Neurotoxic alkaloids

Vinca alkaloids (vincristine, vinblastine, vindesine) are derived from the periwinkle plant (Vinca rosea), they bind to tubulin and inhibit its polymerization into microtubules and spindle formation, thus producing metaphase arrest. They are cell cycle specific and interfere also with other cellular activities that involve microtubules, such as leukocyte phagocytosis, chemotaxis, and axonal transport in neurons. Vincristine is mainly neurotoxic and mildly hematotoxic, vinblastine is myelosuppressive with veiy low neurotoxicity whereas vindesine has both, moderate myelotoxicity and neurotoxicity. 

Vinca alkaloids are derived from the Madagascar periwinkle plant, Catharanthus roseus. The main alkaloids are vincristine, vinblastine and vindesine. Vinca alkaloids are cell-cycle-specific agents and block cells in mitosis. This cellular activity is due to their ability to bind specifically to tubulin and to block the ability of the protein to polymerize into microtubules. This prevents spindle formation in mitosing cells and causes arrest at metaphase. Vinca alkaloids also inhibit other cellular activities that involve microtubules, such as leukocyte phagocytosis and chemotaxis as well as axonal transport in neurons. Side effects of the vinca alkaloids such as their neurotoxicity may be due to disruption of these functions. 

Vinblastine is another vesicant vinca alkaloid that causes myelo-suppression and less neurotoxicity than vincristine. The pharmacokinetics of vinblastine are best described by a three-compartment model, with an a half-life of 25 minutes, a 3 half-life of 53 minutes, and a terminal half-life of 19 to 25 hours.12 Vinblastine has shown activity in the treatment of bladder, breast, and kidney cancer, as well as some lymphomas. The doses of vinblastine tend to be higher on a milligram per meter squared basis than vincristine. Nausea and vomiting are minimal with vinblastine. Other side effects include mild alopecia, rash, photosensitivity, and stomatitis. 

Vincristine -vinca alkaloid inhibits tubulin polymerization G2 phase specific -neurotoxicity—peripheral neuropathy -vesicant if extravasated -nausea and vomiting -bone marrow suppression—mild -transient transaminase elevation -constipation (often secondary to neuropathy induced ileus) —intrathecal injection is ALWAYS FATAL... 

Cyanobacterial neurotoxins are small ringed alkaloids and have dramatic effects on various components of vertebrate neurons. They are all water soluble and are synthesized by several cyanobacterial genera (Table 5.1). The most commonly isolated neurotoxins are the paralytic shellfish toxins, although several other potent neurotoxic alkaloids are synthesized by freshwater cyanobacteria (Table 5.1). 

Alternative iboga alkaloids Potential neurotoxic effects of ibogaine have raised concern over its clinical use. It is possible that the antiaddictive and neurotoxic actions of ibogaine are discrete, allowing for potential separation of clinical and toxic effects (Molinari et al. 1996). Some other iboga alkaloids may have these properties, such as 18-MC. 

MC is a synthetic iboga alkaloid that may retain ibogaine s antiaddictive effects, but lack the effects of neurotoxicity and tremor (Click... 

The mitotic indices observed after treatment of both cell lines with 10-fold the IC70 concentration of each congener establish that the action of the vinca binary alkaloids with this cellular target in vivo is correlated with the ability of the molecule to inhibit microtubule assembly and not with its high-concentration-dependent activities with MTP or microtubules. Based on the current understanding that neurotoxicity and neuro-ti bule damage are concerted events, the results of our structure-activity studies support the optimistic expectation that the development of a nonneurotoxic vinblastine-vincristine congener can be achieved. 

In an attempt to find an in vitro assay to predict differences in the neurotoxic potential of bisindole alkaloids, an assay using cultured rat midbrain cells was developed. This system provided a qualitative measure of the effect of compounds on neuronal tissue, and when several compounds (for which clinical toxicity data were available) were evaluated using this method the results were consistent in rank order with the compounds clinical manifestation of neurotoxicity. When vinepidine was studied in this system, it was found to produce a minimal effect (Fig. 7). 

Multiple single-point modification of both halves of the bisindole framework provided vinepidine (144), a bisindole alkaloid that exhibited experimental antitumor activity similar to vincristine without demonstrating the acute neuronal toxicity of this alkaloid. Ultimately, the vinepidine experience was both educational and an exercise in humility, since the compound showed promise in preclinical neurotoxicology models yet demonstrated considerable neurotoxicity in clinical trials. Nevertheless, vinepidine brings a rich example of the combined effects of ring D conformation (with its associated effect on N-6 basicity) and the presence of an N-1 formyl group. 

Treatment of cells with vinblastine or vincristine can result in the formation of paracrystals, complexes containing the alkaloid molecules and tubulin dimers in a 1 1 ratio. Paracrystal formation in neuronal tissue of a freshwater snail has been proposed as a model for the neurotoxic effects of Catharanthus alkaloids and derivatives 44). Vincristine is approximately 10-fold more active than vinblastine as an inducer of paracrystal formation when snail neuronal tissue is treated with high concentrations (150 lM) of the alkaloids. 

