Laskowitz Daniel T, McKenna Suzanne E, Song Pingping, Wang Haichen, Durham Lori, Yeung Nolan, Christensen Dale, Vitek Michael P
Division of Neurology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.
J Neurotrauma. 2007 Jul;24(7):1093-107. doi: 10.1089/neu.2006.0192.
Traumatic brain injury (TBI) is a silent epidemic affecting approximately 1.4 million Americans annually, at an estimated annual cost of $60 billion in the United States alone. Despite an increased understanding of the pathophysiology of closed head injury, there remains no pharmacological intervention proven to improve functional outcomes in this setting. Currently, the existing standard of care for TBI consists primarily of supportive measures. Apolipoprotein E (apoE) is the primary apolipoprotein synthesized in the brain in response to injury, where it modulates several components of the neuroinflammatory cascade associated with TBI. We have previously demonstrated that COG133, an apoE mimetic peptide, improved functional outcomes and attenuated neuronal death when administered as a single intravenous injection at 30 min post-TBI in mice. Using the principles of rational drug design, we developed a more potent analog, COG1410, which expands the therapeutic window for the treatment of TBI by a factor of four, from 30 min to 2 h. Mice that received a single intravenous injection of COG1410 at 120 min post-TBI exhibited significant improvement on a short term test of vestibulomotor function and on a long term test of spatial learning and memory. This was associated with a significant attenuation of microglial activation and neuronal death in the hippocampus, the neuroanatomical substrate for learning and memory. Rationally derived apoE mimetic peptides have been demonstrated to exert neuroprotective and anti-inflammatory effects in vitro and in clinically relevant models of brain injury. This represents a novel therapeutic strategy in the treatment of TBI.
创伤性脑损伤(TBI)是一种隐匿性流行病,每年影响约140万美国人,仅在美国,每年估计花费600亿美元。尽管对闭合性颅脑损伤的病理生理学有了更多了解,但仍没有经证实能改善这种情况下功能结局的药物干预措施。目前,TBI现有的护理标准主要包括支持性措施。载脂蛋白E(apoE)是大脑在受到损伤时合成的主要载脂蛋白,它调节与TBI相关的神经炎症级联反应的几个组成部分。我们之前已经证明,载脂蛋白E模拟肽COG133在小鼠TBI后30分钟单次静脉注射时,可改善功能结局并减轻神经元死亡。利用合理药物设计的原理,我们开发了一种更有效的类似物COG1410,它将TBI治疗的治疗窗口扩大了四倍,从30分钟延长到2小时。在TBI后120分钟接受单次静脉注射COG1410的小鼠,在前庭运动功能短期测试以及空间学习和记忆长期测试中表现出显著改善。这与海马体中微胶质细胞激活和神经元死亡的显著减轻有关,海马体是学习和记忆的神经解剖学基础。合理衍生的载脂蛋白E模拟肽已被证明在体外和脑损伤的临床相关模型中具有神经保护和抗炎作用。这代表了TBI治疗中的一种新型治疗策略。