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Misiachna A, Svobodova B, Netolicky J, Chvojkova M, Kleteckova L, Prchal L, Novak M, Hrabinova M, Kucera T, Muckova L, Moravcova Z, Karasova JZ, Pejchal J, Blazek F, Malinak D, Hakenova K, Krausova BH, Kolcheva M, Ladislav M, Korabecny J, Pahnke J, Vales K, Horak M, Soukup O. Phenoxytacrine derivatives: Low-toxicity neuroprotectants exerting affinity to ifenprodil-binding site and cholinesterase inhibition. Eur J Med Chem 2024; 266:116130. [PMID: 38218127 DOI: 10.1016/j.ejmech.2024.116130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/04/2024] [Accepted: 01/05/2024] [Indexed: 01/15/2024]
Abstract
Tacrine (THA), a long withdrawn drug, is still a popular scaffold used in medicinal chemistry, mainly for its good reactivity and multi-targeted effect. However, THA-associated hepatotoxicity is still an issue and must be considered in drug discovery based on the THA scaffold. Following our previously identified hit compound 7-phenoxytacrine (7-PhO-THA), we systematically explored the chemical space with 30 novel derivatives, with a focus on low hepatotoxicity, anticholinesterase action, and antagonism at the GluN1/GluN2B subtype of the NMDA receptor. Applying the down-selection process based on in vitro and in vivo pharmacokinetic data, two candidates, I-52 and II-52, selective GluN1/GluN2B inhibitors thanks to the interaction with the ifenprodil-binding site, have entered in vivo pharmacodynamic studies. Finally, compound I-52, showing only minor affinity to AChE, was identified as a lead candidate with favorable behavioral and neuroprotective effects using open-field and prepulse inhibition tests, along with scopolamine-based behavioral and NMDA-induced hippocampal lesion models. Our data show that compound I-52 exhibits low toxicity often associated with NMDA receptor ligands, and low hepatotoxicity, often related to THA-based compounds.
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Affiliation(s)
- Anna Misiachna
- Institute of Experimental Medicine of the Czech Academy of Sciences, Videnska 1083, 142 20, Prague, Czech Republic; Department of Physiology, Faculty of Science, Charles University in Prague, Albertov 6, 128 43, Prague, Czech Republic
| | - Barbora Svobodova
- Biomedical Research Center, University Hospital Hradec Kralove, Sokolska 581, 500 05, Hradec Kralove, Czech Republic; Department of Toxicology and Military Pharmacy, Military Faculty of Medicine, University of Defence, Trebesska 1575, 500 01, Hradec Kralove, Czech Republic
| | - Jakub Netolicky
- Institute of Experimental Medicine of the Czech Academy of Sciences, Videnska 1083, 142 20, Prague, Czech Republic
| | - Marketa Chvojkova
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
| | - Lenka Kleteckova
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
| | - Lukas Prchal
- Biomedical Research Center, University Hospital Hradec Kralove, Sokolska 581, 500 05, Hradec Kralove, Czech Republic
| | - Martin Novak
- Biomedical Research Center, University Hospital Hradec Kralove, Sokolska 581, 500 05, Hradec Kralove, Czech Republic
| | - Martina Hrabinova
- Biomedical Research Center, University Hospital Hradec Kralove, Sokolska 581, 500 05, Hradec Kralove, Czech Republic; Department of Toxicology and Military Pharmacy, Military Faculty of Medicine, University of Defence, Trebesska 1575, 500 01, Hradec Kralove, Czech Republic
| | - Tomas Kucera
- Department of Toxicology and Military Pharmacy, Military Faculty of Medicine, University of Defence, Trebesska 1575, 500 01, Hradec Kralove, Czech Republic
| | - Lubica Muckova
- Biomedical Research Center, University Hospital Hradec Kralove, Sokolska 581, 500 05, Hradec Kralove, Czech Republic; Department of Toxicology and Military Pharmacy, Military Faculty of Medicine, University of Defence, Trebesska 1575, 500 01, Hradec Kralove, Czech Republic
