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Brewster JT, Dell’Acqua S, Thach DQ, Sessler JL. Classics in Chemical Neuroscience: Donepezil. ACS Chem Neurosci 2019; 10:155-167. [PMID: 30372021 DOI: 10.1021/acschemneuro.8b00517] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
The discovery of acetylcholine and acetylcholinesterase provided the first insight into the intricacies of chemical signal transduction and neuronal communication. Further elucidation of the underlying mechanisms led to an attendant leveraging of this knowledge via the synthesis of new therapeutics designed to control aberrant biochemical processes. The central role of the cholinergic system within human memory and learning, as well as its implication in Alzheimer's disease, has made it a point of focus within the neuropharmacology and medicinal chemistry communities. This review is focused on donepezil and covers the background, synthetic routes, structure-activity relationships, binding interactions with acetylcholinesterase, pharmacokinetics and metabolism, efficacy, adverse effects, and historical importance of this leading therapeutic in the treatment of Alzheimer's disease and true Classic in Chemical Neuroscience.
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Affiliation(s)
- James T. Brewster
- Department of Chemistry, The University of Texas at Austin, Austin, Texas 78712-1224, United States
| | - Simone Dell’Acqua
- Department of Chemistry, University of Pavia, Via Taramelli 12, 27100 Pavia, Italy
| | - Danny Q. Thach
- Department of Chemistry, University of California—Berkeley, Berkeley, California 94720, United States
| | - Jonathan L. Sessler
- Department of Chemistry, The University of Texas at Austin, Austin, Texas 78712-1224, United States
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Wills JH, Dubois KP. The Measurement and Significance Of Changes In The Cholinesterase Activities Of Erythrocytes and Plasma In Man and Animals. ACTA ACUST UNITED AC 2008. [DOI: 10.3109/10408447209104304] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Sramek JJ, Cutler NR. RBC cholinesterase inhibition: a useful surrogate marker for cholinesterase inhibitor activity in Alzheimer disease therapy? Alzheimer Dis Assoc Disord 2000; 14:216-27. [PMID: 11186600 DOI: 10.1097/00002093-200010000-00006] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Red blood cell (RBC) acetylcholinesterase (AChE) inhibition has been used as a peripheral surrogate marker for the activity of centrally acting AChE inhibitors (AChEIs) in the treatment of Alzheimer disease. As a valid peripheral surrogate marker, RBC AChE inhibition should reflect the central pharmacodynamic activity of the compound and should demonstrate a relation with cognitive or global improvement in patients with Alzheimer disease. As a useful clinical tool, RBC AChE inhibition should also provide an advantage in dose optimization. However, the application of surrogate markers in research and clinical use is controversial (Prentice, 1989; Gotzsche, 1996; Colburn, 1997; De Gruttola et al., 1997). For instance, surrogate markers that have been identified or applied inappropriately can lead to erroneous conclusions, slowing the drug development process (Colburn, 1997). Also, the validation of surrogate markers for the pharmacodynamic activity of central nervous system drugs is not always possible because samples of brain tissue cannot be analyzed in humans. Finally, although validation of peripheral markers for central nervous system drugs has been approached via analysis of cerebrospinal fluid (Cutler et al., 1998a), few markers have been subjected to such rigorous evaluation in clinical studies. The extent to which measures of peripheral AChE inhibition accurately model central drug activity and therapeutic effectiveness of AChEIs, both as individual agents and as a drug class, is the focus of this review. AChEIs comprise a group of structurally diverse compounds with a wide range of relative specificities for the various molecular species of cholinesterase found in plasma, RBCs, and the brain. Studies of RBC AChE inhibition after administration of AChEIs in animals are of limited utility because of the differential sensitivity of AChEIs for human versus animal forms of AChE, the poor correlation between effective doses in animals and humans, and the lack of standardized measurements of effectiveness. Although clinical studies of donepezil, metrifonate, and eptastigmine have suggested the potential use of RBC AChE inhibition as a predictor of clinical response, the degree of inhibition yielding maximum cognitive improvements was highly variable from compound to compound (30-80%). Further, investigators did not prove a relation between central and peripheral pharmacodynamics or demonstrate an advantage over dose in the ability of RBC AChE inhibition to predict clinical response. A study of rivastigmine in patients with Alzheimer disease revealed that cerebrospinal fluid AChE inhibition correlated well with cognitive performance, whereas peripheral inhibition did not. Therefore, RBC cholinesterase inhibition is not a reliable surrogate marker for the activity of AChEIs as a class of drugs, and its usefulness as a dose optimization tool for individual agents has yet to be demonstrated clearly.
