Branched-chain amino acid therapy for spinocerebellar degeneration: a pilot clinical crossover trial

Bioprospection of Natural Sources of Polyphenols with Therapeutic Potential for Redox-Related Diseases

Plants are a reservoir of high-value molecules with underexplored biomedical applications. With the aim of identifying novel health-promoting attributes in underexplored natural sources, we scrutinized the diversity of (poly)phenols present within the berries of selected germplasm from cultivated, wild, and underutilized Rubus species. Our strategy combined the application of metabolomics, statistical analysis, and evaluation of (poly)phenols' bioactivity using a yeast-based discovery platform. We identified species as sources of (poly)phenols interfering with pathological processes associated with redox-related diseases, particularly, amyotrophic lateral sclerosis, cancer, and inflammation. In silico prediction of putative bioactives suggested cyanidin-hexoside as an anti-inflammatory molecule which was validated in yeast and mammalian cells. Moreover, cellular assays revealed that the cyanidin moiety was responsible for the anti-inflammatory properties of cyanidin-hexoside. Our findings unveiled novel (poly)phenolic bioactivities and illustrated the power of our integrative approach for the identification of dietary (poly)phenols with potential biomedical applications.

Movement disorders in spinocerebellar ataxias

Autosomal dominant spinocerebellar ataxias (SCAs) can present with a large variety of noncerebellar symptoms, including movement disorders. In fact, movement disorders are frequent in many of the various SCA subtypes, and they can be the presenting, dominant, or even isolated disease feature. When combined with cerebellar ataxia, the occurrence of a specific movement disorder can provide a clue toward the underlying genotype. There are reasons to believe that for some coexisting movement disorders, the cerebellar pathology itself is the culprit, for example, in the case of cortical myoclonus and perhaps dystonia. However, movement disorders in SCAs are more likely related to extracerebellar pathology, and imaging and neuropathological data indeed show involvement of other parts of the motor system (substantia nigra, striatum, pallidum, motor cortex) in some SCA subtypes. When confronted with a patient with an isolated movement disorder, that is, without ataxia, there is currently no reason to routinely screen for SCA gene mutations, the only exceptions being SCA2 in autosomal dominant parkinsonism (particularly in Asian patients) and SCA17 in the case of a Huntington's disease-like presentation without an HTT mutation.

Blood-brain permeability of [3H]-(3-methyl-His2)thyrotropin-releasing hormone (MeTRH) in mice: effects of TRH and its analogues

The present study was undertaken to characterize the transport of (3-methyl-His(2)) thyrotropin-releasing hormone ([(3)H]MeTRH) across the blood-brain barrier in mice and the effects of thyrotropin-releasing hormone (TRH) and its analogues (taltirelin and montirelin) on the transport and brain distribution. Integration plot analysis was used to calculate the influx clearance (CL(in)) of [(3)H]MeTRH after intravenous (i.v.) injection in mice. Furthermore, the capillary depletion method was performed to determine whether [(3)H]MeTRH crossed the blood-brain barrier. The effects of TRH and its analogues on the brain distribution of [(3)H]MeTRH were also examined by co-injection with the radioligand. The brain distribution of [(3)H]MeTRH and [(14)C]sucrose increased with the time after i.v. injection in mice, and the level of [(3)H]MeTRH was significantly higher than that of [(14)C]sucrose 5 min after the injection. The CL(in) value of [(3)H]MeTRH was significantly higher than that of [(14)C]sucrose, and the value of [(3)H]MeTRH was reduced by co-injection with unlabeled MeTRH. Also, capillary depletion showed that [(3)H]MeTRH was distributed largely in the brain parenchyma and this distribution was significantly inhibited by co-injection of TRH and montirelin but not taltirelin. The present study indicates that the transport of [(3)H]MeTRH into the brain may be via a saturable process.

Update on nutritional supplementation with branched-chain amino acids

PURPOSE OF REVIEW

Branched-chain amino acids (BCAAs) have a peculiar role in whole-body nitrogen metabolism. BCAAs are not only a substrate for protein synthesis, but also modulate several components of the synthetic machinery and help to conserve muscle mass; accordingly, several conditions, characterized by protein loss and catabolic status, are likely to benefit from amino acid administration. In addition, the competitive action of BCAAs on amino acid transport across the blood-brain barrier may ultimately alter the synthesis of brain neurotransmitters, involved in neurological diseases.

