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Neuroleptics as therapeutic compounds stabilizing neuromuscular transmission in amyotrophic lateral sclerosis
Shunmoogum A. Patten, Dina Aggad, Jose Martinez, Elsa Tremblay, Janet Petrillo, Gary A.B. Armstrong, Alexandre La Fontaine, Claudia Maios, Meijiang Liao, Sorana Ciura, Xiao-Yan Wen, Victor Rafuse, Justin Ichida, Lorne Zinman, Jean-Pierre Julien, Edor Kabashi, Richard Robitaille, Lawrence Korngut, J. Alexander Parker, Pierre Drapeau
Shunmoogum A. Patten, Dina Aggad, Jose Martinez, Elsa Tremblay, Janet Petrillo, Gary A.B. Armstrong, Alexandre La Fontaine, Claudia Maios, Meijiang Liao, Sorana Ciura, Xiao-Yan Wen, Victor Rafuse, Justin Ichida, Lorne Zinman, Jean-Pierre Julien, Edor Kabashi, Richard Robitaille, Lawrence Korngut, J. Alexander Parker, Pierre Drapeau
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Research Article Clinical trials Neuroscience

Neuroleptics as therapeutic compounds stabilizing neuromuscular transmission in amyotrophic lateral sclerosis

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Abstract

Amyotrophic lateral sclerosis (ALS) is a rapidly progressing, fatal disorder with no effective treatment. We used simple genetic models of ALS to screen phenotypically for potential therapeutic compounds. We screened libraries of compounds in C. elegans, validated hits in zebrafish, and tested the most potent molecule in mice and in a small clinical trial. We identified a class of neuroleptics that restored motility in C. elegans and in zebrafish, and the most potent was pimozide, which blocked T-type Ca2+ channels in these simple models and stabilized neuromuscular transmission in zebrafish and enhanced it in mice. Finally, a short randomized controlled trial of sporadic ALS subjects demonstrated stabilization of motility and evidence of target engagement at the neuromuscular junction. Simple genetic models are, thus, useful in identifying promising compounds for the treatment of ALS, such as neuroleptics, which may stabilize neuromuscular transmission and prolong survival in this disease.

Authors

Shunmoogum A. Patten, Dina Aggad, Jose Martinez, Elsa Tremblay, Janet Petrillo, Gary A.B. Armstrong, Alexandre La Fontaine, Claudia Maios, Meijiang Liao, Sorana Ciura, Xiao-Yan Wen, Victor Rafuse, Justin Ichida, Lorne Zinman, Jean-Pierre Julien, Edor Kabashi, Richard Robitaille, Lawrence Korngut, J. Alexander Parker, Pierre Drapeau

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Figure 8

Pimozide antagonizes T-type Ca2+ channels.

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Pimozide antagonizes T-type Ca2+ channels.
(A) Three T-type Ca2+ channel...
(A) Three T-type Ca2+ channel antagonists (ML218, NNC, and miberfradil) at 20 μM improved motor phenotype in mTDP43 C. elegans (n = 3 batches, each batch consisted a quantification of 30 worms). (B) Total voltage-gated calcium currents mediated by high-voltage–activated (HVA) and low-voltage–activated Ca2+ channels (LVA) were isolated by patch-clamp recording in vivo in mTDP-43 zebrafish motoneurons using a voltage-clamp protocol (depolarizing from –80 mV to +60 mV) (left panel). Pimozide antagonizes LVA Ca2+ currents mediated by T-type Ca2+ channels (isolated by holding at –30 mV) in zebrafish motoneurons (n = 6). Representative recording traces of isolated LVA Ca2+ currents with or without pimozide are presented in the right panel, and the effects of pimozide on HVA and LVA Ca2+ currents are illustrated in the bar graph. ***P < 0.001. All data values are given as mean ± SEM. Significance was determined using one-way ANOVA and Fisher LSD tests for normally distributed and equal variance data; Kruskal-Wallis ANOVA and Dunn’s method of comparison were used for nonnormal distributions.

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