Reversible and Irreversible Small Molecule Inhibitors of Monoamine Oxidase B (MAO-B) Investigated by Biophysical Techniques ⇑ Rafael J

Total Page:16

File Type:pdf, Size:1020Kb

Reversible and Irreversible Small Molecule Inhibitors of Monoamine Oxidase B (MAO-B) Investigated by Biophysical Techniques ⇑ Rafael J Bioorganic & Medicinal Chemistry 23 (2015) 770–778 Contents lists available at ScienceDirect Bioorganic & Medicinal Chemistry journal homepage: www.elsevier.com/locate/bmc Reversible and irreversible small molecule inhibitors of monoamine oxidase B (MAO-B) investigated by biophysical techniques ⇑ Rafael J. Rojas a, , Dale E. Edmondson b, Terri Almos a, Roderick Scott a, Mark E. Massari a a Dart NeuroScience, LLC, San Diego, CA 92131, USA b Departments of Chemistry and Biochemistry, Emory University, Atlanta, GA 30322, USA article info abstract Article history: Monoamine oxidase B (MAO-B) plays a key role in the metabolism of dopamine, a neurotransmitter crit- Received 16 September 2014 ical for the maintenance of cognitive function. Consequently, MAO-B is an important therapeutic target Revised 15 December 2014 for disorders characterized by a decline in dopaminergic neurotransmission, including Parkinson’s dis- Accepted 24 December 2014 ease (PD). An emerging strategy in drug discovery is to utilize the biophysical approaches of thermal shift Available online 3 January 2015 and isothermal titration calorimetry (ITC) to gain insight into binding modality and identify thermody- namically privileged chemical scaffolds. Described here is the development of such approaches for Keywords: reversible and irreversible small molecule inhibitors of MAO-B. Investigation of soluble recombinant Monoamine oxidase MAO-B revealed mechanism-based differences in the thermal shift and binding thermodynamic profiles MAO-B Isothermal titration calorimetry of MAO-B inhibitors. Irreversible inhibitors demonstrated biphasic protein melt curves, large enthalpical- Thermal shift ly favorable and entropically unfavorable binding, in contrast to reversible compounds, which were char- Biochemical analysis acterized by a dose-dependent increase in thermal stability and enthalpically-driven binding. The Enzymatic analysis biophysical approaches described here aim to facilitate the discovery of next-generation MAO-B Small molecule inhibitors inhibitors. Ó 2015 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). 1. Introduction (L-3,4-dihydroxyphenylalanine) resulted in improved episodic memory formation6 and MAO-B inhibitors have been shown to The central role of dopaminergic signaling in memory and cog- improve memory in rodent models7–9 as well as Alzheimer’s dis- nition is well established.1 Reduced dopaminergic neurotransmis- ease (AD) patients.10,11 In addition to its well established role in sion can contribute to cognitive decline in disorders such as monoamine degradation, MAO-B was recently shown to play an Parkinson’s disease (PD).2 Inhibition of the key metabolic enzyme important role in c-aminobutyric acid (GABA)-mediated synaptic for dopamine, monoamine oxidase B (MAO-B), is a clinically vali- inhibition by reactive astrocytes in mouse models of AD.12,13 For dated approach for maintaining dopaminergic signaling in PD these reasons, there has been a reemergence of drug discovery patients and can improve cognitive function in addition to the clas- efforts targeting MAO-B for AD and other disorders of memory sical motor symptoms.3 During aging, dopamine levels decrease, and cognition.14 while MAO-B expression increases 3-fold.4 In addition to mono- Monoamine oxidases are flavin-dependent enzymes responsi- amine degradation, MAO-B activity results in the generation of ble for the oxidative deamination of monoamine neurotransmit- hydrogen peroxide which can promote oxidative stress and mito- ters. The two MAO isoenzymes, MAO-A and MAO-B, share 70% chondrial dysfunction during aging.5 These findings suggest that sequence identity and metabolize serotonin and dopamine, respec- therapeutic maintenance of dopamine may be a strategy to improve tively. Both enzymes are monotopically inserted into the outer cognitive function in the elderly. In support of this concept, mitochondrial membrane by a single C-terminal hydrophobic treatment of otherwise healthy elderly patients with L-DOPA helix. Although MAO-B forms homodimeric structures, there is no evidence of cross-talk between the two active sites.15 