neuroelectrophysiological experiments that a decreased Ih current can increase neuronal excitability. However, some studies have shown that blocking the Ih current in vivo can exert antiepileptic effects. This paradox raises an important question regarding the causal relationship between HCN1 alteration and epileptogenesis, which to date has not been elucidated. In this review, we summarize the literature related to HCN1 and epilepsy, aiming to find a possible explanation for this paradox, and explore the correlation between HCN1 and the mechanism of epileptogenesis. We analyze the alterations in the expression and distribution of HCN1 and the corresponding impact on brain function in epilepsy. In addition, we also discuss the effect of blocking Ih on epilepsy symptoms. Addressing these issues will help to inspire new strategies to explore the relationship between HCN1 and epileptogenesis, and ultimately promote the development of new targets for epilepsy therapy.
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Affiliation(s)
- Ke Zhao
- Department of Neurology, The Seventh Affliated Hospital of Sun Yet-sen University, No. 628, Zhenyuan Road, Xinhu Street, Guangming District, Shenzhen, China
| | - Yinchao Li
- Department of Neurology, The Seventh Affliated Hospital of Sun Yet-sen University, No. 628, Zhenyuan Road, Xinhu Street, Guangming District, Shenzhen, China
| | - Xiaofeng Yang
- Guangzhou Laboratory, Guangzhou, No. 9 XingDaoHuanBei Road, Guangzhou International Bio Island, Guangzhou 510005, Guangdong Province, China
| | - Liemin Zhou
- Department of Neurology, The Seventh Affliated Hospital of Sun Yet-sen University, No. 628, Zhenyuan Road, Xinhu Street, Guangming District, Shenzhen, China
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Kessi M, Peng J, Duan H, He H, Chen B, Xiong J, Wang Y, Yang L, Wang G, Kiprotich K, Bamgbade OA, He F, Yin F. The Contribution of HCN Channelopathies in Different Epileptic Syndromes, Mechanisms, Modulators, and Potential Treatment Targets: A Systematic Review. Front Mol Neurosci 2022; 15:807202. [PMID: 35663267 PMCID: PMC9161305 DOI: 10.3389/fnmol.2022.807202] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 04/06/2022] [Indexed: 12/04/2022] Open
Abstract
Background Hyperpolarization-activated cyclic nucleotide-gated (HCN) current reduces dendritic summation, suppresses dendritic calcium spikes, and enables inhibitory GABA-mediated postsynaptic potentials, thereby suppressing epilepsy. However, it is unclear whether increased HCN current can produce epilepsy. We hypothesized that gain-of-function (GOF) and loss-of-function (LOF) variants of HCN channel genes may cause epilepsy. Objectives This systematic review aims to summarize the role of HCN channelopathies in epilepsy, update genetic findings in patients, create genotype–phenotype correlations, and discuss animal models, GOF and LOF mechanisms, and potential treatment targets. Methods The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, for all years until August 2021. Results We identified pathogenic variants of HCN1 (n = 24), HCN2 (n = 8), HCN3 (n = 2), and HCN4 (n = 6) that were associated with epilepsy in 74 cases (43 HCN1, 20 HCN2, 2 HCN3, and 9 HCN4). Epilepsy was associated with GOF and LOF variants, and the mechanisms were indeterminate. Less than half of the cases became seizure-free and some developed drug-resistant epilepsy. Of the 74 cases, 12 (16.2%) died, comprising HCN1 (n = 4), HCN2 (n = 2), HCN3 (n = 2), and HCN4 (n = 4). Of the deceased cases, 10 (83%) had a sudden unexpected death in epilepsy (SUDEP) and 2 (16.7%) due to cardiopulmonary failure. SUDEP affected more adults (n = 10) than children (n = 2). HCN1 variants p.M234R, p.C329S, p.V414M, p.M153I, and p.M305L, as well as HCN2 variants p.S632W and delPPP (p.719–721), were associated with different phenotypes. HCN1 p.L157V and HCN4 p.R550C were associated with genetic generalized epilepsy. There are several HCN animal models, pharmacological targets, and modulators, but precise drugs have not been developed. Currently, there are no HCN channel openers. Conclusion We recommend clinicians to include HCN genes in epilepsy gene panels. Researchers should explore the possible underlying mechanisms for GOF and LOF variants by identifying the specific neuronal subtypes and neuroanatomical locations of each identified pathogenic variant. Researchers should identify specific HCN channel openers and blockers with high binding affinity. Such information will give clarity to the involvement of HCN channelopathies in epilepsy and provide the opportunity to develop targeted treatments.
