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Antimicrobial Agents and Chemotherapy, February 2006, p. 759-761, Vol. 50, No. 2
0066-4804/06/$08.00+0 doi:10.1128/AAC.50.2.759-761.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.
A Porphyrin Increases Survival Time of Mice after Intracerebral Prion Infection
David A. Kocisko,1*
Winslow S. Caughey,1
Richard E. Race,1
Grant Roper,2
Byron Caughey,1 and
John D. Morrey2
Laboratory of Persistent Viral Diseases, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana,1
Institute for Antiviral Research, Animal, Dairy, and Veterinary Sciences Department, Utah State University, Logan, Utah2
Received 8 September 2005/
Returned for modification 14 November 2005/
Accepted 23 November 2005

ABSTRACT
Prion diseases, including scrapie, are incurable neurodegenerative
disorders. Some compounds can delay disease after a peripheral
scrapie inoculation, but few are effective against advanced
disease. Here, we tested multiple related porphyrins, but only
Fe(III)
meso-tetra(4-sulfonatophenyl)porphine injected into mouse
brains after intracerebral scrapie inoculation substantially
increased survival times.

TEXT
The transmissible spongiform encephalopathies (TSEs or prion
diseases) are neurodegenerative diseases that include Creutzfeldt-Jakob
disease (CJD) of humans, bovine spongiform encephalopathy, chronic
wasting disease of deer and elk, and scrapie of sheep. The infectious
agent of TSEs is not fully characterized, but there is evidence
that an abnormal, protease-resistant form of prion protein is
involved (
10). Over 160 cases of variant CJD, caused by the
consumption of bovine spongiform encephalopathy-infected beef,
have increased concern about the impact of TSEs on human health.
While TSEs are incurable, various compounds dosed at or near
the time of infection have delayed the onset of scrapie in animals
after inoculation with high peripheral doses of infectant or
even prevented disease after low peripheral doses (reviewed
in references
1 and
4). Compounds that have delayed the onset
of clinical scrapie after intracerebral (i.c.) inoculation include
amphotericin B (
7), pentosan polysulfate (PPS) (
3), and, to
a lesser extent, Congo red (
6).
Most compounds active against scrapie, including cyclic tetrapyrroles, also inhibit protease-resistant prion protein formation in cell cultures (2), which may explain their in vivo activity. A metal-free phthalocyanine and two iron porphyrins, types of cyclic tetrapyrroles, have been shown to delay scrapie onset after peripheral but not i.c. inoculation (8, 9). In the search for more effective anti-TSE compounds, we evaluated two types of previously untested porphyrins with or without central metals (Fig. 1).
meso-tetra(4-sulfonatophenyl)porphine (TSP), iron(III)TSP (FeTSP),
meso-tetra(4-
N,
N,
N-trimethylanilinium)porphine (TAP), and iron(III)TAP
(FeTAP) were tested for the ability to delay scrapie in transgenic
mice (Tg7) that are very susceptible to hamster scrapie strain
263K (
9,
11). (All animal use was approved by the appropriate
institutions animal care and use committee.) All four
porphyrins injected intraperitoneally (i.p.) prior to and for
4 or 5 weeks after i.p. scrapie inoculation significantly increased
survival times (Table
1). FeTAP was most effective, increasing
survival times more than fourfold. In a further test, FeTAP
administered i.p. beginning 50 days after i.p. scrapie challenge
and continuing three times per week until near death was ineffective
(average survival time ± standard deviation of 85.0 ±
13.2 days versus 83.1 ± 7.5 days for the control). This
is not surprising as TAP and TSP compounds may have little blood-brain
barrier (BBB) permeability. Since these four porphyrins demonstrated
prophylactic activity after i.p. scrapie inoculation in a test
where infectant and compound can interact without crossing the
BBB, they were further tested against scrapie via i.c. injections
to bypass the BBB.
In one type of antiscrapie assay, the test compound and infected
brain homogenate are mixed prior to i.c. inoculation. Some compounds
in such tests have produced increased survival times, presumably
due to either direct inactivation of the infectant or the presence
of the compound in the brain at the time of infection (
5). As
FeTAP was the most effective prophylactic compound, FeTAP and
other metal TAPs were tested in this manner. The toxicity of
i.c.-administered TAP compounds varied greatly, and 50 µl
of 0.5 mM TAP, ZnTAP, CrTAP, InTAP, or CdTAP was not tolerated
(data not shown). The results from FeTAP and other tolerated
TSP and TAP compounds are shown in Table
2. A dilution series
of untreated infected brain homogenate was also included to
allow estimation of the apparent reduction in scrapie titer.
NiTAP and FeTAP, the most active compounds in this "inactivation"
test, produced survival times that correlated with a reduction
of between 3 and 4 logs of infectivity. When the metal was changed
to Cu(II), the activity was greatly reduced, indicating the
importance of the metal ion.
While this inactivation test can help rank compounds' abilities
to slow the effects of scrapie inocula, it does not measure
activity against late-stage TSE infection. To test therapeutic
potential, a number of the more effective TAP and TSP scrapie
inactivation compounds were dosed once a week for 5 weeks starting

