Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/13—Amines
  • A61K31/135—Amines having aromatic rings, e.g. ketamine, nortriptyline
  • A61K31/136—Amines having aromatic rings, e.g. ketamine, nortriptyline having the amino group directly attached to the aromatic ring, e.g. benzeneamine
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
  • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/13—Amines
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/13—Amines
  • A61K31/14—Quaternary ammonium compounds, e.g. edrophonium, choline
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/08—Antiepileptics; Anticonvulsants
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/28—Drugs for disorders of the nervous system for treating neurodegenerative disorders of the central nervous system, e.g. nootropic agents, cognition enhancers, drugs for treating Alzheimer's disease or other forms of dementia
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/30—Drugs for disorders of the nervous system for treating abuse or dependence
  • A61P25/32—Alcohol-abuse
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P39/00—General protective or antinoxious agents
  • A61P39/06—Free radical scavengers or antioxidants
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P9/00—Drugs for disorders of the cardiovascular system
  • A61P9/10—Drugs for disorders of the cardiovascular system for treating ischaemic or atherosclerotic diseases, e.g. antianginal drugs, coronary vasodilators, drugs for myocardial infarction, retinopathy, cerebrovascula insufficiency, renal arteriosclerosis
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K2300/00—Mixtures or combinations of active ingredients, wherein at least one active ingredient is fully defined in groups A61K31/00 - A61K41/00

Definitions

• the invention relates to the field of neurodegenerative diseases.
• the invention relates to a compound of formula (I) for its use in inducing neuroprotection, in a subject in need thereof.
• the invention further relates to a combination comprising the compound of formula (I) and at least one other compound such as, but not limited to, a connexin modulator, an acetylcholinesterase inhibitor, a sigma 1 positive modulator, or a antibodies to fight against the formation of amyloid plaques or against the hyperphosphorylation of the Tau protein.
• a connexin modulator such as, but not limited to, a connexin modulator, an acetylcholinesterase inhibitor, a sigma 1 positive modulator, or a antibodies to fight against the formation of amyloid plaques or against the hyperphosphorylation of the Tau protein.
• the World Health Organization estimates that by 2050 the number of people over the age of 60 is expected to reach two billion. This unprecedented aging of the world population suggests a strong pressure of chronic diseases linked to aging on health systems. Dementia is one of them. For example, WHO estimates that the total number of people with dementia is expected to exceed 150 million people by 2050.
• Dementia is characterized by a degradation of cognitive functions, in particular memory and reasoning, which affects the behavior of the patient and his ability to perform daily tasks.
• Dementia is a syndrome which covers pathologies with very diverse etiologies which affect different areas of the brain and / or other regions of the central nervous system and involve in particular the neurodegeneration and death of neuronal cells.
• mitochondrial dysfunction and oxidative stress play a crucial role in the pathogenesis of neurodegenerative diseases.
• These diseases are also often linked to an abnormal accumulation of certain proteins and / or the accumulation of mutated and or abnormally folded proteins as observed in Amyloidosis due to Ab, tauopathies, synucleinopathies, aggregation of superoxide dismutase.
• Neurodegenerative diseases do not all involve, however at an early stage, a deterioration of cognitive abilities. In particular, symptoms can be mainly motor. Likewise, not all of them are linked to aging, especially when they are linked to genetic mutations or traumatic accidents. Alzheimer's disease is the most common form of neurodegenerative disease and causes 60-70% of dementia cases. Other prevalent forms of neurodegenerative disease include vascular dementia, Lewy body dementia (parkinsonian dementia), frontotemporal dementia (degeneration of the frontal lobes of the brain), Huntington's disease, posterior cortical atrophy, Parkinson's disease, amyotrophic lateral sclerosis, stroke.
• vascular dementia Lewy body dementia (parkinsonian dementia), frontotemporal dementia (degeneration of the frontal lobes of the brain), Huntington's disease, posterior cortical atrophy, Parkinson's disease, amyotrophic lateral sclerosis, stroke.
• Excitotoxicity is commonly observed in neural tissues during acute and chronic neurological disorders, such as the aforementioned neurodegenerative pathologies, but also spinal cord injuries, head injuries, alcoholism and alcohol withdrawal (Korsakoff syndrome). Excitotoxicity corresponds to the overactivation of glutamate receptors selectively activated by N-methyl-D-aspartate (NMDA receptors) which results in the death of neuronal cells by apoptosis, in particular, but not exclusively, in connection with the massive entry calcium in cells and which causes mitochondrial dysfunction.
• NMDA receptors N-methyl-D-aspartate
• NMDA receptors are therefore known to be neuroprotective in various acute models of neurotoxicity.
• WO 2009/062391 describes such antagonists including memantine. Nevertheless, the doses required to achieve the neuroprotective effect are such that undesirable side effects, even contrary to the expected effect on memory capacities, render these molecules unusable in humans.
• memantine (3,5-Dimethyl-1 -adamantanamine), a non-competitive inhibitor of NMDA channels, is the only compound of this class to have been authorized by certain national health agencies for the symptomatic treatment of dementia. 'Alzheimer's in its mild to moderately severe forms, to treat cognitive disorders related to Alzheimer's disease. However, in humans, the only symptomatic effects are found to be limited.
• NMDA receptor inhibitors are still prime candidates in the treatment of neurodegeneration. There is therefore a strong need for such an inhibitor, which would be usable at doses making it possible to envisage reaching effective doses in the cerebrospinal fluid (CSF) to induce inhibition of neurotoxicity in patients and that without have unacceptable side effects without worsening cognitive symptoms.
• CSF cerebrospinal fluid
• NMDA receptors like other glutamatergic receptors also play a role in neuronal plasticity; thus, while agents blocking these receptors do not prevent synaptic transmission, it is known that some prevent the onset of long-term potentiation: as the dose of antagonist is increased, synaptic plasticity decreases and Memory deficits are reinforced.
• NMDA receptor antagonists have different modes of action, so it is difficult to predict the effects from one antagonist to another, from one type of pathology to another and the same for molecules having a similar structure.
• Application WO 2014/191424 describes 2-fluoroethyl normémantine (3- (2-fluoroethyl) adamantan-1 -amine, FENM) labeled with 18 F for the labeling of NMDA receptors and their visualization by positron emission tomography to study the distribution of these receptors and their response to drug treatments or in the development of neurodegenerative diseases.
• This application describes an affinity of FENM for NMDA receptors of an order of magnitude comparable to that of memantine.
• Application WO 2013/064579 describes a combination of an agent blocking connexins (such as meclofenamic acid) with an acetylcholine esterase inhibitor (such as than donepezil) for use in the treatment of cognitive impairment.
• an agent blocking connexins such as meclofenamic acid
• an acetylcholine esterase inhibitor such as than donepezil
• acetylcholine esterase inhibitors initially authorized in the symptomatic treatment of Alzheimer's disease, have also been waived in France because of their low efficacy.
• patients today face the absence of a convincing therapeutic solution capable of inducing neuroprotection in the context of neurodegeneration or acute neuronal damage.
• the aim of the invention is therefore to remedy the drawbacks of the prior art.
• the invention aims to provide a compound for its use in neuroprotection; said compound exhibiting a neuroprotective effect which makes it possible to prevent the mechanisms of cell death of neurons and to lead to the maintenance of the cognitive capacities of subjects suffering from pathologies, in particular, but not exclusively, in connection with excitotoxicity.
• the object of the present invention is to provide a compound which does not exhibit deleterious effects on cognition such as those observed for inhibitors of NMDA receptors, thus making it possible to safely broaden the range of doses which can be administered to humans. for the symptomatic treatment of Alzheimer's disease.
• the aim of the present invention is to provide a compound which is effective in the symptomatic treatment of cognitive disorders induced by neurodegeneration.
• an object of the present invention relates to a compound of formula (I): or a pharmaceutically acceptable salt thereof for its use to induce neuroprotection, in a subject in need thereof.
• the pharmaceutically acceptable salt corresponds to formula (II): in which, X- denotes a counter anion selected from the group consisting of chloride, bromide, iodide, acetate, methane sulfonate, benzene sulfonate, camphosulphonate, tartrate, dibenzoate, ascorbate, fumarate, citrate, phosphate, salicylate, oxalate, hydrobromide ions and tosylate.
• X- denotes a counter anion selected from the group consisting of chloride, bromide, iodide, acetate, methane sulfonate, benzene sulfonate, camphosulphonate, tartrate, dibenzoate, ascorbate, fumarate, citrate, phosphate, salicylate, oxalate, hydrobromide ions and tosylate.
• FENM induces significant protection against the various components of neurodegeneration, thus:
• the neuroprotection conferred by the compounds of the invention includes the prevention or reduction of neuroinflammation.
• the neuroprotection conferred by the compounds of the invention includes the prevention or reduction of oxidative stress in neuronal cells.
• the neuroprotection conferred by the compounds of the invention includes the prevention or reduction of apoptosis of neuronal cells in said subject.
• the neuroprotection conferred by the compounds of the invention includes inhibiting cell loss of the hippocampus in said subject. Changes in the structure and volume of the hippocampus are detected by medical imaging and can help monitor the effectiveness of treatment.
• the neuroprotection conferred by the compounds of formula (I) also results in the preservation of the cognitive capacities of the subject.
• the neuroprotection conferred by the compounds of the invention includes the prevention or reduction of alterations in the cognitive abilities of the subject, in particular, the prevention or reduction of alterations:
• the compounds of formula (I) are particularly effective in inducing neuroprotection against the toxicity of toxic aggregates of proteins, such as oligomerized Ab 25-35.
• the neuroprotection includes protection against the toxicity of the aggregates. of b-amyloid fragments or oligomers, in said subject.
• the invention also relates to the compound of formula (I) for its use in a suffering subject, being suspected of suffering or being considered at risk of suffering from a pathology of the central nervous system selected from among the following.
• tauopathies synucleinopathies, amyloidopathies, Alzheimer's disease, Parkinson's disease, multisystem atrophy, Huntington's disease, posterior cortical atrophy, Pick's disease, epilepsy, vascular dementia, fronto dementia -temporal, Lewy body dementia, amyotrophic lateral sclerosis, Korsakoff syndrome, alcohol withdrawal, ischemia, neonatal ischemia, head trauma, stroke, preferably Alzheimer's disease .
