ABSTRACT
Amongst organophosphate compounds, both pesticides and warfare neurotoxics are probably the most representative. These compounds are irreversible acetylcholinesterase inhibitors. Usual clinical signs observed after acute poisoning are mainly respiratory distress, convulsions and seizures. Following acute poisoning, an emergency treatment must be provided as soon as possible (maximum delay of 1 hour post-poisoning), to prevent irreversible brain damage and patient death. At the present time, there is no efficient delayed treatment which could be provided if this 1 hour latency is overpassed. However, neurogenesis by stem cell engraftment, eventually complemented by gene therapy strategy, could be a potential therapeutic approach to repair organophosphate-induced brain damage. Main stem cell engraftement strategies successfully used for brain damage of various origins are reviewed in this Article.
Subject(s)
Brain Diseases/chemically induced , Brain Diseases/therapy , Neurotoxicity Syndromes/therapy , Organophosphate Poisoning , Stem Cell Transplantation , Animals , Brain Diseases/pathology , Chemical Warfare Agents/poisoning , Humans , Neurons/transplantation , Neurotoxicity Syndromes/pathologyABSTRACT
PYR, a reversible AChE inhibitor, is the current pretreatment against OP intoxication. However, PHY in the presence or absence of SCO on one side, and HUP on the other side, could be considered as potential substitutes for PYR. In the present study, the effects of the subchronic administration of these different current or potential pretreatments on the BBB permeability for blood-borne albumin and on the activity of the blood and central cholinesterases are comparatively evaluated in guinea-pigs. Altogether, although some marginal disruptions of BBB are detected, the different current or potential pretreatments studied seem to have a total innocuousness on the permeability of the BBB for proteins. Finally, at the light of its particular inhibitory effects on blood and central cholinesterases, HUP, compared to the other drugs, seems to be the optimal candidate to be used as pretreatment against OP poisoning.
Subject(s)
Blood-Brain Barrier/drug effects , Brain/metabolism , Cholinesterase Inhibitors/toxicity , Cholinesterases/metabolism , Neuroprotective Agents/pharmacology , Serum Albumin/metabolism , Alkaloids , Animals , Cholinesterases/blood , Erythrocytes/enzymology , Evans Blue , Guinea Pigs , Male , Microscopy, Fluorescence , Physostigmine/pharmacology , Pyridostigmine Bromide/pharmacology , Sesquiterpenes/pharmacologyABSTRACT
OP nerve agents, such as soman, are potent irreversible inhibitors of central and peripheral acetylcholinesterases. Pretreatment of OP poisoning relies on the subchronic administration of a reversible acetylcholinesterase inhibitor. In the present study, the protective effects against soman toxicity of such compounds i.e. pyridostigmine, physostigmine (alone or associated with scopolamine) or huperzine are compared in guinea-pigs instrumented for EEG recording. Each medication is given via a subcutaneous mini-osmotic pump for 6 days at a delivery rate providing about 30% maximal inhibition of red cell acetylcholinesterase activity. The animals then receive iterative injections of soman (1/3 LD50) every 10 min. With pyridostigmine, reflecting a decreased overall tolerance to the poisoning, the cumulative doses of soman producing either tremors and convulsions or seizures are lower than those found in non-pretreated intoxicated controls. On the other hand, physostigmine does not afford satisfactory protection against the early mortality after intoxication. On this specific point, physostigmine + scopolamine and huperzine, although they do not prevent the appearance of seizures, give best results. The effects of each pretreatment on acetylcholinesterase, butyrylcholinesterase and carboxylesterase (these two latter enzymes may act as endogenous scavengers of OP compounds) are also examined in vitro and in the blood of each animal during subchronic administration. Huperzine appears as a selective inhibitor of red cell acetylcholinesterase activity while pyridostigmine or physostigmine additionally inhibit plasmatic butyrylcholinesterase. Considerations about huperzine or physostigmine + scopolamine as the most appropriate candidate for the pretreatment of OP poisoning are given.
