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Vol. 281, Issue 3, 1191-1198, 1997
Department of Physiology, Worsley Medical and Dental Building, University of Leeds, Leeds LS2 9NQ, U.K.
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Abstract |
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The effects of the resolved enantiomers of the anticonvulsant ARL 12495AA ((S,R)-1-methyl-1,2-diphenylethylamine-monohydrochloride), (S)-ARL 12495 and (R)-ARL 12495, on (1) sustained repetitive firing and (2) action potential properties of rat hippocampal neurons were assessed. Whole-cell current-clamp recordings were made from CA1 neurons in slices of adult rat brain. Sustained repetitive firing was evoked by injection of long duration (500 msec) depolarizing (20-400 pA) current pulses. Sustained repetitive firing was inhibited by (S)-ARL 12495 and by (R)-ARL 12495; the threshold concentration was 5 µM reaching a near maximum at 400 µM. Comparing the potencies of the two isomers, IC50 values of 55 and 39 µM were calculated for (S)-ARL 12495 and (R)-ARL 12495, respectively. The actions of the two drugs on neuronal firing were not therefore markedly stereoselective. Examination of individual spike properties revealed a concentration-related (12-400 µM) and time-dependent increase in the spike duration by (S)-ARL 12495 and (R)-ARL 12495. The spike amplitude and rate-of-rise were attenuated significantly by these two drugs. Both isomers decreased the after-hyperpolarization after a single spike and after trains of spikes. No clear stereoselectivity was demonstrable for the effects of the two enantiomers on action potential properties. Possible mechanisms of action for (S)-ARL 12495 and (R)-ARL 12495 including partial blockade of voltage-sensitive sodium channels and modulation of potassium channels are considered. The possibility that multiple mechanisms of action contribute to the therapeutic efficacy of the anticonvulsant ARL 12495AA is discussed.
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Introduction |
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Because of the resistance of some
forms of epilepsy to treatment using conventional anticonvulsants and
the development of refractoriness as a consequence of long-term
medication there is a need for effective anticonvulsants with low
toxicity. Strategies for the development of novel anticonvulsants have
focused on the suspected underlying central pathophysiologies such as
decreased inhibitory (
-aminobutyric acid mediated) or increased
excitatory (L-glutamate mediated) neurotransmission and
abnormal neuronal excitability. The synthetic compound remacemide
hydrochloride ((S,R)-2-amino-N-(1-methyl-1,2-diphenylethyl)-acetamide
hydrochloride) has been favorably assessed for its antiepileptic and
neuroprotective potential (Palmer et al., 1992
, 1993
) and
has entered phase II clinical trials. Studies with radiolabeled
remacemide hydrochloride in a number of animal species including human
indicate that ARL 12495AA
((S,R)-1-methyl-1,2-diphenylethylamine-monohydrochloride) is a major
desglycinate metabolite of remacemide hydrochloride, and that ARL
12495AA also possesses anticonvulsant properties (Palmer et
al., 1992
, 1993
).
Although some progress has been made in understanding the complex
etiology of epilepsy and in the development of therapeutically useful
drugs, a major consideration is the determination of central actions
that may relate to clinical efficacy. Considering the anticonvulsant
efficacy of remacemide hydrochloride and ARL 12495AA it was proposed
that a contributory mechanism of action may be partial blockade of the
NMDA receptor-ion channel complex. This suggestion was based on the
fact that both the parent compound and its metabolite ARL 12495AA are
effective against MES and NMDA-induced seizures in rats and mice
(Stagnitto et al., 1990
; Garske et al., 1991
;
Palmer et al., 1992
). Also, remacemide hydrochloride did not
prevent seizures in mice elicited by bicuculline or picrotoxin (Palmer
et al., 1993
). Both compounds are noncompetitive antagonists of [3H]-dizocilpine (MK 801) binding to rat brain
homogenates (Palmer et al., 1992
). The metabolite ARL
12495AA has been shown to be more potent than remacemide hydrochloride
against MES- and NMDA-induced seizures (Palmer et al., 1992
)
and at displacing [3H]-dizocilpine binding
(IC50 values of 0.48 and 68 µM for ARL 12495AA and
remacemide hydrochloride, respectively (Palmer et al.,
1992
). Such observations have raised the possibility that some of the
anticonvulsant activity of remacemide hydrochloride may be attributable
to effects mediated by ARL 12495AA.
