Medivation, Inc., San Francisco, California 94105, USA.
J Pharmacol Exp Ther. 2010 Jun;333(3):748-57. doi: 10.1124/jpet.109.164491. Epub 2010 Mar 1.
Dimebon (dimebolin) treatment enhances cognition in patients with Alzheimer's disease (AD) or Huntington's disease. Although Dimebon was originally thought to improve cognition and memory through inhibition of acetylcholinesterase (AChE) and the N-methyl-d-aspartate (NMDA) receptor, the low in vitro affinity for these targets suggests that these mechanisms may not contribute to its clinical effects. To test this hypothesis, we assessed whether Dimebon enhances cognition in rats and if such an action is related to either mechanism or additional candidate mechanisms. Acute oral administration of Dimebon to rats (0.05, 0.5, and 5 mg/kg) enhanced cognition in a novel object recognition task and produced Dimebon brain concentrations of 1.7 +/- 0.43, 14 +/- 5.1, and 172 +/- 94 nM, respectively. At these concentrations, Dimebon did not alter the activity of recombinant human or rat brain AChE. Unlike the AChE inhibitors donepezil and galantamine, Dimebon did not change acetylcholine levels in the hippocampus or prefrontal cortex of freely moving rats. Dimebon displays affinity for the NMDA receptor (K(i) = 105 +/- 18 microM) that is considerably higher than brain concentrations associated with cognition enhancement in the novel object recognition task and 200-fold weaker than that of memantine (K(i) = 0.54 +/- 0.05 microM). Dimebon did not block NMDA-induced calcium influx in primary neuronal cells (IC(50) > 50 microM), consistent with a lack of significant effect on this pathway. The cognition-enhancing effects of Dimebon are unlikely to be mediated by AChE inhibition or NMDA receptor antagonism, and its mechanism of action appears to be distinct from currently approved medications for AD.
地美波恩(地美溴铵)治疗可改善阿尔茨海默病(AD)或亨廷顿病患者的认知功能。尽管地美波恩最初被认为通过抑制乙酰胆碱酯酶(AChE)和 N-甲基-D-天冬氨酸(NMDA)受体来改善认知和记忆,但体外对这些靶点的低亲和力表明这些机制可能与它的临床效果无关。为了验证这一假说,我们评估了地美波恩是否能增强大鼠的认知功能,以及这种作用是否与任何机制或其他候选机制有关。急性口服给予大鼠地美波恩(0.05、0.5 和 5mg/kg)可增强新颖物体识别任务中的认知功能,并分别产生 1.7+/-0.43、14+/-5.1 和 172+/-94nM 的地美波恩脑浓度。在这些浓度下,地美波恩不改变重组人或大鼠脑 AChE 的活性。与 AChE 抑制剂多奈哌齐和加兰他敏不同,地美波恩不会改变自由活动大鼠海马体或前额叶皮质中的乙酰胆碱水平。地美波恩对 NMDA 受体具有亲和力(K(i)=105+/-18μM),远高于与新颖物体识别任务中认知增强相关的脑浓度,比美金刚(K(i)=0.54+/-0.05μM)弱 200 倍。地美波恩不会阻断原代神经元细胞中 NMDA 诱导的钙内流(IC(50)>50μM),这与该途径无显著影响一致。地美波恩的认知增强作用不太可能通过 AChE 抑制或 NMDA 受体拮抗介导,其作用机制似乎与目前批准用于 AD 的药物不同。