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© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner
Rejuvenation of the Aged Brain
An Example of Drug Delivery in Drug Repurposing
Ludwig Aigner
IntelGenx, Grand Opening, Saint-Laurent, May 10th 2016
YESTERDAY
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 2
TODAY
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 3
TOMORROW
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 4
5
Age: Risk Factor Number 1
Teresa Niccoli , Linda Partridge, Ageing as a Risk Factor for Disease, Current Biology, Volume 22, Issue 17, 2012, R741 - R752
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 6
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 7
Massive Increase in the Prevalence of AD
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 8
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 9
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 10
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 11
GeneticNon-Genetic
Alt
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 12
Alzheimer Pathology
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 13
Are We Targeting the Right Thing ?
Rodrigue et al., Neuropsychol Rev. 2009
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 14
1001 Reasons for Neuronal Cell Death ???
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 15
Neurodegeneration
eg Schapira et al. 2011
Neuroinflammation
eg Hirsch et al. 2009
Blood Brain Barrier
eg Zlokovic et al. 2008
Neurogenesis
eg Regensburger et al. 2014
Neurotransmission
eg Calabresi et al. 2007
Our Targets:
Pleiotropic Signaling
Demyelination
Axonal Damage
eg Franklin et al. 2008
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 16
AGING and REJUVENATION
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 17
Neurodegeneration
eg Schapira et al. 2011
Neuroinflammation
eg Hirsch et al. 2009
Blood Brain Barrier
eg Zlokovic et al. 2008
Neurogenesis
eg Regensburger et al. 2014
Neurotransmission
eg Calabresi et al. 2007
Demyelination
Axonal Damage
eg Franklin et al. 2008
The Aged Brain is a „Diseased“ Brain
Regeneration
Disease Risk
Disease Risk
Live = Aging
Growth Plasticity Degeneration Disease
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 18
Growth Plasticity Degeneration
Aging and Rejuvenation
„Regenerative Pharmacology“
Disease
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 19
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 20
Can We Turn Back the Clock ?
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 21
Muscle Research, Aging, and Regenerative Medicine ?
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 22
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 23
inflammation
neurogenesis
cognitiion
Modulating the Systemic Milieu: a Valid Approach
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 24
Eotaxin Reduces Neurogenesis
Eotaxin Worsens Cognition
Old Blood Contributes to Brain Aging
EOTAXIN
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 25
Eotaxin Leukotrienes
Allergy / Asthma Brain Aging
Aging / Degeneration
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 26
Leukotrienes Impact on Brain Aging
Leukotrienes
Neurodegeneration
eg Schapira et al. 2011
Neuroinflammation
eg Hirsch et al. 2009
Blood Brain Barrier
eg Zlokovic et al. 2008
Neurogenesis
eg Regensburger et al. 2014
Neurotransmission
eg Calabresi et al. 2007
Demyelination
Axonal Damage
eg Franklin et al. 2008
Montelukast
Proof of Principle:
Inhibition of Leukotriene Receptors Improves Cognition in Aged Rats
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 27
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 28
symptoms pathology therapy
motoric dopaminergic cell loss dopamine replacement
60%
Parkinson´s Disease Dementia / Lewy Body Dementia
symptoms pathology therapy
motoric dopaminergic cell loss dopamine replacement
dementia ??? rivastigmine
Neurogenesis
Blood Brain Barrier
Neuroinflammation
Neurodegeneration
Neurotransmission
eg Schapira et al. 2011
eg Hirsch et al. 2009
eg Zlokovic et al. 2008
eg Regensburger et al. 2014
eg Calabresi et al. 2007
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 29
**
Learning Memory
*
Montelukast Improves Cognitive Functions in PD / LBD Animals
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 30
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 31
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 32
1 1 2 2 1 1 2 3 3 4 3 2 2 4 4 2 3 3 6 7 6 11 7
14
7 13 15 12 15 19 17 23 25
50 48
99
126
239
317
414
0
50
100
150
200
250
300
350
400
450
1973
1975
1976
1977
1978
1979
1980
1982
1983
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
NumberofPublications
Annual Counts of Publications “Drug Repurposing”
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 33
“All De- and Regenerations are Similar”
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 34
REPAIR
REPLACE
RESTORE
REGENERATE
REJUVENATE
Regenerative Medicine
All Organs
Different Diseases
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 35
MMSE 13:
moderate to severe dementia
Montelukast as an Anti-Dementia Therapeutic
Before After 2 Months of Montelukast
MMSE 22:
mild dementia
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 36
Discover
y
Preclini
c
Phase
I
Phase
II
Phase
III
Approval
BIOTECH
Academia Big Pharma
© Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 37
Let‘s make a better Montelukast

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Aigner intelgenx

  • 1. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner Rejuvenation of the Aged Brain An Example of Drug Delivery in Drug Repurposing Ludwig Aigner IntelGenx, Grand Opening, Saint-Laurent, May 10th 2016
  • 2. YESTERDAY © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 2
  • 3. TODAY © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 3
  • 4. TOMORROW © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 4
  • 5. 5 Age: Risk Factor Number 1 Teresa Niccoli , Linda Partridge, Ageing as a Risk Factor for Disease, Current Biology, Volume 22, Issue 17, 2012, R741 - R752 © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner
  • 6. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 6
  • 7. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 7 Massive Increase in the Prevalence of AD
  • 8. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 8
  • 9. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 9
  • 10. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 10
  • 11. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 11 GeneticNon-Genetic
  • 12. Alt © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 12 Alzheimer Pathology
  • 13. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 13 Are We Targeting the Right Thing ? Rodrigue et al., Neuropsychol Rev. 2009
  • 14. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 14 1001 Reasons for Neuronal Cell Death ???