• the compound of formula (I) is particularly suitable for use in combination with compounds targeting other aspects or pathways involved in neurodegenerative processes.
• an object of the invention therefore relates to a combination of the compound of formula (I) with:
• acetylcholinesterase inhibitor preferably selected from donepezil, rivastigmine, galantamine, or one of their pharmaceutically acceptable salts,
• At least one connexin inhibitor agent preferably selected from meclofenamic acid, enoxolone, mefloquine and 2-amino ethoxy diphenyl borate (APB), or one of their pharmaceutically acceptable salts,
• WO2017191034 or one of their pharmaceutically acceptable salts, preferably selected from 2- (2-Chlorophenyl) -2-oxo-3,3,5,5-tetramethyl- [1, 4,2] - oxazaphosphinane; 2- (4-Chlorophenyl) -2-oxo-3,3,5,5-tetramethyl- [1, 4,2] - oxazaphosphinane 2- (3,5-Dichlorophenyl) -2-oxo-3,3,5 , 5-tetramethyl- [1, 4,2] - oxazaphosphinane 2- (2,3-Dichlorophenyl) -2-oxo-3,3,5,5-tetramethyl- [1, 4,2] - oxazaphosphinane; 2- (3-Fluorophenyl) -2-oxo-3,3,5,5-tetramethyl- [1, 4,2] - oxazaphosphinane; 2- (4-Fluor
• the invention relates to said combination for its use to induce neuroprotection, in a subject in need thereof, in particular a suffering subject, being suspected of suffering or at risk of suffering from a pathology of the aforementioned central nervous system, and particularly a suffering subject, being suspected of or at risk of suffering from Alzheimer's disease.
• the activity profile of the compound of formula (I) shows neuroprotection over large dose intervals, without any deleterious effect on the cognitive capacities of the subjects treated.
• larger dosages than those currently authorized for memantine, and therefore more effective treatment are possible.
• the invention therefore relates to the compound of formula (I) for inducing neuroprotection in a subject in need thereof, said compound being administered orally at a dose greater than 20 mg per day, preferably greater than or equal to 30 mg per day, optionally in a combination as described above.
• FIG. 1 experimental schemes for the administration of the oligomerized 25 -35 Ab peptide, of the test compounds and of the performance of behavioral tests to evaluate the cognitive capacities of the animals.
• A, B Evaluation of the symptomatic effects on the amnesia induced by the oligomerized Ab 25 -35 peptide.
• C Evaluation of the neuroprotective effect of the test compounds.
• YMT Y-maze (Y-maze tests the Anglo-Saxon language); PAT, Passive Avoidance Test (Passive Avoidance Test); ORT, object recognition test; WMT, spatial learning test in the Morris pool; ⁇ , sacrifice; black arrow: intracerebroventricular injection of the oligomerized Ab 25 -35 peptide; gray arrows: administration of test compounds / vehicle.
• FIG. 3 effect of memantine (MEM) and of FENM (0.3 mg / Kg ip) on the astroglial reaction following the administration of oligomerized Ab 25 -35 peptide.
• V vehicle solution. The number of mice per group is indicated in each column. The percentage increase induced by oligomerized Ab 25 -35 compared to the non-intoxicated, untreated control group (V + V) is indicated above the columns.
• FIG. 4 effect of memantine (MEM) and of FENM (0.3 mg / Kg ip) on the microglial reaction following the administration of oligomerized Ab 25 -35 peptide.
• the present invention relates to 2-fluoroethyl normémantine (FENM) for use in inducing neuroprotection in a subject in need thereof.
• FENM 2-fluoroethyl normémantine
• the invention also relates to combinations of FENM for their use to induce said neuroprotection.
• FENM protects neuronal cells and prevents induced cell death by reducing apoptosis, oxidative stress in said cells and by reducing neuroinflammation in the brain. This results in the prevention of the resulting cognitive deficits. This also results in efficacy in the symptomatic correction of cognitive disorders induced by neurotoxicity.
• the mention of a specific drug or compound includes not only the specifically named drug or compound, but also any salt, hydrate, derivative, isomer, racemate, enantiomerically pure composition, conjugate or corresponding, pharmaceutically acceptable prodrug of the active molecule of the drug or of said compound.
• the mention of a compound includes the compound specifically named, as well as any salt, hydrate, isomer, racemate, isomer, enantiomerically pure, pharmaceutically acceptable composition of said compound. More preferably, the designation of a compound is intended to designate the compound as specifically designated per se, as well as any pharmaceutically acceptable salt thereof.
• salts are meant within the meaning of the invention, a pharmaceutically acceptable and relatively non-toxic inorganic or organic acid addition salt of a compound of the present invention.
• Pharmaceutical salt formation involves coupling an acidic, basic, or zwitterionic drug molecule with a counterion to create a saline version of the drug.
• a wide variety of chemical species can be used in the neutralization reaction.
• the pharmaceutically acceptable salts of the invention therefore include those obtained by reacting the main compound, functioning as a base, with an inorganic or organic acid to form a salt, for example, salts of acetic acid, nitric acid, tartaric acid, hydrochloric acid, sulfuric acid, phosphoric acid, methane sulfonic acid, camphor sulfonic acid, oxalic acid, maleic acid, succinic acid or citric acid.
• Pharmaceutically acceptable salts of the invention also include those in which the main compound functions as an acid and is reacted with an appropriate base to form, for example, sodium, potassium, calcium, magnesium, sodium, calcium salts. ammonium or choline.
• salt selection is now a common standard operation in the drug development process as taught by Stahl and Wermuth in their manual (Stahl and Wermuth).
• neuroprotection is understood, within the meaning of the invention, to prevent or slow down the progression of a disease affecting the central or peripheral nervous system by stopping or at least slowing down the loss of functionality of the nerve cells. , degeneration or loss of cells in these systems, especially neurons, leading to cognitive decline.
• a subject in need of neuroprotection is defined as a suffering subject, being suspected of suffering or being considered at risk of suffer from a pathology linked to neuronal cell death and / or neurodegeneration, in particular linked, but not exclusively, to excitotoxicity.
• pathologies are, for example, neurodegenerative pathologies such as tauopathies, synucleopathies or amyloidopathies such as Alzheimer's disease, Parkinson's disease, multisystem atrophy, dementia with Lewy bodies, cortico-basal degeneration, Pick's disease, frontotemporal dementia, posterior cortical atrophy.
• Other neurodegenerative pathologies are, for example, Huntington's disease, amyotrophic lateral sclerosis, epilepsy, vascular dementia, Korsakoff's syndrome, or acute neuronal pathologies such as alcohol withdrawal, ischemia, neonatal ischemia. , head trauma, stroke.
• subject is meant herein any member of the animal kingdom, preferably mammals and even more preferably humans.
• bees insects which also exhibit an NMDA system controlling memory generation, are also included.
• combination or “combination treatment” or “combination therapy” mean a combination based on the compound of formula (I) or one of its pharmaceutically acceptable salts (in other words, FENM), and of at least one other compound or drug coadministered to said subject for the purpose of obtaining a biological effect.
• FENM pharmaceutically acceptable salts
• the FENM and said at least one other compound, in this combination, can be administered together or separately, concomitantly or sequentially. are administered together, they can be administered in a single composition comprising the FENM and said at least one other compound or drug.
• the FENM and said at least one other compound or drug are then formulated together Alternatively, they can be administered separately to said subject, by the same or different route of administration
• FENM can be administered orally and said at least one other compound with which FENM is coadministered. can be injected into said subject, for example, intravenously or subcutaneously.
• FENM can be administered orally and said at least one other compound with which FENM is co-administered can also be administered orally to said subject.
• the sequence of administration of the active principles of the combination is such that said active principles or the active metabolites exert their biological effects at the same time, so that the subject benefits from the maximum effect of said combination.
• the FENM and said at least one other compound or drug are administered so as to reach their maximum concentration in the plasma or the cerebrospinal fluid, preferably the cerebrospinal fluid, at the same time.
• the “beta-peptides”, or “Ab” or “beta-amyloid peptides”, or “amyloid peptides”, or even “beta-amyloid” result from the cleavage by gamma and beta-secretases of the APP protein (for “ Amyloid Protein Precursor ”in English) localized to the membrane of neurons. They can have variable sizes in humans (mainly 38 to 42 amino acids) and appear in the form of oligomeric assemblages of variable size and solubility.
• Each type of oligomer potentially exhibits a toxic character leading to an alteration in structure, function and synaptic plasticity which ultimately results in neuronal death (Pike et al., 1991).
• This alteration of the synapses is at the origin of the dysfunction of the regions involved in the processes of memory and learning. These fragments are also found in the so-called amyloid plaques which accumulate with age or in certain diseases.
• Abi- 42 has a strong propensity to self-aggregate; familial forms of Alzheimer's disease are accompanied by an increase in the relative level of Abi- 42 / Abi- 4 o peptide, and it is rather this relative level which would be indicative of the diagnosis of the pathology rather than the accumulation of Abi- 2 and / or Abi- 0 peptides.
• Ab 25-35 q5 ⁇ a fragment toxic to neuronal cells in vitro.
• intracerebroventricular (icv) injection of Ab 25-35 peptide oligomers is one of the models used to study the neurodegeneration induced by Ab oligomers, in particular in the context of Alzheimer's disease and for testing drug candidates for this disease (Maurice et al., 1996).
• neurotoxicity of “beta-peptides”, or “Ab” or “beta-amyloid peptides”, or “amyloid peptides”, or even “beta-amyloid” is therefore meant, within the meaning of the invention, the neurotoxicity induced by any oligomer and / or aggregate formed from one or more peptide (s) resulting from the cleavage of the APP protein.
• FENM can effectively induce neuroprotection against toxicity induced by intracerebral injection of Ab 25-35 oligomers in an animal model.
• Oligomers of Ab 25-35 are known to induce inflammatory process, oxidative stress and apoptosis in neuronal cells when injected into the brains of animal models.
• the administration of FENM to animals from the day of injection of the oligomers of Ab 25-35 makes it possible to reduce the levels of the markers of apoptosis and mitochondrial stress, of neuroinflammation, and to reduce cell death of hippocampal cells. This reduction is accompanied by a restoration of the cognitive capacities of the animals to levels not statistically different from those of the animals not injected with Ab 25-35 .