| | - Zuzana Moravcova
- Faculty of Pharmacy in Hradec Králové, Charles University, Akademika, Heyrovskeho 1203, 50005, Hradec Králové, Czech Republic
| | - Jana Zdarova Karasova
- Biomedical Research Center, University Hospital Hradec Kralove, Sokolska 581, 500 05, Hradec Kralove, Czech Republic; Department of Toxicology and Military Pharmacy, Military Faculty of Medicine, University of Defence, Trebesska 1575, 500 01, Hradec Kralove, Czech Republic
| | - Jaroslav Pejchal
- Biomedical Research Center, University Hospital Hradec Kralove, Sokolska 581, 500 05, Hradec Kralove, Czech Republic
| | - Filip Blazek
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, Rokitanskeho 62, 500 03, Hradec Kralove, Czech Republic
| | - David Malinak
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, Rokitanskeho 62, 500 03, Hradec Kralove, Czech Republic
| | - Kristina Hakenova
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic; Third Faculty of Medicine, Charles University, Ruska 87, 100 00, Prague 10, Czech Republic
| | - Barbora Hrcka Krausova
- Institute of Experimental Medicine of the Czech Academy of Sciences, Videnska 1083, 142 20, Prague, Czech Republic
| | - Marharyta Kolcheva
- Institute of Experimental Medicine of the Czech Academy of Sciences, Videnska 1083, 142 20, Prague, Czech Republic
| | - Marek Ladislav
- Institute of Experimental Medicine of the Czech Academy of Sciences, Videnska 1083, 142 20, Prague, Czech Republic
| | - Jan Korabecny
- Biomedical Research Center, University Hospital Hradec Kralove, Sokolska 581, 500 05, Hradec Kralove, Czech Republic; Department of Toxicology and Military Pharmacy, Military Faculty of Medicine, University of Defence, Trebesska 1575, 500 01, Hradec Kralove, Czech Republic
| | - Jens Pahnke
- Department of Neuro-/Pathology, University of Oslo & Oslo University Hospital, Oslo, Norway
| | - Karel Vales
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic; Third Faculty of Medicine, Charles University, Ruska 87, 100 00, Prague 10, Czech Republic
| | - Martin Horak
- Institute of Experimental Medicine of the Czech Academy of Sciences, Videnska 1083, 142 20, Prague, Czech Republic.
| | - Ondrej Soukup
- Biomedical Research Center, University Hospital Hradec Kralove, Sokolska 581, 500 05, Hradec Kralove, Czech Republic.
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Krahulik D, Blazek F, Halaj M, Hrabalek L, Stepanova E, Pavelka Z, Rohanova M. Surgical Treatment of Paediatric Thalamic Gliomas-Single-Centre Experience. Brain Sci 2024; 14:141. [PMID: 38391716 PMCID: PMC10886717 DOI: 10.3390/brainsci14020141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/24/2024] Open
Abstract
The surgical treatment of paediatric thalamic gliomas has been burdened with high morbidity, and these lesions were often considered inoperable. With new approaches and intraoperative technologies, we can remove tumours once deemed inoperable. In our single centre, we have operated on 11 paediatric patients over the course of 8 years. We have performed eight GTR resections and three intended subtotal resections. The postoperative neurological deficit ranged from mild to very severe for motor weakness and none to severe for aphasia after surgery, with all of the patients improving at 3-month follow-up. Radicality in the surgical approach to thalamic gliomas in children has shown significant benefits when compared to more conservative approaches. For children with LGGs, extensive surgical resection is associated with improved prognosis and longer progression-free survival. However, it does not yield the same proportional benefit for HGGs due to its aggressive nature and worse outlook.
