The reduced release of GH by GHRH in 8 subjects aged 65-69 years is augmented considerably by rivastigmine, a drug for Alzheimer's disease

Effects of Rikkunshi-To, a Japanese kampo medicine, on donepezil-induced gastrointestinal side effects in mice

Donepezil, an acetylcholinesterase inhibitor, is associated with gastrointestinal symptoms, such as nausea, vomiting, and anorexia, which may affect adherence to continuous therapy. Since Rikkunshi-To, a Japanese herbal medicine, activates the ghrelin signaling pathway and promotes gastrointestinal function, it is administered to prevent gastrointestinal symptoms. We herein investigated whether donepezil-induced gastrointestinal side effects in mice are ameliorated by Rikkunshi-To and if its therapeutic efficacy is mediated by ghrelin. Since pica behavior, the ingestion of kaolin, correlates with nausea and vomiting in humans, donepezil was intraperitoneally administered with or without Rikkunshi-To daily to mice, and food and kaolin intakes were monitored. The effects of donepezil on intestinal motility and a ghrelin receptor antagonist on donepezil-induced pica behavior, anorexia, and changes in intestinal motility were examined in mice treated with Rikkunshi-To. Pica behavior and anorexia were significantly induced by donepezil and significantly inhibited by Rikkunshi-To. Intestinal motility was significantly suppressed by donepezil and promoted by Rikkunshi-To. Furthermore, the therapeutic effects of Rikkunshi-To were antagonized by the ghrelin receptor antagonist. The present results support the therapeutic efficacy of Rikkunshi-To against donepezil-induced gastrointestinal side effects.

Somatopause, weaknesses of the therapeutic approaches and the cautious optimism based on experimental ageing studies with soy isoflavones

The pathological phenomenon of somatopause, noticeable in hypogonadal ageing subjects, is based on the growth hormone (GH) production and secretion decrease along with the fall in GH binding protein and insulin-like growth factor 1 (IGF-1) levels, causing different musculoskeletal, metabolic and mental issues. From the perspective of safety and efficacy, GH treatment is considered to be highly controversial, while some other therapeutic approaches (application of IGF-1, GH secretagogues, gonadal steroids, cholinesterase-inhibitors or various combinations) exhibit more or less pronounced weaknesses in this respect. Soy isoflavones, phytochemicals that have already demonstrated the health benefits in treated elderly, at least experimentally reveal their potential for the somatopausal symptoms remediation. Namely, genistein enhanced GHRH-stimulated cAMP accumulation and GH release in rat anterior pituitary cells; refreshed and stimulated the somatotropic system (hypothalamic nuclei and pituitary GH cells) function in a rat model of the mild andropause, and stimulated the GH output in ovariectomized ewes as well as the amplitude of GH pulses in the rams. Daidzein, on the other hand, increased body mass, trabecular bone mass and decreased bone turnover in the animal model of severe andropause, while both isoflavones demonstrated blood cholesterol-lowering effect in the same model. These data, which necessarily need to be preclinically and clinically filtered, hint some cautious optimism and call for further innovative designing of balanced soy isoflavone-based therapeutics.

Effect of intra-hippocampal injection of human recombinant growth hormone on synaptic plasticity in the nucleus basalis magnocellularis-lesioned aged rats

In this study, we proposed that administration of hippocampal growth hormone in ageing animals with growth hormone deficiency can compensate long-term potentiation and synaptic plasticity in nucleus basalis magnocellularis (NBM)-lesioned rats. Aged male Wistar rats were randomly divided into six groups (seven in each) of sham-operated healthy rats (Cont); NBM-lesioned rats (L); NBM-lesioned rats and intrahippocampal injection of growth hormone vehicle (L + Veh); NBM-lesioned and intrahippocampal injection of growth hormone (10, 20 and 40 µg.2 µl-1) (L + GH). In vivo electrophysiological recording techniques were used to characterize maintenance of long-term potentiation at distinct times (1, 2, 3, 24 and 48 hours) after high-frequency stimulation. The population spike was enhanced significantly for about 48 hours following tetanic stimulation in rats treated with a dose-dependent growth hormone compared to the vehicle group (p < 0.05), possibly through neuronal plasticity and neurogenesis in affected areas.