Subject(s)
Cholinesterase Inhibitors/toxicity , Neuroprotective Agents/pharmacology , Soman/toxicity , Alkaloids , Animals , Electroencephalography , Guinea Pigs , Male , Neuroprotective Agents/administration & dosage , Physostigmine/pharmacology , Pyridostigmine Bromide/pharmacology , Scopolamine/pharmacology , Seizures/chemically induced , Sesquiterpenes/pharmacology , Time FactorsABSTRACT
We performed an experiment to characterize the toxicity of soman in cynomolgus monkeys in which organophosphorus intoxication was followed by treatment with either the current three-drug therapy atropine/pralidoxime/diazepam or a combination of atropine/pralidoxime/avizafone, avizafone being the water soluble prodrug of diazepam. Clinical, electrophysiological, and histological approaches were combined. When benzodiazepines were injected at the similar molar dose of 0.7 micromol/kg, the protection against soman toxicity was better with the atropine/ pralidoxime/diazepam combination than with the atropine/pralidoxime/avizafone one. Pharmacokinetic studies demonstrated that this difference of efficacy could be explained by a lower plasmatic load of diazepam obtained after injection of avizafone at 0.7 micromol/kg, compared to the administration of diazepam at the same molar dose. Moreover, after injection of avizafone, plasmatic levels of diazepam were achieved faster and declined more rapidly than after administration of diazepam. Compared to diazepam given at a dose of 0.7 micromol/kg, injection of 1 micromol avizafone/kg gave a similar plasmatic load of benzodiazepine, but with a lower time to maximum plasma concentration (tmax) and a higher maximum plasma concentration (Cmax) for plasmatic diazepam. We therefore went on to demonstrate that administration of the atropine/pralidoxime/avizafone combination at a dose 1 micromol benzodiazepine/kg to intoxicated monkeys afforded electrophysiological and histological protection similar to that obtained after administration of atropine/pralidoxime/diazepam at a dose of 0.7 micromol diazepam/kg. Reflections on the possible incorporation of avizafone in three-drug emergency treatment are presented.
Subject(s)
Brain/drug effects , Cholinesterase Inhibitors/poisoning , Diazepam/therapeutic use , Dipeptides/therapeutic use , Electroencephalography/drug effects , Soman/poisoning , Animals , Atropine/therapeutic use , Brain/pathology , Diazepam/pharmacokinetics , Dipeptides/pharmacokinetics , Drug Therapy, Combination , Macaca fascicularis , Male , Pralidoxime Compounds/therapeutic useABSTRACT
The effects of soman, a potent irreversible inhibitor of acetylcholinesterase, on central neuropathology in rats were studied in relation with subsequent spatial memory impairments. In a first step, it was found that, without treatment, neuropathology and learning impairment were observed only in rats which experienced convulsions. Then, treatment consisting of atropine sulfate, and/or TCP and/or NBQX was administered to intoxicated animals at infraanticonvulsant doses to obtain a graded subsequent neuropathology and to appreciate an eventual relation between neuropathology and spatial memory impairment. Thus, a correlation between neuropathology in the hippocampal CA1 region and spatial learning performance was found, the degradation of performance of rat being directly related to the amplitude of their neural damage. A threshold was emphasized : below a certain degree of neural loss, no memory impairment was found. Only treatment with tritherapy (atropine + TCP + NBQX) was able to improve the different parameters of spatial learning, despite no effect on the convulsions of the animals.
