Orally available selective melanocortin-4 receptor antagonists stimulate food intake and reduce cancer-induced cachexia in mice.

BACKGROUND: Cachexia is among the most debilitating and life-threatening aspects of cancer. It represents a metabolic syndrome affecting essential functional circuits involved in the regulation of homeostasis, and includes anorexia, fat and muscle tissue wasting. The anorexigenic peptide alpha-MSH is believed to be crucially involved in the normal and pathologic regulation of food intake. It was speculated that blockade of its central physiological target, the melanocortin (MC)-4 receptor, might provide a promising anti-cachexia treatment strategy. This idea is supported by the fact that in animal studies, agouti-related protein (AgRP), the endogenous inverse agonist at the MC-4 receptor, was found to affect two hallmark features of cachexia, i.e. to increase food intake and to reduce energy expenditure. METHODOLOGY/PRINCIPAL FINDINGS: SNT207707 and SNT209858 are two recently discovered, non peptidic, chemically unrelated, orally active MC-4 receptor antagonists penetrating the blood brain barrier. Both compounds were found to distinctly increase food intake in healthy mice. Moreover, in mice subcutaneously implanted with C26 adenocarcinoma cells, repeated oral administration (starting the day after tumor implantation) of each of the two compounds almost completely prevented tumor induced weight loss, and diminished loss of lean body mass and fat mass. CONCLUSIONS/SIGNIFICANCE: In contrast to the previously reported peptidic and small molecule MC-4 antagonists, the compounds described here work by the oral administration route. Orally active compounds might offer a considerable advantage for the treatment of cachexia patients.

Fluoxetine protects hippocampal plasticity during conditioned fear stress and prevents fear learning potentiation.

RATIONALE: Contextual fear conditioning can produce both changes in hippocampal synaptic efficacy and potentiation of subsequent fear learning. OBJECTIVES: In this study, we tested whether fluoxetine reverses these effects. MATERIALS AND METHODS: In the first experiment, we examined alterations of baseline synaptic efficacy and induction of synaptic plasticity in the CA3 region of the hippocampus during re-exposure of rats, treated with fluoxetine (7 mg/kg) or vehicle, in a context where they previously received 15 eyelid shocks or no shock (controls). In the second experiment, fear learning potentiation was examined in rats that were initially submitted to conditioning (15 eyelid shocks) and extinction training and then re-exposed to a less intense stressor (three eyelid shocks). RESULTS: Conditioned fear stress decreased synaptic efficacy and blocked the induction of synaptic potentiation in the fimbria-CA3 pathway. Conditioned rats treated with fluoxetine were protected against these electrophysiological changes and did not differ from controls (i.e., no depression and normal induction of potentiation of synaptic efficacy). However, fluoxetine treatment did not suppress conditioned freezing. After fear extinction, exposure of rats to a subconditioning stressor provoked conditioning (fear learning potentiation) in rats treated with vehicle but not in those treated with fluoxetine. CONCLUSIONS: These findings indicate that fluoxetine treatment, which is ineffective on conditioned fear stress-induced freezing, may have beneficial effects on conditioned fear stress-induced disturbance of hippocampal plasticity. These data also suggest that restoration of hippocampal functioning may contribute to protection against exaggerated reactions to mild stressors reported in patients with post-traumatic stress disorder.

SGS742: the first GABA(B) receptor antagonist in clinical trials.

The GABA(B) receptor antagonist SGS742 (CGP36742) displays pronounced cognition enhancing effects in mice, young and old rats and in Rhesus monkeys in active and passive avoidance paradigms, in an eight-arm radial maze and a Morris water maze and in a social learning task. SGS742 blocks the late inhibitory postsynaptic potential and the paired-pulse inhibition of population spikes recorded from CA1 pyramidal neurons of the hippocampus of rats in vitro and in vivo. SGS742 significantly enhances the release of glutamate, aspartate, glycine and somatostatin in vivo. Chronic administration of SGS742 causes an up-regulation of GABA(B) receptors in the frontal cortex of rats. Single doses cause a significant enhancement of the mRNA and protein levels of NGF and BDNF in the cortex and hippocampus of rats. The observed antidepressant effects of SGS742 in rats may be explained by these findings. SGS742 was well tolerated in experimental animals as well as in young and elderly human volunteers with an absolute bioavailability in humans of 44%. In a Phase II double-blind, placebo-controlled study in 110 patients with mild cognitive impairment (MCI), oral administration of SGS742 at a dose of 600 mg t.i.d. for 8 weeks significantly improved attention, in particular choice reaction time and visual information processing as well as working memory measured as pattern recognition speed. A second Phase II clinical trial in 280 Alzheimer's disease patients is underway.