  • 15. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 15 Neurodegeneration eg Schapira et al. 2011 Neuroinflammation eg Hirsch et al. 2009 Blood Brain Barrier eg Zlokovic et al. 2008 Neurogenesis eg Regensburger et al. 2014 Neurotransmission eg Calabresi et al. 2007 Our Targets: Pleiotropic Signaling Demyelination Axonal Damage eg Franklin et al. 2008
  • 16. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 16 AGING and REJUVENATION
  • 17. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 17 Neurodegeneration eg Schapira et al. 2011 Neuroinflammation eg Hirsch et al. 2009 Blood Brain Barrier eg Zlokovic et al. 2008 Neurogenesis eg Regensburger et al. 2014 Neurotransmission eg Calabresi et al. 2007 Demyelination Axonal Damage eg Franklin et al. 2008 The Aged Brain is a „Diseased“ Brain
  • 18. Regeneration Disease Risk Disease Risk Live = Aging Growth Plasticity Degeneration Disease © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 18
  • 19. Growth Plasticity Degeneration Aging and Rejuvenation „Regenerative Pharmacology“ Disease © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 19
  • 20. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 20 Can We Turn Back the Clock ?
  • 21. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 21 Muscle Research, Aging, and Regenerative Medicine ?
  • 22. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 22
  • 23. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 23 inflammation neurogenesis cognitiion Modulating the Systemic Milieu: a Valid Approach
  • 24. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 24 Eotaxin Reduces Neurogenesis Eotaxin Worsens Cognition Old Blood Contributes to Brain Aging EOTAXIN
  • 25. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 25 Eotaxin Leukotrienes Allergy / Asthma Brain Aging Aging / Degeneration
  • 26. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 26 Leukotrienes Impact on Brain Aging Leukotrienes Neurodegeneration eg Schapira et al. 2011 Neuroinflammation eg Hirsch et al. 2009 Blood Brain Barrier eg Zlokovic et al. 2008 Neurogenesis eg Regensburger et al. 2014 Neurotransmission eg Calabresi et al. 2007 Demyelination Axonal Damage eg Franklin et al. 2008 Montelukast
  • 27. Proof of Principle: Inhibition of Leukotriene Receptors Improves Cognition in Aged Rats © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 27
  • 28. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 28
  • 29. symptoms pathology therapy motoric dopaminergic cell loss dopamine replacement 60% Parkinson´s Disease Dementia / Lewy Body Dementia symptoms pathology therapy motoric dopaminergic cell loss dopamine replacement dementia ??? rivastigmine Neurogenesis Blood Brain Barrier Neuroinflammation Neurodegeneration Neurotransmission eg Schapira et al. 2011 eg Hirsch et al. 2009 eg Zlokovic et al. 2008 eg Regensburger et al. 2014 eg Calabresi et al. 2007 © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 29
  • 30. ** Learning Memory * Montelukast Improves Cognitive Functions in PD / LBD Animals © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 30
  • 31. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 31
  • 32. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 32 1 1 2 2 1 1 2 3 3 4 3 2 2 4 4 2 3 3 6 7 6 11 7 14 7 13 15 12 15 19 17 23 25 50 48 99 126 239 317 414 0 50 100 150 200 250 300 350 400 450 1973 1975 1976 1977 1978 1979 1980 1982 1983 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 NumberofPublications Annual Counts of Publications “Drug Repurposing”
  • 33. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 33 “All De- and Regenerations are Similar”
  • 34. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 34 REPAIR REPLACE RESTORE REGENERATE REJUVENATE Regenerative Medicine All Organs Different Diseases
  • 35. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 35 MMSE 13: moderate to severe dementia Montelukast as an Anti-Dementia Therapeutic Before After 2 Months of Montelukast MMSE 22: mild dementia
  • 36. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 36 Discover y Preclini c Phase I Phase II Phase III Approval BIOTECH Academia Big Pharma
  • 37. © Paracelsus Medizinische Privatuniversität | Institute of Molecular Regenerative Medicine | Ludwig Aigner 37 Let‘s make a better Montelukast