title: Why Have Clinical Trials of Antioxidants to Prevent Neurodegeneration Failed? - A Cellular Investigation of Novel Phenothiazine-Type Antioxidants Reveals Competing Objectives for Pharmaceutical Neuroprotection.
abstract: Only a fraction of the currently established low-molecular weight antioxidants exhibit cytoprotective activity in living cells, which is considered a prerequisite for their potential clinical usefulness in Parkinson's disease or stroke. Post hoc structure-activity relationship analyses have predicted that increased lipophilicity and enhanced radical stabilization could contribute to such cytoprotective activity.
  
  
  
  We have synthesized a series of novel phenothiazine-type antioxidants exhibiting systematic variation in their lipophilicity and radical stabilization. Phenothiazine was chosen as lead structure for its superior activity at baseline. The novel compounds were evaluated for their neuroprotective potency in cell culture, and for their primary molecular targets.
  
  
  
  Lipophilicity was associated with enhanced cytoprotective activity, but only to a certain threshold (logP ≈ 7). Benzannulation likewise produced improved cytoprotectants that exhibited very low EC50values of ~8 nM in cultivated neuronal cells. Inhibition of global protein oxidation was the best molecular predictor of cytoprotective activity, followed by the inhibition of membrane protein autolysis. In contrast, the inhibition of lipid peroxidation in isolated brain lipids and the suppression of intracellular oxidant accumulation were poor predictors of cytoprotective activity, primarily as they misjudged the cellular advantage of high lipophilicity.
  
  
  
  Lipophilicity, radical stabilization and molecular weight appear to form an uneasy triangle, in which a slightly faulty selection may readily abolish neuroprotective activity.
authors.affiliation: Institute for Pathobiochemistry, University Medical Center of the Johannes Gutenberg University, Duesbergweg 6, 55099, Mainz, Germany. maikeohlow@gmx.de.|Department of Nuclear Medicine, University Medical Center of the Johannes Gutenberg University, Langenbeckstraße 1, 55131, Mainz, Germany. maikeohlow@gmx.de.
authors.forename: Maike J
authors.initials: MJ
authors.lastname: Ohlow
authors.affiliation: Institute for Pathobiochemistry, University Medical Center of the Johannes Gutenberg University, Duesbergweg 6, 55099, Mainz, Germany.
authors.forename: Selina
authors.initials: S
authors.lastname: Sohre
authors.affiliation: Institute for Pathobiochemistry, University Medical Center of the Johannes Gutenberg University, Duesbergweg 6, 55099, Mainz, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Granold
authors.affiliation: Department of Nuclear Medicine, University Medical Center of the Johannes Gutenberg University, Langenbeckstraße 1, 55131, Mainz, Germany.
authors.forename: Mathias
authors.initials: M
authors.lastname: Schreckenberger
authors.affiliation: Institute for Pathobiochemistry, University Medical Center of the Johannes Gutenberg University, Duesbergweg 6, 55099, Mainz, Germany. moosmann@uni-mainz.de.
authors.forename: Bernd
authors.initials: B
authors.lastname: Moosmann
mesh_terms: D000818:Animals; D000975:Antioxidants / Q000494:pharmacology*; D001921:Brain / Q000187:drug effects; D002460:Cell Line; D002986:Clinical Trials as Topic; D015227:Lipid Peroxidation / Q000187:drug effects; D051379:Mice; D019636:Neurodegenerative Diseases / Q000188:drug therapy*; D009474:Neurons / Q000187:drug effects; D000066829:Neuroprotection / Q000187:drug effects*; D018696:Neuroprotective Agents / Q000494:pharmacology*; D010084:Oxidation-Reduction / Q000187:drug effects; D018384:Oxidative Stress / Q000187:drug effects; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D010640:Phenothiazines / Q000494:pharmacology*; D013329:Structure-Activity Relationship
chemical_list: D000975:Antioxidants; D018696:Neuroprotective Agents; D004364:Pharmaceutical Preparations; D010640:Phenothiazines
keywords: neuroprotection; oxidative stress; phenothiazine; protein oxidation; structure-activity relationship