Here's the text.....
-----------------------------------------------------------------------------------------------------------------------------
1. Bioorg Med Chem Lett. 2014 Mar 15;24(6):1472-8. doi: 10.1016/j.bmcl.2014.02.008.
Epub 2014 Feb 14.
Evaluation of nicotine and cotinine analogs as potential neuroprotective agents
for Alzheimer's disease.
The currently available therapies for Alzheimer's disease (AD) and related forms
of dementia are limited by modest efficacy, adverse side effects, and the fact
that they do not prevent the relentless progression of the illness. The purpose
of the studies described here was to investigate the neuroprotective effects of
the nicotine metabolite cotinine as well as a small series of cotinine and
nicotine analogs (including stereoisomers) and to compare their effects to the
four clinically prescribed AD therapies.
2. J Mol Model. 2014 Mar;20(3):2109. doi: 10.1007/s00894-014-2109-8. Epub 2014 Feb
25.
Targeted studies on the interaction of nicotine and morin molecules with amyloid
β-protein.
Alzheimer's disease (AD) is a neurodegenerative disorder that occurs due to
progressive deposition of amyloid β-protein (Aβ) in the brain. Stable
conformations of solvated Aβ₁₋₄₂ protein were predicted by molecular dynamics
(MD) simulation using the OPLSAA force field. The seven residue peptide
(Lys-Leu-Val-Phe-Phe-Ala-Glu) Aβ₁₆₋₂₂ associated with AD was studied and reported
in this paper. Since effective therapeutic agents have not yet been studied in
detail, attention has focused on the use of natural products as effective
anti-aggregation compounds, targeting the Aβ₁₋₄₂ protein directly. Experimental
and theoretical investigation suggests that some compounds extracted from natural
products might be useful, but detailed insights into the mechanism by which they
might act remains elusive. The molecules nicotine and morin are found in
cigarettes and beverages. Here, we report the results of interaction studies of
these compounds at each hydrophobic residue of Aβ₁₆₋₂₂ peptide using the hybrid
ONIOM (B3LYP/6-31G**:UFF) method. It was found that interaction with nicotine
produced higher deformation in the Aβ₁₆₋₂₂ peptide than interaction with morin.
MD simulation studies revealed that interaction of the nicotine molecule with the
β-sheet of Aβ₁₆₋₂₂ peptide transforms the β-sheet to an α-helical structure,
which helps prohibit the aggregation of Aβ-protein.
3. Acta Neuropathol. 2014 Jan;127(1):53-69. doi: 10.1007/s00401-013-1210-x. Epub
2013 Nov 16.
Neuropathology of cigarette smoking.
Chang RC(1), Ho YS, Wong S, Gentleman SM, Ng HK.
It is well established that cigarette smoking is hazardous to health and is a
risk factor for many chronic diseases. However, its impact on the brain, whether
it be from prenatal exposure to maternal cigarette smoking, cerebrovascular
disease, Alzheimer's disease (AD) or Parkinson's disease, is still not very
clear. Neuroimaging and neuropathological investigations suggest that there are
heterogeneous effects of cigarette smoking on the brain. On the one hand, it is
quite clear that cigarette smoking causes damage to endothelial cells, resulting
in increased risk of cerebrovascular disease. On the other hand, it seems to be
associated with different Alzheimer's pathologies in post-mortem brains and
experimental models, despite the fact that epidemiological studies clearly
indicate a positive correlation between cigarette smoking and increased risk for
AD. Interestingly, cigarette smoking appears to be associated with reduced
Parkinson's pathology in post-mortem brains. However, although nicotine in
cigarettes may have some neuroprotective actions, the effects of all the other
toxic compounds in cigarettes cannot be ignored. It is, therefore, our aim to
summarize what is known about the neuropathology of cigarette smoking and, in
particular, its implications for neurodegenerative diseases.
4. Neuromolecular Med. 2013 Sep;15(3):549-69. doi: 10.1007/s12017-013-8242-1. Epub
2013 Jul 11.
Nicotine prevents synaptic impairment induced by amyloid-β oligomers through
α7-nicotinic acetylcholine receptor activation.
