Baakman Anne Catrien, Alvarez-Jimenez Ricardo, Rissmann Robert, Klaassen Erica S, Stevens Jasper, Goulooze Sebastiaan C, den Burger Jeroen C G, Swart Eleonora L, van Gerven Joop M A, Groeneveld Geert Jan
Centre for Human Drug Research, Leiden, The Netherlands.
Department of Clinical Pharmacology and Pharmacy, VU University Medical Center, Amsterdam, The Netherlands.
Br J Clin Pharmacol. 2017 Aug;83(8):1676-1687. doi: 10.1111/bcp.13268. Epub 2017 Apr 8.
The muscarinic acetylcholine receptor antagonist scopolamine is often used for proof-of-pharmacology studies with pro-cognitive compounds. From a pharmacological point of view, it would seem more rational to use a nicotinic rather than a muscarinic anticholinergic challenge to prove pharmacology of a nicotinic acetylcholine receptor agonist. This study aims to characterize a nicotinic anticholinergic challenge model using mecamylamine and to compare it to the scopolamine model.
In this double-blind, placebo-controlled, four-way cross-over trial, 12 healthy male subjects received oral mecamylamine 10 and 20 mg, intravenous scopolamine 0.5 mg and placebo. Pharmacokinetics were analysed using non-compartmental analysis. Pharmacodynamic effects were measured with a multidimensional test battery that includes neurophysiological, subjective, (visuo)motor and cognitive measurements.
All treatments were safe and well tolerated. Mecamylamine had a t of 2.5 h and a C of 64.5 ng ml for the 20 mg dose. Mecamylamine had a dose-dependent effect decreasing the adaptive tracking performance and VAS alertness, and increasing the finger tapping and visual verbal learning task performance time and errors. Scopolamine significantly affected almost all pharmacodynamic tests.
This study demonstrated that mecamylamine causes nicotinic receptor specific temporary decline in cognitive functioning. Compared with the scopolamine model, pharmacodynamic effects were less pronounced at the dose levels tested; however, mecamylamine caused less sedation. The cognitive effects of scopolamine might at least partly be caused by sedation. Whether the mecamylamine model can be used for proof-of-pharmacology of nicotinic acetylcholine receptor agonists remains to be established.
毒蕈碱型乙酰胆碱受体拮抗剂东莨菪碱常用于认知增强化合物的药理学验证研究。从药理学角度来看,使用烟碱型而非毒蕈碱型抗胆碱能激发试验来验证烟碱型乙酰胆碱受体激动剂的药理学似乎更为合理。本研究旨在表征使用美加明的烟碱型抗胆碱能激发试验模型,并将其与东莨菪碱模型进行比较。
在这项双盲、安慰剂对照、四交叉试验中,12名健康男性受试者口服10毫克和20毫克美加明、静脉注射0.5毫克东莨菪碱以及安慰剂。采用非房室分析方法分析药代动力学。使用包括神经生理学、主观、(视觉)运动和认知测量的多维测试组合来测量药效学效应。
所有治疗均安全且耐受性良好。20毫克剂量的美加明t为2.5小时,C为64.5纳克/毫升。美加明具有剂量依赖性效应,可降低适应性跟踪性能和视觉模拟评分警觉性,并增加手指敲击和视觉言语学习任务的执行时间及错误。东莨菪碱显著影响几乎所有药效学测试。
本研究表明美加明会导致烟碱受体特异性的认知功能暂时下降。与东莨菪碱模型相比,在所测试的剂量水平下药效学效应不太明显;然而,美加明引起的镇静作用较小。东莨菪碱的认知效应可能至少部分是由镇静引起的。美加明模型是否可用于烟碱型乙酰胆碱受体激动剂的药理学验证仍有待确定。