Edaravone is a
free-radical scavenger drug that was recently approved for the treatment of
amyotrophic lateral sclerosis (ALS), a
neurodegenerative disease. A pathological hallmark of ALS is the accumulation of ubiquitinated or phosphorylated aggregates of the 43-kDa transactive response
DNA binding protein (TDP-43) within the cytoplasm of motor neurons. This study revealed the efficacy of
edaravone in preventing neuronal cell death in a
TDP-43 proteinopathy model and analyzed the molecular changes associated with the neuroprotection. The viability of the neuronal cells expressing TDP-43 was reduced by oxidative stress, and
edaravone (≥10 μmol/L) protected in a concentration-dependent manner against the neurotoxic insult. Differential gene expression analysis revealed changes among pathways related to nuclear erythroid 2-related-factor (Nrf2)-mediated oxidative stress response in cells expressing TDP-43. In
edaravone-treated cells expressing TDP-43, significant changes in gene expression were also identified among Nrf2-oxidative response, unfolded protein response, and autophagy pathways. In addition, the expression of genes belonging to
phosphatidylinositol metabolism pathways was modified. These findings suggest that the
neuroprotective effect of
edaravone involves the prevention of TDP-43 misfolding and enhanced clearance of pathological TDP-43 in
TDP-43 proteinopathy.