Subject(s)
Hippocampus/drug effects , Memory Disorders/chemically induced , Phencyclidine/analogs & derivatives , Quinoxalines/pharmacology , Soman/toxicity , Animals , Antidotes/pharmacology , Atropine/pharmacology , Behavior, Animal/drug effects , Cholinergic Antagonists/pharmacology , Convulsants/toxicity , Dose-Response Relationship, Drug , Drug Interactions , Excitatory Amino Acid Agonists/pharmacology , Excitatory Amino Acid Antagonists/pharmacology , Hippocampus/pathology , Male , Maze Learning/drug effects , Neuroprotective Agents/pharmacology , Phencyclidine/pharmacology , Rats , Rats, Wistar , Spatial Behavior/drug effects , Survival Rate , Time FactorsABSTRACT
Today, organophosphorus nerve agents are still considered as potential threats in both military or terrorism situations. These agents act as potent irreversible inhibitors of acetylcholinesterase in both central and peripheral nervous systems. Conventional treatment of organophosphate poisoning includes the combined administration of a cholinesterase reactivator (an oxime), a muscarinic cholinergic receptor antagonist (atropine) and a benzodiazepine anticonvulsant (diazepam). However, numerous studies have demonstrated that the excitatory amino acid glutamate also plays a prominent role in the maintenance of organophosphate-induced seizures and in the subsequent neuropathology especially through an overactivation of the N-methyl-D-aspartate (NMDA) receptor subtype. Contrary to other non-competitive NMDA antagonists successfully tested in rodents exposed to organophosphate, gacyclidine is a novel antiNMDA compound which is in the process of approval for human use in France for neurotraumatology. This review summarizes the therapeutic value of gacyclidine as a complement to the available emergency treatment against severe organophosphate poisoning. Previous data obtained from experiments on primates in several scenarios mimicking military or terrorist attacks, using soman as the nerve agent, were used. Primates pretreated with pyridostigmine and receiving conventional emergency therapy at the first signs of poisoning survive. However, only gacyclidine is able to ensure complete management of nerve agent poisoning for rapid normalization of EEG activity, clinical recovery and neuroprotection. Gacyclidine also ensures optimal management of severe nerve agent poisoning in animals neither pretreated nor receiving emergency therapy likewise during an unexpected exposure. However, this beneficial effect is obtained provided that medical intervention is conducted rapidly after intoxication. Globally, the current lack of any other NMDA receptor antagonist suitable for human use reinforces the therapeutic value of gacyclidine as a central nervous system protective agent for the treatment of OP poisoning.
Subject(s)
Cyclohexanes/therapeutic use , Excitatory Amino Acid Antagonists/therapeutic use , Organophosphorus Compounds/toxicity , Piperidines/therapeutic use , Seizures/prevention & control , Soman/toxicity , Animals , Cyclohexenes , Haplorhini , Humans , N-Methylaspartate/antagonists & inhibitors , Receptors, N-Methyl-D-Aspartate/drug effects , Receptors, N-Methyl-D-Aspartate/metabolism , Time FactorsABSTRACT
The acetylcholinesterase inhibitor, soman, induces marked and sustained hypertension and tachycardia associated with a convulsive syndrome in rats. The aims of the present study were to distinguish between the cardiovascular and convulsant effects of soman and to determine whether the maintenance of the soman-induced hypertension and tachycardia depends solely on a central muscarinic effect. To this end, using a computerised analysis of blood pressure (BP) in conscious freely moving rats, we examined the consequences on the increase in mean BP (MBP) and heart rate (HR) induced by soman (60 micrograms/kg, i.v.) of 1) a pre-treatment with the anticonvulsant drug diazepam (3 mg/kg, i.v.) and 2) atropine sulphate (10 mg/kg, i.v.) administered 10 or 60 min after the intoxication. Pretreatment with diazepam prevented the convulsions, assessed by electroencephalogram (EEG) recording, but modified neither the magnitude nor the kinetics of the pressor and tachycardic effects of soman (delta MBP = 74 +/- 2 and 73 +/- 5 mmHg, delta HR = 69 +/- 10 and 79 +/- 7 bpm, maximum MBP = 186 +/- 3 and 182 +/- 6 mmHg, maximum HR = 545 +/- 9 and 522 +/- 16 bpm in solvent- (n = 8) and diazepam- (n = 8) pre-treated rats, respectively). Whatever its time of administration, atropine sulphate fully and immediately reversed the rise in BP induced by soman. The soman-induced tachycardia was also suppressed by atropine administered 10 min after soman whereas it persisted when atropine was injected 60 min after the intoxication. These results show that the cardiovascular effects of soman can occur independently of the convulsive syndrome and that the maintenance of the soman-induced hypertension depends entirely on a permanent central muscarinic stimulation.
