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Ivanov A, Shamagsumova R, Larina M, Evtugyn G. Electrochemical Acetylcholinesterase Sensors for Anti-Alzheimer's Disease Drug Determination. BIOSENSORS 2024; 14:93. [PMID: 38392012 PMCID: PMC10886970 DOI: 10.3390/bios14020093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 02/02/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024]
Abstract
Neurodegenerative diseases and Alzheimer's disease (AD), as one of the most common causes of dementia, result in progressive losses of cholinergic neurons and a reduction in the presynaptic markers of the cholinergic system. These consequences can be compensated by the inhibition of acetylcholinesterase (AChE) followed by a decrease in the rate of acetylcholine hydrolysis. For this reason, anticholinesterase drugs with reversible inhibition effects are applied for the administration of neurodegenerative diseases. Their overdosage, variation in efficiency and recommendation of an individual daily dose require simple and reliable measurement devices capable of the assessment of the drug concentration in biological fluids and medications. In this review, the performance of electrochemical biosensors utilizing immobilized cholinesterases is considered to show their advantages and drawbacks in the determination of anticholinesterase drugs. In addition, common drugs applied in treating neurodegenerative diseases are briefly characterized. The immobilization of enzymes, nature of the signal recorded and its dependence on the transducer modification are considered and the analytical characteristics of appropriate biosensors are summarized for donepezil, huperzine A, rivastigmine, eserine and galantamine as common anti-dementia drugs. Finally, the prospects for the application of AChE-based biosensors in clinical practice are discussed.
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Affiliation(s)
- Alexey Ivanov
- A.M. Butlerov’ Chemistry Institute, Kazan Federal University, 18 Kremlevskaya Street, 420008 Kazan, Russia; (R.S.); (G.E.)
| | - Rezeda Shamagsumova
- A.M. Butlerov’ Chemistry Institute, Kazan Federal University, 18 Kremlevskaya Street, 420008 Kazan, Russia; (R.S.); (G.E.)
| | - Marina Larina
- Institute of Fundamental Medicine and Biology, Kazan Federal University, 18 Kremlevskaya Street, 420008 Kazan, Russia;
| | - Gennady Evtugyn
- A.M. Butlerov’ Chemistry Institute, Kazan Federal University, 18 Kremlevskaya Street, 420008 Kazan, Russia; (R.S.); (G.E.)
- Analytical Chemistry Department, Chemical Technology Institute, Ural Federal University, 19 Mira Street, 620002 Ekaterinburg, Russia
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Bierly JJ, Peterson BL. Distribution of donepezil in postmortem casework. J Forensic Leg Med 2024; 101:102625. [PMID: 38043240 DOI: 10.1016/j.jflm.2023.102625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/22/2023] [Accepted: 11/24/2023] [Indexed: 12/05/2023]
Abstract
Donepezil is one of the primary treatments options for patients suffering from Alzheimer's Disease. In a review of more than 2200 postmortem donepezil positive blood specimens, 76% of concentrations were higher than the proposed therapeutic range. Means and medians were similar between central blood specimens and peripheral specimens, indicating minimal postmortem redistribution. Postmortem concentrations may not reflect those circulating antemortem. Mean and median postmortem blood concentrations were approximately 3-fold higher than those in antemortem blood specimens. Additionally, in cases where antemortem blood was available for testing, large increases in donepezil concentrations were reported between antemortem and postmortem specimens without documented administration by medical personnel. Elevated blood donepezil concentrations have been reported in multiple postmortem cases where cause of death was unrelated. The blood concentrations reported in cases where donepezil did not contribute to death overlapped with those in suspected drug overdose cases where other drugs may have been present. In 4 out of 5 suspected donepezil overdose cases, blood concentrations greater than 1000 ng/mL were reported, whereas less than 1% of all postmortem blood samples reviewed achieved these concentrations. Blood concentrations greater than 1000 ng/mL should be considered contributory when a drug overdose is suspected. Postmortem donepezil concentrations should be interpreted with caution in the context of a comprehensive case history.
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Wong WF, Ang KP, Sethi G, Looi CY. Recent Advancement of Medical Patch for Transdermal Drug Delivery. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040778. [PMID: 37109736 PMCID: PMC10142343 DOI: 10.3390/medicina59040778] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/31/2023] [Accepted: 04/05/2023] [Indexed: 04/29/2023]
Abstract
Transdermal patches are a non-invasive method of drug administration. It is an adhesive patch designed to deliver a specific dose of medication through the skin and into the bloodstream throughout the body. Transdermal drug delivery has several advantages over other routes of administration, for instance, it is less invasive, patient-friendly, and has the ability to bypass first-pass metabolism and the destructive acidic environment of the stomach that occurs upon the oral ingestion of drugs. For decades, transdermal patches have attracted attention and were used to deliver drugs such as nicotine, fentanyl, nitroglycerin, and clonidine to treat various diseases or conditions. Recently, this method is also being explored as a means of delivering biologics in various applications. Here, we review the existing literatures on the design and usage of medical patches in transdermal drug delivery, with a focus on the recent advances in innovation and technology that led to the emergence of smart, dissolvable/biodegradable, and high-loading/release, as well as 3D-printed patches.
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Affiliation(s)
- Won Fen Wong
- Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Kuan Ping Ang
- Department of Medical Microbiology, University Malaya Medical Center, Kuala Lumpur 59100, Malaysia
| | - Gautam Sethi
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117600, Singapore
| | - Chung Yeng Looi
- School of Biosciences, Faculty of Health & Medical Sciences, Taylor's University, Subang Jaya 47500, Malaysia
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Kiriyama A, Kimura S, Yamashita S. Pharmacokinetic/Pharmacodynamic Models of an Alzheimer's Drug, Donepezil, in Rats. Drug Metab Dispos 2023; 51:329-337. [PMID: 36810198 DOI: 10.1124/dmd.122.001061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 12/01/2022] [Indexed: 12/13/2022] Open
Abstract
To investigate the relationship between the pharmacokinetics (PK) and pharmacodynamics (PD) of donepezil (Don), simultaneous examination of the PK of Don and the change in acetylcholine (ACh) in the cerebral hippocampus was analyzed using microdialysis in rats. Don plasma concentrations reached their maximum at the end of a 30-minute infusion. The maximum plasma concentrations (Cmaxs) of the major active metabolite, 6-O-desmethyl donepezil, were 9.38 and 13.3 ng/ml at 60 minutes after starting infusions at 1.25 and 2.5 mg/kg doses, respectively. The amount of ACh in the brain increased shortly after the start of the infusion and reached the maximum value at about 30 to 45 minutes, then decreased to the baseline with a slight delay from the transition of the Don concentration in plasma at a 2.5 mg/kg dose. However, the 1.25 mg/kg group showed little increase in ACh in the brain. The PK/PD models of Don, which were constructed using a general 2-compartment PK model with/without Michaelis-Menten metabolism and the suppressive effect of conversion of ACh to choline using an ordinary indirect response model, were able to effectively simulate Don's plasma and ACh profiles. The ACh profile in the cerebral hippocampus at a 1.25 mg/kg dose was effectively simulated using both constructed PK/PD models and parameters obtained at a 2.5 mg/kg dose by the PK/PD models and indicated that Don largely had no effect on ACh. When these models were used to simulate at 5 mg/kg, the Don PK were nearly linear, whereas the ACh transition had a different profile to lower doses. SIGNIFICANCE STATEMENT: Efficacy/safety of a drug and its pharmacokinetics (PK) are closely correlated. Therefore, it is important to understand the relationship between the drug's PK and its pharmacodynamics (PD). A quantitative procedure of achieving these goals is the PK/PD analysis. We constructed the PK/PD models of donepezil in rats. These models can predict the acetylcholine-time profiles from the PK. The modeling technique is a potential therapeutic application to predict the effect when changes in the PK are caused by pathological condition and co-administered drugs.
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Affiliation(s)
- Akiko Kiriyama
- Department of Pharmacokinetics, Faculty of Pharmaceutical Sciences, Doshisha Women's College of Liberal Arts, Kyoto, Japan
| | - Shunsuke Kimura
- Department of Pharmacokinetics, Faculty of Pharmaceutical Sciences, Doshisha Women's College of Liberal Arts, Kyoto, Japan
| | - Shugo Yamashita
- Department of Pharmacokinetics, Faculty of Pharmaceutical Sciences, Doshisha Women's College of Liberal Arts, Kyoto, Japan
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Postulating the possible cellular signalling mechanisms of antibody drug conjugates in Alzheimer's disease. Cell Signal 2023; 102:110539. [PMID: 36455831 DOI: 10.1016/j.cellsig.2022.110539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 11/30/2022]
Abstract
Alzheimer's disease (AD) is one of the most common neurodegenerative disorders in the world. Although the basic pathology of the disease is elucidated, it is difficult to restore or prevent the worsening of neurodegeneration and its symptoms. Antibody and small molecule-based approaches have been studied and are in study individually, but a combined approach like conjugation has not been performed to date. The conjugation between antibodies and drugs which are already used for Alzheimer's treatment or developed specifically for this purpose may have better efficacy and dual action in mitigating Alzheimer's disease. A probable mechanism for antibody-drug conjugates in Alzheimer's disease is discussed in the present review.
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Nguyen HD. Combination of Donepezil and Memantine Attenuated Cognitive Impairment Induced by Mixed Endocrine-Disrupting Chemicals: an In Silico Study. Neurotox Res 2022; 40:2072-2088. [PMID: 36367679 DOI: 10.1007/s12640-022-00591-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/06/2022] [Accepted: 10/08/2022] [Indexed: 11/13/2022]
Abstract
Little is known about the effects of endocrine-disrupting chemicals (EDCs) and the combination of memantine and donepezil on the pathogenesis of cognitive impairment. Here, we aimed to identify in silico the molecular mechanisms of the combination of memantine and donepezil that combat cognitive impairment induced by nine common EDCs using GeneMania, AutoDock Vina, Metascape, SwissADME, MIENTURNET, and miRNAsong. We observed that the mixture of memantine and donepezil had therapeutic effects on mixed EDC-induced cognitive impairment via five genes (TNF, ACHE, BAX, IL1B, and CASP3). With ACHE and TNF, donepezil and memantine both had a high docking score, respectively. The predominant connections among five mutual genes were physical interactions (77.6%). The major pathways associated with memantine and donepezil countering cognitive impairment generated by mixed EDCs were discovered to be "AGE-RAGE signaling pathway in diabetic complications," "pro-survival signaling of neuroprotectin D1," and "non-alcoholic fatty liver disease." The miRNAs and transcription factors implicated in memantine and donepezil protecting against mixed EDCs were hsa-miR-128-3p and hsa-miR-34a-5p, NFKB1, NFKB2, IRF8, and E2F4. The sponges' tertiary structure predictions for two major miRNAs were provided. The physicochemical and pharmacokinetic properties of memantine and donepezil highlighted the need for a therapeutic combination of these medications to treat cognitive impairment.
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Affiliation(s)
- Hai Duc Nguyen
- Department of Pharmacy, College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Suncheon, 57922, Republic of Korea.
