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Symptomatic relief of botulinum neurotoxin/a intoxication with aminopyridines: a new twist on an old molecule.

Abstract
Botulinum neurotoxins (BoNT) are the etiological agents responsible for botulism, a disease characterized by peripheral neuromuscular blockade and a characteristic flaccid paralysis of humans. BoNT/A is the most toxic protein known to man and has been classified by the Centers of Disease Control (CDC) as one of the six highest-risk threat agents for bioterrorism. Of particular concern is the apparent lack of clinical interventions that can reverse cellular intoxication. Efforts to uncover molecules that can act within an intoxicated cell so as to provide symptomatic relief to BoNT/A are paramount. Aminopyridines have shown clinical efficacy for multiple sclerosis treatment as well as BoNT/A intoxication; yet, aminopyridines for BoNT/A treatment has been abandoned because of blood brain barrier (BBB) penetration producing undesired neurotoxic side effects. Two aminopyridines (5 and 11) exhibited inhibitory activity toward Shaker-IR voltage-gated potassium (K(V)1.x) channels with potencies similar to that of the previous "gold-standard", 3,4-diaminopyridine (3,4-DAP), including reversal of symptoms from BoNT-induced paralysis in phrenic nerve-hemidiaphragm preparations. Importantly, pharmacokinetic experiments revealed a lack of BBB penetration of 5, which is a significant advancement toward resolving the neurotoxicity issues associated with prolonged 3,4-DAP treatments. Finally, 5 was found to be as effective as 3,4-DAP in rescuing BoNT-poisoned mice in the mouse lethality assay, signifying an optimized balance between the undesired permeability across the BBB and the required permeability across lipid cellular membranes. The results demonstrate that 5 is the most promising small molecule K(+) channel inhibitor discovered to date for the treatment of BoNT/A intoxication.
AuthorsAlexander V Mayorov, Bert Willis, Antonia Di Mola, Derek Adler, Jennifer Borgia, Olin Jackson, Jie Wang, Yongyi Luo, Lei Tang, Richard J Knapp, Chandra Natarajan, Michael C Goodnough, Noam Zilberberg, Lance L Simpson, Kim D Janda
JournalACS chemical biology (ACS Chem Biol) Vol. 5 Issue 12 Pg. 1183-91 (Dec 17 2010) ISSN: 1554-8937 [Electronic] United States
PMID20936877 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
Chemical References
  • Aminopyridines
  • Botulinum Toxins
Topics
  • Aminopyridines (chemistry, therapeutic use)
  • Animals
  • Botulinum Toxins (toxicity)
  • Botulism (drug therapy)
  • Female
  • Male
  • Mice
  • Molecular Structure
  • Xenopus laevis

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