Current drug targets. CNS and neurological disorders最新文献

Perinatal stroke represents an important cause of severe neurological deficits that span the individual's lifetime, including delayed mental and motor development, epilepsy and major cognitive deficits. Most strokes occurring in term births, infants and children can be caused by thromboembolism from intracranial and extracranial vessels and are associated with a variety of risk factors such as birth asphyxia, cardiac diseases, blood disorders, maternal disorders, trauma. Animal models of perinatal stroke have been developed to examine the nature and the time course of the events occurring after the ischemic insult and the possible therapeutic strategies useful in reducing ischemic damage. The present article addresses the potential pharmacological treatments targeting the inflammatory process and apoptotic cell death, with a specific emphasis on the emerging role of statins as neuroprotective agents in perinatal stroke. As a prelude, we will also review advances in our understanding on the mechanisms underlying the hypoxic-ischemic reperfusion injury in the newborn.

Along with inflammation, apoptosis appears a common feature of cell death in non-infectious neurodegenerative diseases. The apoptotic program is an energy-requiring, slowly developing process that evolves in three main steps; initiation, progression and execution. Each step of the program is controlled by a number of molecules with synergistic or antagonistic functions, among which the family of cystein proteases called caspases has a primary role. The central position of caspases in all steps of the apoptotic process had led to the development of several families of inhibitory drugs based on the tetrapeptidic sequence of their preferred cleavage site on target molecules. The initial classes of compounds had problems of toxicity, specificity and blood brain barrier penetration, but even so, gave encouraging preclinical results in animal models of neurological diseases. New generations of anti-caspase drugs have been developed, including non peptide-based compounds, which have shown satisfactory pharmaceutical activity. In addition, pre-clinical developments include advances in protein therapy based on the use of natural inhibitors of caspases, which possess the advantage of targeting synergistic neuroprotective pathways. This strategy uses peptidic vectors to carry large molecules through the blood brain barrier and the membrane of brain cells. Although pre-clinical data are compelling, the activity of these various drug families in patients with acute and/or progressive brain lesions has yet to be demonstrated.

In most central neurons, small conductance Ca(2+)-activated K(+) channels (SK channels) contribute to afterhyperpolarizations (AHPs), which control neuronal excitability. The medium AHP has pharmacological properties similar to recombinant SK channels, consistent with the hypothesis that SK channels generate this afterhyperpolarization component. It is still unclear how recombinant SK channels are functionally related to the slow AHP component. Cloned SK channels are heteromeric complexes of SK channel subunits and calmodulin. The channels are activated by Ca(2+) binding to calmodulin that induces conformational changes resulting in channel opening. Channel deactivation is the reverse process brought about by dissociation of Ca(2+) from calmodulin. In the mammalian brain, the three SK channel subunits (SK1-3) display partially overlapping distributions. Most of the higher brain regions such as the neocortex and hippocampus show expression of both genes encoding SK1 and SK2 channels, whereas phylogenetically older brain regions such as the thalamus, basal ganglia, cerebellum, and brainstem show high levels of SK3 gene expression. At present, it is still unclear whether native SK channels are generated as heteromeric or homomeric channels. Peptide toxins such as apamin and scyllatoxin, as well as organic compounds such as quaternary salts of bicuculline, dequalinium, UCL 1684 and UCL 1848 serve as non-specific SK channel blockers. The only known exceptions so far are the scorpion toxin tamapin and the peptide inhibitor Lei-Dab(7), which bind preferentially to SK2. Electrophysiological and behavioral studies indicate that blockade of SK channels by apamin increases excitability, lowers the threshold for the induction of synaptic plasticity, and facilitates hippocampus-dependent memory. The potential value of pharmacological SK channel modulation in various pathological states such as increased epileptiform activity, cognitive impairment, pain, mood disorders and schizophrenia will be discussed.

Considerable attention has recently been paid to astrocyte functions, which are briefly summarized. A large amount of data is available about adrenoceptor expression and function in astrocytes, some of it dating back to the 1970's and some of it very recent. This material is reviewed in the present paper. The brain is innervated by noradrenergic fibers extending from locus coeruleus in the brain stem, which in turn is connected to a network of adrenergic and noradrenergic nuclei in the medulla and pons, contributing to the control of (nor)adrenergic, serotonergic, dopaminergic and cholinergic function, both in the central nervous system (CNS) and in the periphery. In the CNS astrocytes constitute a major target for noradrenergic innervation, which regulates morphological plasticity, energy metabolism, membrane transport, gap junction permeability and immunological responses in these cells. Noradrenergic effects on astrocytes are essential during consolidation of episodic, long-term memory, which is reinforced by beta-adrenergic activation. Glycogenolysis and synthesis of glutamate and glutamine from glucose, both of which are metabolic processes restricted to astrocytes, occur at several time-specific stages during the consolidation. Astrocytic abnormalities are almost certainly important in the pathogenesis of multiple sclerosis and in all probability contribute essentially to inflammation and malfunction in Alzheimer's disease and to mood disturbances in affective disorders. Noradrenergic function in astrocytes is severely disturbed by chronic exposure to cocaine, which also changes astrocyte morphology. Development of drugs modifying noradrenergic receptor activity and/or down-stream signaling is advocated for treatment of several neurological/psychiatric disorders and for neuroprotection. Astrocytic preparations are suggested for study of mechanism(s) of action of antidepressant drugs and pathophysiology of mood disorders.