• FENM is devoid of amnesic effects.
• FENM allows symptomatic treatment of cognitive disorders induced by the injection of Ab 25-35 , more effectively than memantine.
• a first object of the present invention relates to the compound of formula (I): its pharmaceutically acceptable salts, for its use to induce neuroprotection in a subject in need thereof.
• said subject in need thereof suffers, is suspected of suffering or is considered at risk of suffering from a pathology of the central nervous system.
• this pathology of the central nervous system is linked to neuronal cell death and / or neurodegeneration.
• this pathology of the central nervous system is linked to excitotoxicity.
• said subject suffers, is suspected of suffering or is considered at risk of suffering from a pathology of the central nervous system selected from tauopathies, from synucleopathies or from amyloidopathies such as the disease of '' Alzheimer's disease, Parkinson's disease, multisystem atrophy, Lewy body dementia, cortico-basal degeneration, Pick's disease, frontotemporal dementia, posterior cortical atrophy, or pathologies such as the disease de Huntington's disease, amyotrophic lateral sclerosis, epilepsy, vascular dementia, Korsakoff syndrome, alcohol withdrawal, ischemia, neonatal ischemia, head trauma, stroke.
• tauopathies such as the disease of '' Alzheimer's disease, Parkinson's disease, multisystem atrophy, Lewy body dementia, cortico-basal degeneration, Pick's disease, frontotemporal dementia, posterior cortical atrophy, or pathologies such as the disease de Huntington's disease, amyotrophic lateral sclerosis, epilepsy, vascular dementia
• said subject may thus have been diagnosed as suffering from a pathology of the central nervous system.
• this pathology is linked to neuronal cell death and / or neurodegeneration.
• said subject may have been diagnosed as suffering from tauopathy, synucleopathy or amyloidopathy such as Alzheimer's disease, Parkinson's disease, multisystem atrophy, Lewy body dementia, cortico-basal degeneration, Pick's disease, frontotemporal dementia, posterior cortical atrophy, or pathologies such as Huntington's disease, amyotrophic lateral sclerosis, epilepsy, vascular dementia, Korsakoff syndrome , the alcohol withdrawal, ischemia, neonatal ischemia, head trauma, stroke.
• tauopathy synucleopathy or amyloidopathy
• Alzheimer's disease Parkinson's disease, multisystem atrophy
• Lewy body dementia dementia
• cortico-basal degeneration cortico-basal degeneration
• Pick's disease frontotemporal dementia
• posterior cortical atrophy or pathologies such as Huntington'
• This diagnosis is based on behavioral, cognitive, biological and / or medical imaging analyzes well known to those skilled in the art.
• the neuroprotection conferred by the compound of formula (I) will make it possible to slow down or even stop the progression of the disease, that is to say to stop or slow down the neuronal cell death and / or the neurodegeneration already initiated in the disease. context of the disease thus diagnosed. Consequently, said neuroprotection thus conferred on said subject will result in the arrest, or the slowing down of the evolution of the cognitive impairments resulting from the neurodegeneration and the associated symptoms.
• said subject may also be suspected of suffering from a pathology related to neuronal cell death and / or neurodegeneration.
• diagnosis made for this subject is uncertain, i.e., for example, the subject does not have one level of symptoms (in their intensity), or all of the different symptoms or signs of the clinical picture that allow a formal diagnosis of the pathology to be established.
• the symptoms or signs noted are relevant in the context of the pathology. For example, these may be patients at the start of the development of the disease and who then present only a few warning signs, potentially of low intensity.
• said subject presents symptoms or signs relevant in the context of tauopathy, synucleopathy or amyloidopathy such as Alzheimer's disease, Parkinson's disease, multisystem atrophy, body dementia.
• de Lewy cortico-basal degeneration, Pick's disease, frontotemporal dementia, posterior cortical atrophy, or symptoms or signs relevant to pathologies such as Huntington's disease, amyotrophic lateral sclerosis, l epilepsy, vascular dementia, Korsakoff syndrome, alcohol withdrawal, ischemia, neonatal ischemia, head trauma, stroke.
• the relevant symptoms or signs can be detected by behavioral, cognitive, biological and / or medical imaging analyzes well known to those skilled in the art and commonly used in the diagnosis of these pathologies.
• the tests commonly used for the cognitive evaluation of human subjects are for example, the Mini-Mental State Examination (MMSE or Folstein test), Modified Mini-Mental State Examination (or 3MS scale), Abbreviated Mental Test Score (AMTS or Abbreviated mental test), Dementia questionnaire for persons with Mental Retardation (or DMR questionnaire), Cognitive Abilities Screening Instrument (CASI), Trail-making test, Clock drawing test, Alzheimer's disease assessment scale - Cognition (ADAS -Cog or Cognitive sub-scale of the disease assessment scale Alzheimer's), General Practitioner Assessment of Cognition (GPCOG), Montreal Cognitive Assessment (MoCA), or Rowland Universal Dementia Assessment Scale (RUDAS) universal dementia), or Alzheimer's Disease Cooperative Study - Activities of Daily Living (ADCS-ADL) according to their name in English.
• MMSE Mini-Mental State Examination
• MTS Modified Mini-Mental State Examination
• AMTS Abbreviated Mental Test Score
• the MMSE makes it possible to screen people suffering from a major neurocognitive impairment (dementia) without attaching it to a particular pathology.
• the MMSE is also used to monitor people's cognitive status and measure the decline in cognitive function in people with neurocognitive impairment. This test assesses orientation, recording, attention and arithmetic, memory retention, language and construction praxis.
• CERAD in its name in English language Consortium to Establish a Registry for Alzheimer's Disease or Consortium to establish a registry of Alzheimer's disease established a scale of severity of dementia associated with the scores obtained in the MMSE. A score between 19 and 24 is associated with mild dementia, between 10 and 18, moderate dementia, and a score below 10 corresponds to severe dementia, the maximum score being 30.
• the ADAS-Cog is a cognitive subscale of the Alzheimer's Disease Rating Scale and therefore only addresses cognition-related aspects of dementia. So it can be used to assess (i.e. score) and monitor the progress of any type of dementia. ADAS-Cog assesses orientation, memory, executive function, visuospatial ability, language or practice, with a score range of 0 to 70, with a higher score indicating greater impairment. ADAS-Cog is considered to be more sensitive than MMSE. It is one of the most commonly used tests for the clinical evaluation of candidate compounds for obtaining a Marketing Authorization in the context of anti-dementia treatments and also in the measurement of the evolution of the attacks. cognitive.
• Medical imaging can help identify structural or functional damage to particular areas of the brain, and also help diagnose some of these neurodegenerative pathologies. For example, cerebral scintigraphy with ioflupane makes it possible to characterize the impairment of dopaminergic neurons in the case of Parkinson's disease or dementia with Lewy bodies.
• the 18 F-labeled FENM is itself considered as a marker of NMDA receptors by positron emission tomography (PET) and is the subject of a pilot study in humans (Beaurain et al., 2019).
• MRI or PET can be used to diagnose, for example, frontotemporal dementia (by identifying atrophy of the frontal and temporal lobes) or Alzheimer's disease (cortical atrophy and / or atrophy of the hippocampi).
• frontotemporal dementia by identifying atrophy of the frontal and temporal lobes
• Alzheimer's disease cortical atrophy and / or atrophy of the hippocampi.
• the subject in need of neuroprotection presents impairment of dopaminergic neurons, atrophy of the fronto and / or temporals, or cortical atrophy and or atrophy of one or both hippocampi.
• the analysis of the presence of certain proteins in the CSF can make it possible to establish the diagnosis, for example, of Alzheimer's disease, the typical profile of which associates a decrease in the concentration of the peptide Ab 2 and an increase of the Tau proteins. and their phosphorylated P-Tau forms.
• the dosage of I ⁇ bi- 4 o and the measurement of the Abi- 2 / Abi- o ratio can improve the diagnosis.
• the imaging and CSF markers allow early diagnosis of disease, in some cases before the onset of cognitive symptoms.
• the subject in need of neuroprotection exhibits an abnormal profile of the levels of the peptides Abi- 2 and / or Abi- 0 and / or of the Tau protein and / or of its phosphorylated forms and / or of the protein.
• Abi- 2 / Abi- 0 ratio Abi- 2 / Abi- 0 ratio.
• ERP evoked potentials recordings
• LES are observed in response to a discordant stimulus and represent activated cognitive phenomena such as perception, attention, decision making process, memory process, language, etc.
• ERPs are recorded, for example, by electroencephalography (EEG) or magnetoencephalography (MEG).
• EEG electroencephalography
• MEG magnetoencephalography
• LES provide information about the brain's processing of the stimulus even when no change in behavior is noticeable.
• the characteristics of the ERP may vary depending on various factors such as the relevance of the stimulus, the task performed, damage to the nervous system or the use of drugs.
• ERPs are known in the state of the art as cognitive biomarkers useful for diagnosing dementia, monitoring disease progression and evaluating the pro-cognitive effect of treatments.
• the ERPs are for example impaired in patients suffering from Alzheimer's disease, vascular dementia or dementia associated with parkinsonian symptoms, such as for example Lewy body dementia. More particularly, the ERP measurements make it possible to detect an alteration in cognitive function at an early stage and in particular in the case of the early or mild stage of Alzheimer's disease.
• the most frequently examined PRA in clinical practice is the P300 (or P3) wave which is a large centroparietal positivity that occurs with a latency of about 300 ms after the discordant stimulus.
• the P300 wave can be divided into two subcomponents P3a and P3b.
• P3a is generally considered to relate to the degree of focal attention, while P3b is believed to index working memory update.
• the amplitude of the P300 wave refers in particular to motivation (in connection with the difficulty of the task) and vigilance according to the probability of occurrence of the stimulus.
• Latency refers to the time it takes to make a decision. An increase in the latency of P300 (or its subcomponents) and a decrease in its amplitude (or its subcomponents) are observed in patients with dementia, in particular Alzheimer's disease. The study of the evolution of latency is useful for monitoring the progression of dementia, especially Alzheimer's disease, and for evaluating the response to treatment for Alzheimer's disease.