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Redman RR, Mackenzie H, Dissanayake KN, Eddleston M, Ribchester RR. Donepezil inhibits neuromuscular junctional acetylcholinesterase and enhances synaptic transmission and function in isolated skeletal muscle. Br J Pharmacol 2022; 179:5273-5289. [PMID: 36028305 PMCID: PMC9826304 DOI: 10.1111/bph.15940] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND AND PURPOSE Donepezil, a piperidine inhibitor of acetylcholinesterase (AChE) prescribed for treatment of Alzheimer's disease, has adverse neuromuscular effects in humans, including requirement for higher concentrations of non-depolarising neuromuscular blockers during surgery. Here, we examined the effects of donepezil on synaptic transmission at neuromuscular junctions (NMJs) in isolated nerve-muscle preparations from mice. EXPERIMENTAL APPROACH We measured effects of therapeutic concentrations of donepezil (10 nM to 1 μM) on AChE enzymic activity, muscle force responses to repetitive stimulation, and spontaneous and evoked endplate potentials (EPPs) recorded intracellularly from flexor digitorum brevis muscles from CD01 or C57BlWldS mice. KEY RESULTS Donepezil inhibited muscle AChE with an approximate IC50 of 30 nM. Tetanic stimulation in sub-micromolar concentrations of donepezil prolonged post-tetanic muscle contractions. Preliminary Fluo4-imaging indicated an association of these contractions with an increase and slow decay of intracellular Ca2+ transients at motor endplates. Donepezil prolonged spontaneous miniature EPP (MEPP) decay time constants by about 65% and extended evoked EPP duration almost threefold. The mean frequency of spontaneous MEPPs was unaffected but the incidence of 'giant' MEPPs (gMEPPs), some exceeding 10 mV in amplitude, was increased. Neither mean MEPP amplitude (excluding gMEPPs), mean EPP amplitude, quantal content or synaptic depression during repetitive stimulation were significantly altered by concentrations of donepezil up to 1 μM. CONCLUSION AND IMPLICATIONS Adverse neuromuscular signs associated with donepezil therapy, including relative insensitivity to neuromuscular blockers, are probably due to inhibition of AChE at NMJs, prolonging the action of ACh on postsynaptic nicotinic acetylcholine receptors but without substantively impairing evoked ACh release.
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Affiliation(s)
- Robert R. Redman
- Centre for Discovery Brain SciencesUniversity of EdinburghEdinburghUK
| | - Harry Mackenzie
- Centre for Discovery Brain SciencesUniversity of EdinburghEdinburghUK
| | | | - Michael Eddleston
- Pharmacology, Toxicology and Therapeutics, Centre for Cardiovascular Science, Queen's Medical Research InstituteUniversity of EdinburghEdinburghUK
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Ovejero-Benito MC, Ochoa D, Enrique-Benedito T, del Peso-Casado M, Zubiaur P, Navares M, Román M, Abad-Santos F. Pharmacogenetics of Donepezil and Memantine in Healthy Subjects. J Pers Med 2022; 12:jpm12050788. [PMID: 35629210 PMCID: PMC9145014 DOI: 10.3390/jpm12050788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/08/2022] [Accepted: 05/11/2022] [Indexed: 02/01/2023] Open
Abstract
Donepezil and memantine are the most common drugs used for Alzheimer’s disease. Their low effectiveness could partly be explained by genetic factors. Thus, we aim to identify Single Nucleotide Polymorphisms (SNPs) associated with pharmacokinetics, pharmacodynamics, and the safety of donepezil and memantine. For this regard, 25 volunteers enrolled in a bioequivalence clinical trial were genotyped for 67 SNPs in 21 genes with a ThermoFisher QuantStudio 12K Flex OpenArray. The statistical strategy included a univariate analysis that analyzed the association of these SNPs with pharmacokinetic parameters or the development of adverse drug reactions (ADRs) followed by a Bonferroni-corrected multivariate regression. Statistical analyses were performed with SPSS software v.21 and R commander (version v3.6.3). In the univariate analysis, fourteen and sixteen SNPs showed a significant association with memantine’s and donepezil’s pharmacokinetic parameters, respectively. Rs20417 (PTGS2) was associated with the development of at least one ADR. However, none of these associations reached the significance threshold in the Bonferroni-corrected multivariate analysis. In conclusion, we did not observe any significant association of the SNPs analyzed with memantine and donepezil pharmacokinetics or ADRs. Current evidence on memantine and donepezil pharmacogenetics does not justify their inclusion in pharmacogenetic guidelines.
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Affiliation(s)
- María C. Ovejero-Benito
- Clinical Pharmacology Department, Instituto de Investigación Sanitaria La Princesa (IP), Hospital Universitario de La Princesa, 28006 Madrid, Spain; (D.O.); (T.E.-B.); (M.d.P.-C.); (P.Z.); (M.N.); (M.R.)
- Correspondence: (M.C.O.-B.); (F.A.-S.); Tel.: +34-913724752 (M.C.O.-B.); +34-915202425 (F.A.-S.)
| | - Dolores Ochoa
- Clinical Pharmacology Department, Instituto de Investigación Sanitaria La Princesa (IP), Hospital Universitario de La Princesa, 28006 Madrid, Spain; (D.O.); (T.E.-B.); (M.d.P.-C.); (P.Z.); (M.N.); (M.R.)
- Faculty of Medicine, Universidad Autónoma de Madrid (UAM), 28006 Madrid, Spain
- Unidad de Investigación Clínica y Ensayos Clínicos (UICEC), Instituto de Investigación Sanitaria La Princesa (IP), Hospital Universitario de La Princesa, Plataforma SCReN (Spanish Clinical Research Network), 28006 Madrid, Spain
| | - Teresa Enrique-Benedito
- Clinical Pharmacology Department, Instituto de Investigación Sanitaria La Princesa (IP), Hospital Universitario de La Princesa, 28006 Madrid, Spain; (D.O.); (T.E.-B.); (M.d.P.-C.); (P.Z.); (M.N.); (M.R.)
| | - Miriam del Peso-Casado
- Clinical Pharmacology Department, Instituto de Investigación Sanitaria La Princesa (IP), Hospital Universitario de La Princesa, 28006 Madrid, Spain; (D.O.); (T.E.-B.); (M.d.P.-C.); (P.Z.); (M.N.); (M.R.)
| | - Pablo Zubiaur
- Clinical Pharmacology Department, Instituto de Investigación Sanitaria La Princesa (IP), Hospital Universitario de La Princesa, 28006 Madrid, Spain; (D.O.); (T.E.-B.); (M.d.P.-C.); (P.Z.); (M.N.); (M.R.)
- Unidad de Investigación Clínica y Ensayos Clínicos (UICEC), Instituto de Investigación Sanitaria La Princesa (IP), Hospital Universitario de La Princesa, Plataforma SCReN (Spanish Clinical Research Network), 28006 Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Marcos Navares
- Clinical Pharmacology Department, Instituto de Investigación Sanitaria La Princesa (IP), Hospital Universitario de La Princesa, 28006 Madrid, Spain; (D.O.); (T.E.-B.); (M.d.P.-C.); (P.Z.); (M.N.); (M.R.)
| | - Manuel Román
- Clinical Pharmacology Department, Instituto de Investigación Sanitaria La Princesa (IP), Hospital Universitario de La Princesa, 28006 Madrid, Spain; (D.O.); (T.E.-B.); (M.d.P.-C.); (P.Z.); (M.N.); (M.R.)
- Unidad de Investigación Clínica y Ensayos Clínicos (UICEC), Instituto de Investigación Sanitaria La Princesa (IP), Hospital Universitario de La Princesa, Plataforma SCReN (Spanish Clinical Research Network), 28006 Madrid, Spain
| | - Francisco Abad-Santos
- Clinical Pharmacology Department, Instituto de Investigación Sanitaria La Princesa (IP), Hospital Universitario de La Princesa, 28006 Madrid, Spain; (D.O.); (T.E.-B.); (M.d.P.-C.); (P.Z.); (M.N.); (M.R.)
- Faculty of Medicine, Universidad Autónoma de Madrid (UAM), 28006 Madrid, Spain
- Unidad de Investigación Clínica y Ensayos Clínicos (UICEC), Instituto de Investigación Sanitaria La Princesa (IP), Hospital Universitario de La Princesa, Plataforma SCReN (Spanish Clinical Research Network), 28006 Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto Teófilo Hernando, 28029 Madrid, Spain
- Correspondence: (M.C.O.-B.); (F.A.-S.); Tel.: +34-913724752 (M.C.O.-B.); +34-915202425 (F.A.-S.)
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Amat-ur-Rasool H, Ahmed M, Hasnain S, Ahmed A, Carter WG. In Silico Design of Dual-Binding Site Anti-Cholinesterase Phytochemical Heterodimers as Treatment Options for Alzheimer’s Disease. Curr Issues Mol Biol 2021; 44:152-175. [PMID: 35723391 PMCID: PMC8929005 DOI: 10.3390/cimb44010012] [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: 11/29/2021] [Revised: 12/24/2021] [Accepted: 12/27/2021] [Indexed: 12/14/2022] Open
Abstract
The number of patients with neurodegenerative diseases, particularly Alzheimer’s disease (AD), continues to grow yearly. Cholinesterase inhibitors (ChEIs) represent the first-line symptomatic drug treatment for mild-to-moderate AD; however, there is an unmet need to produce ChEIs with improved efficacy and reduced side effects. Herein, phytochemicals with reported anti-acetylcholinesterase (AChE) activity were ranked in silico for their anti-AChE potential. Ligands with a similar or higher binding affinity to AChE than galantamine were then selected for the design of novel dual-binding site heterodimeric drugs. In silico molecular docking of heterodimers with the target enzymes, AChE and butyrylcholinesterase (BuChE), were performed, and anti-cholinesterase binding affinities were compared with donepezil. Drug-likeliness properties and toxicity of the heterodimers were assessed using the SwissADME and ProTox-II webservers. Nine phytochemicals displayed similar or higher binding affinities to AChE than galantamine: sanguinarine > huperzine A > chelerythrine > yohimbine > berberine > berberastine > naringenin > akuammicine > carvone. Eleven heterodimeric ligands were designed with phytochemicals separated by four- or five-carbon alkyl-linkers. All heterodimers were theoretically potent AChE and BuChE dual-binding site inhibitors, with the highest affinity achieved with huperzine-4C-naringenin, which displayed 34% and 26% improved affinity to AChE and BuChE, respectively, then the potent ChEI drug, donepezil. Computational pharmacokinetic and pharmacodynamic screening suggested that phytochemical heterodimers would display useful gastrointestinal absorption and with relatively low predicted toxicity. Collectively, the present study suggests that phytochemicals could be garnered for the provision of novel ChEIs with enhanced drug efficacy and low toxicity.
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Affiliation(s)
- Hafsa Amat-ur-Rasool
- School of Medicine, Royal Derby Hospital Centre, University of Nottingham, Derby DE22 3DT, UK;
- Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore 54590, Pakistan; (M.A.); (S.H.)
| | - Mehboob Ahmed
- Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore 54590, Pakistan; (M.A.); (S.H.)
| | - Shahida Hasnain
- Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore 54590, Pakistan; (M.A.); (S.H.)
| | - Abrar Ahmed
- Faculty of Pharmacy, Punjab University College of Pharmacy, University of the Punjab, Lahore 54590, Pakistan;
| | - Wayne Grant Carter
- School of Medicine, Royal Derby Hospital Centre, University of Nottingham, Derby DE22 3DT, UK;
- Correspondence: ; Tel.: +44-(0)-1332-724738
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Choi GW, Lee S, Kang DW, Kim JH, Kim JH, Cho HY. Long-acting injectable donepezil microspheres: Formulation development and evaluation. J Control Release 2021; 340:72-86. [PMID: 34715262 DOI: 10.1016/j.jconrel.2021.10.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 10/17/2021] [Indexed: 11/15/2022]
Abstract
Novel formulations of donepezil (DNP)-loaded microspheres based on a bio-degradable polymer of poly(lactic-co-glycolic acid) (PLGA) with a one-month duration of effect were developed, aimed at reducing dosing frequency and adverse effects and improving patient adherence. The spherical and monodispersed DNP-loaded microspheres were precisely fabricated by the Inventage Lab Precision Particle Fabrication method (IVL-PPFM®) based on micro-electromechanical systems (MEMS) and microfluidic technology. The types of polymers and end-groups, the drug/polymer ratio (DPR), and the routes of administration for DNP were studied to ensure an effective concentration and desired duration. Laser-light particle size analysis and scanning electron microscopy were used to characterization. Also, non-clinical animal models of beagle dogs are used to optimize DNP formulations and evaluate their pharmacokinetic properties. The PK results showed that the DPR was a critical factor in determining the exposure level and duration of DNR release. Furthermore, the lactide ratio, which varied depending upon the type of polymer, determined the hydrophobic interaction and was also an important factor affecting the desired DNP release. Since DNP shows a large inter-species variation between dogs and humans, PK modeling and simulation of the reference drug (i.e., Aricept®) and DNP-loaded microspheres were used for formulation development to overcome and interpret these variations. In addition, the developed PK model was extrapolated to humans using the estimated PK parameter and published clinical pharmacology data for DNP. The predicted PK profile of the DNP-loaded microsphere in humans showed that the formulation with PLGA 7525A and the DPR of 1/9 could maintain drug concentration for a month and could control initial burst release. The data obtained from the study could be used as scientific evidence for decision-making in future formulation development.