Subject(s)
Brain/drug effects , Cholinesterase Inhibitors/toxicity , Hypertension/physiopathology , Muscarinic Antagonists/pharmacology , Soman/toxicity , Animals , Anticonvulsants/pharmacology , Atropine/pharmacology , Atropine Derivatives/pharmacology , Blood Pressure/drug effects , Brain/physiopathology , Diazepam/pharmacology , Electroencephalography , Heart Rate/drug effects , Hypertension/chemically induced , Male , Rats , Rats, Wistar , Seizures/chemically inducedABSTRACT
Organophosphorus (OP) nerve agents are still used as warfare and terrorism compounds. Classical delayed treatment of victims of organophosphate poisoning includes combined i.v. administration of a cholinesterase reactivator (an oxime), a muscarinic cholinergic receptor antagonist (atropine) and a benzodiazepine anticonvulsant (diazepam). The objective of this study was to evaluate, in a realistic setting, the therapeutic benefit of administration of GK-11 (gacyclidine), an antiglutamatergic compound, as a complement to the above therapy against organophosphate poisoning. Gacyclidine was injected (i.v.) in combination with atropine/diazepam/pralidoxime at man-equivalent doses after a 45- or 30-min latency period to intoxicated primates (2 LD50). The effects of gacyclidine on the animals' survival, electroencephalographic (EEG) activity, signs of toxicity, recovery after challenge and central nervous system histology were examined. The present data demonstrated that atropine/diazepam/pralidoxime alone or combined with gacyclidine did not prevent signs of soman toxicity when treatment was delayed 45 min after poisoning. Atropine/diazepam/pralidoxime also did not control seizures or prevent neuropathology in primates exhibiting severe signs of poisoning when treatment was commenced 30 min after intoxication. However, in this latter case, EEG recordings revealed that additional treatment with gacyclidine was able to stop soman-induced seizures and restore normal EEG activity. This drug also totally prevented the neuropathology observed 5 weeks after soman exposure in animals treated with atropine/diazepam/pralidoxime alone. Overall, in the case of severe OP-poisoning, gacyclidine represents a promising adjuvant therapy to the currently available polymedication to ensure optimal management of organophosphate poisoning in man. This drug is presently being evaluated in a human clinical trial for a different neuroprotective indication. However, it should always be kept in mind that, in the case of severe OP-poisoning, medical intervention must be conducted as early as possible.
Subject(s)
Chemical Warfare Agents/poisoning , Cyclohexanes/therapeutic use , Excitatory Amino Acid Antagonists/therapeutic use , Piperidines/therapeutic use , Soman/poisoning , Animals , Anticonvulsants/therapeutic use , Antidotes/therapeutic use , Atropine/therapeutic use , Brain/drug effects , Brain/pathology , Cerebellum/drug effects , Cerebellum/pathology , Cerebral Cortex/drug effects , Cerebral Cortex/pathology , Cholinesterase Reactivators/therapeutic use , Cyclohexanes/administration & dosage , Cyclohexenes , Diazepam/therapeutic use , Drug Therapy, Combination , Electrocardiography , Excitatory Amino Acid Antagonists/administration & dosage , Haplorhini , Macaca fascicularis , Male , Piperidines/administration & dosage , Poisoning/pathology , Pralidoxime Compounds/therapeutic use , Seizures/drug therapy , Time FactorsABSTRACT
Stress due to forced swimming was recently shown to allow penetration of pyridostigmine (PYR) into the brain of mice. Accordingly, it was suggested that in troops exposed to emotional stress under conditions of war, as during the Gulf War, the BBB may have unexpectedly become permeable to PYR thus leading to an increased frequency of CNS symptoms. In this study, the entry of PYR into the brain was investigated in guinea pigs subjected to different heat stress levels. In a first group, guinea pigs were maintained at room temperature for 2 hours, their core temperature remaining stable at about 39.8 degrees C. In a second group, animals were placed in a climatic chamber in order to keep their core temperature at 41.5 degrees C for 2 hours. In a third group, animals were subjected to a high ambient temperature (42.6 degrees C) during about 2 hours and developed heatstroke symptoms, their core temperature progressively increasing and reaching around 44.3 degrees C. In each group, the stress of the animals was assessed by measuring the increase of plasma cortisol level. PYR (0.2 mg/kg, s.c.) was injected 90 minutes after beginning the experiment. Penetration of the drug into the brain was examined by measurement of acetylcholinesterase (AChE) activity in the cortex, the striatum and the hippocampus of the animals 30 minutes after PYR administration. A passage of this drug into the brain was also evaluated autoradiographically after i.v. injection of tritiated PYR 90 minutes after the beginning of the experiment (100 microCi/animal). Whatever the group examined, no entry of PYR into the CNS could be detected. Exposure to an ambient temperature at 42.6 degrees C for 2 hours resulted by itself in a partial inhibition of cerebral AChE activity. Our results, which agree with previous data obtained in humans exposed to heat stress, are opposite to the recent research showing a central passage of PYR in mice following a forced swim stress test. This demonstrated that the penetration of PYR into the brain of rodents under stress depends on the experimental conditions used (animal species, nature of the stressor, etc.). Extrapolations to humans of results primarily obtained in rodents about central passage of a drug under stress must thus be done very carefully.