Purification and functional characterization of a protein: Bombyx mori human growth hormone like protein in silkworm pupa

Human growth hormone (hGH) is a peptide hormone secreted by eosinophils of the human anterior pituitary, and a regulatory factor for a variety of metabolic pathways. A 30-kD protein from the pupa stage of silkworm was detected by Western blotting and confirmed by immunoprecipitation based on its ability to bind to anti-hGH antibody. This protein, named BmhGH-like protein, was purified from fresh silkworm pupas through low-temperature homogenization, filtration, and centrifugation to remove large impurity particles. The supernatants were precipitated, resuspended, and passed through a molecular sieve. Further purification by affinity chromatography and two-dimensional electrophoresis resulted in pure protein for analysis by MS MALDI-TOF-MS analysis. An alignment with predicted proteins indicated that BmhGH-like protein consisted of two lipoproteins, which we named hGH-L1 and hGH-L2. These proteins belong to the β-trefoil superfamily, with β domains similar to the spatial structure of hGH. Assays with K562 cells demonstrated that these proteins could promote cell division in vitro. To further validate the growth-promoting effects, hGH-L2 was cloned from pupa cDNA to create recombinant silkworm baculovirus vBmNPV-hGH-L2, which was used to infect silkworm BmN cells at low titer. Flow cytometric analysis demonstrated that the protein shortened the G0/G1 phase of the cells, and enabled the cells to rapidly traverse the G1/S phase transition point to enter S phase and promote cell division. Discovery of hGH-like protein in silkworm will once again arouse people’s interest in the potential medicinal value of silkworm and establish the basis for the development of new hormone drugs.

The effect of peripheral administration of growth hormone on AD-like cognitive deficiency in NBM-lesioned rats

This study aimed to evaluate the peripheral administration of growth hormone (GH) on AD-like cognitive deficiency in NBM-lesioned rats induced by ibotenic acid (5 microg/microl, in each side). Forty-eight male Wistar rats (20-24 months old; weighing 330+/-30 g) randomly divided into six groups (n=8). The groups include control group, which were intact rats; n-L+GH group: non-lesioned rats with GH treatment (1mg/kg, 9.00 am, for 10 consecutive days); n-L+Veh group: non-lesioned rats with vehicle treatment; L group: NBM-lesioned rats; L+GH group: NBM-lesioned rats with GH treatment and L+Veh group: NBM-lesioned rats with same volume of vehicle treatment. Peripheral administration of GH in control had no effect on learning and memory, while in L+GH group produced a significant enhancement in spatial learning and memory comparing to L and L+Veh groups. The percent of time spent in goal quarter during probe trial has decreased significantly in L and L+Veh groups compared to n-L groups. While it has increased significantly in L+GH group compared to L and L+Veh groups. No significant difference in percent of time spent was seen between the control and n-L groups. The GH has known as a mediate that effect through IGF-1. As the IGF-1 itself is earlier shown to improve cognitive function it is likely that the observed effect of GH is mediated through release of IGF-1 from peripheral tissue into the circulation for further transport across the BBB. This mechanism may result in the improvement of learning and memory in rats with NBM lesion.

Symptomatic treatment of Alzheimer’s disease: identification of biomarkers to aid translation from bench to bedside

In the absence of robust pharmacodynamic markers, the potential success of novel therapeutic agents for the symptomatic relief of Alzheimer’s disease is largely unknown until the drugs enter relatively large studies, assessing clinical outcome over a 6-month period. In order to increase the efficiency of future clinical development there is, therefore, a need to identify pharmacodynamic markers of drug response, pharmacodynamic models that allow early prediction of efficacy and markers to aid the stratification of the patient population. Using literature available from cholinesterase inhibitors, memantine and Ginkgo biloba, this review focuses on the identification of potential pharmacodynamic markers/models and highlights the utility of these end points throughout the drug discovery process, from preclinical to clinical development.

Sex influences on cholinesterase inhibitor treatment in elderly individuals with alzheimer's disease

BACKGROUND

The second generation of cholinesterase inhibitors (ChEIs) is approved in the United Kingdom for the treatment of mild to moderate Alzheimer's disease (AD). The UK National Institute of Clinical Excellence has raised questions, however, about whether ChEIs are cost-effective for the treatment of dementia. To address these concerns, it is important to identify factors that predict which patients may have the best response to ChEl treatment.

OBJECTIVE

We reviewed animal studies and human clinical studies to address whether sex can predict and influence the response to ChEI treatment based on differences in neuroanatomy, pharmacokinetics, and prevalence of dementia.

METHODS

Relevant articles examining the use of ChEIs in humans with dementia (especially in AD) and in animals were identified through searches of several databases, including MEDLINE, PubMed, and EMBASE for general medical topics, the Cochrane Controlled Clinical Trials Register and CINAHL DIRECT for nursing and allied health issues, and PsycLIT for reviews of psychology and psychiatry topics (1980 June 2006). Articles reviewed were limited to those that discussed the use of ChEIs in relation to sex.

RESULTS

Animal studies have produced a substantial amount of evidence to support the hypothesis that sex may influence the response to ChEIs and, in particular, that testosterone may play a significant role in producing this difference by its influence on the entry of ChEIs into the brain. The results of clinical studies in humans, on the other hand, have been mixed. Two double-label and open-label clinical studies suggested that there may be a 3-way interaction between apolipoprotein E genotype, sex, and tacrine (range, P = 0.03 to P = 0.05). Seven double-blind, open-label clinical trials and 13 case studies of donepezil, rivastigmine, and galantamine produced little evidence of an association between treatment outcomes (as measured with clinical rating scales) and sex, although in an open-label 2-year study in women with AD treated with donepezil, women had lower mortality rates than men (10% and 20%, respectively; P = 0.003). One study produced weak evidence that women treated with ChEIs may experience more adverse effects than men, but this may have been attributable to low body weight rather than to sex differences.

