2012
DOI: 10.1124/jpet.111.190132
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Fumarates Promote Cytoprotection of Central Nervous System Cells against Oxidative Stress via the Nuclear Factor (Erythroid-Derived 2)-Like 2 Pathway

Abstract: Oxidative stress is central to the pathology of several neurodegenerative diseases, including multiple sclerosis, and therapeutics designed to enhance antioxidant potential could have clinical value. The objective of this study was to characterize the potential direct neuroprotective effects of dimethyl fumarate (DMF) and its primary metabolite monomethyl fumarate (MMF) on cellular resistance to oxidative damage in primary cultures of central nervous system (CNS) cells and further explore the dependence and fu… Show more

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Cited by 407 publications
(407 citation statements)
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“…In randomized, double-blind, placebo-controlled DEFINE and CONFIRM studies involving patients with relapsing-remitting MS, dimethyl fumarate significantly reduced the relapse rate and improved the neuroradiological outcome compared with the placebo. 22,23 Several mechanisms of action, such as the activation of anti-oxidants, nuclear factor (erythroid-derived 2)-like 2, [11][12][13]24 or glutathione and heme oxygenase-1, have been attributed to the effects of fumarates. 14 In addition, DMF switched the immune system towards a Th2 anti-inflammatory type response through the activation of type II DCs and the suppression of type I DCs, which consequently inhibits the generation of inflammatory Th1 or Th17 cells.…”
Section: Discussionmentioning
confidence: 99%
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“…In randomized, double-blind, placebo-controlled DEFINE and CONFIRM studies involving patients with relapsing-remitting MS, dimethyl fumarate significantly reduced the relapse rate and improved the neuroradiological outcome compared with the placebo. 22,23 Several mechanisms of action, such as the activation of anti-oxidants, nuclear factor (erythroid-derived 2)-like 2, [11][12][13]24 or glutathione and heme oxygenase-1, have been attributed to the effects of fumarates. 14 In addition, DMF switched the immune system towards a Th2 anti-inflammatory type response through the activation of type II DCs and the suppression of type I DCs, which consequently inhibits the generation of inflammatory Th1 or Th17 cells.…”
Section: Discussionmentioning
confidence: 99%
“…11,12 Consequently, DMF protects neurons and astrocytes against oxidative stress, which induces cellular injury. 13 In addition, DMF reduces the nuclear factor NF-kB in astrocytes and C6 cells, inhibits the degradation of IkBa, and reduces the expression of nitric oxide synthase 2. 14 In the experimental autoimmune encephalomyelitis model, DMF exerts clinical effects through the reduction of macrophage-induced inflammation in the spinal cord.…”
Section: Introductionmentioning
confidence: 99%
“…The therapeutic mechanism of action for DMF has been attributed to both immunosuppression and induction of antioxidant pathways 2, 3, 4. The induction of antioxidant response element (ARE) genes by DMF is attributed to the activation of the Nrf2 transcription factor that leads to subsequent reductions in oxidative stress and increased neuroprotection in vivo 2, 5. The induction of Nrf2 is achieved through glutathione depletion as well as direct binding of fumaric acid esters to the Nrf2 repressor KEAP1 3, 6, 7.…”
Section: Introductionmentioning
confidence: 99%
“…Keap1 has reactive thiol groups and is considered as a sensor of oxidants or electrophilic compounds. Some of the electrophilic compounds, for example, sulforaphane, 11 curcumin, 12 zerumbone, 19,20 piperlongumine, 21 bardoxolone methyl 22 and dimethyl fumarate, 23 activate the Keap1-Nrf2 pathway. They bind directly with the thiol group of Keap1 and causes conformational changes to Keap1.…”
Section: Discussionmentioning
confidence: 99%