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Emerging therapeutic agents for transmissible spongiform encephalopathies: a review

Koster, T., Singh, K., Zimmermann, M., Gruys, E.
Journal of veterinary pharmacology and therapeutics 2003 v.26 no.5 pp. 315-326
anthracyclines, antibodies, blood-brain barrier, chlorpromazine, clinical trials, dextran, drug therapy, immunization, peptides, pharmacokinetics, polyamines, prions, quinacrine, scrapie, sulfates, tetracyclines, toxicity
Transmissible spongiform encephalopathies (TSEs) are a group of fatal neurodegenerative disorders associated with misfolding of prion protein, from PrP(C) to PrP(Sc). Different types of experimental studies have resulted in a better understanding of the pathogenesis of the prion diseases. Genetic and molecular properties of PrP isoforms have been explained but the conformational conversion of the PrP(C) isoform to the PrP(Sc) isoform has not yet been entirely elucidated. However, a number of possible therapeutic agents have been tried and some have proven to be effective against TSEs but most have limitations in terms of toxicity and pharmacokinetics. Congo red (CR), anthracyclines, and polyanionic dextran sulfate have limited ability to cross the blood–brain barrier and may be toxic. The efficacy of polyene antibiotics seems to be restricted to certain scrapie strains. Tetrapyrroles and tetracyclines with low toxicities and favorable pharmacokinetics could be useful in preventing PrP(Sc) accumulation. Compounds like branched polyamines, Cp-60, analogs of CR, quinacrine and chlorpromazine, β-sheet breaker peptides and inhibitory peptides, active immunization using recombinant PrP and passive immunization with anti-PrP antibodies, have potential use as therapeutic agents but would need further research and clinical trials.