Excess cerebral TNF causing glutamate excitotoxicity rationalizes treatment of neurodegenerative diseases and neurogenic pain by anti-TNF agents
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The basic mechanism of the major neurodegenerative diseases, including neurogenic pain, needs to be agreed upon before rational treatments can be determined, but this knowledge is still in a state of flux. Most have agreed for decades that these disease states, both infectious and non-infectious, share arguments incriminating excitotoxicity induced by excessive extracellular cerebral glutamate. Excess cerebral levels of tumor necrosis factor (TNF) are also documented in the same group of...[Show more]
dc.contributor.author | Clark, Ian A | |
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dc.contributor.author | Vissel, Bryce | |
dc.date.accessioned | 2018-09-10T02:56:14Z | |
dc.date.available | 2018-09-10T02:56:14Z | |
dc.identifier.uri | http://hdl.handle.net/1885/147267 | |
dc.description.abstract | The basic mechanism of the major neurodegenerative diseases, including neurogenic pain, needs to be agreed upon before rational treatments can be determined, but this knowledge is still in a state of flux. Most have agreed for decades that these disease states, both infectious and non-infectious, share arguments incriminating excitotoxicity induced by excessive extracellular cerebral glutamate. Excess cerebral levels of tumor necrosis factor (TNF) are also documented in the same group of disease states. However, no agreement exists on overarching mechanism for the harmful effects of excess TNF, nor, indeed how extracellular cerebral glutamate reaches toxic levels in these conditions. Here, we link the two, collecting and arguing the evidence that, across the range of neurodegenerative diseases, excessive TNF harms the central nervous system largely through causing extracellular glutamate to accumulate to levels high enough to inhibit synaptic activity or kill neurons and therefore their associated synapses as well. TNF can be predicted from the broader literature to cause this glutamate accumulation not only by increasing glutamate production by enhancing glutaminase, but in addition simultaneously reducing glutamate clearance by inhibiting re-uptake proteins. We also discuss the effects of a TNF receptor biological fusion protein (etanercept) and the indirect anti-TNF agents dithio-thalidomides, nilotinab, and cannabinoids on these neurological conditions. The therapeutic effects of 6-diazo-5-oxo-norleucine, ceptriaxone, and riluzole, agents unrelated to TNF but which either inhibit glutaminase or enhance re-uptake proteins, but do not do both, as would anti-TNF agents, are also discussed in this context. By pointing to excess extracellular glutamate as the target, these arguments greatly strengthen the case, put now for many years, to test appropriately delivered ant-TNF agents to treat neurodegenerative diseases in randomly controlled trials. | |
dc.description.sponsorship | This research was supported by the National Health and Medical Research Council (NHMRC) of Australia via research project grant #1083569, Iain S. Gray in memory of Kylie, the Roth family Foundation, and the Boyarsky family. | |
dc.format | 16 pages | |
dc.format.mimetype | application/pdf | |
dc.publisher | BMC | |
dc.rights | © 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. | |
dc.source | Journal of neuroinflammation | |
dc.subject | astrocyte | |
dc.subject | glutamate | |
dc.subject | glutaminase | |
dc.subject | neurodegenerative disease | |
dc.subject | neurogenic pain | |
dc.subject | re-entry proteins | |
dc.subject | synapse | |
dc.subject | TNF | |
dc.subject | animals | |
dc.subject | cerebral cortex | |
dc.subject | glutamic acid | |
dc.subject | humans | |
dc.subject | tumor necrosis factor-alpha | |
dc.subject | neuralgia | |
dc.subject | neurodegenerative diseases | |
dc.title | Excess cerebral TNF causing glutamate excitotoxicity rationalizes treatment of neurodegenerative diseases and neurogenic pain by anti-TNF agents | |
dc.type | Journal article | |
local.identifier.citationvolume | 13 | |
dcterms.dateAccepted | 2016-08-30 | |
dc.date.issued | 2016-09-05 | |
local.publisher.url | https://www.biomedcentral.com/ | |
local.type.status | Published Version | |
local.contributor.affiliation | Clark, Ian A., ANU Medical School, CHM ANU Medical School, The Australian National University | |
dc.relation | http://purl.org/au-research/grants/nhmrc/1083569 | |
local.identifier.essn | 1742-2094 | |
local.bibliographicCitation.issue | 1 | |
local.bibliographicCitation.startpage | 236 | |
local.identifier.doi | 10.1186/s12974-016-0708-2 | |
dcterms.accessRights | Open Access | |
Collections | ANU Research Publications |
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01 Clark Ian A and Vissel B Excess cerebral TNF 2016.pdf | 1.68 MB | Adobe PDF |
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