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Affiliation(s)
- David Krahulik
- Department of Neurosurgery, University Hospital Olomouc, 77900 Olomouc, Czech Republic
| | - Filip Blazek
- Department of Neurosurgery, University Hospital Olomouc, 77900 Olomouc, Czech Republic
| | - Matej Halaj
- Department of Neurosurgery, University Hospital Olomouc, 77900 Olomouc, Czech Republic
| | - Lumir Hrabalek
- Department of Neurosurgery, University Hospital Olomouc, 77900 Olomouc, Czech Republic
| | - Eva Stepanova
- Department of Paediatric Neurology, University Hospital Ostrava, 70852 Ostrava, Czech Republic
| | - Zdenek Pavelka
- Department of Paediatric Oncology, University Hospital Brno, 66263 Brno, Czech Republic
| | - Marie Rohanova
- Department of Paediatrics, University Hospital Olomouc, 77900 Olomouc, Czech Republic
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Krahulik D, Hrabalek L, Blazek F, Halaj M, Slachta M, Klaskova E, Maresova K. Sensitivity of Papilledema as a Sign of Increased Intracranial Pressure. Children (Basel) 2023; 10:children10040723. [PMID: 37189972 DOI: 10.3390/children10040723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/05/2023] [Accepted: 04/12/2023] [Indexed: 05/17/2023]
Abstract
Our study evaluates the sensitivity of papilledema as a sign of high intracranial pressure in children. Patients younger than 18 years old, diagnosed with increased ICP, and who had received dilated fundus examination between 2019 and 2021 were retrospectively reviewed. Factors including the patient's age, sex, aetiology, duration of signs or symptoms, intracranial pressure (ICP), and presence of papilledema were evaluated. We included 39 patients in this study, whose mean age was 6.7 years. The 31 patients without papilledema had a mean age of 5.7 years, and 8 patients (20%) with papilledema had a mean age of 10.4 (p < 0.037). The mean duration of signs or symptoms was nine weeks in patients without papilledema and seven weeks in those with papilledema (p = 0.410). The leading causes of increased ICP with papilledema were supratentorial tumor (12.5%), infratentorial tumor (33.3%), and hydrocephalus (20%) (p = 0.479). Papilledema was statistically significantly more common in older patients. We found no statistical significance between sex, diagnosis, and symptoms. The relatively low incidence of papilledema (20%) in our study shows that papilledema's absence does not ensure the absence of increased ICP, especially in younger patients.
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Affiliation(s)
- David Krahulik
- Department of Neurosurgery, University Hospital Olomouc, 779 00 Olomouc, Czech Republic
| | - Lumir Hrabalek
- Department of Neurosurgery, University Hospital Olomouc, 779 00 Olomouc, Czech Republic
| | - Filip Blazek
- Department of Neurosurgery, University Hospital Olomouc, 779 00 Olomouc, Czech Republic
| | - Matej Halaj
- Department of Neurosurgery, University Hospital Olomouc, 779 00 Olomouc, Czech Republic
| | - Marek Slachta
- Department of Neurosurgery, University Hospital Olomouc, 779 00 Olomouc, Czech Republic
| | - Eva Klaskova
- Department of Pediatrics, University Hospital Olomouc, 779 00 Olomouc, Czech Republic
| | - Klara Maresova
- Department of Ophthalmology, University Hospital Olomouc, 779 00 Olomouc, Czech Republic
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Krahulik D, Blazek F, Nevrly M, Otruba P, Hrabalek L, Kanovsky P, Valosek J. Imaging Modalities Used for Frameless and Fiducial-Less Deep Brain Stimulation: A Single Centre Exploratory Study among Parkinson's Disease Cases. Diagnostics (Basel) 2022; 12:diagnostics12123132. [PMID: 36553139 PMCID: PMC9777451 DOI: 10.3390/diagnostics12123132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/06/2022] [Accepted: 12/10/2022] [Indexed: 12/14/2022] Open
Abstract
Deep brain stimulation (DBS) is a beneficial procedure for treating idiopathic Parkinson's disease (PD), essential tremor, and dystonia. The authors describe their set of imaging modalities used for a frameless and fiducial-less method of DBS. CT and MRI scans are obtained preoperatively, and STN parcellation is done based on diffusion tractography. During the surgery, an intraoperative cone-beam computed tomography scan is obtained and merged with the preoperatively-acquired images to place electrodes using a frameless and fiducial-less system. Accuracy is evaluated prospectively. The described sequence of imaging methods shows excellent accuracy compared to the frame-based techniques.
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Affiliation(s)
- David Krahulik
- Department of Neurosurgery, University Hospital Olomouc, 77900 Olomouc, Czech Republic
- Correspondence:
| | - Filip Blazek
- Department of Neurosurgery, University Hospital Olomouc, 77900 Olomouc, Czech Republic
| | - Martin Nevrly
- Department of Neurology, University Hospital Olomouc, 77900 Olomouc, Czech Republic
| | - Pavel Otruba
- Department of Neurology, University Hospital Olomouc, 77900 Olomouc, Czech Republic
| | - Lumir Hrabalek
- Department of Neurosurgery, University Hospital Olomouc, 77900 Olomouc, Czech Republic
| | - Petr Kanovsky
- Department of Neurology, University Hospital Olomouc, 77900 Olomouc, Czech Republic
| | - Jan Valosek
- Department of Neurosurgery, University Hospital Olomouc, 77900 Olomouc, Czech Republic
- Department of Neurology, University Hospital Olomouc, 77900 Olomouc, Czech Republic
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