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Affiliation(s)
- Go-Wun Choi
- College of Pharmacy, CHA University, 335 Pangyo-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 13488, Republic of Korea
| | - Sangno Lee
- Headquarter, Inventage Lab, Inc., 12, Yanghyeon-ro 405beon-gil, Jungwon-gu, Seongnam-si, Gyeonggi-do 13438, Republic of Korea
| | - Dong Wook Kang
- College of Pharmacy, CHA University, 335 Pangyo-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 13488, Republic of Korea
| | - Ju Hee Kim
- Headquarter, Inventage Lab, Inc., 12, Yanghyeon-ro 405beon-gil, Jungwon-gu, Seongnam-si, Gyeonggi-do 13438, Republic of Korea
| | - Ju Hee Kim
- College of Pharmacy, CHA University, 335 Pangyo-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 13488, Republic of Korea
| | - Hea-Young Cho
- College of Pharmacy, CHA University, 335 Pangyo-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 13488, Republic of Korea.
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Vora LK, Moffatt K, Tekko IA, Paredes AJ, Volpe-Zanutto F, Mishra D, Peng K, Raj Singh Thakur R, Donnelly RF. Microneedle array systems for long-acting drug delivery. Eur J Pharm Biopharm 2021; 159:44-76. [DOI: 10.1016/j.ejpb.2020.12.006] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/25/2020] [Accepted: 12/08/2020] [Indexed: 12/31/2022]
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Levi DM, Li RW, Silver MA, Chung STL. Sequential perceptual learning of letter identification and "uncrowding" in normal peripheral vision: Effects of task, training order, and cholinergic enhancement. J Vis 2021; 20:24. [PMID: 32347910 PMCID: PMC7405719 DOI: 10.1167/jov.20.4.24] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Human adults with normal vision are capable of improving performance on visual tasks through repeated practice. Previous work has shown that enhancing synaptic levels of acetylcholine (ACh) in healthy human adults with donepezil (trade name: Aricept) can increase the magnitude and specificity of perceptual learning (PL) for motion direction discrimination in the perifovea. In the current study, we ask whether increasing the synaptic levels of ACh in healthy human adults with donepezil boosts learning of low-contrast isolated letter identification and high-contrast flanked letter identification in normal peripheral vision. Two groups of observers performed sequential training over multiple days while ingesting donepezil. One group trained on isolated low-contrast letters in Phase 1 and crowded high-contrast letters in Phase 2, and the other group performed the reverse sequence, thereby enabling us to differentiate possible effects of drug and training order on PL of letter identification. All testing and training were performed monocularly in peripheral vision, at an eccentricity of 10 degrees along the lower vertical meridian. Our experimental design allowed us to evaluate the effects of sequential training and to ask whether increasing cholinergic signaling boosted learning and/or transfer of low-contrast isolated letter identification and high-contrast flanked letter identification in normal peripheral vision. We found that both groups improved on each of the two tasks. However, our results revealed an effect of training task order on flanked letter identification: Observers who trained on isolated targets first showed rapid early improvement in flanked letter identification but little to no additional improvement after 30 training blocks, while observers who first trained with flanked letters improved gradually on flanked letter identification over the entire 100-block course of training. In addition, we found no effect of donepezil on PL of either isolated or flanked letter identification. In other words, donepezil neither boosted nor blocked learning to identify isolated low-contrast letters or learning to uncrowd in normal peripheral vision.
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Gupta M, Ojha M, Yadav D, Pant S, Yadav R. Novel Benzylated (Pyrrolidin-2-one)/(Imidazolidin-2-one) Derivatives as Potential Anti-Alzheimer's Agents: Synthesis and Pharmacological Investigations. ACS Chem Neurosci 2020; 11:2849-2860. [PMID: 32816447 DOI: 10.1021/acschemneuro.0c00403] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
A series of N-benzylated (pyrrolidin-2-one)/(imidazolidin-2-one) derivatives were synthesized and evaluated for anti-Alzheimer's activity. The analogs were designed and synthesized on the basis of lead compound donepezil, which is currently prescribed as a major drug for the management of mild to severe Alzheimer's disease. Considering the structure activity relationship (SAR) of the lead compound, we first replaced the 5,6-dimethoxy-1-indanone moiety with N-benzylated (pyrrolidin-2-one)/(imidazolidin-2-one) (head) without depriving the key functionality interactions like carbonyl and dimethoxyphenyl and second substituted the spacer linkage (tail) in donepezil. The newly synthesized compounds were characterized by structural conformity and purity using various techniques. The compounds were then subjected to in vivo (behavioral studies) and in vitro (biochemical assays) evaluation using appropriate animal models against the standard drug. Compounds 3-(4-(4-fluorobenzoyl)-piperidin-1-yl)-1-(4-methoxybenzyl)-pyrrolidin-2-one (10b) and 1-(3,4-dimethoxybenzyl)-3-((1-(2-(trifluoromethyl)-benzyl)-piperidin-4-yl)-methyl)-imidazolidin-2-one (18c) displayed an excellent anti-Alzheimer's profile, while the rest of the compounds showed satisfactory results in comparison to donepezil.
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Affiliation(s)
- Mohan Gupta
- Department of Pharmacy, Banasthali Vidyapith, Banasthali, Rajasthan 304022, India
| | - Madhwi Ojha
- Department of Pharmacy, Banasthali Vidyapith, Banasthali, Rajasthan 304022, India
| | - Divya Yadav
- Department of Pharmacy, Banasthali Vidyapith, Banasthali, Rajasthan 304022, India
| | - Swati Pant
- Department of Pharmacy, Banasthali Vidyapith, Banasthali, Rajasthan 304022, India
| | - Rakesh Yadav
- Department of Pharmacy, Banasthali Vidyapith, Banasthali, Rajasthan 304022, India
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14
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Ortner M, Stange M, Schneider H, Schröder C, Buerger K, Müller C, Müller-Sarnowski F, Diehl-Schmid J, Förstl H, Grimmer T, Steimer W. Therapeutic Drug Monitoring of Rivastigmine and Donepezil Under Consideration of CYP2D6 Genotype-Dependent Metabolism of Donepezil. Drug Des Devel Ther 2020; 14:3251-3262. [PMID: 32848364 PMCID: PMC7431170 DOI: 10.2147/dddt.s247259] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 06/26/2020] [Indexed: 11/28/2022] Open
Abstract
Background The efficacy of acetylcholinesterase inhibitors (AChE-I) might depend on blood concentration. While rivastigmine metabolism is independent of the cytochrome P450 system, its isoenzymes, especially CYP2D6, metabolize donepezil. CYP2D6 polymorphisms can cause altered enzyme activity resulting in lower or higher than expected drug concentrations of donepezil. Objective We investigated correlations between clinical efficacy and serum concentrations of rivastigmine and donepezil under special consideration of CYP2D6 genotype or gene dose–dependent metabolism of donepezil. Methods Serum concentrations of donepezil and rivastigmine were measured by liquid chromatography – tandem mass spectrometry (LC-MS/MS). Real-time quantitative polymerase chain reaction (PCR) and allele-specific PCR were performed to assess CYP2D6 genotype and gene dose. Results Patients treated with rivastigmine (n=28) or donepezil (n=48) were included in the study. Both gene dose and metabolism type significantly predicted the level of donepezil serum concentration (p=0.019 and p=0.013, respectively). In the rivastigmine group, changes of the word list delayed recall subtest before treatment and under stable medication were significantly associated with rivastigmine serum levels (β=0.465; p=0.018). Drug serum concentrations were outside the recommended range in a substantial percentage of participants, which might have contributed to poor correlations between changes in cognitive measures and drug concentrations. Donepezil serum concentrations significantly depended on CYP2D6 gene dose. Conclusion Testing AChE-I serum concentration should be considered in patients without clinical response to treatment or those with severe side effects. Patients with donepezil drug levels outside the recommended range might additionally profit from CYP2D6 genotyping or treatment with an AChE-I independent of CYP metabolism.
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Affiliation(s)
- Marion Ortner
- Department of Psychiatry and Psychotherapy, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Marion Stange
- Department of Psychiatry and Psychotherapy, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Heike Schneider
- Department of Psychiatry and Psychotherapy, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Charlotte Schröder
- Institute for Clinical Chemistry and Pathobiochemistry, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Katharina Buerger
- Institute for Stroke and Dementia Research (ISD), University of Munich, School of Medicine, Klinikum der Universität München, Munich, Germany
| | - Claudia Müller
- Institute for Stroke and Dementia Research (ISD), University of Munich, School of Medicine, Klinikum der Universität München, Munich, Germany
| | - Felix Müller-Sarnowski
- Department of Psychiatry and Psychotherapy, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Janine Diehl-Schmid
- Department of Psychiatry and Psychotherapy, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Hans Förstl
- Department of Psychiatry and Psychotherapy, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Werner Steimer
- Institute for Clinical Chemistry and Pathobiochemistry, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany
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15
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Stuart S, Morris R, Giritharan A, Quinn J, Nutt JG, Mancini M. Prefrontal Cortex Activity and Gait in Parkinson's Disease With Cholinergic and Dopaminergic Therapy. Mov Disord 2020; 35:2019-2027. [PMID: 32830901 DOI: 10.1002/mds.28214] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/10/2020] [Accepted: 06/15/2020] [Indexed: 12/25/2022] Open
Abstract
Degradation of striatal dopamine in Parkinson's disease (PD) may initially be supplemented by increased cognitive control mediated by cholinergic mechanisms. Shift to cognitive control of walking can be quantified by prefrontal cortex activation. Levodopa improves certain aspects of gait and worsens others, and cholinergic augmentation influence on gait and prefrontal cortex activity remains unclear. This study examined dopaminergic and cholinergic influence on gait and prefrontal cortex activity while walking in PD. A single-site, randomized, double-blind crossover trial examined effects of levodopa and donepezil in PD. Twenty PD participants were randomized, and 19 completed the trial. Participants were randomized to either levodopa + donepezil (5 mg) or levodopa + placebo treatments, with 2 weeks with treatment and a 2-week washout. The primary outcome was change in prefrontal cortex activity while walking, and secondary outcomes were change in gait and dual-task performance and attention. Levodopa decreased prefrontal cortex activity compared with off medication (effect size, -0.51), whereas the addition of donepezil reversed this decrease. Gait speed and stride length under single- and dual-task conditions improved with combined donepezil and levodopa compared with off medication (effect size, 1 for gait speed and 0.75 for stride length). Dual-task reaction time was quicker with levodopa compared with off medication (effect size, -0.87), and accuracy improved with combined donepezil and levodopa (effect size, 0.47). Cholinergic therapy, specifically donepezil 5 mg/day for 2 weeks, can alter prefrontal cortex activity when walking and improve secondary cognitive task accuracy and gait in PD. Further studies will investigate whether higher prefrontal cortex activity while walking is associated with gait changes. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Samuel Stuart
- Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA.,Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - Rosie Morris
- Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA.,Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - Andrew Giritharan
- Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA
| | - Joseph Quinn
- Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA
| | - John G Nutt
- Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA
| | - Martina Mancini
- Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA
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16
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Vaucher E, Laliberté G, Higgins MC, Maheux M, Jolicoeur P, Chamoun M. Cholinergic potentiation of visual perception and vision restoration in rodents and humans. Restor Neurol Neurosci 2020; 37:553-569. [PMID: 31839615 DOI: 10.3233/rnn-190947] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND The cholinergic system is a potent neuromodulator system that plays a critical role in cortical plasticity, attention, and learning. Recently, it was found that boosting this system during perceptual learning robustly enhances sensory perception in rodents. In particular, pairing cholinergic activation with visual stimulation increases neuronal responses, cue detection ability, and long-term facilitation in the primary visual cortex. The mechanisms of cholinergic enhancement are closely linked to attentional processes, long-term potentiation, and modulation of the excitatory/inhibitory balance. Some studies currently examine this effect in humans. OBJECTIVE The present article reviews the research from our laboratory, examining whether potentiating the central cholinergic system could help visual perception and restoration. METHODS Electrophysiological or pharmacological enhancement of the cholinergic system are administered during a visual training. Electrophysiological responses and perceptual learning performance are investigated before and after the training in rats and humans. This approach's ability to restore visual capacities following a visual deficit induced by a partial optic nerve crush is also investigated in rats. RESULTS The coupling of visual training to cholinergic stimulation improved visual discrimination and visual acuity in rats, and improved residual vision after a deficit. These changes were due to muscarinic and nicotinic transmissions and were associated with a functional improvement of evoked potentials. In humans, potentiation of cholinergic transmission with 5 mg of donepezil showed improved learning and ocular dominance plasticity, although this treatment was ineffective in augmenting the perceptual threshold and electroencephalography. CONCLUSIONS Potential therapeutic outcomes ought to facilitate vision restoration using commercially available cholinergic agents combined with visual stimulation in order to prevent irreversible vision loss in patients. This approach has the potential to help a large population of visually impaired individuals.
