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Reiners JJ, Mathieu PA, Gargano M, George I, Shen Y, Callaghan JF, Borch RF, Mattingly RR. Synergistic Suppression of NF1 Malignant Peripheral Nerve Sheath Tumor Cell Growth in Culture and Orthotopic Xenografts by Combinational Treatment with Statin and Prodrug Farnesyltransferase Inhibitor PAMAM G4 Dendrimers. Cancers (Basel) 2023; 16:89. [PMID: 38201517 PMCID: PMC10778372 DOI: 10.3390/cancers16010089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/16/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Neurofibromatosis type 1 (NF1) is a disorder in which RAS is constitutively activated due to the loss of the Ras-GTPase-activating activity of neurofibromin. RAS must be prenylated (i.e., farnesylated or geranylgeranylated) to traffic and function properly. Previous studies showed that the anti-growth properties of farnesyl monophosphate prodrug farnesyltransferase inhibitors (FTIs) on human NF1 malignant peripheral nerve sheath tumor (MPNST) cells are potentiated by co-treatment with lovastatin. Unfortunately, such prodrug FTIs have poor aqueous solubility. In this study, we synthesized a series of prodrug FTI polyamidoamine generation 4 (PAMAM G4) dendrimers that compete with farnesyl pyrophosphate for farnesyltransferase (Ftase) and assessed their effects on human NF1 MPNST S462TY cells. The prodrug 3-tert-butylfarnesyl monophosphate FTI-dendrimer (i.e., IG 2) exhibited improved aqueous solubility. Concentrations of IG 2 and lovastatin (as low as 0.1 μM) having little to no effect when used singularly synergistically suppressed cell proliferation, colony formation, and induced N-RAS, RAP1A, and RAB5A deprenylation when used in combination. Combinational treatment had no additive or synergistic effects on the proliferation/viability of immortalized normal rat Schwann cells, primary rat hepatocytes, or normal human mammary epithelial MCF10A cells. Combinational, but not singular, in vivo treatment markedly suppressed the growth of S462TY xenografts established in the sciatic nerves of immune-deficient mice. Hence, prodrug farnesyl monophosphate FTIs can be rendered water-soluble by conjugation to PAMAM G4 dendrimers and exhibit potent anti-tumor activity when combined with clinically achievable statin concentrations.
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Affiliation(s)
- John J. Reiners
- Institute of Environmental Health Sciences, Wayne State University, Detroit, MI 48201, USA; (J.J.R.J.); (P.A.M.); (M.G.)
- Department of Pharmacology, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Patricia A. Mathieu
- Institute of Environmental Health Sciences, Wayne State University, Detroit, MI 48201, USA; (J.J.R.J.); (P.A.M.); (M.G.)
- Department of Pharmacology, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Mary Gargano
- Institute of Environmental Health Sciences, Wayne State University, Detroit, MI 48201, USA; (J.J.R.J.); (P.A.M.); (M.G.)
- Department of Pharmacology, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Irene George
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, IN 47907, USA; (I.G.); (R.F.B.)
- Currently College of Arts and Sciences, Ohio State University, Columbus, OH 43210, USA
| | - Yimin Shen
- Department of Radiology, Wayne State University, Detroit, MI 48201, USA;
| | - John F. Callaghan
- Department of Pharmacology and Toxicology, East Carolina University, Greenville, NC 27834, USA;
| | - Richard F. Borch
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, IN 47907, USA; (I.G.); (R.F.B.)
