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2020 (4)

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Dissertation
Modeling Renal Fibrosis in Zebrafish Using Aristolochic Acid I
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Year: 2020 Publisher: Leuven KU Leuven. Faculty of Pharmaceutical Sciences

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Abstract

Chronic kidney disease (CKD) is a major global health problem that is characterized by a slow and progressive loss of kidney function. The endpoint of virtually all progressive renal diseases is fibrosis, characterized histologically by an excessive accumulation and deposition of extracellular matrix (ECM) disrupting the normal histo-architecture of the organ.The number of renal fibrosis patients doubled from 1990 to 2016 making it increasingly urgent to generate and validate models for a better understanding of the disease and to find potential novel therapies. Although they offer a high throughput screening capacity, in vitro models have limitedly been utilized due to the fact that they cannot recapitulate the complex interaction among various cell types. In contrast, rodents have been used extensively to model the disease and to elucidate the pathogenesis and underlying mechanisms of renal fibrosis. However, none of these in vivo models are suitable for screening of large compounds libraries owing to their high costs and labor-intensive procedures. Therefore, it would be very useful to be able to develop an animal model for therapy testing which is cost-efficient and mirrors well the characteristics of human renal fibrosis.Zebrafish (Danio rerio) are small vertebrates with highly conserved physiology to humans and with a high degree of conservation to the human genome also with respect to pharmaceutical drug targets. By combining these features with easy handling and speed, they have emerged as a cost-efficient and valid alternative for disease modeling and large-scale drug screening over the last decade. Recent studies also show that the zebrafish is a suitable and cost-effective model to study fibrosis.Aristolochic acid (AA)-induced nephropathy in humans is characterized by progressive renal interstitial fibrosis and urothelial malignancy and has been observed after unintentional oral intake of Aristolochia species. Of interest, similar results as found in patients were observed in rats after chronic AA treatment. For instance, when rats were s.c. injected daily with 10 mg/kg AA, tubular necrosis associated with lymphocytic infiltrates and tubular atrophy surrounded by interstitial fibrosis was present at day 10 and day 35, respectively. Moreover, C57Bl/6J male mice subjected to daily i.p. administration of AA (3.5 mg/kg) already developed clear renal fibrosis from 5 days onwards.With the aim to explore the possibility to generate a zebrafish model of renal fibrosis, in this study the fibrogenic renal effect of aristolochic acid I (AAІ) after immersion was assessed. Our results reveal that larval zebrafish at 15 dpf (days post-fertilization) exposed for 8 days to 0.5 µM AAI showed clear signs of AKI (acute kidney injury). The damage resulted in the relative loss of the functional glomerular filtration barrier. Conversely, we did not observe any deposition of collagen, nor could we immunodetect α-SMA, a hallmark of myofibroblasts, in the tubules. In addition, no increase in gene expression of fibrogenesis biomarkers after whole animal RNA extraction was found. As zebrafish have a high capability for tissue regeneration possibly impeding fibrogenic processes, we also used a tert–/– zebrafish line exhibiting telomerase deficiency and impaired tissue homeostasis. AAI-treated tert–/– larvae displayed an increased sensitivity towards 0.5 µM AAI. Importantly, after AAI treatment a mild collagen deposition could be found in the tubules. The outcome implies that sustained AKI induced by nephrotoxic compounds combined with defective tert–/– stem cells can produce a fibrotic response. However, we further show that the limited time slot and overall induced toxicity dramatically limits the feasibility to deploy AAI as a chemical to set-up a renal fibrosis model in zebrafish.Nothwitstanding the current outcome, it is anticipated that finding the right conditions to model renal fibrosis in zebrafish is a matter of time. In that respect, we have suggested a few alternative approaches, like the use of other fibrogenic compounds, and the overexpression of TGF-b1a by a mifepristone-inducible LexPR system. Possibly, also the use of a genetic ablation approach expressing nitroreductase in the nephron, in combination with chemical renal stress, could be advantageous.