Currently, the only FDA-approved MAO-B-selective inhibitors, selegiline Abbreviations: AD, Alzheimer’s disease; ANS, 1-8-anilinonaphthalene sulfonate; (L-deprenyl,) and rasagiline (Azilect), are irreversible, forming FAD, flavin adenine dinucleotide; ITC, isothermal titration calorimetry; MAO, covalent adducts to the flavin adenine dinucleotide (FAD) cofactor monoamine oxidase; PBS, phosphate-buffered saline; PD, Parkinson’s disease; RFU, 16–18 relative fluorescence units; RLU, relative luminescence units. within the MAO-B active site. More recently, there has been an ⇑ Corresponding author. Tel.: +1 858 246 8151. effort to develop reversible MAO-B inhibitors with higher selectiv- E-mail address: [email protected] (R.J. Rojas). ity for MAO-B over MAO-A in order to circumvent off-target http://dx.doi.org/10.1016/j.bmc.2014.12.063 0968-0896/Ó 2015 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). R.J. Rojas et al. / Bioorg. Med. Chem. 23 (2015) 770–778 771 liabilities, such as hypertensive crisis associated with inhibition of MAO-A in the gastrointestinal tract.19 This has resulted in next- generation reversible MAO-B inhibitors, such as lazabemide (Roche), EVT-302 (Evotec), safinamide (Newron Pharmaceuticals), and HT-3951 (Dart NeuroScience) entering clinical trials. Described here is the development of biophysical approaches using isother- mal titration calorimetry (ITC) and thermal shift which can compli- ment traditional measures of affinity and enable the discovery of next-generation MAO-B inhibitors. ITC allows for the complete thermodynamic characterization of inhibitor binding by measuring the heat evolved upon complex formation. The change in free energy (DG) upon inhibitor binding can be defined by changes in both enthalpy (DH) and entropy 20 (DS) and is directly related to binding affinity (KD). Favorable enthalpic contributions are largely driven by specific bonding net- works mediated by hydrogen bonds, shape complementarity (van der Waals’ interactions), and salt bridges, while favorable entropic contributions are derived from bulk hydration effects, such as the release of water molecules upon binding, hydrophobic interac- tions, or an increase in the conformational flexibility of the protein or ligand.20 Retrospective studies have shown that best-in-class Figure 1. Structures of MAO-B inhibitors. drugs demonstrate improved enthalpy values relative to their first-in-class counterparts, supporting the concept that aminopropylether analog of a methyl ester luciferin precursor sub- enthalpically-driven compounds are preferred candidates for drug strate that is then converted into light by the addition of a lucifer- 31 development.21 As such, there is growing support for the notion ase-containing detection solution. The Amplex Red assay is a that thermodynamic studies should be harnessed early in drug dis- fluorescence-based method for measuring hydrogen peroxide for- covery to differentiate chemical scaffolds based on their enthalpic mation, which is a product of substrate oxidation. Hydrogen perox- efficiency.22,23 ide produced by MAO activity is then used by horseradish The capacity for a compound to influence the structural integ- peroxidase to convert non-fluorescent Amplex Red to the fluores- 32,33 rity of a protein can be assessed using plate-based assays for ther- cent product Resorufin. An advantage of the MAO-Glo assay is mal stability.24 Protein thermal stability can be measured using its large signal window and adaptability to screening in high-den- hydrophobic-sensitive fluorophores to monitor protein unfolding sity microtiter plates. However, the reliance on endpoint reading resulting from an increase in temperature using a standard quanti- with a non-native substrate limits its use for detailed biochemical tative PCR instrument. Inhibitor binding results in a shift in the studies. The Amplex Red assay has the advantage of using native substrates with real-time monitoring. observed melting temperature (Tm) providing additional insight into binding modality.25 Fluorescence-based assays for thermal Substrate saturation experiments frequently result in reaction stability are commonly referred to in the literature as thermal shift rates that exceed the assay linear range, this can be overlooked assay (TSA), differential scanning fluorimetry (DSF), temperature- when reading in endpoint mode. Therefore, the MAO-Glo substrate dependent fluorescence (TdF), ThermoFluor, or protein thermal saturation experiments were conducted at multiple time points to shift (PTS). Such assays are increasingly used to characterize and ensure progress curve linearity to 60 min for each substrate con- differentiate compounds during drug discovery.26 centration. Observed Km values for the MAO-Glo substrate were Integral membrane proteins can pose significant challenges to 1.1 (±0.07) lM for soluble and 0.6 (±0.09) lM for microsomal the development of thermal shift and ITC assays27 and although MAO-B (Fig. 2A). These Km values were more potent relative to MAO-B is classified as an integral membrane protein, it can be the published value of 4 lM using microsomal MAO-B, an observa- purified in a soluble form which was crucial to enabling the bio- tion that is most likely the
Recommended publications
  • The In¯Uence of Medication on Erectile Function
    International Journal of Impotence Research (1997) 9, 17±26 ß 1997 Stockton Press All rights reserved 0955-9930/97 $12.00 The in¯uence of medication on erectile function W Meinhardt1, RF Kropman2, P Vermeij3, AAB Lycklama aÁ Nijeholt4 and J Zwartendijk4 1Department of Urology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands; 2Department of Urology, Leyenburg Hospital, Leyweg 275, 2545 CH The Hague, The Netherlands; 3Pharmacy; and 4Department of Urology, Leiden University Hospital, P.O. Box 9600, 2300 RC Leiden, The Netherlands Keywords: impotence; side-effect; antipsychotic; antihypertensive; physiology; erectile function Introduction stopped their antihypertensive treatment over a ®ve year period, because of side-effects on sexual function.5 In the drug registration procedures sexual Several physiological mechanisms are involved in function is not a major issue. This means that erectile function. A negative in¯uence of prescrip- knowledge of the problem is mainly dependent on tion-drugs on these mechanisms will not always case reports and the lists from side effect registries.6±8 come to the attention of the clinician, whereas a Another way of looking at the problem is drug causing priapism will rarely escape the atten- combining available data on mechanisms of action tion. of drugs with the knowledge of the physiological When erectile function is in¯uenced in a negative mechanisms involved in erectile function. The way compensation may occur. For example, age- advantage of this approach is that remedies may related penile sensory disorders may be compen- evolve from it. sated for by extra stimulation.1 Diminished in¯ux of In this paper we will discuss the subject in the blood will lead to a slower onset of the erection, but following order: may be accepted.
    [Show full text]
  • Questions in the Chemical Enzymology of MAO
    Review Questions in the Chemical Enzymology of MAO Rona R. Ramsay 1,* and Alen Albreht 2 1 Biomedical Sciences Research Complex, School of Biology, University of St Andrews, St Andrews KY16 9ST, UK 2 Laboratory for Food Chemistry, Department of Analytical Chemistry, National Institute of Chemistry, Hajdrihova 19, SI-1000 Ljubljana, Slovenia; [email protected] * Correspondence: [email protected]; Tel.: +44-(0)-1334-474740 Abstract: We have structure, a wealth of kinetic data, thousands of chemical ligands and clinical information for the effects of a range of drugs on monoamine oxidase activity in vivo. We have comparative information from various species and mutations on kinetics and effects of inhibition. Nevertheless, there are what seem like simple questions still to be answered. This article presents a brief summary of existing experimental evidence the background and poses questions that remain intriguing for chemists and biochemists researching the chemical enzymology of and drug design for monoamine oxidases (FAD-containing EC 4.1.3.4). Keywords: chemical mechanism; kinetic mechanism; oxidation; protein flexibility; cysteine modifica- tion; reversible/irreversible inhibition; molecular dynamics; simulation 1. Introduction Monoamine oxidase (E.C. 1.4.3.4) enzymes MAO A and MAO B are FAD-containing Citation: Ramsay, R.R.; Albreht, A. proteins located on the outer face of the mitochondrial inner membrane, retained there Questions in the Chemical Enzymology of MAO. Chemistry 2021, by hydrophobic interactions and a transmembrane helix. The redox co-factor (FAD) is 3, 959–978. https://doi.org/10.3390/ covalently attached to a cysteine and buried deep inside the protein [1].
