AIT-082 (an analog of hypoxanthine) is an orally-active nerve growth factor (NGF) agonist under development by NeoTherapeutics as a potential treatment for Alzheimer's disease (AD), stroke and motor neuron disease. A phase II safety and efficacy trial in AD, originally scheduled to begin in the summer of 1997 [283677], began in May 1998 [286975,285562]. The study will enroll more than 60 AD patients [286975]. In February 1998, NeoTherapeutics began a phase I multiple-dose pharmacokinetic study of AIT-082 in 24 healthy elderly volunteers. Subjects of the phase I study will be administered AIT-082 once a day for 7 consecutive days at doses of 100 to 2000 mg per dose [279422]. A limited double-blind, placebo-controlled phase I/II trial in 10 AD patients commenced in Canada in the first quarter of 1997. Treatment with 4000 mg improved memory in 60% of the patients within 3 h, as determined by the word recall test. A decrease in memory was observed in 80% of placebo-treated patients [257132]. A phase I US trial, conducted by the Alzheimer's Disease Cooperative Study, with funding from the National Institute of Aging, began in July 1997. AIT-082 was administered to eight healthy, elderly volunteers as part of an escalating single-dose study. Oral administration of AIT-082 was well-tolerated at high doses [284325] AIT-082 also enhanced memory function in both young adult and aged mice within 2 h of oral administration. Prophylactic treatment prevented or delayed the onset of age-induced memory deficits in mice when administered in drinking water. When memory impairment was produced by brain lesions, the drug restored memory performance and increased the genetic expression of neurotrophin-3 (NT-3), a natural protein growth factor associated with nerve cell function [284325]. AIT-082 appears to have at least three effects on the growth of PC-12 cells in culture. Firstly, it stimulates outgrowth of neurites, secondly it potentiates the growth effects of neurotrophin, and thirdly, it stimulates the synthesis of certain neurotrophins (nerve growth factor, neurotrophin-3 and fibroblast growth factor) and pleiotrophins by astrocytes. These progrowth mechanisms are thought to form the basis of the ability of AIT-082 to restore and prevent age-related working memory deficits in mice [195438]. In October 1997, further preclinical results were presented, demonstrating that treatment with AIT-082 produced an increase in neurotrophic factors following spinal cord injury in rats. This study was conducted at NeoTherapeutics and McMaster University, and was partially funded by the Amyotrophic Lateral Sclerosis Society of Canada. After 7 days of treatment, rats with spinal cord injuries showed an increase in the levels of CNTF and BDNF, naturally occurring growth factors in the spinal cord [267514].

译文

AIT-082 (次黄嘌呤的类似物) 是新疗法正在开发的口服活性神经生长因子 (NGF) 激动剂,可作为阿尔茨海默氏病 (AD),中风和运动神经元疾病的潜在治疗方法。AD的II期安全性和有效性试验原定于夏季1997年开始 [283677],于1998年5月 [286975,285562] 开始。该研究将招募超过60名AD患者 [286975]。在1998年2月,新疗法开始了AIT-082在24名健康老年志愿者中的I期多剂量药代动力学研究。I期研究的受试者将连续7天每天一次以100 2000年mg的剂量服用AIT-082 [279422]。1997年第一季度,加拿大开始了一项针对10名AD患者的有限双盲,安慰剂对照的I/II期试验。4000 mg治疗可在3小时内改善60% 患者的记忆力,如单词回忆测试所确定的。在80% 接受安慰剂治疗的患者中观察到记忆力下降 [257132]。由阿尔茨海默氏病合作研究在美国国家老龄化研究所的资助下进行的美国第一阶段试验于1997年7月开始。AIT-082作为逐步升级的单剂量研究的一部分,被给予八名健康的老年志愿者。AIT-082的口服给药在高剂量下具有良好的耐受性 [284325] AIT-082还在口服给药的2小时内增强了年轻成年和老年小鼠的记忆功能。当在饮用水中施用时,预防性治疗可预防或延迟小鼠年龄引起的记忆缺陷的发作。当大脑损伤产生记忆障碍时,药物恢复记忆性能并增加neurotrophin-3 (NT-3) 的基因表达,这是一种与神经细胞功能相关的天然蛋白质生长因子 [284325]。AIT-082似乎对培养物中PC-12细胞的生长具有至少三种作用。首先,它刺激神经突的生长,其次,它增强神经营养蛋白的生长作用,第三,它刺激某些神经营养蛋白 (神经生长因子,neurotrophin-3和成纤维细胞生长因子) 和星形胶质细胞的合成。这些促生长机制被认为构成了AIT-082在小鼠中恢复和预防与年龄有关的工作记忆缺陷的能力的基础 [195438]。1997年10月,提出了进一步的临床前结果,表明用AIT-082治疗大鼠脊髓损伤后神经营养因子增加。这项研究是在NeoTherapeutics和麦克马斯特大学进行的,部分由加拿大肌萎缩性侧索硬化症学会资助。治疗7天后,脊髓损伤大鼠的CNTF和BDNF (脊髓中天然存在的生长因子) 水平升高 [267514]。

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