• the subject needing neuroprotection exhibits an alteration in his cognitive capacities.
• this alteration is measured by MMSE or ADAS-Cog.
• said subject has an MMSE score less than 30, less than or equal to 29, 28, 27, 26, 25, 24, 23, 22, 21, 20, 19, 18, 17, 16, 15, 14 , 13, 12, 11, 10, 9, 8, 7, 6, 5, 4, 3, or even less than or equal to 2.
• this deterioration is measured in said subject by analysis of the P300 wave of the subject's LES, the subject exhibiting a decrease in the amplitude and / or latency of the P300 wave or a component thereof.
• said subject in need of neuroprotection suffers from mild dementia.
• said subject in need of neuroprotection suffers from moderate dementia.
• said subject in need of neuroprotection suffers from severe dementia.
• the subject in need of neuroprotection suffers from mild dementia.
• the invention relates to the compound of formula (I) or one of its pharmaceutically acceptable salts, for its use to induce neuroprotection in a subject suffering from mild dementia.
• the subject in need of neuroprotection is diagnosed as suffering from a pathology of the central nervous system linked to neuronal cell death and / or neurodegeneration as defined above, but does not exhibit cognitive symptoms or many symptoms were not detected in this subject.
• a pathology of the central nervous system linked to neuronal cell death and / or neurodegeneration as defined above but does not exhibit cognitive symptoms or many symptoms were not detected in this subject.
• the neuroprotective properties described in the experimental part it will be possible to prevent, delay or slow down the occurrence of these symptoms and therefore maintain the quality of life of patients and avoid the occurrence of other pathologies. associated with neurodegenerative pathologies, in particular psychiatric pathologies such as depression.
• said subject in need of neuroprotection can also be considered as a subject at risk of suffering from a pathology of the central nervous system, particularly a pathology related to neuronal cell death and / or neuronal cell death. neurodegeneration as described above.
• said subject does not present any symptoms or signs associated with said pathology, but presents an increased risk of developing this pathology compared to the general population, because he presents risk factors linked to his lifestyle. , genetic predispositions or his family history, the presence of comorbidities and / or his age.
• said subject has a lifestyle, presents genetic predispositions or has a family history, suffers from comorbidities and / is of an age which increases (s) his risk (compared to the general population) of developing tauopathy, synucleopathy or amyloidopathy such as Alzheimer's disease, Parkinson's disease, multisystem atrophy, Lewy body dementia, cortico-basal degeneration, Pick's disease, frontotemporal dementia, posterior cortical atrophy, or to develop pathologies such as Huntington's disease, amyotrophic lateral sclerosis, epilepsy, vascular dementia, Korsakoff syndrome, alcohol withdrawal, ischemia, neonatal ischemia, head trauma, stroke.
• tauopathy synucleopathy or amyloidopathy
• synucleopathy or amyloidopathy such as Alzheimer's disease, Parkinson's disease, multisystem atrophy, Lewy body dementia, cortico-basal degeneration, Pick's disease, frontotemporal dementia, posterior cortical atrophy, or to develop pathologies such as
• age is the primary risk factor for dementias, of which Alzheimer's disease is one, since 5 to 8% of people over the age of 60 have it.
• CNS diseases pathology linked to neuronal cell death and / or neurodegeneration
• ApoE apolipoprotein E
• mutations in the genes SNCA (alpha-synuclein), PRKN (parkin), LRRK2 (leucine-rich repeat kinase 2), PINK1 (PTEN-induced putative kinase 1), DJ-1 and ATP13A2 and in the 11 loci of the PARK1 -PARK11 genes are associated with an increased risk of Parkinson's disease for the subject carrying such genetic predispositions or mutations; the mutation of the SOD1 gene and its link with amyotrophic lateral sclerosis or the mutations of the gene encoding huntingtin are also examples of genetic predisposition to CNS diseases.
• comorbidities associated with an increased risk of developing these pathologies we can cite diseases such as, for example, Down's syndrome, post-traumatic stress disorder (PTSD), depression, arterial hypertension, diabetes, head trauma or stroke. Excessive alcohol consumption is associated with an increased risk of dementia. Exposure to certain metals such as manganese, copper, lead or certain chemicals such as paraquat, rotenone or maneb is associated with an increased risk of developing Parkinson's disease.
• diseases such as, for example, Down's syndrome, post-traumatic stress disorder (PTSD), depression, arterial hypertension, diabetes, head trauma or stroke.
• Excessive alcohol consumption is associated with an increased risk of dementia.
• Exposure to certain metals such as manganese, copper, lead or certain chemicals such as paraquat, rotenone or maneb is associated with an increased risk of developing Parkinson's disease.
• the subject in need of neuroprotection is a subject having a risk factor for central nervous system pathology, more particularly a pathology related to neuronal cell death and / or neurodegeneration. More particularly, the subject does not present other symptoms of the pathology. Preferably, the subject does not present any cognitive symptom of the pathology. In a preferred embodiment, the subject has a genetic predisposition for said pathology. In another preferred embodiment, the subject has a pathology associated with an increased risk of developing a pathology of the central nervous system, more particularly a pathology related to neuronal cell death and / or neurodegeneration.
• the present invention relates to the compound of formula (I) or a pharmaceutically acceptable salt thereof for its use to induce neuroprotection in a subject suffering from PTSD.
• An even more particular embodiment of the present invention relates to the compound of formula (I) or a pharmaceutically acceptable salt thereof for inducing neuroprotection in a subject suffering from PTSD, for example to prevent the onset of the disease. 'Alzheimer's or its symptoms.
• the experimental data presented show that the compound of formula (I) is particularly effective in preventing neuroinflammation, oxidative stress and apoptosis of neuronal cells induced by the toxicity of Ab oligomers and which are the source of neurodegeneration and death of CNS cells more particularly neurons in many pathologies, such as, but not exclusively, Alzheimer's disease.
• an object of the present invention also relates to the compound of formula (I) or one of its pharmaceutically acceptable salts for its use for preventing or reducing the toxicity of the oligomers Ab, and more particularly for preventing or reducing the neurotoxicity of the oligomers.
• a particular embodiment of the invention also relates to the compound of formula (I) or one of its pharmaceutically acceptable salts for its use for preventing or reducing the toxicity of the oligomers Ab, and more particularly for preventing or reducing the toxicity thereof.
• neurotoxicity of the Ab oligomers in a subject suffering from, suspected of suffering or at risk of suffering from Alzheimer's disease or from a pathology in which the Ab aggregates or oligomers are involved, such as dementia with Lewy bodies.
• neuroinflammation, oxidative stress and apoptosis of neuronal cells are observed in many neurodegenerative pathologies.
• Another object of the present invention also relates to the compound of formula (I) or a pharmaceutically acceptable salt thereof for its use for preventing or reducing neuroinflammation in a subject in need thereof.
• An object of the present invention also relates to the compound of formula (I) or one of its pharmaceutically acceptable salts for its use for preventing or reducing oxidative stress in a subject in need thereof.
• An object of the present invention is also the compound of formula (I) or one of its pharmaceutically acceptable salts for its use to prevent or decrease apoptosis in the CNS in a subject in need thereof, comprising administration to said subject of a compound of formula (I) or a pharmaceutically acceptable salt thereof.
• An object of the present invention is also the compound of formula (I) or one of its pharmaceutically acceptable salts for its use for preventing or reducing cell loss from the hippocampus in said subject.
• This loss can be detected, as mentioned previously, in particular, by the observation of atrophy, a decrease in volume, a change in the shape of the hippocampus or atrophy or decrease in the volume.
• cerebral cortex for example in Magnetic Resonance Imaging (MRI).
• MRI Magnetic Resonance Imaging
• the compounds and combinations for their use according to the invention comprise the structural and or functional monitoring of the CNS by medical imaging.
• said subject suffers, is suspected of suffering or is considered at risk of suffering from a pathology of the central nervous system selected from tauopathies, synucleinopathies, amyloidopathies, Alzheimer's disease , Parkinson's disease, multisystem atrophy, Huntington's disease, posterior cortical atrophy, Pick's disease epilepsy, vascular dementia, frontotemporal dementia, Lewy body dementia, lateral sclerosis amyotrophic, Korsakoff syndrome, alcohol withdrawal, ischemia, neonatal ischemia, head trauma, stroke, preferably Alzheimer's disease.
• tauopathies tauopathies, synucleinopathies, amyloidopathies, Alzheimer's disease , Parkinson's disease, multisystem atrophy, Huntington's disease, posterior cortical atrophy, Pick's disease epilepsy, vascular dementia, frontotemporal dementia, Lewy body dementia, lateral sclerosis amyotrophic, Korsakoff syndrome, alcohol withdrawal, ischemia, neonatal ischemia, head trauma, stroke,
• an object of the invention is also the compound of formula (I) or of one of its pharmaceutically acceptable salts for its use for preventing or reducing alterations in cognitive capacities in a subject in need thereof.
• “Cognitive capacities”, within the meaning of the invention, relate to intellectual functions such as memory, perception, coordination and reasoning.
• the ADAS-Cog is in particular a composite test which makes it possible to test these different aspects of cognition in subjects.
• Another particular object of the invention relates to the compound of formula (I) or of one of its pharmaceutically acceptable salts for its use for preventing or reducing alterations in short, medium and / or long term memory in a subject. needing it.
• Another particular object of the invention relates to the compound of formula (I) or of one of its pharmaceutically acceptable salts for its use for preventing or reducing alterations in spatial memory in a subject in need thereof comprising administration to said subject of a compound of formula (I) or a pharmaceutically acceptable salt thereof.
• Another particular object of the invention relates to the compound of formula (I) or of one of its pharmaceutically acceptable salts for its use for preventing or reducing alterations in the recognition and / or learning capacities in a subject by having need.
• said subject suffers, is suspected of suffering or is considered at risk of suffering from a pathology of the central nervous system selected from tauopathies, synucleinopathies, amyloidopathies, Alzheimer's disease , Parkinson's disease, multisystem atrophy, Huntington's disease, posterior cortical atrophy, Pick's disease epilepsy, vascular dementia, frontotemporal dementia, Lewy body dementia, lateral sclerosis amyotrophic, Korsakoff syndrome, alcohol withdrawal, ischemia, neonatal ischemia, head trauma, stroke, preferably Alzheimer's disease.
