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Objective: The primary objective of this real-world study was to describe the response to fampridine and changes of gait parameters in multiple sclerosis (MS) patients’ walking disability (Expanded Disability Status Scale (EDSS): 4–7) after treatment with fampridine for 2 weeks as recommended by the European Medicines Agency (EMA) and compare it with the overall physician’s judgement. Methods: A total of 211 adult MS patients were analyzed using a multimodal gait assessment including the timed 25-foot walk test (T25FW), 2-minute walking test (2-MWT), 12-item Multiple Sclerosis Walking Scale (MSWS-12), the GAITRite electronic walkway system, and the patients’ clinical global impression (CGI). Multimodal gait assessment was compared with the clinician’s impression of overall improvement after 2 weeks. Results: In total, 189 subjects were included, of which 133 (70.37%) were responders to fampridine (RF), according to physician’s judgement. Looking at independent multimodal gait assessment, RFs showed improvement of 12.60% in the T25FW, 19.25% in the 2-MWT, 21.12% in the MSWS-12, and 6.54% in their Functional Ambulation Profile (FAP) score. The combination of the T25FW and the MSWS-12 would offer the best sensitivity and specificity for determining response to fampridine according to both neurologists’ and patients’ classification. Conclusion: This study provides new information on the use of fampridine in a real-world setting with a large patient sample on the potential benefit of using more definitive responder criteria to fampridine for the clinical setting.

The subcellular mechanism and site of action of linopirdine or DuP 996 (3,3‐bis(4‐pyridinylmethyl)‐1‐phenylindolin‐2‐one) was investigated at the frog neuromuscular junction, using miniature endplate potential (m.e.p.p.) counts and a new method for obtaining unbiased estimates of n (number of functional release sites), p (probability of release), and varsp (spatial variance in p). DuP 996 produced an increase in m (no. of quanta released), which was due to an increase in n and p. The increase in m was concentration‐dependent over a range of 0.1–100 μm and completely reversible with 15 min of wash. There was a saturation in the increase in p, but not in the increase in m and n, for [DuP 996] >10 μm. By contrast, there was no major change in varsp. Block of presynaptic Na+‐ and Ca2+‐channels with 3 μm tetrodotoxin and 1.8 mm Co2+prevented the m.e.p.p. frequency increase to DuP 996, and this effect was completely reversed by washing. Application of the neuronal Ca2+‐channel blocker, ω‐conotoxin GVIA (1 μm) brought about a rapid and profound decrease in the m.e.p.p. frequency increase produced by DuP 996. The effect of the toxin was not reversed by prolonged washing. Block of voltage‐gated K+‐channels with 100 μm 4‐aminopyridine (4‐AP) resulted in only a small (28%) increase in m. The combination of 4‐AP (100 μm) and DuP 996 (10 μm) produced an increase in m (189%) which was much greater than the sum of the responses to each agent alone. This increase in m was due solely to an increase in n, as p and varsp were unchanged. For [DuP 996] up to 100 μm, there was no apparent change in the mean size, amplitude distribution, or time course of m.e.p.ps, signifying that it had no anticholinesterase activity. It is concluded that DuP 996 increases the release of quantal transmitter but not the postsynaptic response to the quanta. This appears to involve an effect at the nerve terminal membrane, most likely an increase in Ca2+‐conductance, and not an action to block K+‐conductance or to release Ca2+from intraterminal organelles. 1994 British Pharmacological Society