Efficacy in the MES test predicts effectiveness against generalized
tonic/clonic seizures (Upton, 1994
), and drugs used in the treatment of
generalized seizures such as phenytoin, carbamazepine and valproate,
have been shown to limit high frequency firing of fast sodium-dependent
action potentials in central neurons (McLean and Macdonald, 1983
;
1986a
, b). Thus, an alternative and perhaps overlapping mechanism of
action that has been considered for some anticonvulsants is a direct or
indirect interaction with neuronal sodium channels. Diazepam, for
example, is believed to augment inhibitory synaptic transmission but at
clinically relevant doses it limits the generation of sodium-dependent
action potentials in cultured spinal neurons (Backus et al.,
1991
). Remacemide hydrochloride and ARL 12495AA have been reported to
limit action potential firing of mouse cultured neurons (Wamil et
al., 1992
), and ARL 12495AA has been shown to inhibit
veratridine-evoked (and hence sodium channel-mediated) release of
glutamate from mouse cortical slices (Srinivasan et al.,
1994
). Such observations suggest that modulation of sodium channel
activity may be relevant to the anticonvulsant efficacy of ARL 12495AA.
Recent studies on ARL 12495AA have reported stereoselectivity,
i.e., the activity of the resolved isomer (S)-ARL 12495 is higher compared to (R)-ARL 12495. The displacement of
[3H]-dizocilpine binding by ARL 12495AA is
stereoselective, (S)-ARL 12495 is more than an order of magnitude
more potent than (R)-ARL 12495 (IC50 values of 0.25 and 3.4 µM, respectively) (Palmer et al., 1992
). In
autoradiographic studies, (S)-ARL 12495 is more potent than (R)-ARL
12495 at displacing [3H]-dizocilpine binding in the CA1
region of rat brain slices (IC50 values of 1.5 and 18.4 µM, respectively) (Porter and Greenamyre, 1995
). In the same study,
remacemide hydrochloride only weakly displaced
[3H]-dizocilpine binding in the CA1 area with an
IC50 value of 968 µM. A similar order of potency has been
reported for inhibition of NMDA-evoked currents in rat cultured
hippocampal neurons, i.e., (IC50 values);
(S)-ARL 12495 (0.6 µM) > (R)-ARL 12495 (4 µM) > (S)-remacemide
hydrochloride (67 µM) = (R)-remacemide hydrochloride (75 µM)
(Subramaniam et al., 1993
).
In the light of these findings, the aim of our study was first, to determine whether both enantiomers of ARL 12495AA were able to limit SRF of rat CA1 hippocampal neurons in vitro and second to determine any differences in the potency of (S)-ARL 12495 compared to (R)-ARL 12495.
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Methods |
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Brain Slice Preparation
Adult female Wistar rats (80-100 g) were anesthetized with
urethane (2 g kg
1, i.p.) then killed by decapitation. The
brain was rapidly removed and placed in ice-cold artificial CSF of the
following composition (concentrations in mM); NaCl 128, KCl 1.9, KH2PO4 1.2, MgCl2, 1.3, CaCl2 2.4, NaHCO3 26, glucose 10, pH 7.4, saturated with 95% O2 and 5% CO2. Serial
coronal sections (350 to 400-µm thick) of the hippocampus were cut in
ice-cold artificial CSF using a vibrating microtome (Vibratome,
Intracel. Ltd., Royston, Herts, U.K.). Slices were allowed to
equilibrate in artificial CSF at room temperature for 1 hr. A single
slice was then submerged in a tissue bath and perfused continuously
with artificial CSF (21-23°C, 4 ml min
1).
Experimental Procedure
Drug preparation.
Drugs were dissolved in distilled water to
give stock solutions of 10 mM. Stock solutions were made up freshly
each day then diluted in artificial CSF to the desired concentration
and perfused through separate gravity-fed inlets for at least 15 min.
Drug removal was achieved by returning to perfusion with drug-free artificial CSF. (S)-ARL 12495 and (R)-ARL 12495 (also known as ARL
12859AE and ARL 12860AE, respectively) were kindly provided by Astra
Charnwood (Loughborough, U.K.) as the maleate salts. The structures for
these compounds have been published in Palmer et al.,
(1992)
. All other compounds were purchased from Sigma-Aldrich Co. Ltd.,
Poole, Dorset, U.K.
Electrophysiological recordings.
