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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 6

Pimozide rescues synaptic strength deficits in the SOD1G37R EDL at disease onset (P400) and at the presymptomatic stage (P160).

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Pimozide rescues synaptic strength deficits in the SOD1G37R EDL at disea...
(A) Schema of the electrophysiology experiment. Muscles were impaled at 50 μm from an adjacent NMJ to perform intracellular recordings of EPP amplitude. (B) Example traces of nerve-evoked EPPs following a paired-pulse facilitation protocol elicited at 0.2 Hz, for WT (left), nontreated SOD1 (middle, SOD1-Ctrl), and pimozide-treated NMJs (right, SOD1-Pim). Histograms show the mean ± SEM of EPP amplitude at P400 (C) and P160 (G), quantal content (D and H), mEPP frequency (E and I), and mEPP amplitude (F and J) of the WT, SOD1, and SOD1-Pim NMJs from WT and SOD1G37R mice. Quantal content was obtained by dividing the mean EPP of the first EPPs, including failures, divided by the mean mEPP amplitude. *P < 0.05, **P < 0.01. The sample numbers were as follows: (for P400) WT, n = 16; SOD1, n = 12; SOD1-Pim, n = 8; (for P160) WT, n = 13; SOD1, n = 17; SOD1-Pim, n = 8. 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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