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Experimental models of seizure in animals have represented an important role for the understanding of the physiological and behavioural alterations associated with the human epilepsy. The induction of partial or generalized seizures is an efficient method for evaluating both the susceptibility to seizures and to investigate new anticonvulsant agents. In this sense, studies showed that the convulsive actions of the diphenyl diselenide (PhSe)2 and 2,3-dimercaptopropanol (BAL) compounds are inhibited by diazepam and phenobarbital, two classic allosteric modulators of the GABAergic system. Therefore, arises the interest of to investigate the interaction of the (PhSe)2 and BAL compounds with convulsive agents that act via blockade and/or modulation of the GABAergic system. This is the case of the pentylenetetrazol (PTZ), which exerts its convulsive action by blocking of Cl- channel of the GABAA receptor complex. Taking into account these facts, the present study had as first objective to investigate the effects of the pre-administration of (PhSe)2 and BAL in the model of chemical seizure PTZ-induced in mice (Article 1). For this purpose, mice were pretreated with (PhSe)2 (150 μmol/kg, i.p.) or BAL (250, 500, or 1000 μmol/kg, i.p.) 10 minutes prior to administration of PTZ. The obtained results showed that the pretreatment with (PhSe)2 reduced the latency for seizure PTZ-induced at doses of 40 and 60 mg/kg, beyond to cause a decrease in the latency for death PTZ-induced at dose of 60 mg/kg. However, the convulsive and lethal action PTZ-induced at dose of 80mg/kg was not affected by the pretreatment with (PhSe)2. Similarly, the pretreatment of the animals with BAL reduced the latency for seizure induced by 40 and 50 mg/kg PTZ. In addition, the latency for death PTZ-induced at dose of 40 mg/kg was significantly decreased by the pretreatment with BAL in all doses tested. Particularly, in the dose of 50 mg/kg of PTZ, a significant decrease in the latency for death occurred only when the mice were pretreated with 500 and 1000 μmol/kg of BAL. These results show that (PhSe)2 and BAL act in synergysm with PTZ potentializing its convulsive action, possibly through a modulation of the GABAergic system. Tacking into account the structural similarities between (PhSe)2 and diphenyl ditelluride (PhTe)2 compounds, our further objective was to investigate the effects of the (PhSe)2 and (PhTe)2 compounds on a model of chemical seizure 4-aminopyridine (4-AP)-induced in mice (Article 2). The convulsive action of this agent occurs through a blockade of K+ channels and activation of Ca2+ channels, with consequent release of neurotransmitters, predominantly the glutamate. Moreover, it was investigated the brain lipid peroxidation level after treatment of the animals with 4-AP, as well the effect of the pretretament with the (PhSe)2 and (PhTe)2 compounds on this level. For this purpose, mice were pretreated with (PhSe)2 and (PhTe)2 (50, 100, or 150 μmol/kg, s.c.) 30 minutes before administration of 4-AP (12 mg/kg, i.p.). The obtained results showed that the pretreatment with (PhSe)2 and (PhTe)2 (50, 100, and 150 μmol/kg) significantly increased the latency for clonic and tonic seizure, as well as inhibited the death 4-AP-induced. In addition, it was observed a significant increase in the brain lipid peroxidation levels after treatment with 4-AP, which was significantly inhibited by pretreatment with the (PhSe)2 and (PhTe)2 compounds. Therefore, these results show that (PhSe)2 and (PhTe)2 increase the latency for seizures, as well as inhibit the death 4-AP-induced. It is possible that this effect result of the modulation of redox sites of NMDA receptors, and/or modulation in the Ca2+ channels activity with consequent alteration in the neurotransmitters release. Moreover, the work provided evidences for the anticonvulsant and antioxidant properties of the (PhSe)2 and (PhTe)2 compounds, which point out for its neuroprotective properties in this model. Of general model, the utilization of the models of chemical seizure PTZ- or 4-AP-induced in mice was a useful method in the investigation of the actions on central nervous system of the (PhSe)2, (PhTe)2, and BAL compounds. The use of these convulsive models provided evidences about the convulsive actions, as well as possible mechanisms of action of the evaluated compounds. / Modelos experimentais de convulsão em animais têm representado um papel importante para a compreensão das alterações fisiológicas e comportamentais associadas com a epilepsia humana. A indução de convulsões parciais ou generalizadas é um método eficiente para avaliar tanto a