Subject(s)
Blood-Brain Barrier , Brain/metabolism , Cholinesterase Inhibitors/pharmacokinetics , Hot Temperature , Persian Gulf Syndrome/etiology , Pyridostigmine Bromide/pharmacokinetics , Stress, Physiological/metabolism , Animals , Autoradiography , Guinea Pigs , Humans , Injections, Intravenous , MaleABSTRACT
NBQX, a specific and potent AMPA receptor antagonist has been found to be neuroprotective in various models of ischemia and to have anticonvulsant properties in different models of epilepsy. In this experiment, the neurobehavioral effects of NBQX were studied. In an open field, an important ataxia was emphasized at a dose of 60 mg/kg. In a swimming task, an increase of the escape latencies was noted on the third day at a dose of 40 mg/kg. In a Morris water maze task, doses devoid of effects on locomotion were used (10, 20, and 30 mg/kg). There was no effect on the acquisition of the task at 10 mg/kg and a slight impairment at 20 mg/kg, but the rats did not learn the task at 30 mg/kg. This impairment was reversible, as shown by the increasing performance of this group without treatment. No impairment was noted in the retention phase of the Morris water maze task. The results are discussed relative to the role of the AMPA receptor in memory processes.
Subject(s)
Excitatory Amino Acid Antagonists/pharmacology , Quinoxalines/pharmacology , Receptors, AMPA/antagonists & inhibitors , Animals , Male , Maze Learning/drug effects , Memory/drug effects , Motor Activity/drug effects , Rats , Rats, WistarABSTRACT
Organophosphorus nerve agents are still in use today in warfare and as terrorism compounds. Classical emergency treatment of organophosphate poisoning includes the combined administration of a cholinesterase reactivator (an oxime), a muscarinic cholinergic receptor antagonist (atropine) and a benzodiazepine anticonvulsant (diazepam). However, recent experiments with primates have demonstrated that such treatment, even when administered immediately after organophosphate exposure, does not rapidly restore normal electroencephalographic (EEG) activity and fails to totally prevent neuronal brain damage. The objective of this study was to evaluate, in a realistic setting, the therapeutic benefit of administration of GK-11 (gacyclidine), an antiglutamatergic compound, as a complement to the available emergency therapy against organophosphate poisoning. GK-11 was injected at a dose of 0.1 mg/kg (i.v) after a 45-min latency period to heavily intoxicated (8 LD50) primates. Just after intoxication, man-equivalent doses of one autoinjector containing atropine/pralidoxime/diazepam were administered. The effects of GK-11 were examined on survival, EEG activity, signs of toxicity, recovery after challenge and central nervous system histology. The present data demonstrate that treatment with GK-11 prevents the mortality observed after early administration of classical emergency medication alone. EEG recordings and clinical observations also revealed that GK-11 prevented soman-induced seizures and motor convulsions. EEG analysis within the classical frequency bands (beta, theta, alpha, delta) demonstrated that central activity was totally restored to normal after GK-11 treatment, but remained profoundly altered in animals receiving atropine/pralidoxime/diazepam alone. GK-11 also markedly accelerated clinical recovery of soman-challenged primates. Lastly, this drug totally prevented the neuropathology observed 3 weeks after soman exposure in animals treated with classical emergency treatment alone. GK-11 represents a promising adjuvant therapy to the currently available emergency polymedication to ensure optimal management of organophosphate poisoning in man. This drug is presently being evaluated in a human clinical trial for a different neuroprotective indication.
