The establishment of effective therapeutic interventions for prion diseases is necessary. We report on a newly developed amyloidophilic compound that displays therapeutic efficacy when administered orally. This compound inhibited abnormal prion protein formation in prion-infected neuroblastoma cells in a prion straindependent manner: effectively for RML prion and marginally for 22L prion and Fukuoka-1 prion. When the highest dose (0.2% [wt/wt] in feed) was given orally to cerebrally RML prion-inoculated mice from inoculation until the terminal stage of disease, it extended the incubation periods by 2.3 times compared to the control. The compound exerted therapeutic efficacy in a prion strain-dependent manner such as that observed in the cell culture study: most effective for RML prion, less effective for 22L prion or Fukuoka-1 prion, and marginally effective for 263K prion. Its effectiveness depended on an earlier start of administration. The glycoform pattern of the abnormal prion protein in the treated mice was modified and showed predominance of the diglycosylated form, which resembled that of 263K prion, suggesting that diglycosylated forms of abnormal prion protein might be least sensitive or resistant to the compound. The mechanism of the prion strain-dependent effectiveness needs to be elucidated and managed. Nevertheless, the identification of an orally available amyloidophilic chemical encourages the pursuit of chemotherapy for prion diseases.
Recent outbreaks of variant Creutzfeldt-Jakob disease and iatrogenic Creutzfeldt-Jakob disease have aroused great concern in many countries and have necessitated the development of suitable therapies. We have demonstrated that sulfated glycans such as pentosan polysulfate and fucoidan, and amyloidophilic compounds such as amyloid dye derivatives, styrylbenzoazole derivatives, and phenylhydrazine derivatives have efficacies in prion-infected animals. Amyloidophilic compounds present potentialities not only as therapeutic candidates but also as prion amyloid imaging probes for use in nuclear medicine technology such as positron emission tomography. A representative of styrylbenzoazole compounds has been used recently for clinical trials of brain prion amyloid imaging in patients. On the other hand, a representative of phenylhydrazine compounds, compB, displays excellent effectiveness in prolonging the incubation times of infected animals when given orally. However, both its anti-prion effectiveness in vitro and its therapeutic efficacy in vivo are consistently dependent on the prion strain. This prion-strain-dependency is similarly observed in other amyloidophilic compounds. Therefore, aside from further improvement of the safety profiles and pharmacokinetic properties of such compounds, elucidation and management in the mechanism of the prion strain-dependent effectiveness is necessary. Nevertheless, because compB studies suggest that amyloidophilic compounds are also therapeutic candidates for Alzheimer's disease, amyloidophilic compounds might be attractive as drug candidates for various conformational diseases and hasten development of therapeutic drugs for prion diseases.
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