susceptibilidade às convulsões quanto investigar novos agentes anticonvulsivantes. Neste sentido, estudos demonstraram que as ações convulsivantes dos compostos disseleneto de difenila (PhSe)2 e 2,3-dimercaptopropanol (BAL) são inibidas por diazepam e fenobarbital, dois moduladores alostéricos clássicos do sistema GABAérgico. Logo, surge o interesse de investigar os efeitos da interação dos compostos (PhSe)2 e BAL e agentes convulsivantes que ajam através do bloqueio e/ou modulação do sistema GABAérgico. Este é o caso do agente pentilenotetrazol (PTZ), o qual exerce sua ação convulsiva por meio de um bloqueio do canal de Cl- do complexo do receptor GABAA. Considerando estes fatos, o presente estudo teve como primeiro objetivo investigar os efeitos da pré-administração de (PhSe)2 e BAL no modelo de convulsão química induzida por PTZ em camundongos (Artigo 1). Para este propósito, camundongos foram pré-tratados com (PhSe)2 (150 μmol/kg, i.p.) ou BAL (250, 500 ou 1000 μmol/kg, i.p.) 10 minutos antes da administração de PTZ. Os resultados obtidos demonstraram que o pré-tratamento com (PhSe)2 reduziu a latência para a convulsão induzida por PTZ nas doses de 40 e 60 mg/kg, além de causar um decréscimo na latência para a morte induzida por PTZ na dose de 60 mg/kg. Entretanto, a ação convulsivante e letal induzida por PTZ na dose de 80 mg/kg não foi afetada pelo pré-tratamento com (PhSe)2. Similarmente, o pré-tratamento dos animais com BAL reduziu a latência para a convulsão induzida por 40 e 50 mg/kg de PTZ. Além disso, a latência para a morte induzida por PTZ na dose de 40 mg/kg foi significativamente diminuída pelo pré-tratamento com BAL em todas as doses testadas. Particularmente, na dose de 50 mg/kg de PTZ, decréscimo significativo na latência para a morte ocorreu somente quando os camundongos foram pré-tratados com 500 e 1000 μmol/kg de BAL. Estes resultados demonstram que o (PhSe)2 e BAL agem em sinergismo com o PTZ potencializando sua ação convulsiva, possivelmente através de uma modulação do sistema GABAérgico. Tendo em vista as similaridades estruturais entre os compostos (PhSe)2 e ditelureto de difenila (PhTe)2, nosso próximo objetivo foi investigar o efeito dos compostos (PhSe)2 e (PhTe)2 sobre um modelo de convulsão química induzida por 4-aminopiridina (4-AP) em camundongos (Artigo 2). A ação convulsiva deste agente ocorre através do bloqueio de canais de K+ e ativação de canais de Ca2+, com conseqüente liberação de neurotransmissores, predominantemente o glutamato. Além disso, foram investigados os níveis de peroxidação lipídica cerebral após o tratamento dos animais com 4-AP, bem como o efeito do pré-tratamento com os compostos (PhSe)2 e (PhTe)2 sobre esses níveis. Para este fim, camundongos foram pré-tratados com (PhSe)2 e (PhTe)2 (50, 100 ou 150 μmol/kg, s.c.) 30 minutos antes da administração de 4-AP (12 mg/kg, i.p.). Os resultados obtidos demonstraram que o pré-tratamento com (PhSe)2 e (PhTe)2, nas doses de 50, 100 e 150 μmol/kg, aumentou significativamente a latência para a convulsão clônica e tônica, bem como inibiu a morte induzida por 4-AP. Além disso, observamos um significativo aumento nos níveis de peroxidação lipídica cerebral após o tratamento com 4-AP, o qual foi significativamente inibido pelo pré-tratamento com os compostos (PhSe)2 e (PhTe)2. Portanto, estes resultados demonstram que (PhSe)2 e (PhTe)2 aumentam a latência para as convulsões, bem como inibem a morte induzida por 4-AP. É possível que este efeito resulte da modulação de sítios redox de receptores NMDA, e/ou modulação na atividade de canais de Ca2+ com conseqüente alteração na liberação de neurotransmissores. Além disso, o trabalho forneceu evidências para as propriedades anticonvulsivas e antioxidantes dos compostos (PhSe)2 e (PhTe)2, as quais apontam para suas propriedades neuroprotetoras neste modelo. De forma geral, a utilização dos modelos de convulsão química induzida por PTZ e 4-AP em camundongos foi um método útil na investigação das ações sobre o sistema nervoso central dos compostos (PhSe)2, (PhTe)2 e BAL. O emprego destes modelos convulsivos forneceu evidências acerca das ações convulsivas, bem como possíveis mecanismos de ação dos compostos avaliados.