• the MMSE and / or ADAS-Cog can make it possible to easily follow the evolution of the symptoms and thus to control the neuroprotection conferred by the compound of formula (I) or one of its pharmaceutically acceptable salts or combinations for their use according to invention.
• a drop in the MMSE score or an increase in ADAS-cog (or one of its items) is indicative of a deterioration in the cognitive abilities of the individual tested. Without this being limiting, it has been estimated that the average degradation of cognitive performance in the mild and moderate stages of the disease by the loss of 2 to 4 points per year in the MMSE and an increase of 6 to 8 points per year at l 'ADAS-Cog (Institute of Alzheimer's Disease; ⁇ http://www.imaalzheimer.com>.
• ADAS-Cog An increase in ADS-cog on two consecutive tests will signify worsening of the disease and / or symptoms. A decrease in MMSE on two consecutive tests will signify worsening of the disease and / or symptoms. Tests can be done every 1, 2, 3, 4 weeks, every month, every 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 months or 3 to 4 times a year or even once a year. For example, an increase of less than or equal to 20%, 15%, preferably less than or equal to 10%, or even preferably less than or equal to 5% of the Adas-Cog for two tests carried out one month apart will be sign of neuroprotection.
• a decrease of less than or equal to 20%, 15%, preferably less than or equal to 10%, or even preferably less than or equal to 5% of the MMSE for two tests carried out one month apart will be a sign of neuroprotection.
• a slowing down of the worsening of cognitive symptoms compared to the usual course of the pathology will be a sign of neuroprotection.
• a slowing down in the degradation of the score corresponding to one or more categories of memory or cognitive performance as measured in the composite scores but not necessarily in the overall score of the test will be a sign of neuroprotection.
• the compounds and combinations for their use according to the invention comprise the monitoring of the cognitive state of the subject during the treatment, preferably by the application of an MMSE or ADAS-Cog test.
• the study of ERP makes it possible to follow the evolution of the symptoms of neurodegeneration and thus to control the neuroprotection conferred by the compound of formula (I) or one of its pharmaceutically acceptable salts or combinations for their use according to invention.
• An increase in the latency in the occurrence of the P300 wave and / or a decrease in its amplitude is indicative of a deterioration in the cognitive abilities of the test individual.
• a decrease in the latency of the P300 wave and / or an increase in its amplitude will be a sign of neuroprotection.
• the compounds and combinations for their use according to the invention comprise monitoring the cognitive state of the subject during the treatment, preferably by studying ERP by EGG or MEG.
• Another subject of the invention relates to the compound of formula (I) or of one of its pharmaceutically acceptable salts for its use for preventing or treating a pathology of the central nervous system selected from tauopathies, synucleopathies or amyloidopathies such as Alzheimer's disease, Parkinson's disease, multisystem atrophy, Lewy body dementia, cortico-basal degeneration, Pick's disease, frontotemporal dementia, posterior cortical atrophy, or pathologies such as as Huntington's disease, amyotrophic lateral sclerosis, epilepsy, vascular dementia, Korsakoff syndrome, alcohol withdrawal, ischemia, neonatal ischemia, head trauma, stroke, preferably Alzheimer's disease, in a subject in need of it.
• tauopathies synucleopathies or amyloidopathies
• Alzheimer's disease Parkinson's disease, multisystem atrophy
• Lewy body dementia dementia
• cortico-basal degeneration Pick's disease
• frontotemporal dementia posterior cortical atrophy
• pathologies such
• a particular object of the invention relates to the compound of formula (I) or of one of its pharmaceutically acceptable salts for its use for preventing or treating Alzheimer's disease, in a subject in need thereof.
• Said subject may suffer from Alzheimer's disease at its mild stage (also called early stage), at the moderate stage or at the advanced stage.
• said subject suffers from Alzheimer's disease in its mild stage.
• Another object of the invention relates to the compound of formula (I) or a pharmaceutically acceptable salt thereof for its use in preventing or treating dementia, in a subject in need thereof.
• the subject suffers from mild dementia (e.g. cognitive decline).
• Another object of the invention relates to the compound of formula (I) or of one of its pharmaceutically acceptable salts for its use to prevent or treat excitotoxicity in a suffering subject, being suspected of suffering or being considered at risk of. suffer from a pathology of the central nervous system selected from tauopathies, synucleopathies or amyloidopathies such as Alzheimer's disease, Parkinson's disease, multisystem atrophy, dementia with Lewy bodies, cortico-basal degeneration, Pick's disease, frontotemporal dementia, posterior cortical atrophy, or pathologies such as Huntington's disease, amyotrophic lateral sclerosis, epilepsy, vascular dementia, Korsakoff syndrome, alcohol withdrawal, l ischemia, neonatal ischemia, head trauma, stroke, preferably Alzheimer's disease.
• a particular object of the invention relates to the compound of formula (I) or of one of its pharmaceutically acceptable salts for its use for preventing or treating excitotoxicity in a subject suffering from Alzheimer's disease, in a subject having need
• a pharmaceutically acceptable salt of the compound of formula (i) is selected from the salts of formula (II): in which, X denotes a counter anion selected from the group consisting of chloride, bromide, iodide, acetate, methanesulphonate, benzene sulphonate, camphosulphonate, tartrate, dibenzoate, ascorbate, fumarate, citrate, phosphate, salicylate, oxalate, hydrobromide and tosylate.
• the counter anion is the chloride ion.
• FENM is related to its antagonist activity of NMDA receptors and therefore of modulation of excitotoxicity. Although structurally close to memantine, this compound differs from it by unexpected properties since it induces significant neuroprotection that memantine does not allow. In addition, FENM does not exhibit the deleterious effects for the memory of memantine when FENM is administered in large doses, which is a particular advantage, in particular in the case of neurodegenerative pathologies which result in dementia and / or disorders. cognitive in subjects who have it.
• the compound of formula (I), or one of its pharmaceutically acceptable salts or of the compound of formula (II) for its use in a subject in need thereof is devoid, at the administered dose, adverse cognitive effect, in particular amnesic effect on the patient.
• the compound of formula (I), or a pharmaceutically acceptable salt thereof or of the compound of formula (II) is administered to the subject in the form of a pharmaceutical preparation, for example, without being limiting, orally or parenterally (subcutaneously or intravenously). Oral administration being particularly preferred.
• the compound of formula (I), or one of its pharmaceutically acceptable salts or the compound of formula (II) is administered to the subject at an oral dose of between 1 and 1000 mg per day, limits included, preferably between 5 and 500 mg per day, preferably between 10 and 100 mg per day, particularly preferably between 20 and 70 mg per day, even more preferably between 30 and 60 mg per day.
• the compound of formula (I), or one of its pharmaceutically acceptable salts, or the compound of formula (II) is administered at an oral dose greater than 20 mg per day, preferably greater than or equal to 30 mg per day, 40 mg, 50 mg, 60 mg, 70 mg, 80 mg, 90 mg, or even greater than or equal to 100 mg per day.
• time-limited treatment may be considered. It can last 1, 2, 3, 4, 5, 6, 7 days, or 1, 2, 3, 4, weeks, or 2, 3, 4, 5, 6, 7, 8, 9, 10 , 11, 12 months, or 1, 2, 3, 4, 5, 6 years or even more, that is to say the time of the duration of the need for neuroprotection, in particular against neurotoxicity.
• the treatment comprising the compound of formula (I) or (II) be implemented as soon as possible, to prevent neurodegeneration as best as possible, for example, on the day of their occurrence, the next day, or the day after.
• Said doses can be unitary, that is to say administered all at once to the subject.
• the dose can also be administered in several divided doses throughout the day, the number of doses during the day allowing the desired daily dose to be obtained.
• the doses in question can be administered in one to four daily doses, for example once, for example twice, for example 3 times, or even 4 times.
• the compound of formula (I) or one of its pharmaceutically acceptable salts or the compound of formula (II) is packaged so as to provide the dose corresponding to one intake without requiring manipulation such as a volume measurement, a weighing or the division of a tablet, which is particularly advantageous in subjects with cognitive impairments since this avoids any calculation or particular manipulation.
• the compound of formula (I) or one of its pharmaceutically acceptable salts or the compound of formula (II) is in the form of a tablet or tablet.
• said tablet or tablet can be broken into 1, 2, 3, or even 4 pieces so as to be able to provide the subject with the dose necessary for one setting using 1, 2 or 3 pieces of said tablet. This is of particular interest, for example, in the case where the treatment requires a period of dose escalation, for arrive at the targeted daily dose, the pieces being able to correspond to the increment stages, and the whole tablet or tablet at the target dose of the treatment
• the treatment comprising the administration of the compound of formula (I) or one of its pharmaceutically acceptable salts or the compound of formula (II) comprises a period of dose escalation, to allow the subject to get used to the treatment. This period is at the start of treatment or when treatment is restarted when it has been interrupted. During this period the daily doses are increased regularly until the maximum dose supported by the patient or prescribed by the practitioner is reached.
• the dose escalation steps may be 2, 3, 4, 5, 6, 7 days or even longer, preferably the escalation steps are 7 days, and the doses may be increased by 5 mg. in steps, 10 mg or even more, preferably 5 mg.
• the doses are increased by 5 mg from week to week until the maximum dose supported by the subject or the dose prescribed by the practitioner is reached. In another embodiment, the doses are increased by 10 mg from week to week until the maximum dose supported by the subject or the dose prescribed by the practitioner is reached.
• the compound of formula (I) or a pharmaceutically acceptable salt thereof or the compound of formula (II) is formulated in liquid form. It can then be packaged in unit dose form in containers such as ampoules, or else in a container such as a bottle or a vial associated with a device allowing the withdrawal and, optionally, the administration of the desired volume to obtain the correct dose.
• FENM is effective when used alone to induce neuroprotection in a subject in need thereof, it may be of interest to combine it with at least one other compound known to be of benefit also in neuroprotection or the symptomatic treatment of neurodegenerative pathologies.
• these diseases are complex diseases involving many different biochemical pathways and cellular mechanisms, which it is relevant to target, in certain instances, by a pleiotropic action via combinations to obtain greater therapeutic efficacy and / or allow the reduction of dosages and / or reduction of undesirable effects.