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Affiliation(s)
- Miriam Kessi
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China
- Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
- Department of Pediatrics, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Jing Peng
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China
- Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Haolin Duan
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China
- Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Hailan He
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China
- Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Baiyu Chen
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China
- Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Juan Xiong
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China
- Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Ying Wang
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China
- Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Lifen Yang
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China
- Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Guoli Wang
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China
- Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Karlmax Kiprotich
- Department of Epidemiology and Medical Statistics, School of Public Health, Moi University, Eldoret, Kenya
| | - Olumuyiwa A. Bamgbade
- Department of Anesthesiology and Pharmacology, University of British Columbia, Vancouver, BC, Canada
| | - Fang He
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China
- Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
| | - Fei Yin
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China
- Hunan Intellectual and Developmental Disabilities Research Center, Changsha, China
- *Correspondence: Fei Yin
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8
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Chaudhary R, Albrecht S, Datunashvili M, Cerina M, Lüttjohann A, Han Y, Narayanan V, Chetkovich DM, Ruck T, Kuhlmann T, Pape HC, Meuth SG, Zobeiri M, Budde T. Modulation of Pacemaker Channel Function in a Model of Thalamocortical Hyperexcitability by Demyelination and Cytokines. Cereb Cortex 2022; 32:4397-4421. [PMID: 35076711 PMCID: PMC9574242 DOI: 10.1093/cercor/bhab491] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/26/2021] [Accepted: 11/28/2021] [Indexed: 12/02/2022] Open
Abstract
A consensus is yet to be reached regarding the exact prevalence of epileptic seizures or epilepsy in multiple sclerosis (MS). In addition, the underlying pathophysiological basis of the reciprocal interaction among neuroinflammation, demyelination, and epilepsy remains unclear. Therefore, a better understanding of cellular and network mechanisms linking these pathologies is needed. Cuprizone-induced general demyelination in rodents is a valuable model for studying MS pathologies. Here, we studied the relationship among epileptic activity, loss of myelin, and pro-inflammatory cytokines by inducing acute, generalized demyelination in a genetic mouse model of human absence epilepsy, C3H/HeJ mice. Both cellular and network mechanisms were studied using in vivo and in vitro electrophysiological techniques. We found that acute, generalized demyelination in C3H/HeJ mice resulted in a lower number of spike–wave discharges, increased cortical theta oscillations, and reduction of slow rhythmic intrathalamic burst activity. In addition, generalized demyelination resulted in a significant reduction in the amplitude of the hyperpolarization-activated inward current (Ih) in thalamic relay cells, which was accompanied by lower surface expression of hyperpolarization-activated, cyclic nucleotide-gated channels, and the phosphorylated form of TRIP8b (pS237-TRIP8b). We suggest that demyelination-related changes in thalamic Ih may be one of the factors defining the prevalence of seizures in MS.
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Affiliation(s)
- Rahul Chaudhary
- Institut für Physiologie I, Westfälische Wilhelms-Universität, 48149 Münster, Germany
| | - Stefanie Albrecht
- Institute of Neuropathology, University Hospital Münster, 48149 Münster, Germany
| | - Maia Datunashvili
- Institut für Physiologie I, Westfälische Wilhelms-Universität, 48149 Münster, Germany
| | - Manuela Cerina
- Department of Neurology with Institute of Translational Neurology, Westfälische Wilhelms-Universität, 48149 Münster, Germany
| | - Annika Lüttjohann
- Institut für Physiologie I, Westfälische Wilhelms-Universität, 48149 Münster, Germany
| | - Ye Han
- Vanderbilt University Medical Center, Department of Neurology, Nashville, TN 37232, USA
| | - Venu Narayanan
- Department of Neurology with Institute of Translational Neurology, Westfälische Wilhelms-Universität, 48149 Münster, Germany
| | - Dane M Chetkovich
- Vanderbilt University Medical Center, Department of Neurology, Nashville, TN 37232, USA
| | - Tobias Ruck
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany
| | - Tanja Kuhlmann
- Institute of Neuropathology, University Hospital Münster, 48149 Münster, Germany
| | - Hans-Christian Pape
- Institut für Physiologie I, Westfälische Wilhelms-Universität, 48149 Münster, Germany
| | - Sven G Meuth
- Department of Neurology with Institute of Translational Neurology, Westfälische Wilhelms-Universität, 48149 Münster, Germany
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany
| | - Mehrnoush Zobeiri
- Address correspondence to Dr Thomas Budde, Wilhelms-Universität, Institut für Physiologie I, Robert-Koch-Str. 27a, D-48149 Münster, Germany. ; Dr Mehrnoush Zobeiri, Wilhelms-Universität, Institut für Physiologie I, Robert-Koch-Str. 27a, D-48149 Münster, Germany.
