抗乙酰胆碱酯酶基因表达的反义寡核苷酸的研究进展

反义核酸技术是近年来迅速发展的选择性抑制特定基因表达的一种生物技术，乙酰胆碱酯酶抑制剂可用于治疗早老性痴呆和重症肌无力等疾病，本文综述了利用反义寡核苷酸抑制乙酰胆碱酯酶的表达研制新型胆碱酯酶抑制剂的研究进展。     

治疗阿尔茨海默病的胆碱酯酶抑制剂的研究进展

阿尔茨海默病(AD)即早老性痴呆的患病率正逐年升高.胆碱酯酶抑制剂通过抑制酶的活性,阻止内源性乙酰胆碱的降解,增强了乙酰胆碱对脑胆碱受体的作用,提高AD患者的胆碱神经功能.对他克林、多奈哌齐、利斯的明3种胆碱酯酶抑制剂的药理作用、药代动力学、安全性及耐受性、药物相互作用进行了介绍.     

抗阿尔茨海默病的胆碱酯酶抑制剂研究进展

目前抗阿尔茨海默病的新策略之一是设计具有多靶向的药物。综述抗阿尔茨海默病的胆碱酯酶抑制剂研究的新进展,分类介绍乙酰胆碱酯酶和丁酰胆碱酯酶双重抑制剂、可抑制B-淀粉样蛋白聚集的胆碱酯酶抑制剂、具有抗氧化作用的胆碱酯酶抑制剂、可拮抗H,受体的胆碱酯酶抑制剂以及NO供体型胆碱酯酶抑制剂等多靶向药物,并讨论了各类药物的设计和优化。     

薄层色谱-生物自显影技术在活性物质筛选中的应用

薄层色谱-生物自显影技术(TLC-bioautography)将薄层色谱分离和生物活性测定相结合,是一种活性指导下的快速靶向追踪分离、筛选活性成分的方法。此法操作简单、耗时短、灵敏度和专属性高,常应用于抗细菌、抗真菌、抗氧化,以及对乙酰胆碱酯酶抑制剂、葡萄糖苷酶抑制剂等活性天然产物的筛选。笔者对薄层色谱-生物自显影技术在活性物质筛选方面的应用进行综述。     

新型乙酰胆碱酯酶抑制剂5H-噻唑并[3,2-a]嘧啶类化合物的设计、合成与生物活性研究

目的 寻找作为乙酰胆碱酯酶抑制剂的具有新化学结构类型的化合物。方法 采用分子对接的虚拟筛选方法寻找新型乙酰胆碱酯酶抑制剂，设计了10个5H-噻唑并[3,2-a]嘧啶类化合物。以芳醛、硫脲等为起始原料，通过Biginelli反应生成二氢嘧啶类化合物，再与氯代苯乙酮作用经Hantzsch环合反应制得目标化合物，其结构经红外光谱、质谱、核磁共振氢谱和碳谱确证。采用Ellman方法进行体外抑制乙酰胆碱酯酶活性测试。 结果 合成了10个5H-噻唑并[3,2-a]嘧啶类化合物，体外抑制乙酰胆碱酯酶活性测试结果显示，所有目标化合物均具有乙酰胆碱酯酶抑制活性，其中3个目标化合物在10 μmol.L^-1时抑制活性均超过50%。结论5H-噻唑并[3,2-a]嘧啶类化合物是潜在的乙酰胆碱酯酶抑制剂。将计算机辅助药物分子设计、有机合成和生物活性测试相结合是发现和设计新型乙酰胆碱酯酶抑制剂的有效途径。     

