Sembragiline: A Novel, Selective Monoamine Oxidase Type B Inhibitor for the Treatment of Alzheimer's Disease.

Monoamine oxidase B (MAO-B) has been implicated in the pathogenesis of Alzheimer's disease (AD) and other neurodegenerative disorders. Increased MAO-B expression in astroglia has been observed adjacent to amyloid plaques in AD patient brains. This phenomenon is hypothesized to lead to increased production of hydrogen peroxide and reactive oxygen species (ROS), thereby contributing to AD pathology. Therefore, reduction of ROS-induced oxidative stress via inhibition of MAO-B activity may delay the progression of the disease. In the present study we report the pharmacological properties of sembragiline, a novel selective MAO-B inhibitor specifically developed for the treatment of AD, and on its effect on ROS-mediated neuronal injury and astrogliosis in MAO-B transgenic animals. Sembragiline showed potent and long-lasting MAO-B-selective inhibition and did not inhibit MAO-A at doses where full inhibition of MAO-B was observed. Such selectivity should translate into a favorable clinical safety profile. Indeed, sembragiline neither induced the serotonin syndrome when administered together with the serotonin precursor l-5-hydroxytryptophan in combination with antidepressants such as fluoxetine, nor potentiated the pressor effect of tyramine. Additionally, in experiments using a transgenic animal model conditionally overexpressing MAO-B in astroglia, sembragiline protected against neuronal loss and reduced both ROS formation and reactive astrogliosis. Taken together, these findings warrant further investigation of the potential therapeutic benefit of MAO-B inhibitors in patients with AD and other neurologic disorders.

Up-regulation of the isoenzymes MAO-A and MAO-B in the human basal ganglia and pons in Huntington's disease revealed by quantitative enzyme radioautography.

Huntington's disease (HD) is a rare genetic disease associated with the degeneration of GABAergic striatal projection neurons in the basal ganglia leading to movement disorders with behavioral symptoms for which there is presently no therapy. Abnormally high levels of monoamine oxidase (MAO) activity, which are potentially linked to cytotoxic free radical formation, are known to occur during aging and in neurodegenerative disorders (MAO-B is markedly increased in plaque-associated astrocytes in Alzheimer's disease). We therefore measured, with anatomical resolution, MAO-A and -B activities in 5 cases of HD (severity grades 1-3) and age-matched controls by quantitative enzyme radioautography using radiolabeled enzyme inhibitors (3)H-Ro 41-1049 and (3)H-lazabemide, respectively, as high-affinity ligands in vitro. MAO-A was increased significantly (ca. 50%; p<0.01) in the putamen and substantia nigra pars compacta of the basal ganglia and in the pons. Higher increases in MAO-B (75%-200%; p<0.01) occurred in the putamen, ventral striatum, globus pallidus externus and internus of the basal ganglia and in the insular cortex. The increased enzyme levels (especially of MAO-B) seemed to correlate with the grade of disease severity. We conclude that MAO increases in those regions of HD brains which are known to undergo neurodegeneration accompanied by glioses. Whether or not this increased enzyme activity is a cause or effect of the resulting loss of the GABAergic projection neurons in HD is yet to be clarified. Moreover, it remains to be seen if selective enzyme inhibitors have therapeutic utility in the treatment of HD by reducing oxidative stress locally.