| | - Thomas Budde
- Address correspondence to Dr Thomas Budde, Wilhelms-Universität, Institut für Physiologie I, Robert-Koch-Str. 27a, D-48149 Münster, Germany. ; Dr Mehrnoush Zobeiri, Wilhelms-Universität, Institut für Physiologie I, Robert-Koch-Str. 27a, D-48149 Münster, Germany.
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9
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Xiao HL, Xiao YJ, Wang Q, Chen ML, Jiang AL. Moxibustion Regulates Gastrointestinal Motility via HCN1 in Functional Dyspepsia Rats. Med Sci Monit 2021; 27:e932885. [PMID: 34845181 PMCID: PMC8642983 DOI: 10.12659/msm.932885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Moxibustion therapy has been found to ameliorate clinical symptoms of functional dyspepsia (FD). We aimed to examine the regulatory effect of moxibustion on the gastrointestinal (GI) motility in FD and explore the underlying mechanism based on the hyperpolarization-activated cyclic nucleotide-gated cation channel 1 (HCN1). Material/Methods Moxibustion therapy was used in FD rats induced by using classic tail-pinch and irregular feeding. Weight gain and food intake were recorded weekly, followed by detecting gastric residual rate (GRR) and small intestine propulsion rate (IPR). Next, western blotting was performed to determine the expression levels of HCN1 in the gastric antrum. qRT-PCR was used to detect HCN1 in the small intestine and hypothalamic satiety center. Double immunolabeling was used for HCN1 and ICCs in gastric antrum and small intestine. Results The obtained results suggested that moxibustion treatment could increase weight gain and food intake in FD rats. The GRR and IPR were compared among the groups, which showed that moxibustion treatment could decrease GRR and increase IPR. Moxibustion increased the expression of HCN1 in the gastric antrum, small intestine, and hypothalamic satiety center. Histologically, the co-expressions of HCN1 and ICCs tended to increase in gastric antrum and small intestine. Meanwhile, HCN channel inhibitor ZD7288 prevented the above-mentioned therapeutic effects of moxibustion. Conclusions The results of the present study suggest that moxibustion can effectively improve the GI motility of FD rats, which may be related to the upregulation of HCN1 expression in gastric antrum, small intestine, and satiety center.
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Affiliation(s)
- Hong-Ling Xiao
- School of Nursing, Second Military Medical University, Shanghai, China (mainland).,School of Nursing, Tianjin University of Chinese Medicine, Tianjin, China (mainland)
| | - Yun-Jiu Xiao
- School of Nursing, Anhui University of Chinese Medicine, Hefei, Anhui, China (mainland)
| | - Qian Wang
- School of Nursing, Anhui University of Chinese Medicine, Hefei, Anhui, China (mainland)
| | - Mei-Ling Chen
- School of Nursing, Anhui University of Chinese Medicine, Hefei, Anhui, China (mainland)
| | - An-Li Jiang
- School of Nursing, Second Military Medical University, Shanghai, China (mainland)
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10
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The HCN channel as a pharmacological target: Why, where, and how to block it. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2021; 166:173-181. [PMID: 34303730 DOI: 10.1016/j.pbiomolbio.2021.07.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 06/22/2021] [Accepted: 07/20/2021] [Indexed: 12/19/2022]
Abstract
Hyperpolarization-activated, cyclic nucleotide-gated (HCN) channels, expressed in a variety of cell types and in all tissues, control excitation and rhythm. Since their discovery in neurons and cardiac pacemaker cells, they attracted the attention of medicinal chemistry and pharmacology as novel targets to shape (patho)physiological mechanisms. To date, ivabradine represents the first-in-class drug as specific bradycardic agent in cardiac diseases; however, new applications are emerging in parallel with the demonstration of the involvement of different HCN isoforms in central and peripheral nervous system. Hence, the possibility to target specific isoforms represents an attractive development in this field; indeed, HCN1, HCN2 or HCN4 specific blockers have shown promising features in vitro and in vivo, with remarkable pharmacological differences likely depending on the diverse functional role and tissue distribution. Here, we show a recently developed compound with high potency as HCN2-HCN4 blocker; because of its unique profile, this compound may deserve further investigation.