Subject(s)
Anticonvulsants/therapeutic use , Chemical Warfare Agents/toxicity , Cholinesterase Inhibitors/toxicity , Cholinesterase Reactivators/therapeutic use , Cyclohexanes/therapeutic use , Excitatory Amino Acid Antagonists/therapeutic use , Neuroprotective Agents/therapeutic use , Piperidines/therapeutic use , Soman/toxicity , Animals , Anticonvulsants/pharmacology , Atropine/administration & dosage , Atropine/therapeutic use , Brain/drug effects , Brain/pathology , Cholinesterase Reactivators/administration & dosage , Cyclohexanes/administration & dosage , Cyclohexenes , Diazepam/administration & dosage , Diazepam/therapeutic use , Drug Combinations , Excitatory Amino Acid Antagonists/administration & dosage , Injections, Intravenous , Macaca fascicularis , Male , Muscarinic Antagonists/administration & dosage , Muscarinic Antagonists/therapeutic use , Neuroprotective Agents/pharmacology , Piperidines/administration & dosage , Pralidoxime Compounds/administration & dosage , Pralidoxime Compounds/therapeutic use , Seizures/prevention & control , Staining and Labeling , Time FactorsABSTRACT
Phencyclidine-like drugs are effective against convulsions and brain lesions related to soman intoxication but induce severe side effects. The well tolerated antitussive dextromethorphan (DM) and its metabolite dextrorphan (DX) have antiepileptic and neuroprotective properties that we evaluated in mice against 2 LD50 of soman in a three-drug pretreatment (atropine sulfate and oxime HI-6 plus DM: 20-50 mg/kg or DX: 10-40 mg/kg i.p). Neuroprotection was evaluated by measurement of hippocampal omega 3 binding site density. DM and DX have weak anticonvulsant and neuroprotective activities which are counterbalanced at high doses by an increased mortality due to respiratory distress for DM and by ataxia for DX. Thus DM and DX do not appear to be appropriate for the pretreatment of soman intoxication.
Subject(s)
Angiotensin-Converting Enzyme Inhibitors/toxicity , Anticonvulsants/therapeutic use , Antitussive Agents/therapeutic use , Dextromethorphan/therapeutic use , Dextrorphan/therapeutic use , Neuroprotective Agents/therapeutic use , Animals , Drug Evaluation, Preclinical , Evaluation Studies as Topic , Mice , Soman/antagonists & inhibitors , Soman/toxicityABSTRACT
We performed an experiment to characterize the toxicity of soman in cynomolgus monkeys when the organophosphorus intoxication was followed by a treatment with either the three-drug therapy atropine/pralidoxime/diazepam or the association atropine/HI-6/prodiazepam. Clinical, electrophysiological and histological approaches were combined. Our data demonstrate that the protection afforded against soman toxicity was better with the combination atropine/HI-6/prodiazepam compared to atropine/pralidoxime/diazepam. This was observed transiently in term of vigilance and respiratory function of intoxicated animals, but particularly in term of their EEG- and ECG disturbances. Moreover, compared to those treated with atropine/pralidoxine/diazepam, animals treated with atropine/ HI-6/prodiazepam recovered slightly sooner and did not exhibit prostration 2 days after intoxication although their rapidity of movements was not totally restored. The final recovery observed 3 weeks after intoxication was similar for the two groups. The value of the combination of atropine/HI-6/prodiazepam vs atropine/pralidoxime/diazepam to counteract soman toxicity was also confirmed in term of brain neuroprotection since greater lesions were observed with the second three drug treatment three weeks after intoxication.
Subject(s)
Antidotes/therapeutic use , Cholinesterase Inhibitors/poisoning , Soman/poisoning , Animals , Atropine/therapeutic use , Diazepam/therapeutic use , Dipeptides/therapeutic use , Drug Therapy, Combination , Electrocardiography/drug effects , Electroencephalography/drug effects , Macaca fascicularis , Male , Oximes , Poisoning/drug therapy , Poisoning/pathology , Poisoning/physiopathology , Pralidoxime Compounds/therapeutic use , Prodrugs/therapeutic use , Pyridinium Compounds/therapeutic useABSTRACT
Huperzine A (HUP) is a potent reversible inhibitor of acetylcholinesterase (AChE) that crosses the blood-brain barrier. Its ability to prevent seizures and subsequent hippocampal neuropathological changes induced by the organophosphate soman was studied in guinea pigs. Results were compared to guinea pigs treated with pyridostigmine (PYR, 0.2 mg/kg, subcutaneously). HUP pretreatment at 0.5 mg/kg, intraperitoneally, totally prevented seizures and ensured the survival of all animals for 24 h after intoxication. Hippocampal tissue was then free of any neuronal damage. Comparatively, all animals pretreated with PYR exhibited epileptic activity after soman poisoning and five of six animals died. Examination of the hippocampus of the only surviving guinea pig pretreated with PYR showed extensive neuropathological changes. Although HUP or PYR induced similar inhibitions of blood AChE activity, only HUP pretreatment led to a decrease in central AChE activity. In binding studies on guinea-pig brain homogenates, HUP had no affinity for muscarinic, alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) and gamma-aminobutyric acid (GABA)A receptors and only a very low one for N-methyl-D-aspartate (NMDA) receptors. In conclusion, HUP, unlike PYR, protects against soman-induced convulsions and neuropathological changes in the hippocampus. This efficacy seems to be related to a protection by HUP of both peripheral and central stores of AChE.