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Affiliation(s)
- J J Sramek
- California Clinical Trials, Beverly Hills 90211, USA
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Prall YG, Gambhir KK, Cruz IA, Blassingale J, Ampy FR. Acetylcholinesterase activity in chronic renal failure. Life Sci 2000; 66:835-45. [PMID: 10698358 DOI: 10.1016/s0024-3205(99)00656-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Twenty healthy subjects and 39 Chronic Renal Failure patients (CRF-patients) maintained on chronic hemodialysis were used in this investigation to study the changes in acetylcholinesterase (AChE) activity of red blood cells (RBCs). The CRF-patients were all undergoing hemodialysis treatment. AChE activity from the CRF-patients was determined before and after dialysis. An additional objective was to study the effect of chronic renal failure on human red blood cell aging. Blood samples were drawn from controls and CRF-patients in tubes containing EDTA or sodium heparin as an anticoagulant. Red blood cells were purified to avoid interference with monocytes, reticulocytes and leukocytes. The purified RBCs were subfractionated into young (y) (1.08-1.09), mid (m) (1.09-1.11) and old (o) (1.11-1.12) percoll density (g/mL) fractions using a discontinous percoll gradient. The mean +/- SD AChE per gram hemoglobin (U/g Hgb) activities in whole blood (WB), purified human red blood cells (PRBCs), young human red blood cells (y-RBCs), mid age human red blood cells (m-RBCs) and old human red blood cells (o-RBCs) in CRF-patients were 31.2+/-3.43, 29.3+/-3.26, 30.4+/-3.91, 25.1+/-5.25, 17.1+/-6.02 in females and 29.8+/-5.39, 28.8+/-5.29, 28.7+/-5.29, 23.7+/-5.39 and 16.0+/-5.60 in males. AChE activity from CRF-patients were higher than that found in the control subjects. The aging of human RBCs in both the controls and CRF-patients showed a progressive reduction in AChE activity. AChE activity of RBCs from female CRF-patients were significantly higher (p < 0.05) than that of the female control subjects. The RBCs isolated from male CRF-patients showed a higher AChE activity than control males, but a significant difference was only observed with the mid-age-cells. These studies further indicate that AChE activity remained insignificantly different in the various density based age subfractions of RBCs of both CRF-patients and controls.
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Affiliation(s)
- Y G Prall
- Department of Biology, Howard University, Washington, DC 20059, USA.
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al-Jafari AA, Kamal MA. The preparation and kinetic properties of multiple forms of chicken brain acetylcholinesterase. Cell Biochem Funct 1994; 12:29-35. [PMID: 8168228 DOI: 10.1002/cbf.290120105] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A method for preparing various forms of acetylcholinesterase (AChE) from chicken brain has been developed and they have been characterized in terms of kinetic parameters such as Km, rate constant (k), turnover number (kp), specificity constant (ksp), Vmax and half-life (t1/2). The solubility experiments show that, there are two major forms of AChE i.e. water-soluble and membrane-bound AChE (MBAChE). The MBAChE shows several subforms, and on the basis of percentage activity only three MBAChE forms have been selected for complete characterization by various kinetic parameters. It was found that these three forms of MBAChE demonstrate significant differences in their kinetic properties.