2 weeks after i.c. scrapie inoculation (Table
3). Compounds
were injected i.c. to overcome suspected low BBB permeability.
PPS, which has antiscrapie activity when it is continuously
infused into an infected brain (
3), was injected directly to
the brain as a positive control (Table
3). Other than a small
but statistically significant increase in survival time with
FeTAP, only FeTSP was effective as a therapeutic treatment,
with activity comparable to that of a 10-fold-lower dose of
PPS. The reason that FeTAP was the most active prophylactic
compound but had little activity as a treatment after i.c. scrapie
inoculation is not known. FeTSP was then further tested using
six weekly i.c. doses of 50 µl of 0.5, 0.16, or 0.05 mM
FeTSP (25, 8, or 2.5 nanomoles/mouse) (Table
3). The average
survival time increased between the 8- and 25-nanomole doses
but changed little between the 8- and 2.5-nanomole doses. ZnTSP
and InTSP, injected at the same dose and frequency as that of
FeTSP, gave no benefit, further demonstrating the importance
of the central metal ion. It is also curious that NiTAP, which
was quite effective in the inactivation test, was ineffective
when dosed i.c. weekly starting 2 weeks after i.c. scrapie inoculation.
Thus, differences in the central metal may affect not only porphyrin
stereochemistries and reactivities but also, as shown here,
antiscrapie potential. Understanding the reason for the differences
in activity due to metal substitutions may be instructive in
designing therapies for TSEs.
Based on its antiscrapie activity in mice, PPS is currently
being infused into the brains of CJD patients as an experimental
treatment (first patient described in reference
12). As there
is no known effective CJD therapy, experimental treatment will
likely start as soon as a diagnosis is made and will continue
as long as possible. It is not known whether neurodegeneration
can be stopped or reversed, but an important first goal is to
slow disease progression. The discovery reported here that FeTSP
has activity similar to that of PPS suggests that the use of
cyclic tetrapyrroles as a CJD treatment is worth pursuing. With
that goal in mind, testing of FeTSP by continuous brain infusion
in mice to increase efficacy is ongoing. Until this brain infusion
test is completed, it is impossible to know just how effective
FeTSP treatment might be. Depending on these results and additional
toxicology testing, a more informed decision on human clinical
trials can be made. Finally, the demonstrated benefit of FeTSP
against i.c.-inoculated scrapie suggests that other cyclic tetrapyrroles
with even greater activity may yet be discovered.

ACKNOWLEDGMENTS
This work was funded in part by the Intramural Research Program
of the NIH, NIAID, U.S. Department of Defense prion interagency
transfer NP020114, and contract N01-AI-15435 from the Virology
Branch, NIAID, NIH.
We also thank Suzette A. Priola for helpful discussions and Biopharm Australia for a gift of pentosan polysulfate.

FOOTNOTES
* Corresponding author. Mailing address: Rocky Mountain Laboratories, 903 S. 4th Street, Hamilton, MT 59840. Phone: (406) 375-9692. Fax: (406) 363-9286. E-mail:
DKocisko{at}niaid.nih.gov.


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Antimicrobial Agents and Chemotherapy, February 2006, p. 759-761, Vol. 50, No. 2
0066-4804/06/$08.00+0 doi:10.1128/AAC.50.2.759-761.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.
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