丁酰胆碱酯酶抑制剂微量筛选模型的研究

目的为新药发现阶段丁酰胆碱酯酶(butyrylcholines-terase,BChE)抑制剂的筛选提供实用的筛选方法,并为乙酰胆碱酯酶抑制剂的筛选提供选择性评价模型。方法以大鼠血清作为丁酰胆碱酯酶酶源,按照酶反应体系构建原则,在pH 7.4和37℃的条件下,以96孔板为载体,用正交试验法确定酶的最佳反应条件。在确定模型的筛选运行条件后,采用3种阳性药物和115种植物提取物对构建的模型进行筛选测试。结果采用大鼠血清为酶源成功构建了实用的BChE抑制剂微量筛选模型。结论本工作构建的丁酰胆碱酯酶抑制剂微量筛选模型基本具备了简便、快速、可靠、经济、拓展性好的优点,可用于丁酰胆碱酯酶抑制剂的大规模筛选,同时,该模型可与乙酰胆碱酯酶抑制剂筛选模型相互配合使用,用于评价胆碱酯酶抑制剂的选择性。     

乙酰胆碱酯酶抑制剂的构效关系研究

综述用于治疗阿尔茨海默病(AD)的乙酰胆碱酯酶抑制剂的构效关系，为开发新一代治疗老年痴呆症的药物提供理论依据。乙酰胆碱酯酶抑制剂作为治疗AD的一线药物疗效确切，是现阶段对AD病人最有效的治疗手段。     

海洋特征天然产物——硝基苯酯倍半萜类的研究进展

倍半萜类化合物在自然界中广泛存在,而硝基苯酯倍半萜类化合物较为罕见。迄今发现的12种天然来源硝基苯酯倍半萜均来自于海洋曲霉属Aspergillus真菌,是一类典型的海洋特征天然产物。该类天然产物显示了较好的抗肿瘤、抗病毒和抑制破骨细胞分化活性,特别是在治疗破骨细胞相关疾病中显示较好的药用开发价值。本文对硝基苯酯倍半萜的天然产物来源和化学结构、化学和生物合成、生物活性和药理机制进行了综述,并对其吸收(absorption)、分布(distribution)、代谢(metabolism)、排泄(excretion)及毒性(toxicity)(ADME/T)和类药性进行预测和讨论,为海洋来源硝基苯酯倍半萜类天然产物及其药用开发潜力提供较为全面的认识。     

乙酰胆碱酯酶抑制剂药效团模型的构建

利用CATALYST系统，由具有相同作用机制，不同结构特征的93个已知的乙酰胆碱酯酶抑制剂(AChEIs)构建出了含有3个疏水单元，1个环芳香性单元和1个氢键受体单元的药效团模型，优化的模型(RMS=0.53, correl=0.93, weight=3.29, config=19.05，total cost-null cost=62.75)可分别作用于乙酰胆碱酯酶的双活性作用部位，并能准确预测用于临床的阿尔茨海默病(AD)治疗的乙酰胆碱酶抑制剂的活性，有利于设计和改造具有新结构的用于AD治疗的乙酰胆碱酶抑制剂。     

新型乙酰胆碱酯酶抑制剂7H-噻唑并[3,2-b]-1,2,4-三嗪-7-酮类化合物的设计、合成与生物活性

目的 寻找作为乙酰胆碱酯酶抑制剂的具有新化学结构类型的化合物。方法 采用分子对接的方法寻找新型的乙酰胆碱酯酶抑制剂,设计并合成了10个7H-噻唑并[3,2-b]-1,2,4-三嗪-7-酮类化合物。通过Erlenmeyer-Plöchl反应及缩合反应生成目标化合物6-芳甲基-3-芳基-7H-噻唑并[3,2-b]-1,2,4-三嗪-7-酮类化合物,其结构采用红外光谱、质谱和核磁共振氢谱确证。采用Ellman方法进行体外抑制乙酰胆碱酯酶活性测试。 结果 合成了10个7H-噻唑并[3,2-b]-1,2,4-三嗪-7-酮类化合物,体外抑制乙酰胆碱酯酶活性测试结果显示所有目标化合物均具有抑制乙酰胆碱酯酶活性,8个目标化合物在10 μmol.L-1浓度水平抑制活性均超过了50%。结论7H-噻唑并[3,2-b]-1,2,4-三嗪-7-酮类化合物是潜在的乙酰胆碱酯酶抑制剂,是一类具有新骨架结构的AChE抑制剂。     