• Acetylcholine esterase inhibitors have been molecules authorized for more than 20 years in the symptomatic treatment of Alzheimer's disease, dementias associated with Parkinson's disease or other neurodegenerative dementias. By slowing / inhibiting the breakdown of acetylcholine released by still intact cholinergic neurons, these inhibitors are believed to facilitate cholinergic neurotransmission and therefore have a favorable effect on cognitive deficits dependent on these cholinergic pathways during Alzheimer's disease, or dementia associated with Parkinson's disease.
• the acetylcholine esterase inhibitors used are donepezil, rivastigmine, galanthamine. Tacrine, in particular because of its hepatotoxicity, is less desirable.
• An object of the present invention is therefore a combination comprising a compound of formula (I) or one of its pharmaceutically acceptable salts or the compound of formula (II) and at least one acetylcholinesterase inhibitor, preferably selected from donepezil, rivastigmine, galantamine, or a pharmaceutically acceptable salt thereof, for use in inducing neuroprotection in a subject in need thereof.
• said subject suffers from, is suspected of or at risk of suffering from Alzheimer's disease.
• Connexin modulators are in clinical trials for the symptomatic treatment of Alzheimer's disease.
• the object of the trial is a combination treatment of donepezil with mefloquine.
• mefloquine had a modulating effect on connexins and in particular connexin 43, involved in the communicating junctions of astrocytes.
• Astrocytes play a supporting role for neurons in the CNS but also in the transfer of information and in neuronal activity via tripartite synapses. A synergistic effect between donepezil and mefloquine has been reported, allowing a lower dose and more rapid effect of donepezil.
• An object of the present invention is therefore a combination comprising a compound of formula (I) or one of its pharmaceutically acceptable salts or the compound of formula (II) and at least one connexin modulating inhibitor for its use to induce neuroprotection. in a subject in need of it.
• the connexin modulators listed in applications WO 2013/064579 or WO 2010/029131 are incorporated here by reference.
• a particular object of the present invention is therefore a combination comprising a compound of formula (I) or one of its pharmaceutically acceptable salts or the compound of formula (II) and at least one connexin modulator such as those listed in application WO 2013/064579 or WO 2010/029131.
• said at least one connexin modulator is selected from meclofenamic acid, enoxolone, mefloquine and 2-amino ethoxy diphenyl borate (APB), or a pharmaceutically acceptable salt thereof.
• said connexin modulator is meclofenamic acid.
• said subject suffers from, is suspected of or at risk of suffering from Alzheimer's disease.
• a particular object of the present invention is also a combination comprising a compound of formula (I) or one of its pharmaceutically acceptable salts. or of formula (II), at least one connexin modulator such as those listed in application WO 2013/064579 or WO 2010/029131 and at least one acetylcholine esterase inhibitor, for its use to induce neuroprotection in a subject needing it.
• said at least one connexin modulator is selected from meclofenamic acid, enoxolone, mefloquine and 2-amino ethoxy diphenyl borate (APB), or one of their pharmaceutically acceptable salts.
• said connexin modulator is meclofenamic acid.
• said at least one acetylcholine esterase inhibitor is selected from donepezil, rivastigmine and galantamine. In an even more preferred embodiment, said at least one acetylcholine esterase inhibitor is donepezil.
• said combination for its use to induce neuroprotection in a subject in need thereof comprises a compound of formula (I) or a pharmaceutically acceptable salt thereof or the compound of formula (II), of meclofenamic acid, one of its pharmaceutically acceptable salts, and donepezil or one of its pharmaceutically acceptable salts.
• said subject suffers from, is suspected of or at risk of suffering from Alzheimer's disease.
• Aucanumab is a recombinant human antibody that shows excellent selectivity for soluble and insoluble oligomeric fibrillar aggregates of A3, compared to non-pathogenic A3 monomers (Arndt et al., 2018). It is currently in a clinical trial for the treatment of Alzheimer's disease.
• An object of the present invention is therefore a combination comprising a compound of formula (I) or one of its pharmaceutically acceptable salts or the compound of formula (II) and an antibody-based therapy aimed at disrupting the formation of amyloid plaque. , or to prevent or decrease the hyperphosphorylation of the Tau protein.
• a particular object of the invention relates to a combination comprising a compound of formula (I) or one of its pharmaceutically acceptable salts or the compound of formula (II) and aducanumab or one of its fragments binding to a capable antigen. to control the toxicity of b-amyloid aggregates, its fragments or its oligomers for its use to induce neuroprotection in a subject in need thereof.
• said subject suffers, is suspected of suffering or is at risk of suffering from Alzheimer's disease, or Lewy body dementia.
• S ⁇ receptor agonists have currently been developed in several neurodegenerative indications. Neuroprotective effects conferred by agonists of si receptors have been observed in certain models of Alzheimer's disease but also for other pathologies such as Parkinson's disease, Huntington's disease, amyotrophic lateral sclerosis. Some of these agonists have been shown to have neuroprotective effects (Meunier et al., 2006; Maurice et al., 2019). Families of agonist compounds for s ⁇ receptors and neuroprotectors are presented in application WO2017 / 191034. The compounds of this application are incorporated herein by reference.
• PRE-084 (2-morpholin-4-ylethyl 1-phenylcyclohexane-1-carboxylate), (+) - pentazocine), (+) - SKF10,047 (1, 13-dimethyl-10-prop- 2-enyl-10-azatricyclo [7.3.1 .0 27 ] trideca-2 (7), 3,5-trien-4-ol), SA4503 (1- [2- (3,4-dimethoxyphenyl) ethyl] - 4- (3-Phenylpropyl) piperazine), 1 - (2,2-Diphenyltetrahydro-3-furanyl) -N, N-dimethylmethanamine, fluvoxamine (2 - ⁇ [(E) - ⁇ 5-Methoxy-1 - [4-
• an object of the present invention is therefore a combination comprising a compound of formula (I) or one of its pharmaceutically acceptable salts or the compound of formula (II) and at least one agonist of the si receptors, such as those listed in application WO 2017191034, or selected from PRE-084 (2-morpholin-4-ylethyl 1-phenylcyclohexane-1-carboxylate), (+) - pentazocine, (+) - SKF10,047 (1, 13-dimethyl -10- prop-2-enyl-10-azatricyclo [7.3.1.0 27 ] trideca-2 (7), 3,5-trien-4-ol), SA4503 (1- [2- (3,4-dimethoxyphenyl ) ethyl] -4- (3-phenylpropyl) piperazine), 1 - (2,2-Diphenyltetrahydro-3-furanyl) -N, N-dimethylmethanamine, fluvoxamine (2 - ⁇ [(E)
• said at least one agonist of the s ⁇ receptors is chosen from 2- (2-Chlorophenyl) -2-oxo-3, 3,5,5-tetramethyl- [1, 4,2] - oxazaphosphinane; 2- (4-Chlorophenyl) -2-oxo-3,3,5,5-tetramethyl- [1 , 4.2] -oxazaphosphinane; 2- (3,5-Dichlorophenyl) -2-oxo-3,3,5,5-tetramethyl- [1, 4,2] - oxazaphosphinane; 2- (2,3-Dichlorophenyl) -2-oxo-3,3,5,5-tetramethyl- [1, 4,2] - oxazaphosphinane; 2- (3-Fluorophenyl) -2-oxo-3,3,5,5-tetramethyl- [1, 4,2] - oxazaphosphinane; 2- (4-Fluoroph
• PRE-084 (2-morpholin-4-ylethyl 1 -phenylcyclohexane-1 -carboxylate) or a pharmaceutically acceptable salt thereof is also preferred.
• said at least one s receptor agonist is in an enantiomerically pure form.
• said at least one s receptor agonist is in the form of a racemic mixture.
• said subject suffers from, is suspected of suffering from or is at risk of suffering from Alzheimer's disease.
• each of the compounds is suitable for simultaneous administration, separate or spread over time as defined above, depending on the specificities of these compounds but also, preferably, so that these compounds or their active metabolites exert their biological effects at the same time, so that the subject benefits from the maximum effect of said combination.
• An object of the present invention also relates to a pharmaceutical composition
• a pharmaceutical composition comprising at least one compound of formula (I) or one of its pharmaceutically acceptable salts or the compound of formula (II) alone or in combination with another active agent, said composition. being particularly suitable for conferring neuroprotection according to the various and embodiments mentioned.
• Ab 25-35 fragment of 11 amino acids of sequence Nt-GSNKGAIIGLM-Ct (SEQ ID NO 1) of the APP peptide.
• Sc AC 25-35 or Sc Ab, control peptide comprising the 11 amino acids of Ab 25 ⁇ 3he in a random order of sequence Nt-MAKGINGISGL-Ct (SEQ ID NO 2).
• YMT spontaneous alternation test in the Y-maze; “Y-maze test” in English language.
• PAT passive avoidance test
• Passive Avoidance Test or “step-through passive avoidance test” in English.
• ORT object recognition test or "Object Recognition Test” in English.
• WMT spatial learning test in a swimming pool or “Morris Water Maze Test” in English.
• icv intracerebroventicular.
• i.p. intraperitoneal.
• CNS Central Nervous System.
• lba-1 ionized calcium-binding adapter molecule 1
• GFAP Glial Fibrillary Acidic Protein.
• RaD stratum radiatum (Rad).
• PoDG Polymorphic layer of the dentate gyrus.
• LPtA associative lateral parietal area
• mice of the in vivo experiments were carried out on male Swiss CD-1 (RjOrl: SWISS) or C57BI / 6d (Janvier, Le Genest-Saint-Isle, France) mice aged 7 to 9 weeks.
• the animals are housed in groups of 8 to 10 individuals in plastic cages with unlimited access to food and drink, in a controlled environment (23 ⁇ 1 ° C, 40-60% humidity, day cycle / 12h night). All the experiments were carried out on Swiss mice, except the hamlet test (see below) which was carried out on mice of the C57BI / 6j genotype.
• Memantine hydrochloride was used (Sigma-Aldrich, Saint-Quentin-Fallavier, France).
• FENM hydrochloride (FENM HCl) was synthesized by M2i Life Sciences ( Saint-Cloud, France).