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11
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Zhong W, Darmani NA. The HCN Channel Blocker ZD7288 Induces Emesis in the Least Shrew ( Cryptotis parva). Front Pharmacol 2021; 12:647021. [PMID: 33995059 PMCID: PMC8117105 DOI: 10.3389/fphar.2021.647021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 04/12/2021] [Indexed: 12/02/2022] Open
Abstract
Subtypes (1-4) of the hyperpolarization-activated cyclic nucleotide-gated (HCN) channels are widely expressed in the central and peripheral nervous systems, as well as the cells of smooth muscles in many organs. They mainly serve to regulate cellular excitability in these tissues. The HCN channel blocker ZD7288 has been shown to reduce apomorphine-induced conditioned taste aversion on saccharin preference in rats suggesting potential antinausea/antiemetic effects. Currently, in the least shew model of emesis we find that ZD7288 induces vomiting in a dose-dependent manner, with maximal efficacies of 100% at 1 mg/kg (i.p.) and 83.3% at 10 µg (i.c.v.). HCN channel subtype (1-4) expression was assessed using immunohistochemistry in the least shrew brainstem dorsal vagal complex (DVC) containing the emetic nuclei (area postrema (AP), nucleus tractus solitarius and dorsal motor nucleus of the vagus). Highly enriched HCN1 and HCN4 subtypes are present in the AP. A 1 mg/kg (i.p.) dose of ZD7288 strongly evoked c-Fos expression and ERK1/2 phosphorylation in the shrew brainstem DVC, but not in the in the enteric nervous system in the jejunum, suggesting a central contribution to the evoked vomiting. The ZD7288-evoked c-Fos expression exclusively occurred in tryptophan hydroxylase 2-positive serotonin neurons of the dorsal vagal complex, indicating activation of serotonin neurons may contribute to ZD7288-induced vomiting. To reveal its mechanism(s) of emetic action, we evaluated the efficacy of diverse antiemetics against ZD7288-evoked vomiting including the antagonists/inhibitors of: ERK1/2 (U0126), L-type Ca2+ channel (nifedipine); store-operated Ca2+ entry (MRS 1845); T-type Ca2+ channel (Z944), IP3R (2-APB), RyR receptor (dantrolene); the serotoninergic type 3 receptor (palonosetron); neurokinin 1 receptor (netupitant), dopamine type 2 receptor (sulpride), and the transient receptor potential vanilloid 1 receptor agonist, resiniferatoxin. All tested antiemetics except sulpride attenuated ZD7288-evoked vomiting to varying degrees. In sum, ZD7288 has emetic potential mainly via central mechanisms, a process which involves Ca2+ signaling and several emetic receptors. HCN channel blockers have been reported to have emetic potential in the clinic since they are currently used/investigated as therapeutic candidates for cancer therapy related- or unrelated-heart failure, pain, and cognitive impairment.
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Affiliation(s)
| | - N. A. Darmani
- Department of Basic Medical Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, United States
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12
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Testing broad-spectrum and isoform-preferring HCN channel blockers for anticonvulsant properties in mice. Epilepsy Res 2020; 168:106484. [DOI: 10.1016/j.eplepsyres.2020.106484] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/23/2020] [Accepted: 10/05/2020] [Indexed: 12/19/2022]
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13
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Nakagawa T, Yasaka T, Nakashima N, Takeya M, Oshita K, Tsuda M, Yamaura K, Takano M. Expression of the pacemaker channel HCN4 in excitatory interneurons in the dorsal horn of the murine spinal cord. Mol Brain 2020; 13:127. [PMID: 32948209 PMCID: PMC7501643 DOI: 10.1186/s13041-020-00666-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 09/07/2020] [Indexed: 11/17/2022] Open
Abstract
In the central nervous system, hyperpolarization-activated, cyclic nucleotide-gated (HCN1–4) channels have been implicated in neuronal excitability and synaptic transmission. It has been reported that HCN channels are expressed in the spinal cord, but knowledge about their physiological roles, as well as their distribution profiles, appear to be limited. We generated a transgenic mouse in which the expression of HCN4 can be reversibly knocked down using a genetic tetracycline-dependent switch and conducted genetically validated immunohistochemistry for HCN4. We found that the somata of HCN4-immunoreactive (IR) cells were largely restricted to the ventral part of the inner lamina II and lamina III. Many of these cells were either parvalbumin- or protein kinase Cγ (PKCγ)-IR. By using two different mouse strains in which reporters are expressed only in inhibitory neurons, we determined that the vast majority of HCN4-IR cells were excitatory neurons. Mechanical and thermal noxious stimulation did not induce c-Fos expression in HCN4-IR cells. PKCγ-neurons in this area are known to play a pivotal role in the polysynaptic pathway between tactile afferents and nociceptive projection cells that contributes to tactile allodynia. Therefore, pharmacological and/or genetic manipulations of HCN4-expressing neurons may provide a novel therapeutic strategy for the pain relief of tactile allodynia.