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Affiliation(s)
- Elvire Vaucher
- Laboratoire de Neurobiologie de la Cognition Visuelle, École d'optométrie, Université de Montréal, Montréal, Québec, Canada.,Centre de recherche en neuropsychologie et cognition (CERNEC), Montréal, Québec, Canada
| | - Guillaume Laliberté
- Laboratoire de Neurobiologie de la Cognition Visuelle, École d'optométrie, Université de Montréal, Montréal, Québec, Canada
| | - Marie-Charlotte Higgins
- Laboratoire de Neurobiologie de la Cognition Visuelle, École d'optométrie, Université de Montréal, Montréal, Québec, Canada
| | - Manon Maheux
- Centre de recherche en neuropsychologie et cognition (CERNEC), Montréal, Québec, Canada.,Département de Psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Pierre Jolicoeur
- Centre de recherche en neuropsychologie et cognition (CERNEC), Montréal, Québec, Canada.,Département de Psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Mira Chamoun
- Laboratoire de Neurobiologie de la Cognition Visuelle, École d'optométrie, Université de Montréal, Montréal, Québec, Canada
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17
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Byrne KN, McDevitt EA, Sheremata SL, Peters MW, Mednick SC, Silver MA. Transient cholinergic enhancement does not significantly affect either the magnitude or selectivity of perceptual learning of visual texture discrimination. J Vis 2020; 20:5. [PMID: 32511666 PMCID: PMC7416900 DOI: 10.1167/jov.20.6.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Perceptual learning (PL), often characterized by improvements in perceptual performance with training that are specific to the stimulus conditions used during training, exemplifies experience-dependent cortical plasticity. An improved understanding of how neuromodulatory systems shape PL promises to provide new insights into the mechanisms of plasticity, and by extension how PL can be generated and applied most efficiently. Previous studies have reported enhanced PL in human subjects following administration of drugs that increase signaling through acetylcholine (ACh) receptors, and physiological evidence indicates that ACh sharpens neuronal selectivity, suggesting that this neuromodulator supports PL and its stimulus specificity. Here we explored the effects of enhancing endogenous cholinergic signaling during PL of a visual texture discrimination task. We found that training on this task in the lower visual field yielded significant behavioral improvement at the trained location. However, a single dose of the cholinesterase inhibitor donepezil, administered before training, did not significantly impact either the magnitude or the location specificity of texture discrimination learning compared with placebo. We discuss potential explanations for discrepant findings in the literature regarding the role of ACh in visual PL, including possible differences in plasticity mechanisms in the dorsal and ventral cortical processing streams.
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18
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Di Nardo G, Viscogliosi F, Esposito F, Stanghellini V, Villa MP, Parisi P, Morlando A, Caló G, De Giorgio R. Pyridostigmine in Pediatric Intestinal Pseudo-obstruction: Case Report of a 2-year Old Girl and Literature Review. J Neurogastroenterol Motil 2019; 25:508-514. [PMID: 31587541 PMCID: PMC6786444 DOI: 10.5056/jnm19078] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 06/04/2019] [Accepted: 07/20/2019] [Indexed: 12/20/2022] Open
Abstract
Pediatric chronic intestinal pseudo-obstruction is a rare disorder characterized by a severe impairment of gastrointestinal motility leading to intestinal obstruction symptoms in the absence of mechanical causes. The diagnosis is usually clinical and diagnostic work is usually aimed to rule out mechanical obstruction and to identify any underlying diseases. Treatment is challenging and requires a multidisciplinary effort. In this manuscript we describe the youngest child successfully treated with the orally administrable, long-acting, reversible anti-cholinesterase drug, pyridostigmine. Like other drugs belonging to cholinesterase inhibitors, pyridostigmine enhances gut motility by increasing acetylcholine availability in the enteric nervous system and neuro-muscular junctions. Based on the direct evidence from the reported case, we reviewed the current literature on the use of pyridostigmine in severe pediatric dysmotility focusing on intestinal pseudo-obstruction. The overall data emerged from the few published studies suggest that pyridostigmine is an effective and usually well tolerated therapeutic options for patients with intestinal pseudo-obstruction. More specifically, the main results obtained by pyridostigmine included marked reduction of abdominal distension, reduced need of parenteral nutrition, and improvement of oral feeding. The present case and review on pyridostigmine pave the way for eagerly awaited future randomized controlled studies testing the efficacy of cholinesterase inhibitors in pediatric severe gut dysmotility.
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Affiliation(s)
- Giovanni Di Nardo
- NESMOS Department, School of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Federica Viscogliosi
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II," Naples, Italy
| | | | - Vincenzo Stanghellini
- Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, University of Bologna, Italy
| | - Maria Pia Villa
- NESMOS Department, School of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Pasquale Parisi
- NESMOS Department, School of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Alessia Morlando
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II," Naples, Italy
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19
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Yiannopoulou KG, Anastasiou AI, Kyrozis A, Anastasiou IP. Donepezil Treatment for Alzheimer's Disease in Chronic Dialysis Patients. Case Rep Nephrol Dial 2019; 9:126-136. [PMID: 31616673 PMCID: PMC6787415 DOI: 10.1159/000502682] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 08/11/2019] [Indexed: 12/19/2022] Open
Abstract
Donepezil is one of the cholinesterase inhibitors that are indicated for the treatment of mild to moderate Alzheimer's disease (AD). Pharmacokinetic analysis has shown that donepezil is primarily eliminated by renal excretion rather than biliary excretion in humans. Therefore, patients with impaired renal function are at high risk of toxicity caused by accumulation of this drug. It is also well known that dialysis patients have very often cholinergic disorders. On the other hand, with the increasing number of long-term chronic dialysis patients, the prevalence of cognitive disorders is increasing in elderly dialysis patients. Because of the above-mentioned special risks of these patients, acetylcholinesterase inhibitors, such as donepezil, are avoided to be prescribed for them. We studied 5 cases of chronic hemodialysis outpatients (3 men [70, 72, and 86 years old] and 2 women [65 and 71 years old]) who were diagnosed as having moderate AD. We administered donepezil at 2.5 mg/day orally to the patients. After 1 month's treatment, their behavioral symptoms were improved, without them having any adverse events. We enhanced the dose to 5 mg/day without the patients experiencing any episodes of drug toxicity. After 3 months of treatment with the higher dose, their cognitive and executive functions were slightly improved and their behavioral disorders were remarkably milder, without them experiencing any episodes of drug toxicity. The patients' condition remained stable for 6 months after the initial administration of the drug. All of them were followed for the 10 following years, showing a mild cognitive decline per year for the first 5 years and more severe decline for the remaining years of the follow-up. Our cases indicate that donepezil treatment under prudent use may be well tolerated and have a beneficial impact on chronic hemodialysis patients with AD.
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Affiliation(s)
| | | | - Andreas Kyrozis
- First Department of Neurology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis P Anastasiou
- First Urology Department, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece
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20
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Urai AE, de Gee JW, Tsetsos K, Donner TH. Choice history biases subsequent evidence accumulation. eLife 2019; 8:e46331. [PMID: 31264959 PMCID: PMC6606080 DOI: 10.7554/elife.46331] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 06/11/2019] [Indexed: 12/23/2022] Open
Abstract
Perceptual choices depend not only on the current sensory input but also on the behavioral context, such as the history of one's own choices. Yet, it remains unknown how such history signals shape the dynamics of later decision formation. In models of decision formation, it is commonly assumed that choice history shifts the starting point of accumulation toward the bound reflecting the previous choice. We here present results that challenge this idea. We fit bounded-accumulation decision models to human perceptual choice data, and estimated bias parameters that depended on observers' previous choices. Across multiple task protocols and sensory modalities, individual history biases in overt behavior were consistently explained by a history-dependent change in the evidence accumulation, rather than in its starting point. Choice history signals thus seem to bias the interpretation of current sensory input, akin to shifting endogenous attention toward (or away from) the previously selected interpretation.