• the stock solutions of the compounds were obtained by solubilization in NaCl buffer (0.9%, vehicle) at a concentration of 2 ng / mL which corresponds to a dose of 10 mg / kg per 100 ⁇ L.
• Stock solutions are stored at 4 ° C for a maximum of 2 weeks.
• Amyloid peptide stock solution 125-351 training of oliao mothers.
• amyloid peptide [25-35], noted Ab 2 5-35 (suppliers: Polypeptide, Illkirch, France or Eurogentec, Angers, France), was dissolved in sterile distilled water at a concentration of 3 mg / ml, the stock solution thus formed is aliquoted and stored at -20 ° C until use.
• control peptide Sc Ab control peptide
• the oligomers of Ab 25 -35 are formed as described by Maurice et al. (1996), when incubated at 37 ° C for 4 days.
• the vehicle solution or the control peptide are subjected to the same treatment before administration.
• test compounds (memantine, FENM HCl) are administered to the animals by the intraperitoneal route in a dose range of 0.1 to 10 mg / Kg.
• the injection model A6 oligomers icv 25 -35 is a well-known model in the state of the art.
• A6 25 -35 oligomers are known to be cytotoxic to neuronal cells in mice and inducing disorders of the spatial and working memory. This deficit is accompanied by the generation of mitochondrial stress, oxidative stress and apoptosis of cells, especially in the hippocampus, and by inflammation of the central nervous system.
• the A6 25 -35 peptide is also included in the peptide A6i- 4 o or A6i- 42 and autoantibodies against these short fragments were detected in humans (Gruden et al., 2007).
• the model has remarkable predictive validity with respect to studies in the most widely used transgenic mouse models of Alzheimer's disease (Maurice et al., 2013; Rodriguez-Cruz et al., 2017).
• this model is considered to be a relevant screening model for the neuroprotective activity of compounds, and more particularly a relevant first-line model of Alzheimer's disease.
• At least one molecule essentially studied on this model (Villard et al., 2009, 2011) has been shown to be effective in the clinic (Hampel et al., 2020) and is now in phase 3.
• Figure 1 is a schematic description of the course of the various tests as a function of the day of icv administration of the Ab 25 -35 oligomers and of the test compounds.
• Test compounds were tested for their ability to reduce the cognitive symptoms of neurodegeneration induced by Ab oligomers 25- 35, that is to say their ability to anti amnesic symptomatic treatment ( Figures 1A and 1B). Briefly, to test the symptomatic effect of the test compounds, they were administered 8 days after the icv injection of the Ab 25 -35 oligomers, 30 minutes before the performance of the YMT and PAT memory tests or 30 minutes before the test, but after the training session, in the case of the MWT or ORT tests ( Figure 1A).
• the hamlet test (Hamlet test ® , Figure 1 B) involves a training session of 2 weeks (4 hrs / day) then a test (10 min max) in water deprivation and in normal condition; after this first test, the Ab 25 -35 peptide is injected. After one week, the compounds are administered and then a second test under water deprivation conditions and under normal conditions is carried out 30 min after injection. This test measures spatio-temporal disorientation, a major warning sign in Alzheimer's disease (Crouzier et al., 2018).
• the neuroprotective effect of the compounds that is to say their ability to protect cells from the neurotoxicity of the Ab 25 -35 oligomers and from neurodegeneration is also tested (FIG. 1C).
• the administration of the test compounds takes place on the same day as the injection of the Ab 25 -35 oligomers and continues on a daily basis until day 7 after the injection of the oligomers; the mice are then subjected to the YMT, PAT, MWT or ORT tests.
• the analysis of the anatomy of the brain and the counting of neuronal cells by immunohistochemistry is carried out on mice sacrificed on D 13.
• the biochemical quantification analyzes of the markers of oxidative stress and of apoptosis were carried out on D16 on a group. of mice that have been subjected to WMT ( Figure 1C).
• the Ab 25 -35 oligomers are allowed to exert their neurotoxicity and induce neurodegeneration before implementing the treatment, while in the other case the ability of the compounds to prevent this cascade of events is evaluated and therefore to prevent neurodegeneration and cell death.
• the spontaneous alternation test is used to study the spatial working memory (very short term) in rodents.
• the labyrinth is made of gray opaque polyvinyl chloride (PVC).
• PVC gray opaque polyvinyl chloride
• the parameters measured include the percentage of alternation (memory index) and the total number of entries into the arms of the labyrinth (exploration index, Maurice et al., 1994, 1996; Meunier et al., 2006, 2013; Villard et al., 2009, 2011). Data from animals showing extreme behavior (alternation percentage ⁇ 25% or> 90%, or an entry number less than 10) are not taken into account in the calculations. Usually, the attrition rate is 5%. Under normal conditions, a mouse will spontaneously alternate the explorations of each of the arms. A mouse with impaired memory and / or orientation abilities will see its percentage of alternation decrease. Passive Avoidance Test (PAT)
• PAT Passive Avoidance Test
• the apparatus used for this test is a box with two compartments (15 x 20 x 15 cm high) one illuminated with white PVC walls and the other in the dark with black PVC walls and a floor wire mesh.
• a guillotine door separates the compartments.
• a 60 W lamp is positioned 40 cm above the box and illuminates the white compartment.
• Electric shocks (0.3 mA for 3 s) can be applied to the grid ground via a generator (Lafayette Instruments, Lafayette, USA).
• the test consists of a learning session and a test session. The guillotine door is closed during the training session. Each mouse is placed in the white compartment. After 5 seconds, the door rises.
• mice are each placed in a square arena (50 x 50 cm 2 ). In session 1, the mice are allowed to acclimate to the environment for 10 minutes. During session 2, 24 hours after session 1, two identical objects are placed at 1 ⁇ 4 (position 1) and 3 ⁇ 4 (position 2) of one of the diagonals of the arena. The exploratory behavior, activity and position of the animal's nose are recorded for 10 minutes (Nosetrack ® software, Viewpoint, Lissieu, France). The number of contacts with the objects as well as their duration are measured. During session 3, one hour after session 2, the object in position 2 is replaced by a new object different in shape, color and texture. The exploratory behavior of each mouse is then also recorded for 10 minutes. Animals having no contact or less than 10 contacts with an object are excluded from the study.
• An exploratory index is calculated according to the following formula: number (or duration) of contacts with object 2
• Exploratory index - - - - - - - - - - - - - - - - - - - - - - - - - total number (or duration of contacts with the two objects
• mice This test is based on the innate exploratory behavior of mice. It is used to measure recognition memory which involves many areas of the brain. A mouse with impaired memory capabilities will be less likely to prefer Object 2 in its exploratory behavior.
• This test is used to assess long-term reference spatial memory. This test is well known in the state of the art and is described in particular by Rodriguez Cruz et al. (2017) and Maurice et al. (2019). It includes two phases, an acquisition phase and a test phase.
• the pool is circular in shape (with a diameter of 140 cm) and a 10 cm platform is submerged under the water surface during the acquisition phase. Landmarks are placed around the pool to allow the animals to orient themselves. Animal swimming is recorded (Videotrack ® software, Viewpoint), and the trajectories, latency and distances traveled measured.
• the acquisition phase includes 3 swimming sessions per day for 5 days. The starting position of the animal is determined randomly each from the cardinal points north, south, east, west.
• Each animal has 90 seconds to find the submerged platform in the middle of the northeast quarter, the water being made opaque by suspension of Meudon white.
• the animals are left on the platform for 20 seconds. Animals which have not found the platform after 90 seconds are placed on the platform and are left there for 20 seconds as well.
• the median of the latency time (time taken to find the platform) is calculated on each training day and expressed for the group as the average latency time ⁇ the standard deviation.
• a recall test is performed 72 hours after the last training session. In this test, the platform was removed. Each mouse is left for 60 seconds in the water and its swimming is recorded.
• the time spent in the northeast quarter, which originally contained the platform (T) is measured and compared to the average time spent in the other quarters (o).
• a mouse with impaired spatial reference memory capabilities will spend less time (in proportion to the time spent in other shifts) in the shift that contained the platform during training phases, if not significantly more than the level of chance (15 seconds).
• This test is intended to measure the topographic memory of mice in a complex environment. It is based on familiarizing the animal with a complex and enriched environment, and on learning, in this enriched context, by the acquisition of higher memory and social functions (Crouzier et al., 2018).
• the Hamlet Test ® device includes a central square (the agora) and streets that radiate from it and lead to functionalized compartments or houses making it possible to satisfy a physiological function or to enrich the environment.
• the walls and streets of the hamlet are made of transparent infrared PVC, the experiment room is uniformly lit (200 Lux), infrared diodes are placed under the hamlet floor and an infrared camera records the behavior of the animals.
• the agora serves as a meeting place and a starting point for training and testing sessions.
• Houses encode basic physiological functions and contain either granules (Eating house), water (Drinking house), a Novomaze ® maze (Viewpoint) (Hiding house), a training wheel (Running house) or a separation grid isolating an unknown mouse (Interagir house).
• This test was described by Crouzier et al. (2018 a and b). Briefly, the animals from the same cage are placed in the hamlet for 4 hours per day during the two weeks of training. Topographic memory is tested during a test phase (PTO), 72 hours after the last training session, after the mice have been deprived of water (bottle removed the night before, i.e. 15 hours before the test).
• PTO test phase
• the performance of animals to reach the drinking house is compared to the performance of the same animals, retested the next day without water deprivation.
• the animals are placed individually in the hamlet for a 10 minute session. Exploratory behavior is recorded and the time taken to find the Drinking house and the number of errors recorded (entering a street not leading to the Drinking house).
• the oligomerized Ab 25 -35 peptides, or the control, are injected 2 hours after the test phase and the test compounds also (FIG. 1B). The test phase is repeated after 7 days.
• a disorientation index (DI) is calculated for each variable (time to find the water house, number of errors):
• mice are sacrificed after the behavioral test by decapitation 15 days after injection of Ab 25 -35.
• the brains are removed, the hippocampi isolated, weighed and frozen at -80 ° C until biochemical analyzes.
• the quantity of hydroperoxide present in the samples is measured by quantifying the Fe 3+ complex with orange xylenol: in an acidic medium, the hydroperoxides oxidize Fe 2+ to Fe 3+ .