Subject(s)
Cholinesterase Inhibitors/therapeutic use , Hippocampus/pathology , Neuroprotective Agents/therapeutic use , Seizures/drug therapy , Sesquiterpenes/therapeutic use , Alkaloids , Animals , Brain/metabolism , Cholinesterase Inhibitors/metabolism , Electroencephalography , Guinea Pigs , Male , Pyridostigmine Bromide/therapeutic use , Receptors, N-Methyl-D-Aspartate/metabolism , Seizures/chemically induced , Seizures/pathology , Sesquiterpenes/metabolism , SomanABSTRACT
Recent experiments with primates have demonstrated that treatment with atropine/pralidoxime/diazepam, even if administered immediately after organophosphate exposure, does not totally prevent neuronal brain damage. Using primates, we have studied, for the first time, the ability of GK-11 (gacyclidine), an antiglutamatergic drug in the process of agreement for human use, given as an additional therapy, to counteract the neuropathology due to organophosphate exposure that persists after classical treatment with oxime/atropine/benzodiazepine. We have also examined the recovery of the organophosphate-intoxicated primates. Male Cynomolgus monkeys were pretreated 1 hour before poisoning with pyridostigmine, then intoxicated with 8 LD50 of soman and immediately treated with the combination pralidoxime/atropine/diazepam. Some of the animals also received GK-11 at 0.01; 0.03 or 0.1 mg/kg (i.v.) 10 minutes after soman challenge. Recovery of the primates (reflexes, movements, feeding) and the neuropathological changes that occurred three weeks after intoxication (histological examinations and neuronal cell density measurement) were compared in GK-11-treated and control animals. At all doses tested, GK-11 prevented the neuronal rarefaction of the frontoparietal cortex that was observed in soman-intoxicated animals that received only oxime/atropine/diazepam. Moreover, the 0.01 mg/kg dose of GK-11 improved the early recovery of intoxicated primates from 1 day after intoxication. In the view of the most effective management of organophosphate intoxication that is currently available, GK-11 thus appears to be a promising additional neuroprotective therapy. This drug is presently being evaluated in a human clinical trial for a different neuroprotective indication.
Subject(s)
Cyclohexanes/pharmacology , Excitatory Amino Acid Antagonists/pharmacology , Neuroprotective Agents/pharmacology , Organophosphorus Compounds/toxicity , Piperidines/pharmacology , Animals , Cerebral Cortex/drug effects , Cyclohexenes , Dose-Response Relationship, Drug , Macaca , MaleABSTRACT
The effects of the inhibitors of endothelial and neuronal nitric oxide (NO) synthases, N-nitro-L-arginine methyl ester (L-NAME) and 7-nitroindazole (7-NI), respectively, and the precursor of NO, glyceryl trinitrate, on soman-induced seizures, lethality, and neuropathology were studied in rats. It was found that pretreatment of rats with L-NAME and 7-NI potentiated the severity of motor convulsions and enhanced lethality produced by soman. On the other hand, glyceryl trinitrate, administered transdermally at doses ranging from 2.5-5 mg/day 1 day before soman, decreased seizure susceptibility and lethality in soman-intoxicated animals. This was accompanied by a subsequent reduction of central neuronal damage 24 h after soman treatment. Pretreatment with glyceryl trinitrate also reversed seizure latency produced by 7-NI treatment during soman intoxication. These results indicate that neuronal NO may play a prominent role in seizures by acting as an anticonvulsant and neuroprotectant in soman intoxication.