Endogenous depression is a common mental illness which is associated with significant morbidity and mortality. Tricyclic antidepressants and their newer derivatives are the main treatment for this disease. However, there are serious deficiencies in the use of existing antidepressants for the treatment of depressive illness. An obstacle in the development of better antidepressants is that the mechanism of the therapeutic action of these compounds is unknown. The prevailing view is that antidepressants exert their therapeutic effect by inhibiting the pre-synaptic re-uptake of the neurotransmitter amines, noradrenaline and serotonin. However, there are objections to this hypothesis. Transport-P is a new factor in this field; it is an antidepressant-sensitive, proton-dependent, V-ATPase linked uptake process for amines in peptidergic neurones. It differs from other uptake processes in its anatomical location in post-synaptic (peptidergic) neurones, in its functional properties and in the structure of its ligands. Therapeutic concentrations of antidepressants are active at Transport-P. This review describes a hypothesis which postulates that antidepressants exert a therapeutic effect by an action on Transport-P [1]. According to this hypothesis, Transport-P accumulates antidepressants in acidified vesicles in post-synaptic neurones. The normal function of the vesicles is to degrade internalised post-synaptic receptors. As their amine groups are basic, the antidepressants tend to neutralise the acidity of the vesicles. This slows the rate of degradation of post-synaptic receptors, and makes post-synaptic neurones more responsive to the excitatory actions of neurotransmitter amines. This hypothesis resolves the problems with the pre-synaptic re-uptake hypothesis and offers a unitary explanation for hitherto inexplicable observations. If the hypothesis is correct, compounds which act as potent and selective ligands for Transport-P would have a more rapid onset of action and would represent an advance in the treatment of depressive illness. The data on Transport-P which are described in this article are derived entirely from the work of the author who is not aware of any other research groups working on Transport-P. Therefore, the amount of work which has been done so far is relatively limited. The evidence on which the hypothesis is based is derived from work on alpha(1) adrenoceptors in hypothalamic, peptidergic neurones. There are large gaps in the evidence which would be required to support a mechanistic hypothesis: for example, the serotonergic system, which is likely to be involved in depressive illness, has not been investigated. Further, no attempt has been made so far to address the applicability of the phenomena which were observed in the hypothalamus to other brain regions which may be involved in depressive illness. Nevertheless, the hypothesis, as it stands at present, appears to solve problems which have been inexplicable on the basis

One of the conundrums of neuropharmacology is to understand the therapeutic mechanisms of action of antipsychotic drugs. Every drug with antipsychotic activity is a dopamine (DA) D(2)-like receptor antagonist and therefore this function is critical to reducing psychotic symptoms. However, the actions of the archetypal atypical antipsychotic drug clozapine go beyond antipsychotic effects because the drug is efficacious in treating psychotic symptoms that do not respond to drugs mainly directed at antagonizing the DA D(2) receptor, has benefits in cognition and has recently been shown to reduce levels of suicide. A growing understanding of the mechanisms of clozapine and other atypical antipsychotic drugs suggests that both partial and inverse agonism, as well as receptor antagonism, at specific neurotransmitter receptors is required to give full therapeutic benefits. It is, therefore, timely to review the evolving nature of the mechanisms of action of different antipsychotic drugs.

Ethanol is a small molecule acting on several neurotransmitter systems in the brain. Accumulating evidences suggest that the primary excitatory--i.e. the glutamatergic--neurotransmitter system is a particularly important site of ethanol's action. Several studies showed that ethanol is a potent and selective inhibitor of the N-methyl-D-aspartate (NMDA) receptors and prolonged ethanol exposition leads to a compensatory "up-regulation" of these receptors resulting in enhanced NMDA receptor-mediated functions after removal of ethanol. These alterations are supposed to contribute to the development of ethanol tolerance, dependence as well as the acute and delayed signs of ethanol withdrawal. In recent papers, alterations in subunit composition of NMDA receptors were reported after long term ethanol exposure. mRNA and/or protein levels of NR2A and NR2B types of subunits were found elevated both by in vivo and in vitro experiments. Our results showed that especially the NR2B subunit expression is increased in cultured hippocampal and cortical neurones after 3 days of intermittent ethanol treatment. According to the high calcium permeability, the increased agonist sensitivity and the relatively slow closing kinetics of NMDA ion channels composed of NR2B subunits, the above mentioned changes may underlie the enhanced NMDA receptor activation observed after long term ethanol exposure. Accordingly, we have tested NR2B subunit selective NMDA receptor antagonists in primary cultures of rat cortical neurones pre-treated with ethanol intermittently for 3 days and found that these compounds potently inhibited the neurotoxic effect of ethanol withdrawal. Hypothesising the involvement of enhanced NR2B subunit expression in development of alcohol dependence and withdrawal symptoms and considering the tolerable side effect profile of the NR2B subunit selective NMDA receptor antagonists, the NR2B type of NMDA receptor subunit may serve as a possible drug target in pharmacological interventions for alcoholism. The aim of this review is to give an update on the role of altered structure and function of NMDA receptors after ethanol exposure and to summarise the recent data about the activity of NR2B subunit selective NMDA receptor antagonists in model systems related to alcoholism.