Whole-cell recordings were
made from neurons with a resting membrane potential more negative than
50 mV and with action potentials that overshot 0 mV. Recordings were
made without visualization of the neurons. The patch pipettes were
pulled from thin-walled fiber-filled borosilicate glass (1.2 mm o.d.)
on a horizontal puller (Brown-Flaming, Sutter Instruments Co., Novato,
CA). The patch pipettes were back-filled with a solution of the
following composition (concentrations in mM); K-gluconate 125, NaCl 15, MgCl2 2, EGTA 11, HEPES 10, ATP 1.5, GTP 0.2. The pH of the
solution was adjusted to 7.4 with 1 M KOH so that the final
concentration of K+ was 140 mM. The resistance of the patch
pipettes in artificial CSF was 4 to 6 M
. Current-clamp recordings
were made using an Axopatch-1D amplifier (Axon Instruments, Foster
City, CA). Signals were filtered at 2 kHz, digitized by a data recorder
(Instrutech Corp., Great Neck, N.Y.) and stored on video tape (VHS,
Sanyo, London, U.K.). Signals were monitored using a digital
oscilloscope (Tektronix, London, U.K.) and captured on-line with an
IBM-AT computer running SIGAVG software (CED, Cambridge, U.K.).
Stimulation protocol. Repetitive firing was evoked by injection of rectangular depolarizing current pulses (20-400 pA, 500 msec) from the resting membrane potential. A series of pulses of increasing amplitude were applied to each neuron to determine its current-frequency relationship. (S)-ARL 12495 or (R)-ARL 12495 was then perfused for 15 min before the current pulses were repeated in the presence of the drug. Neuronal input resistance was calculated from the steady-state voltage response to a small amplitude hyperpolarising current pulse (20-40 pA, 500 msec).
Data Analysis
Data were sampled at 20 kHz for analysis of single action
potential properties and at 5 kHz for SRF analysis. Statistical significance (95% confidence limits, i.e., P < .05)
was determined using two-tailed, paired or unpaired Student's
t test. Concentration-response relationships were obtained
by plotting the drug concentration vs. the number of spikes
elicited by a maximal depolarizing current pulse (250-350 pA). The
data were normalized to allow for differences in maximal firing.
Concentration-response curves were fitted to the data by least squares
regression to the equation Y = Ymax/(1+(IC50/[drug])n),
where IC50 is the concentration resulting in a 50% block
of SRF and n is a slope factor, using an iterative procedure
on an IBM-AT computer with Sigmaplot 5.0 software (Jandell Corporation, Erkrath, Germany). Ymax was constrained to be
100. All
data are presented as the mean ± S.E.M. Spike amplitude was
measured from the firing threshold to the peak of the spike. Spike
duration was measured from the firing threshold to the same voltage
level on the downstroke of the spike. The rate-of-rise was calculated from the 20 to 80% amplitude values of the spike. The amplitude of the
"fast" AHP after a single spike was measured from firing threshold
level in response to a threshold current pulse. The amplitude of the
"slow" AHP after a train of action potentials was measured 100 msec
after the termination of a maximal depolarizing pulse.
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Results |
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Effects on passive membrane properties.
Whole-cell recordings
were made from CA1 neurons with a mean ± S.E.M. resting membrane
potential of
61.9 ± 0.6 mV and mean input resistance of
165.9 ± 7.3 M
(n = 22). No concentration tested of either (S)-ARL 12495 or (R)-ARL 12495 had any statistically significant effect on membrane potential. For example, the membrane potential was
68.0 ± 3.7 mV (n = 5) in the
presence of 400 µM (S)-ARL 12495, and
64.6 ± 2.0 mV
(n = 5) in the presence of 400 µM (R)-ARL 12495. At
the highest concentration tested (400 µM) each isomer increased
neuronal input resistance; (S)-ARL 12495 caused an increase to
318.8 ± 52.7 M
(n = 5, P < .001) and
(R)-ARL 12495 caused an increase to 320.0 ± 10.4 M
(n = 5, P < .001). However, at the lower
concentration of 40 µM, which was subsequently found to be near the
IC50 for each drug for SRF limitation (see below), neither
isomer had any significant effect on input resistance; the input
resistance was 186.3 ± 5.9 M
(n = 4) after 40 µM (S)-ARL 12495 and 189.0 ± 4.6 M
(n = 5)
after 40 µM (R)-ARL 12495.