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Affiliation(s)
- Anne E Urai
- Department of Neurophysiology and PathophysiologyUniversity Medical Center Hamburg-EppendorfHamburgGermany
- Department of PsychologyUniversity of AmsterdamAmsterdamNetherlands
| | - Jan Willem de Gee
- Department of Neurophysiology and PathophysiologyUniversity Medical Center Hamburg-EppendorfHamburgGermany
- Department of PsychologyUniversity of AmsterdamAmsterdamNetherlands
| | - Konstantinos Tsetsos
- Department of Neurophysiology and PathophysiologyUniversity Medical Center Hamburg-EppendorfHamburgGermany
| | - Tobias H Donner
- Department of Neurophysiology and PathophysiologyUniversity Medical Center Hamburg-EppendorfHamburgGermany
- Department of PsychologyUniversity of AmsterdamAmsterdamNetherlands
- Amsterdam Brain and CognitionUniversity of AmsterdamAmsterdamNetherlands
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21
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Mohamed FA, Khashaba PY, Shahin RY, El-Wekil MM. Tunable ternary nanocomposite prepared by electrodeposition for biosensing of centrally acting reversible acetyl cholinesterase inhibitor donepezil hydrochloride in real samples. Colloids Surf A Physicochem Eng Asp 2019. [DOI: 10.1016/j.colsurfa.2019.01.033] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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Moodie LWK, Sepčić K, Turk T, FrangeŽ R, Svenson J. Natural cholinesterase inhibitors from marine organisms. Nat Prod Rep 2019; 36:1053-1092. [PMID: 30924818 DOI: 10.1039/c9np00010k] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Covering: Published between 1974 up to 2018Inhibition of cholinesterases is a common approach for the management of several disease states. Most notably, cholinesterase inhibitors are used to alleviate the symptoms of neurological disorders like dementia and Alzheimer's disease and treat myasthenia gravis and glaucoma. Historically, most drugs of natural origin have been isolated from terrestrial sources and inhibitors of cholinesterases are no exception. However, the last 50 years have seen a rise in the quantity of marine natural products with close to 25 000 reported in the scientific literature. A number of marine natural products with potent cholinesterase inhibitory properties have also been reported; isolated from a variety of marine sources from algae to ascidians. Representing a diverse range of structural classes, these compounds provide inspirational leads that could aid the development of therapeutics. The current paper aims to, for the first time, comprehensively summarize the literature pertaining to cholinesterase inhibitors derived from marine sources, including the first papers published in 1974 up to 2018. The review does not report bioactive extracts, only isolated compounds, and a specific focus lies on compounds with reported dose-response data. In vivo and mechanistic data is included for compounds where this is reported. In total 185 marine cholinesterase inhibitors and selected analogs have been identified and reported and some of the compounds display inhibitory activities comparable or superior to cholinesterase inhibitors in clinical use.
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Affiliation(s)
- Lindon W K Moodie
- Department of Chemistry, University of Umeå, Umeå, SE-901 87, Sweden
| | - Kristina Sepčić
- Department of Biology, Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Tom Turk
- Department of Biology, Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Robert FrangeŽ
- Institute of Preclinical Sciences, Veterinary Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Johan Svenson
- Department of Chemistry and Materials, RISE Research Institutes of Sweden, Box 857, SE-501 15 Borås, Sweden.
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23
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Ahmad J, Hasan MJ, Anam AM, Barua DK. Donepezil: an unusual therapy for acute diphenhydramine overdose. BMJ Case Rep 2019; 12:12/3/e226836. [PMID: 30898954 DOI: 10.1136/bcr-2018-226836] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
An elderly man presented with the history of diphenhydramine hydrochloride overdose as a suicidal attempt. At presentation, he was in an acute confusional state with several anticholinergic features and had to be managed in intensive care unit. As an antidote for diphenhydramine hydrochloride, donepezil was used instead of physostigmine due to the unavailability of physostigmine in Bangladesh. The patient improved within the next 24 hours; his level of consciousness improved and the anticholinergic features regressed.
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Affiliation(s)
- Jamia Ahmad
- Intensive Care Unit, Square Hospitals Ltd., Dhaka, Bangladesh
| | - Md Jahidul Hasan
- Department of Pharmacy, Square Hospitals Ltd., Dhaka, Bangladesh
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24
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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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Liang J, Li J, Jia R, Wang Y, Wu R, Zhang H, Hang L, Xu Y. Identification of the optimal cognitive drugs among Alzheimer's disease: a Bayesian meta-analytic review. Clin Interv Aging 2018; 13:2061-2073. [PMID: 30425461 PMCID: PMC6201988 DOI: 10.2147/cia.s184968] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
PURPOSE The increasing prevalence of Alzheimer's disease (AD) demands more effective drugs, which are still unclear. The aim of this study is to compare the effectiveness of six drugs, such as donepezil, rivastigmine, galantamine, memantine, huperzine-A, and tacrine, in senior AD patients and identify the most effective one to improve patients' cognitive function. METHODS A system of search strategies was used to identify relevant studies including randomized controlled trials and clinical controlled trials evaluating the efficacy of six drugs in patients with AD. We updated relevant studies that were published before March 2018 as full-text articles. Using Bayesian network meta-analysis (NMA), we ranked cognitive ability objectively based on Mini-Mental State Examination (MMSE). Pairwise and NMAs were sequentially performed for the efficacy of drugs compared to each drug or control group through the trials included. RESULTS Among the 35 trials included, no obvious heterogeneity (I 2=0.0%, P=0.583) was revealed according to the pooled data for cognition in NMA and the mean difference (MD) of memantine (MD=1.7, 95% CI: 0.73, 2.8) showed that the memantine was significantly efficacious in the treatment group in terms of MMSE. Followed by galantamine, huperzine-A, rivastigmine, tacrine, and donepezil. CONCLUSION As the first NMA comparing the major drugs in market for AD, our study suggests that memantine might have a more significant benefit on cognition than other five drugs available.
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Affiliation(s)
- Jinghong Liang
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China,
| | - Jiayu Li
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China,
| | - Ruixia Jia
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China,
| | - Yingquan Wang
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China,
| | - Rongkun Wu
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China,
| | - Hongbo Zhang
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China,
| | - Lei Hang
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China,
| | - Yong Xu
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China,
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Nachlinger RJ, Kauschke V, Trinkaus K, Khassawna TE, Heiss C, Lips KS. Application of donepezil increased collagen 1 expression in mesenchymal stroma cells of an ovine osteoporosis model. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2018; 18:354-365. [PMID: 30179213 PMCID: PMC6146185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Donepezil inhibits the acetylcholine degradation molecule acetylcholinesterase (AChE). Clinical studies reported that Alzheimer's disease (AD) patients with hip fractures had improved bone quality and better fracture healing if they were treated with AD medication donepezil. We asked whether mesenchymal stroma cells (MSC) from an osteoporosis sheep model treated with donepezil increased their proliferation rate and mRNA expression. METHODS Sheep were divided into 4 groups: a) untreated control group, b) sheep with bilateral ovariectomy (OVX), c) sheep with OVX and malnutrition, and d) sheep with OVX, malnutrition, and application of corticosteroid. After 8 months MSC were isolated of iliac crest biopsy, treated with donepezil, and AChE activity, proliferation rate, and mRNA expression were analyzed. RESULTS Application of donepezil resulted in a significant decrease of AChE activity. Inhibition of AChE did not lead to a significant increase in proliferation. Expression of the osteogenic marker osteocalcin was not regulated by donepezil while the mRNA concentration of collagen was increased. CONCLUSION AChE inhibition via donepezil resulted in an increased synthesis of osteoid which consists mainly of collagen. Thus, we suppose that increased acetylcholine levels through AChE inhibition do not support MSC proliferation but osteogenic activity probably combined with osteogenic differentiation.
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Affiliation(s)
| | - Vivien Kauschke
- Experimental Trauma Surgery, Justus-Liebig-University Giessen, Germany
| | - Katja Trinkaus
- Experimental Trauma Surgery, Justus-Liebig-University Giessen, Germany
| | | | - Christian Heiss
- Experimental Trauma Surgery, Justus-Liebig-University Giessen, Germany,Department of Trauma, Hand, and Reconstructive Surgery Giessen, University Hospital of Giessen-Marburg, Germany
| | - Katrin Susanne Lips
- Experimental Trauma Surgery, Justus-Liebig-University Giessen, Germany,Corresponding author: Katrin Susanne Lips, Experimental Trauma Surgery, Justus-Liebig-University Giessen, Aulweg 128, 35392 Giessen, Germany E-mail:
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Jeong HC, Park JE, Hyun JY, Park MK, Shin DS, Shin KH. Determination of donepezil in human plasma using ultra performance liquid chromatography-tandem mass spectrometry. Transl Clin Pharmacol 2018; 26:64-72. [PMID: 32055551 PMCID: PMC6989263 DOI: 10.12793/tcp.2018.26.2.64] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 05/31/2018] [Accepted: 06/04/2018] [Indexed: 01/30/2023] Open
Abstract
An ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method was developed and validated for the quantification of donepezil in human plasma. Donepezil and donepezil-D4 were extracted from human plasma by liquid-liquid extraction using a mixture of hexane and ethyl acetate (70:30 v/v). The extracted samples were analyzed using a Thermo Hypersil Gold C18 column with 5% acetic acid in 20 mM ammonium acetate buffer (pH 3.3) and 100% acetonitrile as a mobile phase with the 60:40 (v:v) isocratic method, at a flow rate of 0.3 mL/min. The injection volume was 3 µL, and the total run time was 3 min. Inter- and intra-batch accuracies ranged from 98.0% to 110.0%, and the precision was below 8%. The developed method was successfully applied to the quantification of donepezil in human plasma. The mean (standard deviation) maximum concentration and the median (range) time to maximum concentration were 8.6 (2.0) ng/mL and 2.0 h (1.0~5.0 h), respectively, in healthy Koreans after oral administration of 5 mg donepezil.
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Affiliation(s)
- Hyeon-Cheol Jeong
- College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea
| | - Jeong-Eun Park
- College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea
| | - Ji-Yeon Hyun
- College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea
| | | | - Dong-Seong Shin
- Clinical Trials Center, Gachon University Gil Medical Center, Incheon 21565, Korea
| | - Kwang-Hee Shin
- College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu 41566, Korea
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28
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Hwang YT, Rocchi L, Hammond P, Hardy CJ, Warren JD, Ridha BH, Rothwell J, Rossor MN. Effect of donepezil on transcranial magnetic stimulation parameters in Alzheimer's disease. ALZHEIMERS & DEMENTIA-TRANSLATIONAL RESEARCH & CLINICAL INTERVENTIONS 2018; 4:103-107. [PMID: 29560413 PMCID: PMC5857494 DOI: 10.1016/j.trci.2018.02.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Introduction There is a need for a reliable, noninvasive biomarker for Alzheimer's disease (AD). We assessed whether short-latency afferent inhibition (SAI), a transcranial magnetic stimulation paradigm that assesses cholinergic circuits of the brain, could become such a biomarker. Methods Nineteen patients with AD underwent four SAI testing sessions. The timing of their usual donepezil dose was altered to create different cholinergic states for each session. This was compared to the SAI results from 20 healthy subjects. Results SAI was not able to distinguish the different cholinergic states assessed in our study. There appeared to be a diurnal variation in cholinergic function in the control group, which was not present in the AD cohort. Discussion SAI does not appear to have a role in diagnosis and assessment of AD patients. The loss of diurnal variation, however, warrants further investigation as it may provide further biochemical insights about AD. Transcranial magnetic stimulation is unable to differentiate various cholinergic states in Alzheimer's disease patients on donepezil. Chronic donepezil therapy may induce neuroplastic changes in hippocampal neurons. A diurnal variation in cholinergic activity may be present in healthy people. Alzheimer's disease may lead to loss of this diurnal cholinergic activity variation.
