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Fatty acid amide hydrolase inhibition for treatment of amyotrophic lateral sclerosis
Daisuke Ito, Madoka Iida, Yohei Iguchi, Atsushi Hashizume, Shinichiro Yamada, Yoshiyuki Kishimoto, Shota Komori, Kazuki Obara, Shuto Nishisaki, Satoshi Yokoi, Teppei Shimamura, Yuto Takemoto, Masahiro Nakatochi, Tomohiro Akashi, Kunihiko Hinohara, Hyeon-Cheol Lee-Okada, Yohei Okada, Junichi Niwa, Gen Sobue, Shinji Tanaka, Ken Takashina, Takehiko Yokomizo, Masahisa Katsuno
Daisuke Ito, Madoka Iida, Yohei Iguchi, Atsushi Hashizume, Shinichiro Yamada, Yoshiyuki Kishimoto, Shota Komori, Kazuki Obara, Shuto Nishisaki, Satoshi Yokoi, Teppei Shimamura, Yuto Takemoto, Masahiro Nakatochi, Tomohiro Akashi, Kunihiko Hinohara, Hyeon-Cheol Lee-Okada, Yohei Okada, Junichi Niwa, Gen Sobue, Shinji Tanaka, Ken Takashina, Takehiko Yokomizo, Masahisa Katsuno
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Research Article Metabolism Neuroscience

Fatty acid amide hydrolase inhibition for treatment of amyotrophic lateral sclerosis

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Abstract

Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disease caused by the selective loss of upper and lower motor neurons. There is a considerable variability in the disease progression of sporadic ALS, but the molecular basis for phenotypic heterogeneity remains largely unknown. Patients with ALS often manifest systemic metabolic abnormalities such as glucose intolerance and hypermetabolic state. We conducted reverse translational research to explore therapeutic targets in ALS based on the systemic metabolic alterations in patients and identified several metabolites associated with the disease progression, including metabolites involved in the expanded endocannabinoid system (ECS). In particular, the levels of N-acyl taurines (NATs) were correlated with the longitudinal change in the revised ALS functional rating scale and survival. Experiments with ALS cellular models and induced pluripotent stem (iPS) cells derived from patients with ALS and SOD1G93A transgenic mice revealed that PF-04457845, a fatty acid amide hydrolase inhibitor, upregulated the expanded ECS, particularly the levels of NATs and ameliorated motor neuron degeneration through the regulation of microglial environment, synapse plasticity, and neuronal development. These results collectively indicate that dysregulation of NATs is associated with ALS progression and PF-04457845 may represent a potential disease-modifying therapy for ALS.

Authors

Daisuke Ito, Madoka Iida, Yohei Iguchi, Atsushi Hashizume, Shinichiro Yamada, Yoshiyuki Kishimoto, Shota Komori, Kazuki Obara, Shuto Nishisaki, Satoshi Yokoi, Teppei Shimamura, Yuto Takemoto, Masahiro Nakatochi, Tomohiro Akashi, Kunihiko Hinohara, Hyeon-Cheol Lee-Okada, Yohei Okada, Junichi Niwa, Gen Sobue, Shinji Tanaka, Ken Takashina, Takehiko Yokomizo, Masahisa Katsuno

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Figure 5

In vivo analysis of hit compounds in SOD1G93A transgenic mice.

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In vivo analysis of hit compounds in SOD1G93A transgenic mice.
(A) Survi...
(A) Survival of SOD1G93A transgenic mice treated with PF-04457845 (~1 mg/kg/day, PF-04457845) or unmodified chow (Untreated) (n = 28, 34; median survival, 138, 129.5 days, respectively; P = 0.0001, log-rank test). PF-04457845 extended the survival of SOD1G93A transgenic mice compared with untreated mice. (B–D) Body weight, grip strength, and rotarod test in SOD1G93A transgenic mice treated with PF-04457845 or unmodified chow. Body weight was not significantly different, whereas grip strength (P < 0.0001) and rotarod test (P = 0.0004) were significantly improved by PF-04457845 (2-way ANOVA). To impute values after the endpoint, the final body weights were carried forward and the values of grip strength and rotarod were imputed to zero. (E–L) IHC images and quantitative analysis of immunoreactivity for choline acetyltransferase (ChAT) (E and F), glial fibrillary acidic protein (GFAP) (G and H), ionized calcium-binding adapter molecule 1 (IBA-1) (I and J), and Sry-related HMG-BOX gene 10 (SOX10) (K and L) in the ventral horn of the spinal cords of 16-week-old mice treated with PF-04457845 (n = 4) or unmodified chow (n = 4). Scale bars: 100 μm. Data are shown as mean ± SEM. Survival was analyzed using the Kaplan-Meier method and compared by the log-rank test. Body weight and motor functions were analyzed by 2-way ANOVA, and P values for the treatment effect are shown in the figure. Quantified pathology measures were compared using 2-sided unpaired t tests. *P < 0.05.

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