| | - Raymond R. Mattingly
- Department of Pharmacology, Wayne State University School of Medicine, Detroit, MI 48201, USA
- Department of Pharmacology and Toxicology, East Carolina University, Greenville, NC 27834, USA;
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Gan L, Zhu W, Fu P. The efficacy of statins for improving cognitive impairments in pediatric patients with neurofibromatosis type 1 (NF-1): a meta-analysis. Front Pediatr 2023; 11:1274972. [PMID: 37876519 PMCID: PMC10591081 DOI: 10.3389/fped.2023.1274972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 09/18/2023] [Indexed: 10/26/2023] Open
Abstract
Background Given the considerable discrepancies in the evidence concerning the efficacy of statins in ameliorating cognitive impairments in pediatric patients with Neurofibromatosis Type 1 (NF-1), this study conducts a systematic review and meta-analysis to consolidate existing evidence to evaluate the efficacy of statins on cognitive impairments in children with NF-1. Methods This study adhered to the PRISMA statement, and the research protocol was pre-registered on PROSPERO (#CRD: 42022369072). Comprehensive searches of databases including PubMed, Embase, and the Cochrane Library were performed up to March 31, 2023 to identify randomized controlled trials (RCTs) investigating the effects of statins on cognitive impairments in children with NF-1. Statistical analyses were conducted using Review Manager 5.4.1. A fixed- or random-effects model was employed according to the I2 statistic. As all data were continuous, MD [95% CI] was used as the pooled estimate. Results The final analysis included five RCTs with a total of 364 patients. The meta-analysis indicated that aside from a statistically significant improvement in internalizing problems (MD [95%CI] = 3.61[0.11, 7.10], p = 0.04), Object assembly Test (MD [95%CI] = 0.53[0.12, 0.93], p = 0.01), Cancellation Test (MD [95%CI] = 3.61[0.11, 7.10], p < 0.0001), statins did not exhibit significant efficacy in improving other cognitive aspects in children with NF-1 (p > 0.05). An additional descriptive analysis on indices that cannot be meta-analyzed revealed considerable inconsistency in the therapeutic effect of statins across different studies. Conclusion Current evidence suggests that statins may not be effective for cognitive performance in children with NF-1.
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Affiliation(s)
- Lutong Gan
- Department of Neurology, The Second Hospital of Guangzhou Medical School of China, Guangzhou, China
| | - Weiwen Zhu
- Department of Neurology, The Second Hospital of Guangzhou Medical School of China, Guangzhou, China
| | - Pengqing Fu
- Department of Cardiology, The Second Hospital of Guangzhou Medical School of China, Guangzhou, China
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Agouridis AP, Palli N, Karagiorga VE, Konsoula A, Markaki L, Spernovasilis N, Tsioutis C. Statins in Children with Neurofibromatosis Type 1: A Systematic Review of Randomized Controlled Trials. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1556. [PMID: 37761518 PMCID: PMC10528298 DOI: 10.3390/children10091556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 08/26/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Statins, apart from their plasma-cholesterol-lowering ability, exert several pleiotropic effects, making them a potential treatment for other diseases. Animal studies have showed that statins, through the inhibition of 3-hydroxy-3-methylglutaryl coenzyme A reductase, can affect the Ras/MAPK pathway, thus providing impetus to examine the efficacy of statins in the pediatric population with neurofibromatosis type 1 (NF1). We aimed to systematically address all relevant evidence of statin treatment in children with NF1. METHODS We searched PubMed and Cochrane Library resources up to 2 June 2023 for randomized controlled trials (RCTs) written in English and evaluating statins versus placebo in children with NF1 (PROSPERO registration number: CRD42023439424). RESULTS Seven RCTs were suitable to be included in this qualitative synthesis, with a total participation of 336 children with NF1. The duration of the studies ranged from 12 to 52 weeks. The mean age of the pediatric population was 10.9 years old. Three studies investigated the role of simvastatin, while four studies examined lovastatin. According to our analysis, neither simvastatin nor lovastatin improved cognitive function, full-scale intelligence, school performance, attention problems, or internalizing behavioral problems when compared with placebo in children with NF1. Statins were well tolerated in all included RCTs. CONCLUSION Although safe, current evidence demonstrates that statins exert no beneficial effect in cognitive function and behavioral problems in children with NF1.
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Affiliation(s)
- Aris P. Agouridis
- School of Medicine, European University Cyprus, 2404 Nicosia, Cyprus; (N.P.); (C.T.)
- Department of Internal Medicine, German Oncology Center, 4108 Limassol, Cyprus
| | - Nikoletta Palli
- School of Medicine, European University Cyprus, 2404 Nicosia, Cyprus; (N.P.); (C.T.)
| | | | - Afroditi Konsoula
- Department of Pediatrics, General Hospital of Sitia, 72300 Sitia, Greece;
| | - Lamprini Markaki
- “Iliaktida” Pediatric & Adolescents Medical Center, 4001 Limassol, Cyprus;
| | | | - Constantinos Tsioutis
- School of Medicine, European University Cyprus, 2404 Nicosia, Cyprus; (N.P.); (C.T.)