    [Show full text]
  • Azilect, INN-Rasagiline
    SCIENTIFIC DISCUSSION 1. Introduction AZILECT is indicated for the treatment of idiopathic Parkinson’s disease (PD) as monotherapy (without levodopa) or as adjunct therapy (with levodopa) in patients with end of dose fluctuations. Rasagiline is administered orally, at a dose of 1 mg once daily with or without levodopa. Parkinson’s disease is a common neurodegenerative disorder typified by loss of dopaminergic neurones from the basal ganglia, and by a characteristic clinical syndrome with cardinal physical signs of resting tremor, bradikinesia and rigidity. The main treatment aims at alleviating symptoms through a balance of anti-cholinergic and dopaminergic drugs. Parkinson’s disease (PD) treatment is complex due to the progressive nature of the disease, and the array of motor and non-motor features combined with early and late side effects associated with therapeutic interventions. Rasagiline is a chemical inhibitor of the enzyme monoamine oxidase (MAO) type B which has a major role in the inactivation of biogenic and diet-derived amines in the central nervous system. MAO has two isozymes (types A and B) and type B is responsible for metabolising dopamine in the central nervous system; as dopamine deficiency is the main contributing factor to the clinical manifestations of Parkinson’s disease, inhibition of MAO-B should tend to restore dopamine levels towards normal values and this improve the condition. Rasagiline was developed for the symptomatic treatment of Parkinson’s disease both as monotherapy in early disease and as adjunct therapy to levodopa + aminoacids decarboxylase inhibitor (LD + ADI) in patients with motor fluctuations. 2. Quality Introduction Drug Substance • Composition AZILECT contains rasagiline mesylate as the active substance.
    [Show full text]
  • Evidence That Formulations of the Selective MAO-B Inhibitor, Selegiline, Which Bypass First-Pass Metabolism, Also Inhibit MAO-A in the Human Brain
    Neuropsychopharmacology (2015) 40, 650–657 OPEN & 2015 American College of Neuropsychopharmacology. All rights reserved 0893-133X/15 www.neuropsychopharmacology.org Evidence that Formulations of the Selective MAO-B Inhibitor, Selegiline, which Bypass First-Pass Metabolism, also Inhibit MAO-A in the Human Brain Joanna S Fowler*,1, Jean Logan2, Nora D Volkow3,4, Elena Shumay4, Fred McCall-Perez5, Millard Jayne4, Gene-Jack Wang4, David L Alexoff1, Karen Apelskog-Torres4, Barbara Hubbard1, Pauline Carter1, 1 6 7 4 1 1 4 Payton King , Stanley Fahn , Michelle Gilmor , Frank Telang , Colleen Shea , Youwen Xu and Lisa Muench 1Biological, Environmental and Climate Sciences Department, Brookhaven National Laboratory, Upton, NY, USA; 2New York University Langone Medical Center, Department of Radiology, New York, NY, USA; 3National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, 4 5 USA; National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA; Targeted Medical Pharma Inc, 6 7 Los Angeles, CA, USA; Department of Neurology, Columbia University Medical Center, New York, NY, USA; Novartis Pharmaceuticals, East Hanover, NJ, USA Selegiline (L-deprenyl) is a selective, irreversible inhibitor of monoamine oxidase B (MAO-B) at the conventional dose (10 mg/day oral) that is used in the treatment of Parkinson’s disease. However, controlled studies have demonstrated antidepressant activity for high doses of oral selegiline and for transdermal selegiline suggesting that when plasma levels of selegiline are elevated, brain MAO-A might also be inhibited. Zydis selegiline (Zelapar) is an orally disintegrating formulation of selegiline, which is absorbed through the buccal mucosa producing higher plasma levels of selegiline and reduced amphetamine metabolites compared with equal doses of conventional selegiline.