RECENT FINDINGS

Both putative actions of BCAAs have been tested in controlled clinical studies in the last few years. The beneficial effects on nutrition were reported to improve muscle performance, reduce protein loss during bed-rest, favor weight loss in obesity, reduce catabolism in trauma patients and improve clinical outcomes in patients with advanced cirrhosis. In this last area, the effects on nutrition might be coupled with the effects on hepatic encephalopathy mediated by improved neurotransmission, successfully tested in mania, tardive dyskinesia and spinocerebellar degeneration.

SUMMARY

After 30 years of investigation with BCAAs, new studies each year provide further evidence supporting their beneficial effect in a variety of diseases. There is a need for long-term, randomized clinical studies, both in the prevention and in the treatment of various pathological conditions.

Studies on the transport of thyrotropin-releasing hormone (TRH) analogues in Caco-2 cell monolayers

The transport mechanisms of thyrotropin-releasing hormone (TRH) and its pharmacologically active analogues ((3-methyl-His(2))TRH (MeTRH), taltirelin, montirelin, azetirelin) across Caco-2 cell monolayers were characterized. The results of kinetic analysis showed a linear relationship between the concentration (over the range 0.5-10 mM) and apical-to-basolateral transport rate of these agents. The permeability coefficients (P(app)) of these agents were not substantially different from each other, and their P(app) ratios of the basolateral-to-apical over the apical-to-basolateral transport were close to one (0.73-1.23). The cellular transport of [(3)H]MeTRH at low concentrations (3-15 nM) showed a linear relationship between the concentration and transport rate. The transport of [(3)H]MeTRH in Caco-2 cell monolayers was neither affected by TRH nor TRH analogues, and there was little difference in P(app) values between [(3)H]MeTRH and [(14)C]mannitol. The cell-per-medium ratio of [(3)H]MeTRH in the cellular uptake experiment was similar to the value of [14C]mannitol. A large excess of TRH and MeTRH did not significantly influence cell-per-medium ratios of [(3)H]MeTRH in Caco-2 cell monolayers. The k'(IAM) value, which represents lipophilicity, was decreased in the following order: montirelin > taltirelin > TRH > azetirelin, and the values varied from 0.234 to 1.028. These results indicate that a paracellular passive diffusion may be the major route for the transport of TRH and its analogues in Caco-2 cell monolayers.

Double-blind crossover study of branched-chain amino acid therapy in patients with spinocerebellar degeneration

To determine whether treatment with branched-chain amino acids (BCAA) can improve the condition of patients with ataxia, a double-blind crossover study of BCAA therapy was performed in 16 patients with spinocerebellar degeneration (SCD). The patients were treated with BCAA in oral doses of 1.5, 3.0, or 6.0 g or with placebo daily for 4 weeks in each study phase. The order of treatment phases (placebo or BCAA) was assigned randomly. An International Cooperative Ataxia Rating Scale (ICARS) was used to quantify the severity of symptoms of SCD. The mean ICARS score improved significantly with BCAA treatment compared with the mean pretreatment score (p<0.01). In addition, the improvement in the mean global ICARS score was significant in the middle-dose group compared with that in the placebo group (p<0.02). The estimated improvement in kinetic functions compared with pretreatment (p<0.01) was significant after treatment with BCAA, 1.5 and 3.0 g. All of the responders manifested predominantly cerebellar symptoms, especially those with spinocerebellar ataxia type 6 (SCA6). Thus, treatment with BCAA may be effective in patients with the cerebellar form of SCD.

Static stabilometry in patients with migraine and tension-type headache during a headache-free period

The vestibulospinal system was evaluated using a stabilometric method in patients with migraine and episodic tension-type headache during headache-free periods. Migraine patients often complain of dizziness or vertigo during headache attacks and some exhibit these symptoms between attacks. Computerized static stabilometry is a reliable and non-invasive technique to evaluate the equilibrium function in various diseases. The subjects consisted of 21 patients with migraine, 12 patients with episodic tension-type headache and, age- and sex-matched controls. We performed two sets of static stabilometric measurements with eyes open (EO) and eyes closed (EC) for 30 s. The averages of two sessions of the following six stabilometric parameters were used for the analysis: locus length (LNG), environmental area (ENV-AREA), rectangle area (REC-AREA), locus length per second, locus length per environ area (L/E), and root mean square area. Romberg quotients (EC/EO) of these six parameters were also analyzed. The mean values of LNG, ENV-AREA and REC-AREA in the EC session in the migraine group were significantly greater than those in the controls (P < 0.05, Mann-Whitney rank sum test). Romberg quotients of all stabilometric parameters except the L/E in the migraine group were significantly greater than in the controls. Patients with episodic tension-type headache did not show any differences in the stabilometric study from the controls. The present findings suggest that patients with migraine show a significant increase of the body sway during the EC session, which indicates an underlying dysfunction in the vestibulospinal system.