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Dissertation
Discovery of antiseizure compounds in zebrafish models for the treatment of drug-resistant epilepsy
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Year: 2020 Publisher: Leuven KU Leuven. Faculty of Pharmaceutical Sciences

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With 70 million people affected worldwide is epilepsy one of the most common neurological diseases characterized by unpredictable, unprovoked, recurrent seizures. Moreover, the disease is often accompanied by psychiatric and cognitive comorbidities, affecting dramatically the quality of life of patients. So far, pharmacological intervention is the first-line treatment for epilepsy. Unfortunately, about 30% of patients experience seizures that cannot be well controlled with the current marketed antiseizure drugs (ASDs). To find novel compounds a wide variety of preclinical animal epilepsy and epileptic seizure models has been generated and employed in phenotypic drug discovery projects. For instance, in 2015, the updated Epilepsy Therapy Screening Program (ETSP) (NIH, USA) has incorporated several rodent seizure models with drug-resistant signature in its working flow. Although those models have the potential to identify innovative ASDs with efficacy in as yet ASDs-resistant patients, the newly screening pipeline is labor-intensive, and has limited throughput. More recently, zebrafish models, especially those with a drug-resistant profile and high-throughput capacity, have gained an increasing popularity in drug discovery. Zebrafish display an excellent compromise between system complexity of the vertebrate organism and the practical simplicity of the in vitro models. Moreover, they allow to find candidate ASDs at a lower cost and time, and thus can be used in the early-stage drug screening to speed up innovative ASDs discovery.In this doctoral research two distinct zebrafish models, a chemically-induced and genetic zebrafish seizure and epilepsy model that proved to exhibit high pharmacoresistant profiles were used for the discovery of new hits and the identification of compounds of interest.
Compared to random screening of compounds, a medicinal plant-based approach has been suggested to result in a faster and cheaper identification of active ingredients, as these plants have been pre-selected through centuries of use by ethnomedical practitioners. Traditional Chinese Medicine (TCM) is one of the most widely practiced forms of botanical therapy in the world, including also multiple recipes of medicinal plants against epilepsy and seizures. Therefore, in the first project 42 extracts of medicinal extracts from fourteen neuroprotective and antiseizure TCM plants were prepared, and a phenotype-based screening was performed using a combination of acute zebrafish seizure models (PTZ and EKP) and a rodent seizure model (mouse 6-Hz psychomotor seizure model). Both the zebrafish EKP seizure and the mouse 6 Hz (44 mA) psychomotor seizure models represent a high potential to identify ASDs with a novel mechanism-of-action. Our strategy led to the identification of magnolol and honokiol, main constituents Magnolia officinalis, as well as the structurally related allyl biphenolic methylhonokiol as potent antiseizure agents. In addition, magnolol was able to protect mice from seizures induced by 6-Hz electrical stimulation in a dose-dependent manner, thereby confirming its antiseizure activity in a mammalian model.
Dravet syndrome (DS) is a catastrophic genetic epilepsy of childhood characterized by a variety of drug-resistant seizures initially often induced by fever. Of interest, distinct de novo mutations in the SCN1A gene are found in about 85% patients with DS. A genetic zebrafish Dravet model based on scn1Lab mutants, has been developed to accurately reflect the genetic basis and characteristics of DS. This model was used in our second study with the aim to explore the antiseizure activity of enantiomers of fenfluramine (FFA) and its presumedly active metabolite norfenfluramine (norFFA), expanding on the clinical treatment of DS patients with racemic FFA. Firstly, we validated the model pharmacologically by using both single and combined ASDs. The results were in accordance with the updated clinical treatment algorithm for DS. Thereafter, the antiseizure activities of the compounds were confirmed showing a concentration-response relationship, thereby demonstrating that both the enantiomers of FFA but also their norFFA metabolites contribute to the antiseizure activity of racemic FFA in DS patients. Taken together, our work discovered three potential hits against therapy-resistant epilepsies and revealed the value of medicinal plants as an interesting resource for ASDs discovery. Furthermore, evidence is provided that the use of zebrafish as high-throughput model of treatment-resistant seizures can be deployed in innovative ASDs discovery.