Progress in acetylcholinesterase inhibitors for Alzheimer’s disease

Current pharmacotherapy of Alzheimer’s disease (AD) involves drugs that are known as acetylcholinesterase inhibitors (AChEIs), which increase the acetylcholine concentration in the brain. Although effective in improving cognitive, behavioural and functional impairments, these drugs are not able to alter disease progression. In this review, the recent patent literature on AChEIs from 2002 to early 2005 will be discussed, focusing attention on the novel analogues of the approved drugs, as well as on the most important AD therapeutic advances. The clinical efficacy of AChEIs will probably be enhanced by their combination with other drugs acting through different pharmacological mechanisms. As the neuronal loss comprises more than the forebrain cholinergic system, the weak effectiveness of AChEIs is not surprising. Besides the ‘cholinergic hypothesis’ approaches, new treatments are emerging based on multipotent compounds able to target the underlying pathogenic mechanisms of AD; these treatments are summarised herein.     

Progress in acetylcholinesterase inhibitors for Alzheimer's disease: an update

Background: To date, the pharmacotherapy of Alzheimer's disease (AD) has been based on acetylcholinesterase inhibitors (AChEIs), and more recently on an N-methyl-d-aspartate receptor antagonist. By increasing acetylcholine concentration in the brain, AChEIs slow behavioral and functional impairments, improving cognitive function. Objective: The review provides an update on novel analogs of approved AChEIs, their combination with other anti-AD agents, natural AChEIs, and modern multitarget-directed ligands (MTDLs) able to hit different biological targets. Methods: We reviewed patents filed during 2005 – 2007 dealing with new AChEIs and their potential application for AD treatment. We point out new chemical structures and scaffolds for designing new AD therapeutic agents as well as new combinations or MTDLs. Results and conclusions: Compared to the limited number of novel commercially available AChEI analogs, many new natural compounds were patented for AD treatment. These might represent a starting point for the rational design of new MTDLs.     

Acetylcholinesterase inhibitors as disease-modifying therapies for Alzheimer's disease

The therapeutic arsenal for the treatment of Alzheimer's disease (AD) remains confined to a group of four inhibitors of AChE and one NMDA receptor antagonist, which are used to provide a relief of the very late symptoms of the dementia, i.e. the cognitive and functional decline. In line with the growing body of evidence of the pivotal role of the beta-amyloid peptide (Abeta) in the pathogenesis of AD, alternative classes of drugs targeting mainly the formation or the aggregation of Abeta are actively pursued by the pharmaceutical industry, as they could positively modify the course of AD, stopping or slowing down disease progression. While the first amyloid-directed disease-modifying drugs go ahead with their clinical development and could reach the market as soon as 2009, mounting preclinical and clinical evidences is pointing towards a disease-modifying role also for currently marketed anti-Alzheimer AChE inhibitors (AChEIs), particularly for donepezil. In this review, the neuroprotective effects exhibited by currently commercialized AChEIs will be briefly discussed, together with the secondary mechanisms through which they could exert such effects. This review will focus also on particular classes of AChEIs, namely dual binding site AChEIs, which are being purposely designed to target Abeta aggregation and / or other biological targets that contribute to AD pathogenesis, thus constituting very promising disease-modifying anti-Alzheimer drug candidates.     

Scope and limitations of acetylcholinesterase inhibitors

Enhancement of the activity of cholinergic neurons has been regarded as one of the most promising methods for treating Alzheimer's disease (AD). Donepezil is a representative acetylcholinesterase inhibitor (AChEI) and is a great success among the AChEI drugs. AChEIs are being studied for other mechanisms of action, neuroprotective action, and nicotinic receptor enhancement. AD is a type of neurodegenerative disease and AChEIs have been found to be an effective anti-AD medication. AChEI can alleviate the symptoms and delay the progression of AD, but it cannot cure the disease. However, AChEIs are now the subject of a wide range of clinical studies for other diseases, for example, other types of dementia (such as Lewy body disease, cerebral vascular dementia, and Parkinson's disease dementia), and migraine. These drugs are also being studied as a combination therapy, for example, with an antioxidant, SERM, and NMDA antagonist.     

