The protein amyloid-β (Aß) is strongly implicated in the development of Alzheimer's dementia, where it aggregates in clumps causing damage and death of brain cells. This clumping is encouraged by copper and zinc (metal ions) in the brain. Metal protein attenuating compounds (MPACS) bind strongly to copper and zinc (this is known as chelation), both preventing the clumping together of Aß and promoting processes which may cause it to dissolve and so be cleared from brain cells. Therefore MPACS may be a potential therapy for Alzheimer's dementia. Two different types of MPAC have been used in clinical trials and the drugs are known as PBT1 and PBT2. The trial of PBT1 compared with placebo (in 36 patients) showed no statistically significant difference in cognition or memory between the active treatment and placebo groups at 36 weeks. We therefore conclude that there is no current evidence that treatment with clioquinol (PBT1) has any significant effect on cognition and in particular memory (as measured by the ADAS-Cog scale) in patients with Alzheimer's dementia. This drug has now been withdrawn from development. The trial of PBT2 showed it was safe after 12 weeks of treatment but demonstrated no overall significant effect on cognition or memory.
"Hence, understanding how PKA is dysregulated in various neuronal subcompartments will help guide the development of future pharmacological therapies for reversing degeneration in various brain degenerative diseases. It is worth noting that the use of mitochondrially directed antioxidants, calcium chelators/metal proteinbinding compounds, N -methyl D-aspartate receptor inhibitors , and caspase inhibitors has been developed but has demonstrated modest to no benefit in clinical trials for treating various brain degenerative disorders ( Snow et al., 2010 ; Johansson et al., 2011 ; Bonelli and Wenning, 2006 ; Regland et al., 2001 ; Sampson et al., 2012 ). "
[Show abstract][Hide abstract] ABSTRACT: In neurons, enhanced PKA signaling elevates synaptic plasticity, promotes neuronal development, and increases dopamine synthesis. On the other hand, a decline in PKA signaling contributes to the etiology of several brain degenerative diseases including Alzheimer’s disease and Parkinson’s disease suggesting that PKA predominantly plays a neuroprotective role. A-kinase anchoring proteins (AKAP) are large multi-domain scaffold proteins that target PKA and other signaling molecules to distinct subcellular sites to strategically localize PKA signaling at dendrites, dendritic spines, cytosol, and axons. PKA can be recruited to the outer mitochondrial mitochondria membrane by associating with three three different AKAPs to regulate mitochondrial dynamics, structure, mitochondrial respiration, trafficking, dendrite morphology, and neuronal survival. In this review, we survey the myriad of essential neuronal functions modulated by PKA but place a special emphasis on mitochondrially-localized PKA. Finally, we offer an updated overview of how loss of PKA signaling contributes to the etiology of several brain degenerative diseases.
Reviews in the neurosciences 01/2015; 26(3). DOI:10.1515/revneuro-2014-0085 · 3.33 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Dementia is a progressive, irreversible decline in cognition that, by definition, impacts on a patient's pre-existing level of functioning. The clinical syndrome of dementia has several aetiologies of which Alzheimer's disease (AD) is the most common. Drug development in AD is based on evolving pathophysiological theory. Disease modifying approaches include the targeting of amyloid processing, aggregation of tau, insulin signalling, neuroinflammation and neurotransmitter dysfunction, with efforts thus far yielding abandoned hopes and ongoing promise. Reflecting its dominance on the pathophysiological stage the amyloid cascade is central to many of the emerging drug therapies. The long preclinical phase of the disease requires robust biomarker means of identifying those at risk if timely intervention is to be possible.
[Show abstract][Hide abstract] ABSTRACT: The prevalence of Alzheimer's disease (AD) is increasing rapidly worldwide due to an ageing population and largely ineffective treatments. In AD cognitive decline is due to progressive neuron loss that begins in the medial temporal lobe and spreads through many brain regions. Despite intense research the pathogenesis of the common sporadic form of AD remains largely unknown. The popular amyloid cascade hypothesis suggests that the accumulation of soluble oligomers of beta amyloid peptides (Aβ) initiates a series of events that cause neuronal loss. Among their putative toxic effects, Aβ oligomers are thought to act as pro-oxidants combining with redox-active metals to produce excessive reactive oxygen and nitrogen species. However, to date the experimental therapies that reduce Aβ load in AD have failed to halt cognitive decline. Another hypothesis proposed by the late Mark Smith and colleagues is that oxidative stress, rather than Aβ, precipitates the pathogenesis of AD. That is, Aβ and microtubule-associated protein tau are upregulated to address the redox imbalance in the AD brain. As the disease progresses, excess Aβ and tau oligomerise to further accelerate the disease process. Here, we discuss redox balance in the human brain and how this balance is affected by ageing. We then discuss where oxidative stress is most likely to act in the disease process and the potential for intervention to reduce its effects.
Redox report: communications in free radical research 07/2013; 18(4):134-141. DOI:10.1179/1351000213Y.0000000052 · 1.52 Impact Factor
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