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Affiliation(s)
- Yun Tae Hwang
- Institute of Neurology, University College London, London, United Kingdom.,Brain and Mind Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Lorenzo Rocchi
- Institute of Neurology, University College London, London, United Kingdom
| | - Paul Hammond
- Institute of Neurology, University College London, London, United Kingdom
| | - Chris Jd Hardy
- Institute of Neurology, University College London, London, United Kingdom
| | - Jason D Warren
- Institute of Neurology, University College London, London, United Kingdom
| | - Basil H Ridha
- NIHR Queen Square Dementia Biomedical Research Unit, Institute of Neurology, University College London, London, United Kingdom
| | - John Rothwell
- Institute of Neurology, University College London, London, United Kingdom
| | - Martin N Rossor
- Dementia Research Centre, Institute of Neurology, University College London, London, United Kingdom
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Harewood Smith AN, Challa JA, Silver MA. Neither Cholinergic Nor Dopaminergic Enhancement Improve Spatial Working Memory Precision in Humans. Front Neural Circuits 2017; 11:94. [PMID: 29259546 PMCID: PMC5723298 DOI: 10.3389/fncir.2017.00094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 11/14/2017] [Indexed: 11/21/2022] Open
Abstract
Acetylcholine and dopamine are neurotransmitters that play multiple important roles in perception and cognition. Pharmacological cholinergic enhancement reduces excitatory receptive field size of neurons in marmoset primary visual cortex and sharpens the spatial tuning of visual perception and visual cortical fMRI responses in humans. Moreover, previous studies show that manipulation of cholinergic or dopaminergic signaling alters the spatial tuning of macaque prefrontal cortical neurons during the delay period of a spatial working memory (SWM) task and can improve SWM performance in macaque monkeys and human subjects. Here, we investigated the effects of systemic cholinergic and dopaminergic enhancement on the precision of SWM, as measured behaviorally in human subjects. Cholinergic transmission was increased by oral administration of 5 mg of the cholinesterase inhibitor donepezil, and dopaminergic signaling was enhanced with 100 mg levodopa/10 mg carbidopa. Each neurotransmitter system was separately investigated in double-blind placebo-controlled studies. On each trial of the SWM task, a square was presented for 150 ms at a random location along an invisible circle with a radius of 12 degrees of visual angle, followed by a 900 ms delay period with no stimulus shown on the screen. Then, the square was presented at new location, displaced in either a clockwise (CW) or counterclockwise (CCW) direction along the circle. Subjects used their memory of the location of the original square to report the direction of displacement. SWM precision was defined as the amount of displacement corresponding to 75% correct performance. We observed no significant effect on SWM precision for either donepezil or levodopa/carbidopa. There was also no significant effect on performance on the SWM task (percent correct across all trials) for either donepezil or levodopa/carbidopa. Thus, despite evidence that acetylcholine and dopamine regulate spatial tuning of individual neurons and can improve performance of SWM tasks, pharmacological enhancement of signaling of these neurotransmitters does not substantially affect a behavioral measure of the precision of SWM in humans.
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Affiliation(s)
- Adeola N Harewood Smith
- Vision Science Graduate Group, University of California, Berkeley, Berkeley, CA, United States
| | - Jnana Aditya Challa
- Department of Electrical Engineering and Computer Science, University of California, Berkeley, Berkeley, CA, United States.,Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, United States
| | - Michael A Silver
- Vision Science Graduate Group, University of California, Berkeley, Berkeley, CA, United States.,Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, United States.,School of Optometry, University of California, Berkeley, Berkeley, CA, United States
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30
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Fernandes TB, Cunha MR, Sakata RP, Candido TM, Baby AR, Tavares MT, Barbosa EG, Almeida WP, Parise-Filho R. Synthesis, Molecular Modeling, and Evaluation of Novel Sulfonylhydrazones as Acetylcholinesterase Inhibitors for Alzheimer's Disease. Arch Pharm (Weinheim) 2017; 350. [PMID: 28940630 DOI: 10.1002/ardp.201700163] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 09/01/2017] [Accepted: 09/05/2017] [Indexed: 12/19/2022]
Abstract
Alzheimer's disease (AD) is the most common type of dementia and related to the degeneration of hippocampal cholinergic neurons, which dramatically affects cognitive ability. Acetylcholinesterase (AChE) inhibitors are employed as drugs for AD therapy. Three series of sulfonylhydrazone compounds were designed, and their ability to inhibit AChE was evaluated. Fifteen compounds were synthesized and twelve of them had IC50 values of 0.64-51.09 μM. The preliminary structure-activity relationships indicated that the methylcatechol moiety and arylsulfonyl substituents generated better compounds than both the benzodioxole and alkylsulfonyl chains. Molecular dynamics studies of compound 6d showed that the interaction with the peripheral binding site of AChE was similar to donepezil, which may explain its low IC50 (0.64 μM). Furthermore, the drug-likeness of 6d suggests that the compound may have appropriate oral absorption and brain penetration. Compound 6d also presented antiradical activity and was not cytotoxic to LL24 cells, suggesting that this compound might be considered safe. Our findings indicate that arylsulfonylhydrazones may be a promising scaffold for the design of new drug candidates for the treatment of AD.
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Affiliation(s)
- Thais B Fernandes
- Faculty of Pharmaceutical Sciences, Department of Pharmacy, University of São Paulo, São Paulo, Brazil
| | - Micael R Cunha
- Faculty of Pharmaceutical Sciences, Department of Pharmacy, University of São Paulo, São Paulo, Brazil
| | - Renata P Sakata
- Faculty of Pharmaceutical Sciences, Department of Pharmacy, University of Campinas, Campinas, Brazil
| | - Thalita M Candido
- Faculty of Pharmaceutical Sciences, Department of Pharmacy, University of São Paulo, São Paulo, Brazil
| | - André R Baby
- Faculty of Pharmaceutical Sciences, Department of Pharmacy, University of São Paulo, São Paulo, Brazil
| | - Maurício T Tavares
- Faculty of Pharmaceutical Sciences, Department of Pharmacy, University of São Paulo, São Paulo, Brazil
| | - Euzébio G Barbosa
- Health Sciences Centre, Department of Pharmacy, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Wanda P Almeida
- Faculty of Pharmaceutical Sciences, Department of Pharmacy, University of Campinas, Campinas, Brazil
| | - Roberto Parise-Filho
- Faculty of Pharmaceutical Sciences, Department of Pharmacy, University of São Paulo, São Paulo, Brazil
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31
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Niu B, Zhang M, Du P, Jiang L, Qin R, Su Q, Chen F, Du D, Shu Y, Chou KC. Small molecular floribundiquinone B derived from medicinal plants inhibits acetylcholinesterase activity. Oncotarget 2017; 8:57149-57162. [PMID: 28915661 PMCID: PMC5593632 DOI: 10.18632/oncotarget.19169] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Accepted: 06/28/2017] [Indexed: 12/12/2022] Open
Abstract
Being a neurodegenerative disorder, Alzheimer's disease (AD) is the one of the most terrible diseases. And acetylcholinesterase (AChE) is considered as an important target for treating AD. Acetylcholinesterase inhibitors (AChEI) are considered to be one of the effective drugs for the treatment of AD. The aim of this study is to find a novel potential AChEI as a drug for the treatment of AD. In this study, instead of using the synthetic compounds, we used those extracted from plants to investigate the interaction between floribundiquinone B (FB) and AChE by means of both the experimental approach such as fluorescence spectra, ultraviolet-visible (UV-vis) absorption spectrometry, circular dichroism (CD) and the theoretical approaches such as molecular docking. The findings reported here have provided many useful clues and hints for designing more effective and less toxic drugs against Alzheimer's disease.
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Affiliation(s)
- Bing Niu
- Shanghai Key Laboratory of Bio-Energy Crops, College of Life Science, Shanghai University, Shanghai, 200444, China.,Gordon Life Science Institute, Boston, MA 02478, USA
| | - Mengying Zhang
- Shanghai Key Laboratory of Bio-Energy Crops, College of Life Science, Shanghai University, Shanghai, 200444, China
| | - Pu Du
- Department of Neurology, The First People's Hospital of Foshan, Foshan, 528000, China
| | - Li Jiang
- Shanghai Key Laboratory of Bio-Energy Crops, College of Life Science, Shanghai University, Shanghai, 200444, China
| | - Rui Qin
- Department of Gynecology, Affiliated Minzu Hospital of Guangxi Medical University, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530001, China
| | - Qiang Su
- Shanghai Key Laboratory of Bio-Energy Crops, College of Life Science, Shanghai University, Shanghai, 200444, China
| | - Fuxue Chen
- Shanghai Key Laboratory of Bio-Energy Crops, College of Life Science, Shanghai University, Shanghai, 200444, China
| | - Dongshu Du
- Shanghai Key Laboratory of Bio-Energy Crops, College of Life Science, Shanghai University, Shanghai, 200444, China.,Department of Life Science, Heze University, Heze, Shandong, 274500, China
| | - Yilai Shu
- Department of Otolaryngology-Head and Neck Surgery, Eye and Ear, Nose, Throat, Hospital, Shanghai Medical College, Fudan University, Shanghai, 200031, China
| | - Kuo-Chen Chou
- Center for Informational Biology, University of Electronic Science and Technology of China, Chengdu, 610054, China.,Gordon Life Science Institute, Boston, MA 02478, USA
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Cholinergic, But Not Dopaminergic or Noradrenergic, Enhancement Sharpens Visual Spatial Perception in Humans. J Neurosci 2017; 37:4405-4415. [PMID: 28336568 DOI: 10.1523/jneurosci.2405-16.2017] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 03/11/2017] [Accepted: 03/16/2017] [Indexed: 11/21/2022] Open
Abstract
The neuromodulator acetylcholine modulates spatial integration in visual cortex by altering the balance of inputs that generate neuronal receptive fields. These cholinergic effects may provide a neurobiological mechanism underlying the modulation of visual representations by visual spatial attention. However, the consequences of cholinergic enhancement on visuospatial perception in humans are unknown. We conducted two experiments to test whether enhancing cholinergic signaling selectively alters perceptual measures of visuospatial interactions in human subjects. In Experiment 1, a double-blind placebo-controlled pharmacology study, we measured how flanking distractors influenced detection of a small contrast decrement of a peripheral target, as a function of target-flanker distance. We found that cholinergic enhancement with the cholinesterase inhibitor donepezil improved target detection, and modeling suggested that this was mainly due to a narrowing of the extent of facilitatory perceptual spatial interactions. In Experiment 2, we tested whether these effects were selective to the cholinergic system or would also be observed following enhancements of related neuromodulators dopamine or norepinephrine. Unlike cholinergic enhancement, dopamine (bromocriptine) and norepinephrine (guanfacine) manipulations did not improve performance or systematically alter the spatial profile of perceptual interactions between targets and distractors. These findings reveal mechanisms by which cholinergic signaling influences visual spatial interactions in perception and improves processing of a visual target among distractors, effects that are notably similar to those of spatial selective attention.SIGNIFICANCE STATEMENT Acetylcholine influences how visual cortical neurons integrate signals across space, perhaps providing a neurobiological mechanism for the effects of visual selective attention. However, the influence of cholinergic enhancement on visuospatial perception remains unknown. Here we demonstrate that cholinergic enhancement improves detection of a target flanked by distractors, consistent with sharpened visuospatial perceptual representations. Furthermore, whereas most pharmacological studies focus on a single neurotransmitter, many neuromodulators can have related effects on cognition and perception. Thus, we also demonstrate that enhancing noradrenergic and dopaminergic systems does not systematically improve visuospatial perception or alter its tuning. Our results link visuospatial tuning effects of acetylcholine at the neuronal and perceptual levels and provide insights into the connection between cholinergic signaling and visual attention.
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Chamoun M, Huppé-Gourgues F, Legault I, Rosa-Neto P, Dumbrava D, Faubert J, Vaucher E. Cholinergic Potentiation Improves Perceptual-Cognitive Training of Healthy Young Adults in Three Dimensional Multiple Object Tracking. Front Hum Neurosci 2017; 11:128. [PMID: 28377707 PMCID: PMC5359296 DOI: 10.3389/fnhum.2017.00128] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 03/06/2017] [Indexed: 11/13/2022] Open
Abstract
A large body of literature supports cognitive enhancement as an effect of cholinergic potentiation. However, it remains elusive whether pharmacological manipulations of cholinergic neurotransmission enhance complex visual processing in healthy individuals. To test this hypothesis, we randomly administered either the cholinergic transmission enhancer donepezil (DPZ; 5 mg P.O.) or placebo (lactose) to young adults (n = 17) 3 h before each session of the three-dimensional (3D) multiple object tracking (3D-MOT) task. This multi-focal attention task evaluates perceptual-cognitive learning over five sessions conducted 7 days apart. A significant amount of learning was observed in the DPZ group but not the placebo group in the fourth session. In the fifth session, this learning effect was observed in both groups. Furthermore, preliminary results for a subgroup of participants (n = 9) 4–14 months later suggested the cholinergic enhancement effect was long lasting. On the other hand, DPZ had no effect on basic visual processing as measured by a motion and orientation discrimination task performed as an independent one-time, pre-post drug study without placebo control (n = 10). The results support the construct that cholinergic enhancement facilitates the encoding of a highly demanding perceptual-cognitive task although there were no significant drug effects on the performance levels compared to placebo.
