Seizure Control by Derivatives of Medium Chain Fatty Acids Associated with the Ketogenic Diet Show Novel Branching-Point Structure for Enhanced Potency
作者:Pishan Chang、Alexandra M. E. Zuckermann、Sophie Williams、Adam J. Close、Marife Cano-Jaimez、James P. McEvoy、John Spencer、Matthew C. Walker、Robin S. B. Williams
DOI:10.1124/jpet.114.218768
日期:2015.1
The medium chain triglyceride (MCT) ketogenic diet is a major treatment of drug-resistant epilepsy but is problematic, particularly in adults, because of poor tolerability. Branched derivatives of octanoic acid (OA), a medium chain fat provided in the diet have been suggested as potential new treatments for drug-resistant epilepsy, but the structural basis of this functionality has not been determined. Here we investigate structural variants of branched medium chain fatty acids as new seizure-control treatments. We initially employ a series of methyl-branched OA derivatives, and using the GABAA receptor antagonist pentylenetetrazol to induce seizure-like activity in rat hippocampal slices, we show a strong, branch-point–specific activity that improves upon the related epilepsy treatment valproic acid. Using low magnesium conditions to induce glutamate excitotoxicity in rat primary hippocampal neuronal cultures for the assessment of neuroprotection, we also show a structural dependence identical to that for seizure control, suggesting a related mechanism of action for these compounds in both seizure control and neuroprotection. In contrast, the effect of these compounds on histone deacetylase (HDAC) inhibition, associated with teratogenicity, shows no correlation with therapeutic efficacy. Furthermore, small structural modifications of the starting compounds provide active compounds without HDAC inhibitory effects. Finally, using multiple in vivo seizure models, we identify potent lead candidates for the treatment of epilepsy. This study therefore identifies a novel family of fatty acids, related to the MCT ketogenic diet, that show promise as new treatments for epilepsy control and possibly other MCT ketogenic diet-responding conditions, such as Alzheimer disease.
中链甘油三酯(MCT)生酮饮食是耐药性癫痫的主要治疗方法,但由于耐受性差,存在问题,特别是在成人中。辛酸(OA)的支链衍生物是饮食中提供的一种中链脂肪,已被建议作为耐药性癫痫的潜在新疗法,但这种功能的结构基础尚未确定。在这里,我们研究支链中链脂肪酸的结构变体作为新的癫痫控制治疗方法。我们首先使用一系列甲基支化的 OA 衍生物,并使用 GABAA 受体拮抗剂戊四唑在大鼠海马切片中诱导癫痫样活性,我们显示出强烈的分支点特异性活性,该活性优于相关癫痫治疗丙戊酸。使用低镁条件在大鼠原代海马神经元培养物中诱导谷氨酸兴奋毒性以评估神经保护作用,我们还表现出与癫痫控制相同的结构依赖性,表明这些化合物在癫痫控制和神经保护方面的相关作用机制。相反,这些化合物对与致畸性相关的组蛋白脱乙酰酶(HDAC)抑制的作用与治疗效果没有相关性。此外,起始化合物的小结构修饰提供了没有HDAC抑制作用的活性化合物。最后,使用多个体内癫痫模型,我们确定了治疗癫痫的有效先导候选药物。因此,这项研究确定了一个与 MCT 生酮饮食相关的新型脂肪酸家族,该家族有望成为控制癫痫和其他可能对 MCT 生酮饮食有反应的疾病(例如阿尔茨海默病)的新疗法。