Axons are essential, vulnerable and often irreplaceable so it is essential to understand how they are lost in neurodegenerative disease. Recent data link the mechanism of injury-induced Wallerian degeneration to that of axon death in CNS and PNS disease. The neuroprotective gene Wld(S) delays Wallerian degeneration, CNS axonal dystrophy, 'dying-back' pathology and to a lesser extent synapse loss, despite the different causes and morphologies of degeneration. These findings validate Wallerian degeneration as a model to understand and prevent mechanisms of axon and synapse loss in neurodegenerative disorders. The existence of a gene that alters Wallerian degeneration suggests it is a regulated program of axon death normally held back by axonal inhibitors, similar in principle to apoptosis. The Wld(S) protein and proteasome inhibitor experiments implicate the ubiquitin proteasome system (UPS) in Wallerian degeneration. However, the site of UPS involvement and the molecular events remain unclear because the UPS is highly compartmentalized in neurons, affecting complex and sometimes conflicting processes in nuclei, axons, growth cones and synapses. Proteasome inhibitors are blunt tools for studying such a complex system and they are also particularly toxic to axons and alter synapse function. In contrast, Wld(S) acts on a specific step, leaving mice healthy with normal development and behavior. This also makes it an attractive drug target. We need to understand which UPS step is blocked in which neuronal compartment, and to define the pathway in order to develop new strategies to block axon pathology.

Glutamate alpha-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA) receptors mediate most of the excitatory neurotransmission in the mammalian central nervous system and also participate in forms of synaptic plasticity thought to underlie memory and learning, and the formation of neural networks during development. Molecular cloning techniques have shown that the AMPA receptor family is composed of four different subunits named GluR1-4 or GluRA-D (newly termed as Glu(A1)-Glu(A4)) and native AMPA receptors are most likely tetramers generated by the assembly of one or more of these subunits, yielding homomeric or heteromeric receptors. Additional complexity among AMPA receptors is conferred by alternative splicing of RNA for each subunit giving rise to flip and flop variants. Clinical and experimental data have suggested that positive modulation of AMPA receptors may be therapeutically effective in the treatment of cognitive deficits. Several classes of AMPA receptor potentiators have been reported, including pyrroliddones (piracetam, aniracetam), benzothiazides (cyclothiazide), benzylpiperidines (CX-516, CX-546) and more recently biarylpropylsulfonamides (LY392098, LY404187 and LY503430). These molecules enhance cognitive function in rodents, which appears to correlate with increased hippocampal activity. In addition, clinical studies have suggested that AMPA receptor modulators enhance cognitive function in elderly subjects, as well as patients suffering from neurological and psychiatric disorders. Several independent studies have suggested that AMPA receptors can increase BDNF expression by both calcium-dependent and independent pathways. For example, recent studies have shown that AMPA receptors interact with the protein tyrosine kinase, Lyn. Activation of Lyn can recruit the mitogen-activated protein kinase (MAPK) signalling pathway and increase the expression of BDNF. Therefore, in addition to directly enhancing glutamatergic synaptic transmission, AMPA receptor activation can increase the expression of BDNF in vitro and in vivo. This may account for activity of AMPA receptor potentiators in rodent models predictive of antidepressant activity (forced swim and tail suspension tests). The increase in neurotrophin expression also may contribute to the functional, neuroprotective and neurotrophic actions of LY404187 and LY503430 after infusion of 6-OHDA into the substantia nigra. In conclusion, several potent, selective and systemically active AMPA receptor potentiators have been reported. Data indicate that these molecules modulate glutamatergic transmission, enhance synaptic transmission, long-term potentiation (LTP) and increase neurotrophin expression. Therefore, these AMPA receptor potentiators offer an exciting new class of drugs with potential for treating (1) cognitive impairment associated with Alzheimer's disease and schizophrenia, (2) depression, (3) slowing the progression and potentially enhancing recovery from Parkinso

Sensorineural hearing loss, characterized by damage to sensory hair cells and/or associated nerve fibers is a leading cause of hearing disorders throughout the world. To date, treatment options are limited and there is no cure for damaged inner ear cells. Because the inner ear is a tiny organ housed in bone deep within the skull, access to the inner ear is limited, making delivery of therapeutic agents difficult. In recent years scientists have investigated a number of growth factors that have the potential to regulate survival or recovery of auditory neurons. Coinciding with the focus on molecules that may restore function are efforts to develop novel delivery methods. Researchers have been investigating the use of mini osmotic pumps, viral vectors and stem cells as a means of providing direct application of growth factors to the inner ear. This review summarizes recent findings regarding the molecules that may be useful for restoring damaged spiral ganglion neurons, as well as the advantages and disadvantages of various delivery systems.