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Affiliation(s)
- Mira Chamoun
- Laboratoire de Neurobiologie de la Cognition Visuelle, École d'optométrie, Université de Montréal Montréal, QC, Canada
| | - Frédéric Huppé-Gourgues
- Laboratoire de Neurobiologie de la Cognition Visuelle, École d'optométrie, Université de Montréal Montréal, QC, Canada
| | - Isabelle Legault
- Laboratoire de Psychophysique et de Perception Visuelle, École d'optométrie, Université de Montréal Montréal, QC, Canada
| | - Pedro Rosa-Neto
- McGill Centre for Studies in Aging Douglas Research Institute, McGill University, Montréal, QC, Canada
| | - Daniela Dumbrava
- Laboratoire des Neurosciences de la Vision, École d'optométrie, Université de Montréal Montréal, QC, Canada
| | - Jocelyn Faubert
- Laboratoire de Psychophysique et de Perception Visuelle, École d'optométrie, Université de Montréal Montréal, QC, Canada
| | - Elvire Vaucher
- Laboratoire de Neurobiologie de la Cognition Visuelle, École d'optométrie, Université de Montréal Montréal, QC, Canada
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Tip-loaded dissolving microneedles for transdermal delivery of donepezil hydrochloride for treatment of Alzheimer’s disease. Eur J Pharm Biopharm 2016; 105:148-55. [DOI: 10.1016/j.ejpb.2016.06.006] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 06/06/2016] [Accepted: 06/07/2016] [Indexed: 11/23/2022]
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35
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Donepezil prevents RANK-induced bone loss via inhibition of osteoclast differentiation by downregulating acetylcholinesterase. Heliyon 2015; 1:e00013. [PMID: 27441211 PMCID: PMC4939821 DOI: 10.1016/j.heliyon.2015.e00013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 07/16/2015] [Indexed: 01/14/2023] Open
Abstract
Objective Donepezil, an inhibitor of acetylcholinesterase (AChE) targeting the brain, is a common medication for Alzheimer's disease. Interestingly, a recent clinical study found that administration of this agent is associated with lower risk of hip fracture independently of falling, suggesting its direct effect on bone tissues as well. AChE has been reported to be involved in osteoblast function, but the role of AChE on osteoclastogenesis still remains unclear. We analyzed the effect of AChE and donepezil on osteoclastogenesis in vivo and in vitro. Methods Cell-based assays were conducted using osteoclasts generated in cultures of murine bone marrow macrophages (BMMs) with receptor activator of nuclear factor-kappa B ligand (RANKL). The effect of donepezil was also determined in vivo using a mouse model of RANKL-induced bone loss. Results Recombinant AChE in BMMs cultured with RANKL further promoted RANKL-induced tartrate-resistant acid phosphatase (TRAP)-positive osteoclast differentiation. RANKL also upregulated AChE expression in BMMs. RNA interference-mediated knockdown of AChE significantly inhibited RANKL-induced osteoclast differentiation and suppressed gene expression specific for osteoclasts. AChE upregulated expression of RANK, the receptor of RANKL, in BMMs. Donepezil decreased cathepsin K expression in BMMs and the resorptive function of osteoclasts on dentine slices. Donepezil decreased RANK expression in BMMs, resulting in the inhibition of osteoclast differentiation with downregulation of c-Fos and upregulation of Id2. Moreover, administration of donepezil prevented RANKL-induced bone loss in vivo, which was associated with the inhibition of bone resorption by osteoclasts. Conclusions AChE promotes osteoclast differentiation in vitro. Donepezil inhibits osteoclast function in vitro and prevents bone loss by suppressing bone resorption in vivo, suggesting the possibility that donepezil reduces fracture risk in patients with Alzheimer's disease.
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36
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Boucart M, Bubbico G, Szaffarczyk S, Defoort S, Ponchel A, Waucquier N, Deplanque D, Deguil J, Bordet R. Donepezil increases contrast sensitivity for the detection of objects in scenes. Behav Brain Res 2015; 292:443-7. [PMID: 26162753 DOI: 10.1016/j.bbr.2015.06.037] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 06/25/2015] [Accepted: 06/28/2015] [Indexed: 11/18/2022]
Abstract
We assessed the effects of donepezil, a drug that stimulates cholinergic transmission, and scopolamine, an antagonist of cholinergic transmission, on contrast sensitivity. 30 young male participants were tested under three treatment conditions: placebo, donepezil, and scopolamine in a random order. Pairs of photographs varying in contrast were displayed left and right of fixation for 50 ms. Participants were asked to locate the scene containing an animal. Accuracy was better under donepezil than under scopolamine, particularly for signals of high intensity (at higher levels of contrast). A control experiment showed that the lower performance under scopolamine did not result from the mydriasis induced by scopolamine. The results suggest that cholinergic stimulation, through donepezil, facilitates signal detection in agreement with studies on animals showing that the pharmacological activation of cholinergic receptors controls the gain in the relationship between the stimulus contrast (intensity of the visual input) and visual response. As Alzheimer disease is associated to depletion in acetylcholine, and there is evidence of deficits in contrast sensitivity in Alzheimer, it might be interesting to integrate such rapid and sensitive visual tasks in the biomarkers at early stage of drug development.
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Affiliation(s)
- Muriel Boucart
- Laboratoire de Sciences Cognitives et Affectives SCALab, Université de Lille, CNRS, France.
| | - Giovanna Bubbico
- Laboratoire de Sciences Cognitives et Affectives SCALab, Université de Lille, CNRS, France
| | - Sebastien Szaffarczyk
- Laboratoire de Sciences Cognitives et Affectives SCALab, Université de Lille, CNRS, France
| | - Sabine Defoort
- Laboratoire de Sciences Cognitives et Affectives SCALab, Université de Lille, CNRS, France
| | - Amelie Ponchel
- U1171, Université de Lille, INSERM, Centre Hospitalier et Universitaire, Lille, France
| | - Nawal Waucquier
- CIC1403, Université de Lille, INSERM, Centre Hospitalier et Universitaire, Lille, France
| | - Dominique Deplanque
- U1171, Université de Lille, INSERM, Centre Hospitalier et Universitaire, Lille, France; CIC1403, Université de Lille, INSERM, Centre Hospitalier et Universitaire, Lille, France
| | - Julie Deguil
- U1171, Université de Lille, INSERM, Centre Hospitalier et Universitaire, Lille, France
| | - Régis Bordet
- U1171, Université de Lille, INSERM, Centre Hospitalier et Universitaire, Lille, France
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Choi HY, Kim YH, Hong D, Kim SS, Bae KS, Lim HS. Therapeutic dosage assessment based on population pharmacokinetics of a novel single-dose transdermal donepezil patch in healthy volunteers. Eur J Clin Pharmacol 2015; 71:967-77. [DOI: 10.1007/s00228-015-1875-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 05/18/2015] [Indexed: 10/23/2022]
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Baek KM, Kwon OD, Kim HS, Park SJ, Song CH, Ku SK. Pharmacokinetic Profiles of Donepezil in Combination with Gwibi-Chongmyungtang in Rats. INT J PHARMACOL 2015. [DOI: 10.3923/ijp.2015.343.350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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McGrane IR, Shuman MD, McDonald RW. Donepezil-related intractable hiccups: a case report. Pharmacotherapy 2015; 35:e1-5. [PMID: 25756505 DOI: 10.1002/phar.1551] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This case report describes a man with intractable hiccups probably caused by donepezil. The patient's symptoms were not responsive to commonly used medications for hiccups, but they were improved and completely relieved upon donepezil dose deescalation and discontinuation. We report two occasions in which the discontinuation of donepezil resulted in hiccup resolution and three occasions in which initiation of donepezil was associated with the onset of hiccups. This report contributes to the growing body of literature that describes an association between centrally acting medications and intractable hiccups.
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Affiliation(s)
- Ian R McGrane
- Department of Pharmacy, Providence St. Joseph Medical Center, Polson, Montana
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40
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Cholinergic modulation of stimulus-driven attentional capture. Behav Brain Res 2015; 283:47-52. [PMID: 25619685 DOI: 10.1016/j.bbr.2015.01.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 01/10/2015] [Accepted: 01/15/2015] [Indexed: 11/21/2022]
Abstract
Distraction is one of the main problems encountered by people with degenerative diseases that are associated with reduced cortical cholinergic innervations. We examined the effects of donepezil, a cholinesterase inhibitor, on stimulus-driven attentional capture. Reflexive attention shifts to a distractor are usually elicited by abrupt peripheral changes. This bottom-up shift of attention to a salient item is thought to be the result of relatively inflexible hardwired mechanisms. Thirty young male participants were randomly allocated to one of two groups: placebo first/donepezil second session or the opposite. They were asked to locate a target appearing above and below fixation whilst a peripheral distractor moved abruptly (motion-jitter attentional capture condition) or not (baseline condition). A classical attentional capture effect was observed under placebo: moving distractors interfered with the task in slowing down response times as compared to the baseline condition with fixed distractors. Increased interference from moving distractors was found under donepezil. We suggest that attentional capture in our paradigm likely involved low level mechanisms such as automatic reflexive orienting. Peripheral motion-jitter elicited a rapid reflexive orienting response initiated by a cholinergic signal from the brainstem pedunculo-pontine nucleus that activates nicotinic receptors in the superior colliculus.
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Choi Y, Rhee SJ, Jang IJ, Yu KS, Yim SV, Kim BH. Bioequivalence study of Donepezil hydrochloride in healthy Korean volunteers. Transl Clin Pharmacol 2015. [DOI: 10.12793/tcp.2015.23.1.26] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Yewon Choi
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul 110-744, Korea
| | - Su-jin Rhee
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul 110-744, Korea
| | - In-Jin Jang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul 110-744, Korea
| | - Kyung-Sang Yu
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul 110-744, Korea
| | - Sung-Vin Yim
- Department of Clinical Pharmacology and Therapeutics, Kyung Hee University College of Medicine and Hospital, Seoul 130-872, Korea
| | - Bo-Hyung Kim
- Department of Clinical Pharmacology and Therapeutics, Kyung Hee University College of Medicine and Hospital, Seoul 130-872, Korea
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McEneny-King A, Edginton AN, Rao PP. Investigating the binding interactions of the anti-Alzheimer’s drug donepezil with CYP3A4 and P-glycoprotein. Bioorg Med Chem Lett 2015; 25:297-301. [DOI: 10.1016/j.bmcl.2014.11.046] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 11/13/2014] [Accepted: 11/17/2014] [Indexed: 11/16/2022]
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Broad J, Kung VWS, Boundouki G, Aziz Q, De Maeyer JH, Knowles CH, Sanger GJ. Cholinergic interactions between donepezil and prucalopride in human colon: potential to treat severe intestinal dysmotility. Br J Pharmacol 2014; 170:1253-61. [PMID: 24032987 DOI: 10.1111/bph.12397] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 08/27/2013] [Accepted: 08/30/2013] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND PURPOSE Cholinesterase inhibitors such as neostigmine are used for acute colonic pseudo-obstruction, but cardio-bronchial side-effects limit use. To minimize side-effects, lower doses could be combined with a 5-HT4 receptor agonist, which also facilitates intestinal cholinergic activity. However, safety concerns, especially in the elderly, require drugs with good selectivity of action. These include the AChE inhibitor donepezil (used for Alzheimer's disease, with reduced cardio-bronchial liability) and prucalopride, the first selective, clinically available 5-HT4 receptor agonist. This study examined their individual and potential synergistic activities in human colon. EXPERIMENTAL APPROACH Neuronally mediated muscle contractions and relaxations of human colon were evoked by electrical field stimulation (EFS) and defined phenotypically as cholinergic, nitrergic or tachykinergic using pharmacological tools; the effects of drugs were determined as changes in 'area under the curve'. KEY RESULTS Prucalopride increased cholinergically mediated contractions (EC50 855 nM; 33% maximum increase), consistent with its ability to stimulate intestinal motility; donepezil (477%) and neostigmine (2326%) had greater efficacy. Concentrations of donepezil (30-100 nM) found in venous plasma after therapeutic doses had minimal ability to enhance cholinergic activity. However, donepezil (30 nM) together with prucalopride (3, 10 μM) markedly increased EFS-evoked contractions compared with prucalopride alone (P = 0.04). For example, the increases observed with donepezil and prucalopride 10 μM together or alone were, respectively, 105 ± 35%, 4 ± 6% and 35 ± 21% (n = 3-7, each concentration). CONCLUSIONS AND IMPLICATIONS Potential synergy between prucalopride and donepezil activity calls for exploration of this combination as a safer, more effective treatment of colonic pseudo-obstruction.