    [Show full text]
  • Title 16. Crimes and Offenses Chapter 13. Controlled Substances Article 1
    TITLE 16. CRIMES AND OFFENSES CHAPTER 13. CONTROLLED SUBSTANCES ARTICLE 1. GENERAL PROVISIONS § 16-13-1. Drug related objects (a) As used in this Code section, the term: (1) "Controlled substance" shall have the same meaning as defined in Article 2 of this chapter, relating to controlled substances. For the purposes of this Code section, the term "controlled substance" shall include marijuana as defined by paragraph (16) of Code Section 16-13-21. (2) "Dangerous drug" shall have the same meaning as defined in Article 3 of this chapter, relating to dangerous drugs. (3) "Drug related object" means any machine, instrument, tool, equipment, contrivance, or device which an average person would reasonably conclude is intended to be used for one or more of the following purposes: (A) To introduce into the human body any dangerous drug or controlled substance under circumstances in violation of the laws of this state; (B) To enhance the effect on the human body of any dangerous drug or controlled substance under circumstances in violation of the laws of this state; (C) To conceal any quantity of any dangerous drug or controlled substance under circumstances in violation of the laws of this state; or (D) To test the strength, effectiveness, or purity of any dangerous drug or controlled substance under circumstances in violation of the laws of this state. (4) "Knowingly" means having general knowledge that a machine, instrument, tool, item of equipment, contrivance, or device is a drug related object or having reasonable grounds to believe that any such object is or may, to an average person, appear to be a drug related object.
    [Show full text]
  • Potent Inhibition of Monoamine Oxidase B by a Piloquinone from Marine-Derived Streptomyces Sp. CNQ-027
    J. Microbiol. Biotechnol. (2017), 27(4), 785–790 https://doi.org/10.4014/jmb.1612.12025 Research Article Review jmb Potent Inhibition of Monoamine Oxidase B by a Piloquinone from Marine-Derived Streptomyces sp. CNQ-027 Hyun Woo Lee1, Hansol Choi2, Sang-Jip Nam2, William Fenical3, and Hoon Kim1* 1Department of Pharmacy and Research Institute of Life Pharmaceutical Sciences, Sunchon National University, Suncheon 57922, Republic of Korea 2Department of Chemistry and Nano Science, Ewha Womans University, Seoul 03760, Republic of Korea 3Center for Marine Biotechnology and Biomedicine, Scripps Institution of Oceanography, University of California, San Diego, La Jolla, CA 92093-0204, USA Received: December 19, 2016 Revised: December 27, 2016 Two piloquinone derivatives isolated from Streptomyces sp. CNQ-027 were tested for the Accepted: January 4, 2017 inhibitory activities of two isoforms of monoamine oxidase (MAO), which catalyzes monoamine neurotransmitters. The piloquinone 4,7-dihydroxy-3-methyl-2-(4-methyl-1- oxopentyl)-6H-dibenzo[b,d]pyran-6-one (1) was found to be a highly potent inhibitor of First published online human MAO-B, with an IC50 value of 1.21 µM; in addition, it was found to be highly effective January 9, 2017 against MAO-A, with an IC50 value of 6.47 µM. Compound 1 was selective, but not extremely *Corresponding author so, for MAO-B compared with MAO-A, with a selectivity index value of 5.35. Compound 1,8- Phone: +82-61-750-3751; dihydroxy-2-methyl-3-(4-methyl-1-oxopentyl)-9,10-phenanthrenedione (2) was moderately Fax: +82-61-750-3708; effective for the inhibition of MAO-B (IC = 14.50 µM) but not for MAO-A (IC > 80 µM).