Thèse numérisée par la Direction des bibliothèques de l’Université de Montréal / Les canaux ioniques présents dans la membrane des cellules musculaires lisses vasculaires, et surtout des cellules retrouvées au niveau des artères de résistance, jouent des rôles prépondérants dans le contrôle du potentiel membranaire et de la contractilité vasculaire. Nos deux études ont porté sur l) les propriétés biophysiques et pharmacologiques des canaux potassiques (K+) et 2) les propriétés fonctionnelles des canaux perméables au chlore (Cl') dans la régulation de l'activité électromécanique des cellules artérielles. Dans la première partie de cette thèse, nous décrivons le mécanisme de l'interaction entre la 4-aminopyridine et un courant K+ sortant à rectification retardée (Kdr) dans des cellules d'artères coronaires de conductance de lapin. Parmi les multiples canaux K identifies au niveau des cellules musculaires lisses vasculaires, Kdr joue un rôle majeur dans le maintien du potentiel membranaire de repos entre -70 et -40 mV. La 4-aminopyridine (4- AP) est un inhibiteur relativement spécifique du canal Kdr et a été utilisée abondamment pour caractériser ses propriétés biophysiques et son rôle physiologique. Malgré son usage répandu, on ne connaît pas la nature de l'interaction entre la 4-AP et le canal Kdr concernant les canaux Kdr, nous estimons que le canal Kdr coronaire est possiblement un hétéro-multimère de plusieurs sous-unités fonctionnelles a et modulatrices P. Le but de notre deuxième étude a été d'évaluer le rôle des canaux Cl' dans la contraction vasculaire induite par la stimulation des récepteurs αi-adrénergiques, et de mesurer l'influence de changements de la pression transmurale sur cette réponse. Malgré l'importance des canaux calciques de type L (CaL) dans la contraction vasculaire, des études récentes suggèrent que deux canaux perméables au Cl' dépendants du Ca2+ intracellulaire (CICa) ou sensibles aux changements de volume (Clvol) sont impliqués, respectivement, dans la dépolarisation et contraction engendrées par certains agonistes vasoconstricteurs ou lors d'une élévation de la pression transmurale ("réponse myogénique"), propriété à laquelle on attribue un rôle important dans les mécanismes d'autorégulation dans plusieurs lits vasculaires. En condition isobarique, nous avons évalué le rôle des canaux Cl' dans les réponses αi-adrénergique (stimulée par la phényléphrine - PE) et myogénique des artérioles (70 -100 pm diamètre interne) mésentériques de lapin. Nos observations nous ont permis de tirer les conclusions suivantes. i) La PE cause une vasoconstriction liée à l'activation des canaux CICaet CaL. ii) L'acide niflumique (NfA) ou le 4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid (DIDS) ne modifie pas la contraction induite par l'activation des canaux CaL. iii) La dilatation induite par l'inhibition de dca par la NfA est dépendante de la pression pour des concentrations faibles et modérées (0.5 à 1 µM) de l'agoniste PE. iv) L'étirement de la paroi causée par une hausse de la pression transmurale active possiblement un courant sensible au DIDS qui "masque" en partie la vasoconstriction induite par la PE attribuée à l'activité des canaux CICa. v) La dépolarisation induite par la PE est renversée complètement par la NfA. vi) Le courant sensible au DIDS contribue à la réponse myogénique. Ces travaux mettent donc en évidence l'importance physiologique des canaux Cl' dans la dépolarisation et la contraction de la microcirculation mésentérique associées à la stimulation par le système nerveux autonome sympathique dans des conditions normales de pression transmurale.