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Virtual Reality Water Maze Navigation in Children with Neurofibromatosis Type 1 and Reading Disability: an Exploratory Study. JOURNAL OF PEDIATRIC NEUROPSYCHOLOGY 2022. [DOI: 10.1007/s40817-022-00132-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Blockade of Serotonin 5-HT 6 Receptor Constitutive Activity Alleviates Cognitive Deficits in a Preclinical Model of Neurofibromatosis Type 1. Int J Mol Sci 2021; 22:ijms221810178. [PMID: 34576341 PMCID: PMC8467191 DOI: 10.3390/ijms221810178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/17/2021] [Accepted: 09/18/2021] [Indexed: 02/04/2023] Open
Abstract
Neurofibromatosis type 1 (NF1) is a common inherited disorder caused by mutations of the NF1 gene that encodes the Ras-GTPase activating protein neurofibromin, leading to overactivation of Ras-dependent signaling pathways such as the mTOR pathway. It is often characterized by a broad range of cognitive symptoms that are currently untreated. The serotonin 5-HT6 receptor is a potentially relevant target in view of its ability to associate with neurofibromin and to engage the mTOR pathway to compromise cognition in several cognitive impairment paradigms. Here, we show that constitutively active 5-HT6 receptors contribute to increased mTOR activity in the brain of Nf1+/− mice, a preclinical model recapitulating some behavioral alterations of NF1. Correspondingly, peripheral administration of SB258585, a 5-HT6 receptor inverse agonist, or rapamycin, abolished deficits in long-term social and associative memories in Nf1+/− mice, whereas administration of CPPQ, a neutral antagonist, did not produce cognitive improvement. These results show a key influence of mTOR activation by constitutively active 5-HT6 receptors in NF1 cognitive symptoms. They provide a proof of concept that 5-HT6 receptor inverse agonists already in clinical development as symptomatic treatments to reduce cognitive decline in dementia and psychoses, might be repurposed as therapies alleviating cognitive deficits in NF1 patients.
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Sato A, Ikeda K. Genetic and Environmental Contributions to Autism Spectrum Disorder Through Mechanistic Target of Rapamycin. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2021; 2:95-105. [PMID: 36325164 PMCID: PMC9616270 DOI: 10.1016/j.bpsgos.2021.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 02/06/2023] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that affects an individual’s reciprocal social interaction and communication ability. Numerous genetic and environmental conditions are associated with ASD, including tuberous sclerosis complex, phosphatase and tensin homolog hamartoma tumor syndrome, fragile X syndrome, and neurofibromatosis 1. The pathogenic molecular mechanisms of these diseases are integrated into the hyperactivation of mTORC1 (mechanistic target of rapamycin complex 1). Rodent models of these diseases have shown high mTORC1 activity in the brain and ASD-related behavioral deficits, which were reversed by the mTORC1 inhibitor rapamycin. Environmental stress can also affect this signaling pathway. In utero exposure to valproate caused ASD in offspring and enhanced mTORC1 activity in the brain, which was sensitive to mTORC1 inhibition. mTORC1 is a signaling hub for diverse cellular functions, including protein synthesis, through the phosphorylation of its targets, such as ribosomal protein S6 kinases. Metabotropic glutamate receptor 5–mediated synaptic function is also affected by the dysregulation of mTORC1 activity, such as in fragile X syndrome and tuberous sclerosis complex. Reversing these downstream changes that are associated with mTORC1 activation normalizes behavioral defects in rodents. Despite abundant preclinical evidence, few clinical studies have investigated the treatment of ASD and cognitive deficits. Therapeutics other than mTORC1 inhibitors failed to show efficacy in fragile X syndrome and neurofibromatosis 1. mTORC1 inhibitors have been tested mainly in tuberous sclerosis complex, and their effects on ASD and neuropsychological deficits are promising. mTORC1 is a promising target for the pharmacological treatment of ASD associated with mTORC1 activation.
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