    [Show full text]
  • Some Pharmacological Properties of Trimethoxy Analogs of Pheniramine, Tripelennamine, and Diphenhydramine
    University of Rhode Island DigitalCommons@URI Open Access Master's Theses 1966 Some Pharmacological Properties of Trimethoxy Analogs of Pheniramine, Tripelennamine, and Diphenhydramine Ronald Otto Langner University of Rhode Island Follow this and additional works at: https://digitalcommons.uri.edu/theses Recommended Citation Langner, Ronald Otto, "Some Pharmacological Properties of Trimethoxy Analogs of Pheniramine, Tripelennamine, and Diphenhydramine" (1966). Open Access Master's Theses. Paper 200. https://digitalcommons.uri.edu/theses/200 This Thesis is brought to you for free and open access by DigitalCommons@URI. It has been accepted for inclusion in Open Access Master's Theses by an authorized administrator of DigitalCommons@URI. For more information, please contact [email protected]. SOME PHARMACOLOGICAL PRDPERTIES OF TRIMETHOXY ANALOGS OF PHENIRAMINE,_ TRIPELENNAMINE, AND DIPHENHYDRAMINE BY RONALD OT'ID LANGNER A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FDR THE DEGREE OF MASTER OF SCIENCE IN PHARMACOLOGY UNIVERSITY OF RHODE ISLAND 1966 ABSTRACT Trimethoxy analogs of tripelennamine, diphenhydramine, and pheniramine were studied to determine the influences of the tri­ methoxy group on the pharmacological activity of known antihista­ mines. In this investigation, the ability of the parent compounds and their analogs to antagonize the histamine-induced contractions of guinea pig ilia were studied as well as their effects on the systolic blood pressure of male albino rats and on the central nervous system of mice as measured by the actophotometer. 'lhe trimethoxy analogs were comparatively weak competitive antagonists of histamine with the exception of N,N,-Diethyl-N'­ (2-pyridyl)-N'-(3,4,S-trimethoxybenzyl) ethylenediamine Dicyclamate (De-TMPBZ) and N,N,-Diethyl-N'-(2-pyridyl)-N'-(3,4,5-trimethoxy­ benzyl) ethylenediamine Disuccinate (TMPBZ) which were weak non­ competitive histamine antagonists.
    [Show full text]
  • Pharmacological Aspects of the Neuroprotective Effects Of
    Journal of Neural Transmission https://doi.org/10.1007/s00702-018-1853-9 NEUROLOGY AND PRECLINICAL NEUROLOGICAL STUDIES - REVIEW ARTICLE Pharmacological aspects of the neuroprotective efects of irreversible MAO‑B inhibitors, selegiline and rasagiline, in Parkinson’s disease Éva Szökő1 · Tamás Tábi1 · Peter Riederer2 · László Vécsei3,4 · Kálmán Magyar1 Received: 4 January 2018 / Accepted: 31 January 2018 © Springer-Verlag GmbH Austria, part of Springer Nature 2018 Abstract The era of MAO-B inhibitors dates back more than 50 years. It began with Kálmán Magyar’s outstanding discovery of the selective inhibitor, selegiline. This compound is still regarded as the gold standard of MAO-B inhibition, although newer drugs have also been introduced to the feld. It was revealed early on that selective, even irreversible inhibition of MAO-B is free from the severe side efect of the non-selective MAO inhibitors, the potentiation of tyramine, resulting in the so-called ‘cheese efect’. Since MAO-B is involved mainly in the degradation of dopamine, the inhibitors lack any antidepressant efect; however, they became frst-line medications for the therapy of Parkinson’s disease based on their dopamine-sparing activity. Extensive studies with selegiline indicated its complex pharmacological activity profle with MAO-B-independent mechanisms involved. Some of these benefcial efects, such as neuroprotective and antiapoptotic properties, were connected to its propargylamine structure. The second MAO-B inhibitor approved for the treatment of Parkinson’s disease, rasagiline also possesses this structural element and shows similar pharmacological characteristics. The preclinical studies performed with selegiline and rasagiline are summarized in this review. Keywords MAO-B inhibition · Selegiline · Rasagiline · Neuroprotection Introduction inhibitor in the 1960s (Knoll et al.
