Abstract

Latrepirdine/Dimebon is a small-molecule compound with attributed neurocognitive-enhancing activities, which has recently been tested in clinical trials for the treatment of Alzheimer's and Huntington's disease. Latrepirdine has been suggested to be a neuroprotective agent that increases mitochondrial function, however the molecular mechanisms underlying these activities have remained elusive. We here demonstrate that latrepirdine, at (sub)nanomolar concentrations (0.1 nM), activates the energy sensor AMP-activated protein kinase (AMPK). Treatment of primary neurons with latrepirdine increased intracellular ATP levels and glucose transporter 3 translocation to the plasma membrane. Latrepirdine also increased mitochondrial uptake of the voltage-sensitive probe TMRM. Gene silencing of AMPKα or its upstream kinases, LKB1 and CaMKKβ, inhibited this effect. However, studies using the plasma membrane potential indicator DisBAC2(3) demonstrated that the effects of latrepirdine on TMRM uptake were largely mediated by plasma membrane hyperpolarization, precluding a purely ‘mitochondrial' mechanism of action. In line with a stabilizing effect of latrepirdine on plasma membrane potential, pretreatment with latrepirdine reduced spontaneous Ca2+ oscillations as well as glutamate-induced Ca2+ increases in primary neurons, and protected neurons against glutamate toxicity. In conclusion, our experiments demonstrate that latrepirdine is a potent activator of AMPK, and suggest that one of the main pharmacological activities of latrepirdine is a reduction in neuronal excitability.

Highlights

  • Latrepirdine/Dimebon has been safely used as an anti-histaminergic agent for the treatment of allergies and travel diseases in Russia for more than 25 years

  • In light of previous findings that linked neuroprotective and neurocognitive effects of latrepirdine to improved mitochondrial bioenergetics,[5,9,21,22] we explored whether the protective effects of latrepirdine pretreatment against glutamate toxicity were related to changes in mitochondrial membrane potential (Dcm), an indicator of mitochondrial bioenergetics

  • Typical Fluo-4 kinetics are shown as change in fluorescence intensity divided by the mean overall fluorescence intensity (DF/F). (d) Quantification of Ca2 þ spike frequency after MgCl2 washout, treatment with latrepirdine (0.1 nM, n 1⁄4 176 cells) or (e) AICAR (0.1 mM) (n 1⁄4 88 cells) addition followed by complete block using tetrodotoxin (TTX, 1 mM). (f ) Quantification of changes of the Ca2 þ -spiking activity due to addition of latrepirdine, AICAR, or vehicle (Control, n 1⁄4 134 cells, latrepirdine, n 1⁄4 176 cells, AICAR n 1⁄4 88 cells, Kruskal–Wallis and subsequent Mann–Whitney tests showed a significant difference in latrepirdine and AICAR compared with control (*) but no significant difference in latrepirdine compared with AICAR

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Summary

INTRODUCTION

Latrepirdine/Dimebon has been safely used as an anti-histaminergic agent for the treatment of allergies and travel diseases in Russia for more than 25 years. Phase 2 study of patients with mild-to-moderate Alzheimer’s disease (AD).[4] The potential mechanisms of latrepirdine’s neurocognition-enhancing activities are unrelated to its antihistaminergic properties, and have been attributed to mitochondria-enhancing or -stabilizing activities.[5,6] these apparent ‘mitochondrial’ activities have been poorly characterized at a molecular level. Despite this shortfall, latrepirdine was subsequently tested in two Phase 3 trials in patients with AD, and in a Phase 2/3 trial in patients with Huntington’s disease. We demonstrate that the molecular actions of latrepirdine include profound changes on plasma membrane potential and neuronal excitability, and investigate the conditions in which latrepirdine may confer protection against excitotoxic neuronal injury

MATERIALS AND METHODS
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