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Affiliation(s)
- Taku Nakagawa
- Department of Physiology, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, 830-0011, Japan.,Department of Anesthesiology, Graduate School of Medicine, Kyushu University, Fukuoka, 812-8582, Japan
| | - Toshiharu Yasaka
- Department of Health and Nutrition, Niigata University of Hearth and Welfare, Niigata, 950-3198, Japan
| | - Noriyuki Nakashima
- Department of Physiology, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, 830-0011, Japan
| | - Mitsue Takeya
- Department of Physiology, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, 830-0011, Japan
| | - Kensuke Oshita
- Department of Physiology, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, 830-0011, Japan.,Department of Anesthesiology, Kurume University School of Medicine, Kurume, 830-0011, Japan
| | - Makoto Tsuda
- Department of Life Innovation, Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
| | - Ken Yamaura
- Department of Anesthesiology, Graduate School of Medicine, Kyushu University, Fukuoka, 812-8582, Japan
| | - Makoto Takano
- Department of Physiology, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, 830-0011, Japan.
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14
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Kharouf Q, Phillips AM, Bleakley LE, Morrisroe E, Oyrer J, Jia L, Ludwig A, Jin L, Nicolazzo JA, Cerbai E, Romanelli MN, Petrou S, Reid CA. The hyperpolarization-activated cyclic nucleotide-gated 4 channel as a potential anti-seizure drug target. Br J Pharmacol 2020; 177:3712-3729. [PMID: 32364262 DOI: 10.1111/bph.15088] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 03/24/2020] [Accepted: 04/16/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND AND PURPOSE Hyperpolarization-activated cyclic nucleotide-gated (HCN) channels are encoded by four genes (HCN1-4) with distinct biophysical properties and functions within the brain. HCN4 channels activate slowly at robust hyperpolarizing potentials, making them more likely to be engaged during hyperexcitable neuronal network activity seen during seizures. HCN4 channels are also highly expressed in thalamic nuclei, a brain region implicated in seizure generalization. Here, we assessed the utility of targeting the HCN4 channel as an anti-seizure strategy using pharmacological and genetic approaches. EXPERIMENTAL APPROACH The impact of reducing HCN4 channel function on seizure susceptibility and neuronal network excitability was studied using an HCN4 channel preferring blocker (EC18) and a conditional brain specific HCN4 knockout mouse model. KEY RESULTS EC18 (10 mg·kg-1 ) and brain-specific HCN4 channel knockout reduced seizure susceptibility and proconvulsant-mediated cortical spiking recorded using electrocorticography, with minimal effects on other mouse behaviours. EC18 (10 μM) decreased neuronal network bursting in mouse cortical cultures. Importantly, EC18 was not protective against proconvulsant-mediated seizures in the conditional HCN4 channel knockout mouse and did not reduce bursting behaviour in AAV-HCN4 shRNA infected mouse cortical cultures. CONCLUSIONS AND IMPLICATIONS These data suggest the HCN4 channel as a potential pharmacologically relevant target for anti-seizure drugs that is likely to have a low side-effect liability in the CNS.
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Affiliation(s)
- Qays Kharouf
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - A Marie Phillips
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia.,School of Biosciences, University of Melbourne, Parkville, Victoria, Australia
| | - Lauren E Bleakley
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Emma Morrisroe
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Julia Oyrer
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Linghan Jia
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Andreas Ludwig
- Institut für Experimentelle und Klinische Pharmakologie und Toxikologie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Liang Jin
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Joseph A Nicolazzo
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Elisabetta Cerbai
- Department of Neurosciences, Psychology, Drug Research and Child Health, (NEUROFARBA), University of Florence, Florence, Italy
| | - M Novella Romanelli
- Department of Neurosciences, Psychology, Drug Research and Child Health, (NEUROFARBA), University of Florence, Florence, Italy
| | - Steven Petrou
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Christopher A Reid
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
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