    [Show full text]
  • Application Number
    CENTER FOR DRUG EVALUATION AND RESEARCH APPLICATION NUMBER: 207145Orig1s000 PHARMACOLOGY REVIEW(S) Tertiary Pharmacology Review By: Paul C. Brown, Ph.D., ODE Associate Director for Pharmacology and Toxicology, OND IO NDA: 207145 Submission date: 5/29/2014 Drug: Safinamide Applicant: Newron Pharmaceuticals Indication: adjunctive treatment to levodopa/carbidopa in patients with Parkinson’s disease experiencing “off” episodes Reviewing Division: Division of Neurology Products Discussion: The primary reviewer and supervisor found the nonclinical information adequate to support the approval of safinamide for the indication listed above. Safinamide is an inhibitor of monoamine oxidase B. Although the exact mechanism by which safinamide exerts it therapeutic effect is not known, increased dopaminergic activity in the brain induced by inhibition of monoamine oxidase B is thought to be beneficial in Parkinson’s disease. The Established Pharmacologic Class of Monoamine Oxidase Type B Inhibitor is appropriate for safinamide. The carcinogenicity of safinamide was assessed in 2-year rat and mouse studies. These studies were found to be acceptable by the executive carcinogenicity assessment committee and the committee concluded that there were no drug- related neoplasms in either species. Retinal toxicity and cataracts were observed in rats treated with safinamide. These effects occurred at exposures below those achieved in humans at the maximum recommended dose. The relevance to humans is unknown but cannot be excluded. Proposed labeling includes warning about this possible toxicity. Safinamide alone and in combination with levodopa and carbidopa produced adverse developmental effects in animals at doses similar to those used in humans. Proposed labeling includes description of these findings. Conclusions: I agree that this NDA can be approved from a pharm/tox perspective for the indication listed above.
    [Show full text]
  • A Abacavir Abacavirum Abakaviiri Abagovomab Abagovomabum
    A abacavir abacavirum abakaviiri abagovomab abagovomabum abagovomabi abamectin abamectinum abamektiini abametapir abametapirum abametapiiri abanoquil abanoquilum abanokiili abaperidone abaperidonum abaperidoni abarelix abarelixum abareliksi abatacept abataceptum abatasepti abciximab abciximabum absiksimabi abecarnil abecarnilum abekarniili abediterol abediterolum abediteroli abetimus abetimusum abetimuusi abexinostat abexinostatum abeksinostaatti abicipar pegol abiciparum pegolum abisipaaripegoli abiraterone abirateronum abirateroni abitesartan abitesartanum abitesartaani ablukast ablukastum ablukasti abrilumab abrilumabum abrilumabi abrineurin abrineurinum abrineuriini abunidazol abunidazolum abunidatsoli acadesine acadesinum akadesiini acamprosate acamprosatum akamprosaatti acarbose acarbosum akarboosi acebrochol acebrocholum asebrokoli aceburic acid acidum aceburicum asebuurihappo acebutolol acebutololum asebutololi acecainide acecainidum asekainidi acecarbromal acecarbromalum asekarbromaali aceclidine aceclidinum aseklidiini aceclofenac aceclofenacum aseklofenaakki acedapsone acedapsonum asedapsoni acediasulfone sodium acediasulfonum natricum asediasulfoninatrium acefluranol acefluranolum asefluranoli acefurtiamine acefurtiaminum asefurtiamiini acefylline clofibrol acefyllinum clofibrolum asefylliiniklofibroli acefylline piperazine acefyllinum piperazinum asefylliinipiperatsiini aceglatone aceglatonum aseglatoni aceglutamide aceglutamidum aseglutamidi acemannan acemannanum asemannaani acemetacin acemetacinum asemetasiini aceneuramic
    [Show full text]
