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依伐卡托及其代谢物潜在有益的中枢神经系统活性概况。

The potentially beneficial central nervous system activity profile of ivacaftor and its metabolites.

作者信息

Schneider Elena K, McQuade Rachel M, Carbone Vincenzo C, Reyes-Ortega Felisa, Wilson John W, Button Brenda, Saito Ayame, Poole Daniel P, Hoyer Daniel, Li Jian, Velkov Tony

机构信息

Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Australia.

Dept of Pharmacology and Therapeutics, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.

出版信息

ERJ Open Res. 2018 Mar 13;4(1). doi: 10.1183/23120541.00127-2017. eCollection 2018 Jan.

Abstract

Ivacaftor-lumacaftor and ivacaftor are two new breakthrough cystic fibrosis transmembrane conductance modulators. The interactions of ivacaftor and its two metabolites hydroxymethylivacaftor (iva-M1) and ivacaftorcarboxylate (iva-M6) with neurotransmitter receptors were investigated in radioligand binding assays. Ivacaftor displayed significant affinity to the 5-hydroxytryptamine (5-HT; serotonin) 5-HT receptor (p=6.06±0.03), β-adrenergic receptor (p=5.71±0.07), δ-opioid receptor (p=5.59±0.06) and the dopamine transporter (p=5.50±0.20); iva-M1 displayed significant affinity to the 5-HT receptor (p=5.81±0.04) and the muscarinic M3 receptor (p=5.70±0.10); iva-M6 displayed significant affinity to the 5-HT receptor (p=7.33±0.05). The central nervous system activity of ivacaftor (40 mg·kg intraperitoneally for 21 days) was assessed in a chronic mouse model of depression. In the forced swim test, the ivacaftor-treated group displayed decreased immobility (52.8±7.6 s), similarly to fluoxetine (33.8±11.0 s), and increased climbing/swimming activity (181.5±9.2 s). In the open field test, ivacaftor produced higher locomotor activity than the fluoxetine group, measured both as mean number of paw touches (ivacaftor 81.1±9.6 fluoxetine 57.9±9.5) and total distance travelled (ivacaftor 120.6±16.8 cm fluoxetine 84.5±16.0 cm) in 600 s. Treatment of 23 cystic fibrosis patients with ivacaftor-lumacaftor resulted in significant improvements in quality of life (including anxiety) in all five domains of the AweScoreCF questionnaire (p=0.092-0.096). Our findings suggest ivacaftor displays potential clinical anxiolytic and stimulating properties, and may have beneficial effects on mood.

摘要

依伐卡托-鲁马卡托和依伐卡托是两种新型的突破性囊性纤维化跨膜传导调节剂。通过放射性配体结合试验研究了依伐卡托及其两种代谢产物羟甲基依伐卡托(iva-M1)和依伐卡托羧酸盐(iva-M6)与神经递质受体的相互作用。依伐卡托对5-羟色胺(5-HT;血清素)5-HT受体(p=6.06±0.03)、β-肾上腺素能受体(p=5.71±0.07)、δ-阿片受体(p=5.59±0.06)和多巴胺转运体(p=5.50±0.20)表现出显著亲和力;iva-M1对5-HT受体(p=5.81±0.04)和毒蕈碱M3受体(p=5.70±0.10)表现出显著亲和力;iva-M6对5-HT受体(p=7.33±0.05)表现出显著亲和力。在慢性抑郁症小鼠模型中评估了依伐卡托(腹腔注射40mg·kg,持续21天)的中枢神经系统活性。在强迫游泳试验中,依伐卡托治疗组的不动时间减少(52.8±7.6秒),与氟西汀组(33.8±11.0秒)相似,攀爬/游泳活动增加(181.5±9.2秒)。在旷场试验中,依伐卡托产生的运动活性高于氟西汀组,在600秒内以平均爪触次数(依伐卡托81.1±9.6,氟西汀57.9±9.5)和总行进距离(依伐卡托120.6±16.8厘米,氟西汀84.5±16.0厘米)来衡量。用依伐卡托-鲁马卡托治疗23例囊性纤维化患者,AweScoreCF问卷所有五个领域的生活质量(包括焦虑)均有显著改善(p=0.092-0.096)。我们的研究结果表明依伐卡托具有潜在的临床抗焦虑和刺激特性,可能对情绪有有益影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/348b/5850045/4dd0a02571df/00127-2017.01.jpg

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Lumacaftor-Ivacaftor in Patients with Cystic Fibrosis Homozygous for Phe508del CFTR.
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