Effects on sustained repetitive firing.
All sampled neurons
fired trains of fast action potentials with no evidence of spike
frequency accommodation on injection of depolarizing current pulses
(fig. 1). Over the range of currents tested (20-400 pA)
and under the present recording conditions, all neurons displayed
almost linear current-frequency relationships (not illustrated).
Typical maximal firing frequencies were 28 to 32 Hz with pulses of 200 to 400 pA. Superfusion with (S)-ARL 12495 (4-400 µM) (fig. 1A) or
(R)-ARL 12495 (4-400 µM) (fig. 1B) significantly reduced the total
number of action potentials evoked by any given depolarizing pulse. In
the neuron of figure 1A, 40 µM (S)-ARL 12495 reduced the firing
frequency from 30 to 14 Hz and in the neuron of figure 1B a similar
concentration of (R)-ARL 12495 reduced the frequency to 16 Hz. The
effects of both drugs were slowly reversible and required a minimum
wash period of 30 min; the re-establishment of SRF in a neuron that was
exposed to 120 µM (S)-ARL 12495 and then returned to control
artificial CSF is illustrated in figure 2A.
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Effects on spike amplitude, rate-of-rise and duration.
(S)-ARL
12495 or (R)-ARL 12495 altered the properties of individual spikes.
Figure 3A shows a typical example of the actions of (S)-
ARL 12495 (40 and 400 µM) (fig. 3A) on the first spike within a train
evoked by a maximal depolarizing pulse. Because the effects of (S)-ARL
12495 and (R)-ARL 12495 on spike shape were equivalent, only examples
for (S)-ARL 12495 are illustrated. In this neuron, it is apparent that
(S)-ARL 12495 reduced first spike amplitude and reduced the
rate-of-rise while increasing first spike duration. Note also the
raised firing threshold (as indicated by the dashed lines in fig. 3A)
after the drug. The quantified data for the effects of either drug over
the concentration range of 12 to 400 µM on these three first spike
parameters are presented in the histograms of figure 3, B, C and D. The
most consistent action of either drug was a concentration-related
increase in the first spike duration (fig. 3D) with a threshold
concentration of 12 µM for either enantiomer. A trend for a reduction
of the first spike rate-of-rise was evident (fig. 3C) but the data was highly significant (P < .01) for either (S)-ARL 12495 or (R)-ARL 12495 only at the highest concentrations tested (400 µM). Considering the first action potential amplitude, although an effect was observed with 12 µM (R)- ARL 12495 a significant reduction by both enantiomers occurred at concentrations of 120 µM (P < .05) and 400 µM
(P < .01). No clear stereoselectivity in the effects of these
drugs on the parameters of the first spike was evident.
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Effects on spike AHP.
(S)- and (R)-ARL 12495 reduced the
"fast" AHP after a single spike evoked by a threshold current pulse
(fig. 5A). The threshold concentration for reduction in
"fast" AHP amplitude was 4 µM for (S)-ARL 12495 and 12 µM for
(R)-ARL 12495 and was concentration-related over the range 4 to 400 µM. In addition, the "slow" AHP after a train of spikes was
reduced by (S)- or (R)-ARL 12495 (fig. 5B) over an equivalent
concentration range. In some neurons abolition of either the "fast"
or "slow" AHP unmasked an after-depolarization (ADP; shown as
negative values in graphs of fig. 5). With high concentrations (120 and
400 µM) of either drug the "slow" AHP was converted to an ADP in
nearly every recorded neuron.
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Discussion |
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Our data show that the resolved enantiomers of ARL 12495AA, namely
(S)-ARL 12495 and (R)-ARL 12495, limited SRF of rat CA1 hippocampal
neurons in vitro. The IC50 values for SRF
limitation were 55 and 39 µM for (S)-ARL 12495 and (R)-ARL 12495, respectively. If the inhibition of SRF by ARL 12495AA is
stereoselective then one isomer should be substantially more potent
than the other at inhibiting SRF. As the potencies of the two
enantiomers are similar to each other it is concluded that the effects
of ARL 12495AA on high-frequency firing are not stereoselective. In
this respect, these data are in agreement with Wamil et al.