CONCLUSIONS

A substantial relation has not been established between sex and the second-generation ChEIs currently used in clinical settings for the treatment of AD. If an interaction between sex and ChEI treatment does exist, as suggested in 10 of the studies we analyzed, it is likely to be small and subtle, with much individual variation, as is the case with most neurologic sex differences. Nevertheless, sexual dimorphism in response to ChEI therapy warrants further investigation, especially in regard to its role in the development of novel AD therapies.

Growth Hormone Responses to Low-Dose Physostigmine in Elderly vs. Young Women and Men

BACKGROUND

Growth hormone (GH) secretion is a sensitive measure of CNS cholinergic neurotransmission, and GH decreases considerably with age. Cholinesterase inhibitors, which increase acetylcholine concentrations, have been used in elderly subjects to investigate the neuroendocrine effects of aging and Alzheimer's disease. However, there have been only a few studies of a potential sex difference in GH responses to cholinesterase inhibitors in elderly subjects, with mixed results.

OBJECTIVE

We therefore administered low-dose physostigmine (PHYSO), a cholinesterase inhibitor, to normal, non-hormone-replaced, elderly women and men, to ascertain a potential sex difference in GH response. We hypothesized: (1) elderly women and men would have similar hormone responses, because of relatively low circulating estrogen in the women, and (2) the elderly women would have significantly lower baseline GH and GH responses to cholinergic challenge than the young women we studied previously.

METHODS

Normal elderly women and men > or =65 years of age meeting stringent inclusion and exclusion criteria were studied on three test days, 4-7 days apart, by serial blood sampling for several hours for baseline GH, followed by administration of low-dose PHYSO (first and third days) or saline (second day) at 18:00 h. Frequent blood sampling was continued for several hours. Plasma GH and hypothalamo-pituitary-adrenal cortical hormones were measured in each sample.

RESULTS

PHYSO administration produced no side effects in about half the elderly subjects and mild side effects in the other half, with no significant female-male differences and no significant relationship between the presence or absence of side effects and GH response. PHYSO significantly increased GH compared to saline, to a similar degree in the elderly women and men. The elderly women had a significantly greater GH response to PHYSO than did the young women, whereas GH responses were similar in the elderly and young men.

CONCLUSIONS

These results indicate similar GH responses to low-dose PHYSO in elderly women compared to elderly men, and a significantly greater GH response in elderly women compared to young women. A likely mechanism is increased sensitivity of central cholinergic systems that inhibit somatostatin and/or enhance GHRH release from the hypothalamus.

Determination of therapeutics with growth-hormone secretagogue activity in human urine for doping control purposes

The administration of growth-promoting agents such as human growth hormone as well as compounds with respective secretagogue activity is prohibited in sports according to the regulations of the World Anti-Doping Agency. Acetylcholine esterase inhibitors have been demonstrated to stimulate growth-hormone secretion in elderly humans, and new orally active drugs have been developed to provide alternatives to therapeutic injections of growth-hormone preparations. Preventive anti-doping strategies include method development for emerging drugs and potentially misused compounds. Hence, the mass spectrometric dissociation behavior of three acetylcholine esterase inhibitors (donepezil, galantamine and rivastigmine) and a structural analogue to the growth-hormone secretagogue SM-130686 were studied using high-resolution/high-accuracy orbitrap mass spectrometry. These data provided substantial information for screening procedures, complementing common methods of sports drug testing. Using liquid-liquid extraction and subsequent liquid chromatography/tandem mass spectrometry (LC/MS/MS) analysis, the four target analytes were determined at urinary concentrations of 15-20 ng/mL, recoveries ranged from 55-97%, and assay precisions were calculated at 5.2-15.8% (intraday) and 10.2-21.6% (interday) for all compounds. The applicability of the developed assay to authentic urine specimens was tested using two administration study urine samples after application of Reminyl (galantamine) and Aricept (donepezil). In both cases, the administered drug and the respective desmethylated metabolites were detected.

Growth Hormone Releaser Attenuates β-Amyloid (1 – 42)-Induced Memory Impairment in Mice

Accumulating evidence indicates that growth hormone (GH) might be effective at preventing the development of Alzheimer's disease. However, exogenous GH treatment has exhibited side effects for clinical application; thus supplementation with amino acids to promote the release of GH could be a possible alternative treatment. In this study, mice that were fed with a diet of GH-releasing supplements had significantly attenuated memory impairments and hippocampal changes in the acetylcholinesterase activity and acetylcholine level induced by amyloid beta protein (Abeta) (1 - 42). Our results suggest that the use of GH-releasing supplement exerts beneficial effects on the memory impairment induced by Abeta (1 - 42).