  • Monoamine Oxidase Inhibition Causes a Long-Term Prolongation of the Dopamine-Induced Responses in Rat Midbrain Dopaminergic Cells
    The Journal of Neuroscience, April 1, 1997, 17(7):2267–2272 Monoamine Oxidase Inhibition Causes a Long-Term Prolongation of the Dopamine-Induced Responses in Rat Midbrain Dopaminergic Cells Nicola B. Mercuri, Mariangela Scarponi, Antonello Bonci, Antonio Siniscalchi, and Giorgio Bernardi Clinica Neurologica, Dipartimento Sanita´ Pubblica, Universita´ di Roma Tor Vergata and Istituto Ricerca e Cura a Carattere Scientifico Ospedale Santa Lucia, Roma, Italy The way monoamine oxidase (MAO) modulates the depression over, the effects of DA were not largely prolonged during the of the firing rate and the hyperpolarization of the membrane simultaneous inhibition of MAO and the DA reuptake system. caused by dopamine (DA) on rat midbrain dopaminergic cells Interestingly, the actions of amphetamine were not clearly aug- was investigated by means of intracellular recordings in vitro. mented by MAO inhibition. The cellular responses to DA, attributable to the activation of From the present data it is concluded that the termination of somatodendritic D2/3 autoreceptors, were prolonged and did DA action in the brain is controlled mainly by MAO enzymes. not completely wash out after pharmacological blockade of This long-term prolongation of the dopaminergic responses both types (A and B) of MAO. On the contrary, depression of the suggests a substitutive therapeutic approach that uses MAO firing rate and membrane hyperpolarization induced by quinpi- inhibitors and DA precursors in DA-deficient disorders in which role (a direct D2 receptor agonist) were not affected by MAO continuous stimulation of the dopaminergic receptors is inhibition. Furthermore, although the inhibition of DA reuptake preferable. by cocaine and nomifensine caused a short-term prolongation of DA responses, the combined inhibition of MAO A and B Key words: pargyline; cocaine; nomifensine; intracellular re- enzymes caused a long-term prolongation of DA effects.
    [Show full text]
  • ANTIHISTAMINES Antihistamines Need to Be Stopped 7 Days Prior to Allergy Testing
    ANTIHISTAMINES Antihistamines need to be stopped 7 days prior to allergy testing Actifed Cetirizine Extendryl Rutuss Advil Allergy Chlorphenirmine Fexofenadine Ryna Advil PM Clortrimeton Hydroxyzine Rynatan Alavert Clarinex Hyzine Ryneze Allegra Claritin Lodrane Semprex Allerhist Clemastine Loratadine Singlet Allertan Cogentin Nyquil Sominex Allerx Comtrex Omnaris nasal spray Astelin nasal spray Contac Optivar eye drops Tandur Astepro nasal spray Coricidin Pataday Travist Atarax Cyproheptadine Patanase nasal spray Temaril Atrohist Deconamine Patanol eye drops Theraflu BC Cold Dimetapp PediaCare Triaminic Benadryl Diphenhydramine Pediatan Trinalin Bentyl Dramamine Periactin Tylenol (any but plain) Benztropin Drixoral Polyhistine Unisom Biohist Durahist Pyribenzamine Vicks Bonine Duratan Rescon Vistacot Bromfed Duravent Restall Vistaril IM Brompheniramine Dytan Robitussin Xyzal Carbinoxamine Excedrin PM Rondec Zyrtec ANTI-INFLAMMATORY Anti-inflammatory medications must be stopped 7 days prior to allergy testing Aspirin Celebrex Motrin Aleve Naprosyn (Naproxen) Flexeril Advil Excedrin (PM & Cold/Sinus) Ibuprofen Alka-Seltzer Prednisone Vioxx Meloxicam cold medications BETA BLOCKERS Beta blocker drugs need to be stopped 7 days prior to allergy testing. DO NOT STOP WITHOUT PRESCRIBING PROVIDERS AUTHORIZATION! ORAL COMBINATION PRODUCTS Brand Name Generic Name Brand Name Generic Name Apo-Metoprolol metoprolol Cobetaloc metroprolol/HCTZ Apo-Propranolol propranolol Corzide Nadolol Betaloc metoprolol Inderide propranolol/HCTZ Betapace/AF sotalol
    [Show full text]