Subject(s)
Brain/drug effects , NG-Nitroarginine Methyl Ester/pharmacology , Nitric Oxide/pharmacology , Nitroglycerin/pharmacology , Seizures/physiopathology , Soman/pharmacology , Animals , Dose-Response Relationship, Drug , Male , Rats , Rats, Sprague-DawleyABSTRACT
Previous investigations have indicated that soman-induced convulsions involve the inositol lipid signalling system. We previously reported that 10 min after the onset of seizures, inositol 1,4,5-triphosphate (IP3) build-up was coupled to activation of non-muscarinic receptor subtypes. In the present study, we demonstrate that (1) in addition to muscarinic receptors, histamine H1 subtypes and glutamate metabotropic receptors contribute to the first IP3 increase (first 10 min of seizures) and (2) the histamine H1 subtype and glutamate metabotropic receptors are also involved in the second step of inositol phosphate response (after 10 min of seizures). alpha 1-adrenoceptor and 5-HT2 receptors, known to be coupled to phosphoinositide turnover, did not participate in soman-induced IP3 response. Neurochemical interactions between cholinergic, histamine H1 and glutamate metabotropic systems, responsible of the phosphoinositide hydrolysis under soman are envisaged.
Subject(s)
Receptors, Muscarinic/metabolism , Seizures/chemically induced , Signal Transduction , Soman/pharmacology , Animals , Chlorpheniramine/pharmacology , Dimethyl Sulfoxide/pharmacology , Electroencephalography , Inositol 1,4,5-Trisphosphate/pharmacology , Ketanserin/pharmacology , Male , Prazosin/pharmacology , Rats , Rats, WistarABSTRACT
Rat hippocampus and piriform cortex were examined for pathological changes 48 hours after exposure to a convulsant dose of soman. Animals were treated with a low dose of atropine just after soman and were then injected, after 10 or 40 minutes of seizures, with both the anticonvulsant drugs NBQX and TCP. Atropine given alone counteracted the extensive neuronal loss due to soman in both areas without prevention of neuronal suffering. Comparatively, the complete anticonvulsant regimen, given before 40 minutes of seizures, totally prevented hippocampal soman-induced neuropathology. Neurones of piriform cortex were still suffering whatever the time of injection of the drugs. This emphasizes the need for a rapid and definitive anticonvulsant treatment just after soman intoxication to block the subsequent neurotoxic effect of nerve-agent exposure.
Subject(s)
Anticonvulsants/pharmacology , Seizures/chemically induced , Seizures/pathology , Soman , Animals , Atropine/pharmacology , Hippocampus/pathology , Male , Olfactory Pathways/pathology , Phencyclidine/analogs & derivatives , Phencyclidine/pharmacology , Quinoxalines/pharmacology , Rats , Rats, Wistar , Receptors, AMPA/antagonists & inhibitorsABSTRACT
The ability of relatively low doses of atropine, NBQX and TCP administered in combination to prevent or stop seizures induced by soman, was studied in rats. While these drugs injected together early after soman prevented the onset of seizures, their delayed concomitant administration after 5 or 30 min of epileptic activity only mildly attenuated the intensity of seizures. Conversely, a total arrest of epileptic activity was observed in 80 to 100% of animals when NBQX and TCP were given together after 5 to 50 min of seizures to atropine pretreated rats. The large time-window for antiepileptic effectiveness of this 'three drug treatment', provided that atropine is administered early after soman, is discussed in relation to reciprocal potentiations of the antiepileptic effects of atropine, NBQX and TCP in combination.
Subject(s)
Atropine/pharmacology , Phencyclidine/analogs & derivatives , Quinoxalines/pharmacology , Receptors, AMPA/antagonists & inhibitors , Seizures/prevention & control , Soman , Animals , Drug Synergism , Electroencephalography/drug effects , Male , Phencyclidine/pharmacology , Rats , Rats, Wistar , Seizures/chemically inducedABSTRACT
The ability of NBQX, a potent antagonist of AMPA glutamatergic receptors, to prevent or stop seizures induced by the organophosphate soman, an irreversible inhibitor of AChE, was studied in rats. NBQX administered concomitantly with soman prevents the onset of seizures (ED50: 29.2 mg kg-1, i.p.). Administered 5 min after the onset of seizures, NBQX greatly reduces the intensity of the epileptic activity. The same decrease of epileptic activity is observed, in the presence of atropine, when the administration of NBQX is delayed 15 min after the onset of seizures. NBQX thus appears as a promising antiepileptic candidate against soman-induced seizures. The roles of AMPA and muscarinic receptors in the onset and propagation of soman-induced epileptic activity are discussed.