(1996)
who showed that remacemide hydrochloride and the racemate ARL 12495AA limited SRF of mouse cultured spinal cord neurons and that the
stereo-isomers of ARL 12495AA were equipotent. These authors reported
IC50 values for SRF limitation of 7.9 µM for remacemide
hydrochloride, 3.3 µM for (S)-ARL 12495 and 3.5 µM for (R)-ARL
12495. These values for cultured spinal neurons are an order of
magnitude more potent than the IC50 values found in this
study of CA1 neurons. The reason for this difference is unclear but
could reflect species variation, differential neuronal susceptibility, variations in the recording conditions (e.g., temperature)
and drug exposure time.
From previous studies, it was suggested that limitation of SRF is a
characteristic effect of anticonvulsant drugs such as phenytoin and
carbamazepine that can partially block voltage-sensitive sodium
channels (Willow et al., 1985
; Lang et al.,
1993
). Although no direct evidence exists for such an action by (S)-ARL
12495 and (R)-ARL 12495, the concentration-related reduction of spike amplitude and rate-of-rise produced by each of the two enantiomers is
consistent with sodium channel blockade. In particular, the spike
rate-of-rise is often used as an indirect measure of the maximum sodium
conductance of excitable membranes (Strichartz and Cohen, 1978
;
Catterall, 1987
). Although the amplitude and rate-of-rise of the first
spike were not significantly reduced by 40 µM (S)- or (R)-ARL 12495, succeeding spikes in the train were significantly reduced by this
concentration (which is similar to the IC50 for SRF
limitation). Mechanistically, phenytoin, carbamazepine and lamotrigine
have each been shown to prolong recovery of sodium channels from
inactivation (Willow et al., 1985
; Lang et al., 1993
) and it is possible that these enantiomers of ARL 12495AA act
similarly. (S)- and (R)-ARL 12495 significantly increased spike
duration, an effect that was due partly to a slower rise time after the
drugs but mostly to a lengthening of the repolarization time. Because
spike repolarization is dependent mainly on potassium channel
activation it is possible that (S)- and (R)-ARL 12495 can modulate such
channels. (S)- and (R)-ARL 12495 also reduced the amplitude of the
"fast" and "slow" AHP which is further indirect evidence that
each compound may modulate potassium conductances. However, the
amplitude of the "slow" AHP depends critically on Ca++
influx during the preceding train of spikes to activate
calcium-sensitive potassium currents (IK(Ca)), therefore
any reduction of the "slow" AHP may be a consequence of reduced SRF
and not due to a reduction of IK(Ca) per se. Spike
broadening is not elicited by anticonvulsants such as phenytoin and
lamotrigine that are thought to block sodium channels only (McLean and
Macdonald, 1983
; Lees and Leach, 1993
). Blockade by (S)- and (R)-ARL
12495 of potassium channels in addition to sodium channel blockade is
consistent with the reported effects of (S,R)-ARL 12495AA on
neurotransmitter release from mouse cortical slices (Srinivasan
et al., 1994
). This group found that (S,R)-ARL 12495AA
inhibited glutamate release evoked by either veratridine (which
prevents sodium channel inactivation) or potassium. By comparison,
lamotrigine (which blocks sodium but not potassium channels) inhibits
veratridine- but not potassium-evoked glutamate release from rat
cerebral cortex slices (Leach et al., 1986
). Voltage-clamp
studies will be required to establish direct blockade of ionic channels
by (S)- or (R)-ARL 12495.
Recently, Wamil et al. (1996)
reported that ARL 12495AA when
applied to mouse spinal cord neurons at a concentration equivalent to
its IC50 for limitation of SRF in these neurons caused a
use-dependent block of NMDA-induced responses. Other studies on
hippocampal neurons have indicated a noncompetitive block of the NMDA
receptor ion channel complex by the resolved enantiomers (Subramaniam
et al., 1996
). Given these proposed interactions with
NMDA-activated channels, sodium and potassium channels, (S,R)-ARL
12495AA and its enantiomers are certainly not selective ion channel
blockers. Paradoxically, it may be their interaction at more than one
site that accounts for effectiveness against seizures in animal models. Indeed, blockade of sodium and NMDA receptor ion channels are synergistic in that both actions would be expected to result in dampening of excessive excitatory activity. Partial blockade of sodium
channels theoretically would (1) stabilize presynaptic membranes,
thereby inhibiting the pathological and potentially excitotoxic release
of neurotransmitters such as L-glutamate and (2) stabilize
postsynaptic membranes thereby limiting high frequency firing. Partial
blockade of NMDA receptor ion channels would reduce NMDA
receptor-mediated excitation thereby limiting excessive
Ca++ entry. Which of these drug actions provides for the
primary mechanism underlying the anticonvulsant action? Because
inhibition of NMDA currents by (S)-ARL12495 has an IC50 of
0.6 µM (Subramaniam et al., 1993
) then it is tempting to
propose a primary action against abnormal excitatory amino
acid-mediated excitation. However, this conclusion may be based on a
premature and overly simplistic assumption about the aetiology of human
epilepsy.