• the latter forms a colored complex with orange xylenol, the formation of which is quantified by measuring its absorbance at 580 nm.
• the hippocampi are homogenized in cold methanol (1/10 w / v), centrifuged at 1000 g for 5 min and the supernatant taken.
• the homogenates are added to a solution containing FeS0 4 (0.25 mM), H 2 S0 4 (25 mM), and xylenol orange (0.1 mM) and incubated for 30 min at room temperature.
• the absorbance at 580 nm (A 5 eo1) is measured then 10 mI of cumene hydroperoxide (CHP, 1 mM) are added and the whole is incubated 30 min at room temperature.
• the absorbance at 580 nm is again measured (A 5 8O2).
• the level of lipid peroxidation is determined in CHP equivalent (CHP eq.) According to the formula:
• CHP eq. X [CHP (nmol)] x dilution factor
• CHP eq. is expressed per tissue mass and presented as a percentage of the value of the control group.
• Interleukin 6 IL-6
• Bcl2 is often referred to as an anti-apoptotic marker
• Bax as a pro-apoptotic marker. Both seahorses from 6-8 animals per condition were used. The tissues were homogenized after thawing in cell lysis buffer (1 mL, 3 IS007, Cloud-Clone) and sonication on ice (2 x 10 s).
• mice were euthanized to conduct these studies. They were previously anesthetized by ip injection of 200 ⁇ L of a solution of ketamine (80 mg / kg) and xylazine (10 mg / kg), then the tissues fixed by intracardiac infusion of 50 mL of a saline solution then of 50 mL of Fixative Antigenfix ® (Diapath). The samples are stored for an additional 48 hours in the fixative at 4 ° C., then the brains of the mice were stored in a 30% sucrose solution in PBS, before being cut into slices.
• ketamine 80 mg / kg
• xylazine 10 mg / kg
• Slices from each area of the brain were made, including the cortex, the magnocellular nucleus basalis and the hippocampus (i.e., between bregma +1.8 and bregma -2.8 according to the stereotaxic coordinates of the mouse brain , Paxinos et al., 2004).
• Serial coronal sections 25 ⁇ m thick were made with a cryo-microtome (Microm HM 450, Thermo Fisher) and stored at -20 ° C in cryoprotectant solution.
• the thickness of the CA1 area as well as the number of pyramidal neurons were measured at 20x magnification (cell count macro of ImageJ v1.46 software (NIH)). The data are expressed as the number of viable cells per mm 2 for 4-6 sections of the hippocampus per mouse (Rodriguez Cruz et al., 2017; Maurice et al., 2019).
• Microglial cells are often presented as the macrophages of the CNS. They proliferate and are activated to deal with a pathological situation. They can secrete cytokines or reactive oxygen species and are thus partially responsible for the phenomenon of excitotoxicity. They are also a marker of pathological neuroinflammation.
• the lba-1 staining is specific for microglial cells in the CNS.
• the GFAP protein is a component of the intermediate filaments of astrocytes and is used as a marker for astrocytes.
• Astrocytes play a role of functional and structural support for neurons. However, astrocytes are also involved in neuroinflammation and can produce many cytokines that exert neurotoxic activity.
• the immunohistochemistry markings are carried out in a conventional manner.
• polyclonal rabbit anti-lba-1 (reference 019-19741, Wako) and monoclonal mouse anti-GFAP (reference G3893, Sigma-Aldrich) respectively diluted 250 th and 400 th were used to mark microglial cells and astrocytes. Labeling took place overnight at 4 ° C. Hybridization with anti-rabbit secondary antibodies coupled to Cy3 and anti-mouse secondary antibodies coupled to Alexa fluor 488, diluted to 1000th, takes place for one hour at room temperature. The sections are then incubated for 5 min in a solution of DAPI at 10 ⁇ g / ml.
• the sections were mounted in an assembly liquid (ProLong, ThermoFischer) and images of each section were taken under a confocal fluorescence microscope (Leica SPE) for different sub-regions of the hippocampus such as the stratum. radiatum (Rad), the stratum moleculare (Mol), the polymorphic layer of the dentate gyrus (PoDG) and, for the cortex, the associative lateral parietal area (LPtA). These regions are known to be sites of astrogliosis and microgliosis induced by the Ab 2 5-35 oligomers (Maurice et al., 2019).
• the neuroprotective effect of memantine and FENM was evaluated biochemically by measuring, in the hippocampus, the level of markers of inflammation (IL-6, Figure 2A), apoptosis (Bax et al. Bcl-2, and the Bax / BI-2 ratio, Figure 2C) and oxidative stress (lipid peroxidation, Figure 2B).
• mice untreated, but poisoned with oligomers of Ab 2 5-35 a significant 83% increase in IL-6 (pro-inflammatory cytokine) levels is observed 5 days after intoxication compared to to non-intoxicated, untreated mice confirming the induction of neuroinflammation by intoxication with oligomers Ab 25 -35.
• the treatment of the mice with memantine (0.3 mg / kg) does not make it possible to obtain a significant decrease in the levels of IL-6, compared with the intoxicated but untreated mice.
• FENM makes it possible to prevent the inflammation induced by the oligomers of Ab 25 -35.
• FENM 0.3 mg / Kg ip
• FENM makes it possible to prevent the cellular and structural alterations of the hippocampus induced by the Ab 25 -35 oligomers.
• mitochondrial dysfunction is also the source of oxidative stress. Peroxidation of lipids is a long-term marker of oxidative stress.
• intoxication with oligomers Ab 25 -35 induces a significant increase (+ 47%, FIG. 2B) in the level of lipid peroxidation in the cells of the hippocampus of intoxicated mice.
• Memantine 0.3 mg / kg
• FENM FENM
• FENM is capable of ensuring effective neuroprotection (in the sense of intensity and statistical significance) against apoptosis and inflammation induced by oligomers
• FENM Although memantine shows a positive effect in the PoDG area, only FENM allows a significant decrease in the astrocytic and microglial reaction in all the areas of the brain tested ( Figures 3 and 4). Memantine is further devoid of any effect regarding astrogliosis in Mol ( Figure 3B) or microgliosis in the cortex ( Figure 4D). Thus, FENM is clearly more effective than memantine in preventing the inflammatory reaction triggered by intoxication with oligomers Ab 25 -35.
• FENM is therefore shown to be particularly more effective with regard to memantine in preventing the development of the inflammatory, oxidative stress and apoptosis mechanisms observed in neurodegeneration at the molecular (biochemical markers) and cellular and morphological level in an experimental neuroprotection plan.
• FENM makes it possible to obtain a significant improvement for all the markers studied.
• FENM and memantine have been evaluated and compared, in the context of cognitive and behavioral tests measuring working memory, medium-term memory, recognition memory, spatial memory at long-term (learning) and guidance skills. These tests were carried out according to the experimental diagrams in FIG. 1C. Unless otherwise specified, memantine and FENM (test compounds) were administered at doses of 0.03; 0.1; 0.3; 1, 0 and 3 mg / Kg. The doses tested are thus distributed logarithmically over the dose range tested, which makes it possible to compare the activity profiles of the two molecules.
• This test corresponds to the assessment of long-term spatial memory and learning abilities.
• the Ab 2 5-35 oligomers induce a loss of long-term learning and memory functions (FIG. 5).
• mice In non-intoxicated, untreated mice (control group) it is observed that the mice spend a time significantly greater than 15 s in the training quadrant; a significant difference is also observed between the time spent in the training quadrant compared to the time spent in the other quadrants.
• the untreated intoxicated mice spend almost as much time in the other quadrants as in the training quadrant and the time spent in the training quadrant is no longer significantly different from 15 s.
• Administration of memantine at 0.3 mg / kg does not prevent impairment of learning and memory functions.
• mice poisoned but treated with FENM 0.3 mg / Kg maintain their learning and memory capacity since they spend significantly more time in the learning quadrant than the other quadrants and that this time is significantly greater than 15 s ( Figure 5).
• this test is a fear motivation test classically used to assess medium-term memory.
• a significant reduction in the latency time to enter the dark compartment is observed for the mice poisoned by the Ab 25 -35 oligomers in comparison with the non-poisoned mice (not shown).
• a protective effect of memantine is only observed in two of the doses tested (0.1 and 1 mg / kg ip).
• FENM confers neuroprotection of memory for all the doses tested from 0.1 mg / kg ip up to, included, 3 mg / kg.
• FENM is therefore more effective in neuroprotection than memantine, including for larger doses at which memantine has no effect.
• FENM is more effective in the prevention of cognitive impairment in the model of neurodegeneration induced by icv injection of oligomers Ab 25- 35
• FENM lacks the amnesic effect of memantine at the same doses.
• FENM is effective over a wider dose range than memantine and especially for the larger doses in the range.
• treatment with FENM was found to be superior in the Y-maze test ( Figure 6) as it was effective at all doses tested from 0.1 mg / Kg, where memantine is only effective. 'at 0.3 mg / kg to restore an Alt% significantly different from untreated intoxicated mice.
• FENM is therefore also more effective in the symptomatic treatment of memory alterations induced by neurodegeneration and can be used at higher doses for which memantine is ineffective or even harmful for memory.
• FENM allows the maintenance of complex memory processes (hamlet test), which memantine does not.
• FENM unlike memantine, is effective in inducing neuroprotection which is detected both at the biochemical and cellular level of the events underlying the death of CNS cells and neuro. degeneration. This neuroprotection results in the prevention of cognitive damage in animals.
• the neuroprotection conferred by treatment with FENM is not observed for memantine.
• FENM lacks the amnesic effects of memantine when administered in large doses and remains effective at these doses for symptomatic treatment.
• FENM is of particular interest for preventive (neuroprotective) and symptomatic treatments of neurodegenerative pathologies.
• the data obtained show a completely atypical and unpredictable behavior of FENM with regard to the ranges of doses found to be effective and of the biological effects obtained for memantine in animal models.
• mice Crouzier L, Gilabert D, Rossel M, Trousse F, Maurice T. Topographical memory analyzed in mice using the Hamlet Test, a novel complex maze. Neurobiol Learn Mem. 2018; 149: 118-134.

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