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Several mGluR5 modulators have became available showing acceptable pharmacokinetics and selectivity. There are negative allosteric modulators such as MTEP, MPEP, or fenobam (NAMs) or positive allosteric modulators (PAMs) such as CDPPB or ADX47273. We performed a verifi cation of the therapeutic potential of these modulators using various behavioural methods. mGluR5 NAMs produced analgesic effects in several pain models such as formalin, and Freund adjuvant model of infl ammatory pain. Additionally they very strongly attenuated L-DOPA induced dyskinesia and produced anxiolytic activity in some models of anxiety such as fear potentiated startle, context freezing. However, effi cacy was not better then respective indication reference agents. mGluR5 PAMs are expected to have antipsychoticlike activity and improve learning. These expectations can be in our hands only partially fulfi lled for schizophrenia (positive effects in amphetamine-induced hyperactvitivity, apomorphine-induced prepulse inhibition, or conditioned avoidance response inhibition). No clear positive effect was observed in models of cognition. Recently, several clinical trials with metabotropic glutamate receptor type 5 negative modulators showed positive effects in indications such as migraine, refl ux and L-DOPA-induced dyskinesia. This regards ADX 10059 from Addex and AFQ056 from Novartis indicating that their introduction to clinical practice may be just a matter of short time.
In spite of intensive research for over 2 decades, number of drugs affecting glutamatergic system that are clinically used is very limited. This presentation will be devoted to overview of selected glutamate targets, current drug development, their potential and pitfalls. In particular, NMDA receptors (channel blockers and NR2B antagonists) and mGluR5 positive and negative modulators will be discussed more extensively. In case of NMDA receptors, some channel blockers (e.g. memantine) or NR2B antagonists are in clinical use for dementia or are in late stages of development for neuropathic pain respectively. In contrast, mGluR5 modulators are less advanced. Recently, several such substances have been introduced such as MTEP, MPEP, CDPPB or ADX47273. mGluR5 negative allosteric modulators (NAMs) e.g. MTEP are active in some models such as formalin, and Freund adjuvant model of infl ammatory pain. Additionally they have potential in the treatment of L-DOPA induced dyskinesia. mGluR5 positive modulators (PAMs, e.g. CDPPB) may have potential as antipsychotics and improve learning. As it will be presented, in our hands these expectations can be only partially fulfi lled as no clear convincing picture arises from testing in various animal models of schizophrenia (amphetamine-induced hyperactivity or apomorphine-induced prepulse inhibition). In learning models positive effect was seen in object recognition task (spontaneous forgetting).
Eltoprazine, a drug that had previously been developed for aggression, has recently been investigated for L‑DOPA‑induced dyskinesia in animal models of Parkinson´s disease (PD) and in dyskinetic PD patients. Much less is known about effects of eltoprazine in other therapeutic indications. Indeed, the pharmacological profile of eltoprazine might suggest its effects on anxiety and food intake, but also adverse effect potential, which is the focus of the present study. Given for 2 weeks either as infusion or as twice‑daily treatment, eltoprazine produced a decrease in food intake and body weight at doses leading to 200–500 nM plasma concentrations. In the elevated plus maze eltoprazine increased anxiety‑like behavior. On the other hand, it induced a clear‑cut anxiolytic effect in context fear conditioning test starting at ca. 0.3 mg/kg, and failed to produce any significant effect in fear potentiated startle test. Regarding adverse effects, eltoprazine was found to produce hypothermia starting from 1 mg/kg. At similar doses it also increased locomotion in the open field. However, eltoprazine failed to affect acquisition in context fear conditioning paradigm, which may indicate lack of its detrimental effect on learning at the doses tested (i.e., up to 5 mg/kg). In summary, effects of eltoprazine in different anxiety tests were equivocal while its effect on body weight seems robust and requires further investigation. It is to be determined whether these effects can be expected at the doses free of adverse effects.
Subtype 5 metabotropic glutamate receptors (mGluR5) have been implicated in the control of movement, mood, cognition, and nociception. Correspondingly, different mGluR5 antagonists have been shown to alleviate L-DOPA-induced dyskinesia (LID), anxiety, and pain in experimental animals. A novel proprietary mGluR5 antagonist 6,6-dimethyl-2-phenylethynyl-7,8-dihydro-6H-quinolin-5-one (MRZ-8676) having ~20 nM affinity to mGluR5, was tested in the rat models of LID, persistent pain, and anxiety. Effects of MRZ-8676 on motor performance and on learning were investigated. Presence of MRZ-8676 at target receptor in the brain was ascertained by measuring its extracellular concentrations and mGluR5 occupancy in vivo. MRZ-8676 had 20–25% bioavailability after oral treatment reaching Tmax at 2.9 h while T1/2 was 11.2 h. At 25 mg/kg p.o. Cmax was 348 ng/ml and AUC 2045 ng*h/ ml). In in vivo microdialysis experiments, pharmacologically effective p.o. doses of MRZ-8676 were found to achieve free brain concentrations sufficient to completely block mGluR5, i.e. above 100 nM. This finding was further confirmed by the results of the in vivo mGluR5 receptor occupancy study showing ED50 of ca. 5 mg/kg after i.p. administration. MRZ-8676 strongly and dose-dependently reduced abnormal involuntary movements in the 6-hydroxydopamine (6-OHDA) rat model of LID starting at 25 mg/kg. No tolerance of the antidyskinetic effects was observed upon subchronic (6-day) treatment with 75 mg/kg p.o. MRZ-8676 produced moderate anxiolytic effect in two rodent anxiety models, the contextual fear conditioning (at 25 mg/kg) and the elevated plus maze (25 mg/kg). At the same dose, MRZ-8676 also attenuated reaction to pain in the first phase of formalin test, the rat model of persistent pain induction. MRZ-8676 did not produce any detrimental effects on motor performance of rats as investigated rotarod test up to 150 mg/kg p.o. In the open field short lasting increase in locomotor activity was observed (25–150 mg/kg). However, MRZ-8676 dose dependently impaired learning in aversive learning paradigm of the contextual fear conditioning test reaching significance at 75 mg/kg which is above minima effective dose in tests for dyskinesia, pain or anxiety. Summing up, MRZ-8676 has clear-cut antidyskinetic properties with a sufficient therapeutic window. Moreover, it has anxiolytic and analgesic properties. Receptor occupancy and microdialysis studies indicate that the behavioural effects of MRZ-8676 are associated with blockade of mGluR5 in the brain. Moreover, preclinical rational and status of clinical trials with mGluR5 NAMs in Parkinson´s disease, Fragile X and gastroesophageal reflux will be presented.
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