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Affiliation(s)
- J Broad
- Neurogastroenterology Group, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Morasch KC, Aaron CL, Moon JE, Gordon RK. Physiological and neurobehavioral effects of cholinesterase inhibition in healthy adults. Physiol Behav 2014; 138:165-72. [PMID: 25455867 DOI: 10.1016/j.physbeh.2014.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 09/26/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Based on common pharmacodynamic mechanisms, recent efforts to develop second generation alternatives for organophosphate (OP) prophylaxis have expanded to include cholinesterase (ChE) inhibiting compounds traditionally approved for use in the treatment of Alzheimer's disease (AD). The primary purpose of this study was to determine the extent to which low-dose huperzine A, galantamine, or donepezil selectively inhibited acetylcholinesterase (AChE) versus butyrylcholinesterase (BChE) activity in healthy adults and whether such inhibition impacted neurobehavioral performance. METHODS In addition to hourly red blood cell cholinesterase sampling, neurobehavioral function was assessed before and after a single oral dose of huperzine A (100 or 200 μg), galantamine (4 or 8 mg), donepezil (2.5 or 5mg), or placebo (n=12 subjects per drug/dose). RESULTS Compared to placebo, both dosages of huperzine A and galantamine inhibited circulating AChE but not BChE. With the exception of huperzine A (200 μg), which maintained declarative recall performance across sessions, compounds did not improve neurobehavioral performance. Some aspects of neurobehavioral performance correlated with AChE activity, although associations may have reflected time of day effects. DISCUSSION Although huperzine A and galantamine significantly inhibited AChE (and likely increased central acetylcholine levels), neither compound improved neurobehavioral performance. The latter was likely due to ceiling effects in this young, healthy test population. Under conditions of reduced cholinergic activity (e.g., Alzheimer's disease), AChE inhibition (and corresponding maintenance of cholinergic tone) could potentially maintain/augment some aspects of neurobehavioral function.
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Affiliation(s)
| | | | - James E Moon
- Walter Reed Army Institute of Research, United States
| | - Richard K Gordon
- United States Army Medical Research and Materiel Command, United States
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Kimmey BA, Rupprecht LE, Hayes MR, Schmidt HD. Donepezil, an acetylcholinesterase inhibitor, attenuates nicotine self-administration and reinstatement of nicotine seeking in rats. Addict Biol 2014; 19:539-51. [PMID: 23231479 DOI: 10.1111/adb.12014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Nicotine craving and cognitive impairments represent core symptoms of nicotine withdrawal and predict relapse in abstinent smokers. Current smoking cessation pharmacotherapies have limited efficacy in preventing relapse and maintaining abstinence during withdrawal. Donepezil is an acetylcholinesterase inhibitor that has been shown previously to improve cognition in healthy non-treatment-seeking smokers. However, there are no studies examining the effects of donepezil on nicotine self-administration and/or the reinstatement of nicotine-seeking behavior in rodents. The present experiments were designed to determine the effects of acute donepezil administration on nicotine taking and the reinstatement of nicotine-seeking behavior, an animal model of relapse in abstinent human smokers. Moreover, the effects of acute donepezil administration on sucrose self-administration and sucrose seeking were also investigated in order to determine whether donepezil's effects generalized to other reinforced behaviors. Acute donepezil administration (1.0 or 3.0 mg/kg, i.p.) attenuated nicotine, but not sucrose self-administration maintained on a fixed-ratio 5 schedule of reinforcement. Donepezil administration also dose-dependently attenuated the reinstatement of both nicotine- and sucrose-seeking behaviors. Commonly reported adverse effects of donepezil treatment in humans are nausea and vomiting. However, at doses required to attenuate nicotine self-administration in rodents, no effects of donepezil on nausea/malaise as measured by pica were observed. Collectively, these results indicate that increased extracellular acetylcholine levels are sufficient to attenuate nicotine taking and seeking in rats and that these effects are not due to adverse malaise symptoms such as nausea.
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Affiliation(s)
- Blake A. Kimmey
- Department of Psychiatry; Perelman School of Medicine; University of Pennsylvania; Philadelphia PA USA
| | - Laura E. Rupprecht
- Department of Psychiatry; Perelman School of Medicine; University of Pennsylvania; Philadelphia PA USA
| | - Matthew R. Hayes
- Department of Psychiatry; Perelman School of Medicine; University of Pennsylvania; Philadelphia PA USA
| | - Heath D. Schmidt
- Department of Psychiatry; Perelman School of Medicine; University of Pennsylvania; Philadelphia PA USA
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Garlich FM, Balakrishnan K, Shah SK, Howland MA, Fong J, Nelson LS. Prolonged altered mental status and bradycardia following pediatric donepezil ingestion. Clin Toxicol (Phila) 2014; 52:291-4. [DOI: 10.3109/15563650.2014.900182] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Otuyama LJ, Rizzi CF, Piovezan RD, Werli KS, Brasil EL, Sukys-Claudino L, Tufik S, Poyares D. The cholinergic system may play a role in the pathophysiology of residual excessive sleepiness in patients with obstructive sleep apnea. Med Hypotheses 2013; 81:509-11. [PMID: 23891038 DOI: 10.1016/j.mehy.2013.06.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Accepted: 06/30/2013] [Indexed: 11/15/2022]
Abstract
Obstructive sleep apnea (OSA) is a prevalent condition characterized by momentary cessations in breathing during sleep due to intermittent obstruction of the upper airway. OSA has been frequently associated with a number of medical comorbidities. CPAP (continuous positive airway pressure) is the gold standard treatment and is known to improve OSA symptoms, including excessive sleepiness. However, 12-14% of CPAP-treated patients continue to complain of sleepiness despite normalization of ventilation during sleep, and 6% after exclusion of other causes of EDS. This is of great concern because EDS is strongly associated with systemic health disorders, lower work performance, and a high risk of accidents. We hypothesized that decreased central cholinergic activity plays a role in the pathophysiology of residual excessive sleepiness in patients with OSA treated with CPAP. Acetylcholine (Ach) plays a large role in wakefulness physiology, and its levels are reduced in sleepiness. Herein, we discuss the potential role of the cholinergic system in this new clinical condition.
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Affiliation(s)
- Leonardo J Otuyama
- Sleep Medicine and Biology Discipline, Psychobiology Department, Universidade Federal de Sao Paulo, Rua Napoleao de Barros, 925. Vila Clementino, Sao Paulo, SP 04024-002, Brazil.
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Thakurathi N, Vincenzi B, Henderson DC. Assessing the prospect of donepezil in improving cognitive impairment in patients with schizophrenia. Expert Opin Investig Drugs 2012; 22:259-65. [PMID: 23215841 DOI: 10.1517/13543784.2013.750650] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Even though cognitive impairment is manifested in almost all patients with schizophrenia, the Clinical Antipsychotic Trials for Intervention Effectiveness (CATIE) study showed no significant difference between first- and second-generation psychotropic drugs in improving cognitive abilities. Discovering new drugs that can improve impaired cognition, thus, is an attractive treatment target for patients with schizophrenia. AREAS COVERED This article briefly reviews about donepezil, a highly selective (IC(50) = 6.7 nM) centrally acting reversible acetylcholinesterase inhibitor that has been approved by FDA for treating cognitive deficit states such as in Alzheimer's disease and its uses in clinical trials for the treatment of schizophrenia. The literature search included PubMed and Cochrane library with the following words: donepezil, schizophrenia and cognitive impairments. EXPERT OPINION The results of several clinical trials utilizing donepezil as an adjunct to second-generation antipsychotic drugs targeting cognitive deficits in schizophrenia subjects have been disappointing and would not lead clinicians to consider this as a potential treatment option. While longer randomized controlled trials, increase dosage and selected groups of patients at different stage of cognitive impairment may provide a better understanding of the potential for this drug in addressing cognitive deficits, results to date have not been encouraging.
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Affiliation(s)
- Neelam Thakurathi
- Massachusetts General Hospital, Schizophrenia Clinical and Research Program, Boston, MA, USA
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Kosovicheva AA, Sheremata SL, Rokem A, Landau AN, Silver MA. Cholinergic enhancement reduces orientation-specific surround suppression but not visual crowding. Front Behav Neurosci 2012; 6:61. [PMID: 23049505 PMCID: PMC3444757 DOI: 10.3389/fnbeh.2012.00061] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2012] [Accepted: 08/28/2012] [Indexed: 11/13/2022] Open
Abstract
Acetylcholine (ACh) reduces the spatial spread of excitatory fMRI responses in early visual cortex and receptive field size of V1 neurons. We investigated the perceptual consequences of these physiological effects of ACh with surround suppression and crowding, two phenomena that involve spatial interactions between visual field locations. Surround suppression refers to the reduction in perceived stimulus contrast by a high-contrast surround stimulus. For grating stimuli, surround suppression is selective for the relative orientations of the center and surround, suggesting that it results from inhibitory interactions in early visual cortex. Crowding refers to impaired identification of a peripheral stimulus in the presence of flankers and is thought to result from excessive integration of visual features. We increased synaptic ACh levels by administering the cholinesterase inhibitor donepezil to healthy human subjects in a placebo-controlled, double-blind design. In Experiment 1, we measured surround suppression of a central grating using a contrast discrimination task with three conditions: (1) surround grating with the same orientation as the center (parallel), (2) surround orthogonal to the center, or (3) no surround. Contrast discrimination thresholds were higher in the parallel than in the orthogonal condition, demonstrating orientation-specific surround suppression (OSSS). Cholinergic enhancement decreased thresholds only in the parallel condition, thereby reducing OSSS. In Experiment 2, subjects performed a crowding task in which they reported the identity of a peripheral letter flanked by letters on either side. We measured the critical spacing between the targets and flanking letters that allowed reliable identification. Cholinergic enhancement with donepezil had no effect on critical spacing. Our findings suggest that ACh reduces spatial interactions in tasks involving segmentation of visual field locations but that these effects may be limited to early visual cortical processing.
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Affiliation(s)
- Anna A Kosovicheva
- Department of Psychology, University of California, Berkeley Berkeley, CA, USA
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