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Dissertation
Plinabulin, a lead compound for drug-resistant epilepsy: efficacy and mode-of-action investigation

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Epilepsy is one of the most common neurological diseases, affecting more than 70 million people worldwide, and is characterized by an enduring predisposition to experience unprovoked seizures. The current anti-epileptic treatment strategy is based on pharmacotherapy with antiseizure drugs (ASDs) to control seizures. However, despite many efforts, 30% of epilepsy patients suffer from a drug-resistant form of epilepsy. Hence, there is a high unmet medical need to develop ASDs that are effective for drug-resistant seizures. Recently, the Laboratory for Molecular Biodiscovery identified a novel antiseizure compound, i.e., plinabulin, using a zebrafish-based screening approach that relied on the larval zebrafish pentylenetetrazole (PTZ) seizure model. Plinabulin showed an additional promising antiseizure efficacy against drug-resistant seizures in both the larval zebrafish ethyl ketopentenoate (EKP) seizure model and the mouse 6-Hz psychomotor seizure model. Interestingly, plinabulin is a well-known microtubule depolymerizing agent (MDA) that is currently in late-stage clinical trials for different therapeutic indications in the field of cancer. The initial characterization of plinabulin’s antiseizure efficacy was performed after a short-term treatment period. As plinabulin has a limited water solubility that could limit the amounts of compound that reach the zebrafish brain, this study aimed to further characterize the antiseizure efficacy in the larval zebrafish PTZ and EKP seizure models by investigating whether the efficacy could be improved by prolonging the treatment period and by determining how the efficacy compares to that of clinically used ASDs. Moreover, this project aimed to explore whether plinabulin’s known mechanism of action (MOA) in the field of cancer could also be responsible for its antiseizure action by investigating if functional analogues of plinabulin (i.e., colchicine and indibulin) also exhibit antiseizure activity in the larval zebrafish EKP seizure model. Plinabulin’s antiseizure efficacy in the larval zebrafish PTZ and EKP seizure models increased remarkably by prolonging the treatment period. In comparison to the positive control of each seizure model, plinabulin was observed to be at least as effective as perampanel, and even more effective than sodium valproate, which are both clinically used ASDs. These data show that plinabulin has a promising antiseizure efficacy in the zebrafish model and further research is needed to investigate plinabulin’s antiseizure potential in rodent seizure models. Finally, no antiseizure properties were observed for colchicine and indibulin in the zebrafish EKP seizure model. These data suggest that microtubule depolymerization, if involved in the antiseizure activity of plinabulin, is at least not sufficient for an antiseizure activity. Further research is needed to identify the antiseizure target(s) of plinabulin and to understand its MOA.

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Dissertation
Towards novel anti-seizure hits via an EKP-induced zebrafish seizure model

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Epilepsy is a common chronic heterogenic neurological disorder that affects approximately 70 million people worldwide. Epilepsy is characterized by the abnormal propensity of having spontaneous recurrent ánd unprovoked seizures. Unfortunately, it is estimated that about 30% of the human epilepsy population cannot control their seizures with the current existing anti-seizure drugs (ASDs) that are on the market. This phenonemon, also called refractory epilepsy, is defined as a failure of adequate trials of two tolerated, appropriately chosen ASD regimens to achieve sustained seizure freedom. As a result, epilepsy is a relevant medical and socio-economic burden that urgently needs new and more efficacious pharmacological approaches. Given the need for new ASDs, we conducted a study wherein 50 compounds were assessed for their anti-seizure effects in locomotor experiments using the zebrafish EKP seizure model. Zebrafish are an emerging in vivo animal model for translational research on human neurological diseases like epilepsy and present major advantages over other animal models. Namely, zebrafish larvae are very small and amenable to a 96-well plate which allows for water immersion of micrograms of investigational compounds and thus a very quick library screen in a high-throughput fashion. Additionaly, zebrafish demonstrate a high degree of genetic and CNS similarity to humans and their embryos and larvae are transparent and develop fast. The EKP zebrafish seizure model has provided evidence that it possibly induces pharmacoresistant seizures in zebrafish larvae without bias for any molecular mechanism of action (MMOA) of the ASDs tested. For this reason, the addition of this model to the armamentarium of pharmacoresistant seizure models has been very important, as it could potentially provide us with anti-seizure molecules with improved efficacy over existing ASDs or, even better, with a novel MMOA. Initially, we tested every compound of the library at concentrations of 10 and 2 uM in 7 dpf D/L larvae. Unfortunately, we did observe toxicity for a few compounds after tracking at 10 uM. Therefore, we performed a toxicity screen on all of the compounds at concentrations of 2 uM and 10 uM during observational experiments after short (2h) and long (22h ±2h) incubation. Tracking was eventually repeated with the remaining compounds for which no toxicity was observed at 10 uM and after a long incubation period. To further explore the anti-seizure effects of the non-toxic investigational compounds, more locomotor experiments will have to be performed in the EKP model.

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