Blockade of multiple ion channel types by an antiepileptic drug is not
unprecedented. Felbamate may block sodium and NMDA receptor ion
channels as it has been shown to limit SRF of mouse spinal cord neurons
(White et al., 1992
) and to inhibit NMDA-evoked currents in
rat hippocampal neurons (Rho et al., 1994
). However, blockade of potassium currents and a slowing of membrane potential repolarization by (S)- or (R)-ARL 12495 would be expected to enhance neuronal excitability, ultimately opposing the effects of sodium and
NMDA ion channel blockade. Given that there is significant broadening
of spikes by (S)- or (R)-ARL 12495 at concentrations that limit SRF it
is probable that potassium channel blockade does occur in
vivo. Why this excitatory action of ARL 12495AA does not appear to
counteract the drugs antiepileptic actions is not clear. Perhaps the
combined effects of sodium and NMDA channel blockade are sufficient to
outweigh the effect of potassium channel block or it may be that
inhibitory neurons are more susceptible than excitatory neurons to
potassium channel blockade by (S,R)-ARL 12495AA.
The question of the therapeutic relevance of any observed
electrophysiological action of anticonvulsants applied acutely to isolated central nervous system preparations is not easily addressed. For clinically available antiepileptics such as lamotrigine and phenytoin, it is claimed that calculated free plasma levels would be in
the concentration range sufficient to limit SRF (Cheung et
al., 1992
, McLean and MacDonald, 1983). In the case of the anticonvulsants remacemide hydrochloride and ARL 12495AA, any comparison is limited by the fact that the pharmacokinetics of the
maximum dose tolerated in humans and its antiepileptic efficacy remains
to be established. The pharmacokinetic profiles of (S)- and
(R)-ARL12495 are also unknown. Remacemide hydrochloride is 77% bound
to plasma protein (Scheyer et al., 1992
) thus measured plasma concentrations undoubtedly will be higher than actual brain levels. In rats, the concentration of ARL 12495AA found in whole brain
homogenates of rats effectively treated against MES (i.v. 20 mg
kg
1) was approximately 10.9 µg g
1 of
tissue estimated to be equivalent to 52 µM (J. Farmer, Astra Charnwood, Loughborough, U.K., personal communication) and this is
similar to the IC50 values of 55 and 39 µM for (S)- and
(R)-ARL 12495 reported here. However, these values should be viewed
cautiously because an average whole brain concentration may not
indicate the concentration localised at the active site.
In summary, (S)-ARL 12495 and (R)-ARL 12495 effectively limited
neuronal SRF. However, unlike the effects of ARL 12495AA at hippocampal
NMDA receptor ion channels (Subramaniam et al., 1993
, 1996
),
these effects on hippocampal firing properties were not markedly
stereoselective. The likelihood that the anticonvulsant activity of ARL
12495AA is mediated by partial blockade of both sodium channels and
NMDA receptor ion channels warrants further investigation.
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Acknowledgments |
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The authors thank Astra Charnwood, Loughborough, U.K. for the gifts of (S)- and (R)-ARL 12495, J. Daniel and S. Shaw for technical assistance and D. Johanson for the photography.
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Footnotes |
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Accepted for publication February 25, 1997.
Received for publication October 7, 1996.
1 This work was supported by Astra Charnwood, Loughborough, UK.
2 Current address: School of Physiology and Pharmacology, University of New South Wales, NSW 2052, Australia.
Send reprint requests to: Dr. A. E. King, Department of Physiology, Worsley Medical and Dental Building, University of Leeds, Leeds LS2 9NQ, U.K.
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Abbreviations |
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CSF, cerebrospinal fluid; ADP, after-depolarization; AHP, after-hyperpolarization; IK(Ca), calcium-sensitive potassium current; NMDA, N-methyl-D-aspartate; MES, maximal electroconvulsive shock; SRF, sustained repetitive firing.
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References |
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