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Affiliation(s)
- A A al-Jafari
- Department of Biochemistry, College of Science, King Saud University, Riyadh, Saudi Arabia
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Abstract
The successful demonstration and localisation of acetylcholinesterase (AChE), in cells by a cytochemical technique requires maximal expression of enzyme activity, minimal loss of AChE and precise, quantitative generation of reaction product at the actual site of the protein in vivo. These requirements are addressed in a standard technique that has been modified to avoid or optimise fixation and to exhibit enzyme activity under close-to-physiological conditions of osmolality, pH, and temperature. With these refinements and with the use of a variety of substrates and enzyme inhibitors of different specificities, true AChE was demonstrable on the membrane of erythrocytes and in the nucleus and cytoplasm of erythroblasts in bone marrow and of the constituent cells of erythroid clones in vitro. The activity in erythrocytes from umbilical cord blood was less than that in corresponding cells from the peripheral circulation of adults. AChE was observed also in human megakaryocytes and in leucocytes at all levels of differentiation, including the components of granulocyte-macrophage clones. Pseudocholinesterase was detected likewise across the spectrum of erythroid (and leucocyte) ontogeny, suggesting that these enzymes may exercise an important function in hematopoiesis.
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Affiliation(s)
- M Koekebakker
- Department of Pediatrics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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Miller RA, Ruddle FH. Teratocarcinoma X friend erythroleukemia cell hybrids resemble their pluripotent embryonal carcinoma parent. Dev Biol 1977; 56:157-73. [PMID: 264845 DOI: 10.1016/0012-1606(77)90159-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Lüdtke AH, Ohnesorge FK. Charakterisierung der Cholinesterasen in verschiedenen Geweben der Schleie (Tinca vulgaris) und des Kaninchens. J Comp Physiol A Neuroethol Sens Neural Behav Physiol 1966. [DOI: 10.1007/bf02427712] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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SCHLANT RC, TSAGARIS TJ, ROBERTSON RJ, WINTER TS, EDWARDS FK. The effect of acetylcholine upon arterial saturation. Am Heart J 1962; 64:512-24. [PMID: 14498507 DOI: 10.1016/0002-8703(62)90037-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Holle F. Studien über das Verhalten der Serum-Cholinesteraseaktivität bei der Entzündung und Röntgenbestrahlung. ACTA ACUST UNITED AC 1949. [DOI: 10.1007/bf02056047] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Über die Wirksamkeit der Cholinesterase im intakten Herzmuskel des Warmblüters und ihre Beeinflußbarkeit durch verschiedene Pharmaka, besonders die Narkotica. Naunyn Schmiedebergs Arch Pharmacol 1941. [DOI: 10.1007/bf01861444] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Physiologisch-chemische Untersuchungen am latenten Allergiker als Beitrag zur Frage der allergischen Konstitution. Clin Exp Med 1941. [DOI: 10.1007/bf02611410] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Werle E. Über die Biologische Inaktivierung Körpereigener Kreislaufaktiver Stoffe. ACTA ACUST UNITED AC 1938. [DOI: 10.1007/bf01778641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Verebély T. Zur Klinischen Bedeutung der Acetylcholinabbaufähigkeit des Menschlichen Blutes. ACTA ACUST UNITED AC 1937. [DOI: 10.1007/bf01774621] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Über die Wirkung von parenteral verabreichtem Acetylcholin auf quergestreifte Muskeln, Gelenke und Knochen. Naunyn Schmiedebergs Arch Pharmacol 1937. [DOI: 10.1007/bf01929684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Die blutdrucksenkende Wirkung der Chorda-Lingualisreizung und ihre Beeinflussung durch Atropin. Naunyn Schmiedebergs Arch Pharmacol 1933. [DOI: 10.1007/bf01954468] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Das Auftreten eines azetylcholinartigen Stoffes im Herzvenenblut von Warmblütern bei Reizung der Nervi vagi. Naunyn Schmiedebergs Arch Pharmacol 1933. [DOI: 10.1007/bf01860490] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Gollwitzer-Meier K, Otte ML. Über den Nachweis einer azetylcholinartigen Substanz bei der reflektorischen Gefäßerweiterung. Naunyn Schmiedebergs Arch Pharmacol 1933. [DOI: 10.1007/bf01981243] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Berk L. diastolische Strophanthinwirkung am isolierten Froschherzen nach Vorbehandlung mit parasympathischen Giften. Naunyn Schmiedebergs Arch Pharmacol 1932. [DOI: 10.1007/bf01861317] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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