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Symptomatic Relief of Botulinum Neurotoxin/A Intoxication with Aminopyridines: A New Twist on an Old Molecule

  作者 MAYOROV ALEXANDER V; WILLIS BERT; DI MOLA ANTONIA; ADLER DEREK; BORGIA JENNIFER; JACKSON OLIN; WANG JIE; LUO YONGYI; TANG LEI; KNAPP RICHARD J; NATARAJAN CHANDRA; GOODNOUGH MICHAEL C; ZILBERBERG NOAM; SIMPSON LANCE L; JANDA KIM D  
  选自 期刊  ACS CHEMICAL BIOLOGY;  卷期  2010年5-12;  页码  1183-1191  
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[摘要]Botulinum neurotoxins (BoNT) are the etiological agents responsible for botulism, a disease characterized by peripheral neuromuscular blockade and a characteristic flaccid paralysis of human. BoNT/A is the most toxic protein known to man and has been classified by the Centers of Disease Control (CDC) as one of the six highest-risk threat agents for bioterrorism. Of particular concern is the apparent lack of clinical interventions that can reverse cellular intoxication. Efforts to uncover molecules that can act within an intoxicated cell so as to provide symptomatic relief to BoNT/A are paramount. Aminopyridines have shown clinical efficacy for multiple sclerosis treatment as well as BoNT/A intoxication; yet, aminopyridines for BoNT/A treatment has been abandoned because of blood brain barrier (BBB) penetration producing undesired neurotoxic side effects. Two aminopyridines (5 and 11) exhibited inhibitory activity toward Shaker-IR voltage-gated potassium (K(V)1.x) channels with potencles similar to that of the previous "gold-standard", 3,4-diaminopyridine (3,4-DAP), including reversal of symptoms from BoNT-induced paralysis in phrenic nerve-hemidiaphragm preparations. Importantly, pharmacokinetic experiments revealed a lack of BBB penetration of 5, which is a significant advancement toward resolving the neurotoxiciy issues associated with prolonged 3,4-DAP treatments. Finally, 5 was found to be as effective as 3,4-DAP in rescuing. BoNT-poisoned mice in the mouse lethality assay, signifying an optimized balance between the undesired permeability across the BBB and the required permeability across lipid cellular membranes. The results demonstrate that 5 is the most promising small molecule. K+ channel inhibitor discovered to date for the treatment of BoNT/A intoxication.

 
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