In silico methods to assist drug developers in acetylcholinesterase inhibitor design

Alzheimer's disease (AD) is a neurodegenerative disease characterized by a low acetylcholine (ACh) concentration in the hippocampus and cortex. ACh is a neurotransmitter hydrolyzed by acetylcholinesterase (AChE). Therefore, it is not surprising that AChE inhibitors (AChEIs) have shown better results in the treatment of AD than any other strategy. To improve the effects of AD, many researchers have focused on designing and testing new AChEIs. One of the principal strategies has been the use of computational methods (structural bioinformatics or in silico methods). In this review, we summarize the in silico methods used to enhance the understanding of AChE, particularly at the binding site, to design new AChEIs. Several computational methods have been used, such as docking approaches, molecular dynamics studies, quantum mechanical studies, electronic properties, hindrance effects, partition coefficients (Log P) and molecular electrostatic potentials surfaces, among other physicochemical methods that exhibit quantitative structure-activity relationships.     

乙酰胆碱酯酶抑制剂罕见不良反应比萨综合征分析

目的:探讨乙酰胆碱酯酶抑制剂(acetylcholinesterase inhibitors, AChEIs)致比萨综合征发生的临床表现、治疗及转归,为安全用药提供参考。方法:检索国内外相关数据库,收集AChEIs致比萨综合征的病例报道,对其临床特点进行汇总与分析。结果:纳入分析的病例共16例,涉及多奈哌齐11例、卡巴拉汀4例、加兰他敏3例;病例中男3例、女13例;比萨综合征发生在服药后的数小时至30个月,中位时间为4个月;发生比萨综合征后14例停药、1例减量、1例停用利培酮;患者转归的时间范围为3～90 d,中位时间为14 d;有2例可能与联合用药有关。结论:临床使用AChEIs应加强监测,警惕其单独使用及药物相互作用时导致的比萨综合征,以促进临床用药安全。     

Treatment of cognitive impairment in multiple sclerosis: is the use of acetylcholinesterase inhibitors a viable option?

Approximately half of all patients with multiple sclerosis (MS) experience cognitive impairment, most commonly with regard to new learning and memory. Cognitive dysfunction is a leading cause of disability in MS and it can have profound social and economic consequences for patients and their families.Research on treatment for cognitive impairment in MS is still in the early stages, as it is for most neurological conditions. The available disease-modifying therapies in MS may provide some modest benefit to cognition, but patients with MS clearly need better treatment for cognitive dysfunction. A number of studies have assessed symptomatic treatments of cognition in MS, and the results of these small, underpowered studies have been mixed. Regardless, acetylcholinesterase inhibitors (AChEIs) have been the most promising class of medications tested in MS to date. Seven of eight studies on AChEIs have shown positive results, although it is difficult to assess their adequacy since only three of the studies have been published in peer reviewed journals, with the rest appearing only as abstracts. The earliest AChEI studies in MS examined physostigmine, but the short half-life and prominent adverse effects of this medication may have limited its use compared with other AChEIs. All of the more recent AChEI studies have used donepezil, which, from the limited data available to date, appears to have been relatively well tolerated among MS patients. The largest randomized controlled trial of donepezil included 69 subjects and found that donepezil improved verbal learning and memory compared with placebo during neuropsychological testing. That study also found that patients receiving donepezil were more likely to report memory improvement than those receiving placebo, and the study clinician also noted a cognitive benefit among those on donepezil as opposed to placebo.There are still many unanswered questions regarding the use of AChEIs in MS, including the effects of their long-term use in a chronic disease such as MS. On the whole, to date the research on AChEIs in MS must be considered preliminary, and it is premature to recommend the clinical use of this class of medications at the present time.     