Neurotoxic - death Poison hemlock (Conium maculatum) Coniine - neurotoxic alkaloid -poison used by Socrates... 

Vincamine, vinblastine and vincristine are very important clinic alkaloids. They are produced naturally by plants vincamine by Vinca minor, and vinblascine and vincristine by Madagascar periwinkle Catharanthus roseus). The vindoline synthesis pathway starts with strictosidine and, via dehydrogeissoschizine, preakuammicine, stemmadenine and tabersonine, is converted to vindoline and vincristine (Figure 42). Conversion from vindoline to vinblastine is based on the NADH enzyme activity. Vinblastine and vincristine are very similar alkaloids. The difference is that vincristine has CHO connected to N, whereas vinblastine in the same situation has only CO3. This synthetic structural differences influence their activity. Vinblastine is used to treat Hodgkin s disease (a form of lymphoid cancer), while vincristine is used clinically in the treatment of children s leukaemia. Vincristine is more neurotoxic than vinblastine. 

Vincristine displays limited myelosuppression but its neurotoxicity is dose limiting. On the other hand the most important toxicity of vinblastine is myelosuppression while it lacks serious risks for neurotoxicity. The toxicity spectrum of vindesine and of vinorelbine is between these two extremes. The vinca alkaloids can cause inappropriate secretion of antidiuretic hormone. 

The best known drugs acting as antimitotics are the vinca alkaloids, vincristine (7.90) and vinblastine (7.91). They are very complex indole derivatives that nevertheless have been synthesized. Both are quite effective in various leukemias and in Hodgkin s lymphoma, but show considerable neurotoxicity. Vinblastine and vincristine bind specifically to the microtubular protein tubulin in dimeric form, precipitating depolymerization of the microtubules and functionally acting as a mitotic poison. Vinorelbine (7.92) is a semisynthetic vinca alkaloid functionally identical to vinblastine. 

In an adult, a typical dose is 20-30 meg. LSD is considered neurotoxic and like most ergot alkaloids, may lead to strong contractions of the uterus that can induce abortion. 

Bacteria, protozoa, and venomous animals synthesize numerous toxins that are used to kill their prey or to defend themselves. Sea anemones, jellyfish, cone snails, insects, spiders, scorpions, and snakes all make potent and highly specific neurotoxins. Plants form a host of alkaloids and other specialized products, some of which are specifically neurotoxic and able to deter predators. More than 500 species of marine cone snails of the genus Conus synthesize a vast array of polypeptide toxins (conotoxins), 487-489 some with unusual posttranslational modifications.490 491 The slow-moving snails are voracious predators that use their toxins, which they inject with a disposible harpoonlike tooth,492 to paralyze fish, molluscs, or worms.493... 

An elegant synthesis of the neurotoxic alkaloid anatoxin has exploited the electrocyclic opening of the dibromobicyclo[5.1.0]octane followed by transannular cyclization (Scheme 13).238 Similarly, the thermal electrocyclic opening of the dichlorocyclopropane followed by intramolecular trapping of the developing allylic cation by a suitably positioned amine has been used in a homoaporphine synthesis.238... 

Psilocybin is a naturally occurring hallucinogen. It exerts neurotoxic effects similar to LSD and has a chemical structure similar to the neurotransmitter serotonin in the human brain. Psilocybin is found as an indole alkaloid (nitrogen-containing organic base) in the fungal (Protista) kingdom. Often it is accompanied by the related alkaloids, psilocin, baeocystin, and norbaeocystin. 

Vinorelbine is a semisynthetic vinca alkaloid whose mechanism of action is identical to that of vinblastine and vincristine, ie, inhibition of mitosis of cells in the M phase through inhibition of tubulin polymerization. Despite its similarities in mechanism of action, vinorelbine has activity in non-small cell lung cancer and in breast cancer. Myelosuppression with neutropenia is the dose-limiting toxicity, but nausea and vomiting, transient elevations in liver function tests, neurotoxicity, and SIADH are also reported. 

A plant neurotoxin that is receiving much current publicity because of its effectiveness in the chemotherapeutic treatment of at least one form of cancer is taxol, a complex molecule that belongs to the class of taxine alkaloids. Taxol occurs in most tissues of Taxus breviofolia, the western yew tree, and is isolated from the bark of that tree (once considered a nuisance tree in forestry, but in short supply following discovery of the therapeutic value of taxol until alternate sources were developed). Ingestion of taxol causes a number of neurotoxic effects, including sensory neuropathy, nausea and gastrointestinal disturbances, and impaired respiration and cardiac function. It also causes blood disorders (leukopenia and thrombocytopenia). The mechanism of taxol neurotoxicity involves binding to tubulin, a protein involved in the assembly of microtubules, which assemble... 

This chapter reviews the nitrogen-containing neurotoxic compounds produced by cyanobacteria, and follows an earlier review in this series which more broadly covered the alkaloid chemistry of these life forms from the marine environment [3]. A description of the discovery, isolation, structural elucidation, biosynthesis, mechanism of action, structure-activity relationship (SAR), and some aspects of chemical synthesis of cyanobacteria toxins is provided. 

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