Old and new acetylcholinesterase inhibitors for Alzheimer’s disease

Introduction: To date, pharmacological treatment of Alzheimer’s disease (AD) includes Acetylcholinesterase Inhibitors (AChEIs) for mild-to-moderate AD, and memantine for moderate-to-severe AD. AChEIs reversibly inhibit acetylcholinesterase (AChE), thus increasing the availability of acetylcholine in cholinergic synapses, enhancing cholinergic transmission. These drugs provide symptomatic short-term benefits, without clearly counteracting the progression of the disease.

Areas covered: On the wake of successful clinical trials which lead to the marketing of AChEIs donepezil, rivastigmine and galantamine, many compounds with AChEI properties have been developed and tested mainly in Phase I-II clinical trials in the last twenty years. Here, we review clinical trials initiated and interrupted, and those ongoing so far.

Expert opinion: Despite many clinical trials with novel AChEIs have been carried out after the registration of those currently used to treat mild to moderate AD, none so far has been successful in a Phase III trial and marketed. Alzheimer’s disease is a complex multifactorial disorder, therefore therapy should likely address not only the cholinergic system but also additional neurotransmitters. Moreover, such treatments should be started in very mild phases of the disease, and preventive strategies addressed in elderly people.     

Galantamine and donepezil attenuate pharmacologically induced deficits in prepulse inhibition in rats

Acetylcholinesterase inhibitors (AChEIs) are currently being evaluated as adjunctive therapy for the cognitive dysfunction of schizophrenia. This core symptom of schizophrenia has often been attributed to impaired attention and abnormal sensory motor gating, features that are also found in Huntington's Disease, autism, and several other psychiatric and neurological disorders. The ability to improve prepulse inhibition (PPI) of the acoustic startle response may predict the efficacy of compounds as cognitive enhancers. In this study, PPI was disrupted in Wistar rats in three pharmacologic models: dopamine receptor agonism by apomorphine, NMDA receptor antagonism by MK801, or muscarinic acetylcholine receptor antagonism by scopolamine. We then evaluated the commonly used AChEIs, donepezil (0.5, 1.0, or 2.0mg/kg) and galantamine (0.3, 1.0, or 3.0mg/kg) for the capacity to improve PPI in each model. Under vehicle conditions, the prepulse stimuli (75, 80 and 85dB) inhibited the startle response to a 120dB auditory stimulus in a graded fashion. Galantamine (depending on dose) improved PPI deficits in all three PPI disruption models, whereas donepezil ameliorated PPI deficits induced by scopolamine and apomorphine, but was not effective in the MK801 model. These results indicate that some AChEIs may have the potential to improve cognition in schizophrenia by improving auditory sensory gating.     

Cholinergic adverse effects of cholinesterase inhibitors in Alzheimer's disease: epidemiology and management.

Cholinergic adverse effects of acetylcholinesterase inhibitors (AChEIs) are caused by their central and peripheral pharmacological actions on a variety of organ tissues. Gastrointestinal adverse effects predominate and these were relatively common in the phase II and III randomised clinical trials of AChEIs for the treatment of probable Alzheimer's disease. However, in these studies forced and rapid titration of drugs was used, which is not the case in clinical practice. Although there is a risk of pharmacodynamic interactions with other drugs leading to enhanced cholinergic adverse effects, very few of these interactions have proven to be clinically significant. Unresolved issues include the mechanism of syncope and neuromuscular weakness, which should be resolved through structured pharmacovigilance programmes and clinical studies. Loss of bodyweight may prove to be a long term significant complication. As a class, the AChEIs have proven to be well tolerated in the symptomatic treatment of Alzheimer's disease in its mild-to-moderately severe stages. The incidence and clinical significance of cholinergic adverse events will need to be carefully studied if the drugs are used for indications other than Alzheimer's disease.