An emerging view on Alzheimer disease's (AD) pathogenesis considers amyloid-β
(Aβ) oligomers as a key factor in synaptic impairment and rodent spatial memory
decline. Alterations in the α7-nicotinic acetylcholine receptor (α7-nAChR) have
been implicated in AD pathology. Herein, we report that nicotine, an unselective
α7-nAChR agonist, protects from morphological and synaptic impairments induced by
Aβ oligomers. Interestingly, nicotine prevents both early postsynaptic impairment
and late presynaptic damage induced by Aβ oligomers through the
α7-nAChR/phosphatidylinositol-3-kinase (PI3K) signaling pathway. On the other
hand, a cross-talk between α7-nAChR and the Wnt/β-catenin signaling pathway was
revealed by the following facts: (1) nicotine stabilizes β-catenin, in a
concentration-dependent manner; (2) nicotine prevents Aβ-induced loss of
β-catenin through the α7-nAChR; and (3) activation of canonical Wnt/β-catenin
signaling induces α7-nAChR expression. Analysis of the α7-nAChR promoter
indicates that this receptor is a new Wnt target gene. Taken together, these
results demonstrate that nicotine prevents memory deficits and synaptic
impairment induced by Aβ oligomers. In addition, nicotine improves memory in
young APP/PS1 transgenic mice before extensive amyloid deposition and senile
plaque development, and also in old mice where senile plaques have already
formed. Activation of the α7-nAChR/PI3K signaling pathway and its cross-talk with
the Wnt signaling pathway might well be therapeutic targets for potential AD
treatments.
5. Ther Adv Chronic Dis. 2011 May;2(3):197-208. doi: 10.1177/2040622310397691.
Enhancement of nicotinic receptors alleviates cytotoxicity in neurological
disease models.
The common pathological mechanisms among the spectrum of neurodegenerative
diseases are supposed to be shared. Multiple lines of evidence, from molecular
and cellular to epidemiological, have implicated nicotinic transmission in the
pathology of the two most common neurodegenerative disorders, namely Alzheimer's
disease (AD) and Parkinson's disease (PD). In this review article we present
evidence of nicotinic acetylcholine receptor (nAChR)-mediated protection against
neurotoxicity induced by β amyloid (Aβ), glutamate, rotenone, and
6-hydroxydopamine (6-OHDA) and the signal transduction involved in this
mechanism. Our studies have clarified that survival signal transduction, the α7
nAChR/Src family/PI3K/AKT pathway and subsequent upregulation of Bcl-2 and Bcl-x,
would lead to neuroprotection. In addition to the PI3K/AKT pathway, two other
survival pathways, JAK2/STAT3 and MEK/ERK, are proposed by other groups. In
rotenone- and 6-OHDA-induced PD models, nAChR-mediated neuroprotection was also
observed, and the effect was blocked not only by α7 but also by α4β2 nAChR
antagonists. We also document that nAChR stimulation blocks glutamate
neurotoxicity in spinal cord motor neurons. These findings suggest that
nAChR-mediated neuroprotection is achieved through subtypes of nAChRs and common
signal cascades. An early diagnosis and protective therapy with nAChR stimulation
could be effective in delaying the progression of neurodegenerative diseases such
as AD, PD and amyotrophic lateral sclerosis.
6. Neurobiol Aging. 2011 May;32(5):834-44. doi:
10.1016/j.neurobiolaging.2009.04.015. Epub 2009 May 22.
Chronic nicotine restores normal Aβ levels and prevents short-term memory and
E-LTP impairment in Aβ rat model of Alzheimer's disease.
Alzheimer's disease (AD) is a devastating neurodegenerative disorder
characterized by increased deposition of beta-amyloid (Aβ) peptides and
progressive cholinergic dysfunction in regions of the brain involved in learning
and memory processing. In AD, progressive accumulation of Aβ peptide impairs
nicotinic acetylcholine receptor (nAChR) function by an unknown mechanism
believed to involve α(7)- and α(4)β(2)-nAChR blockade. The three approaches of
the current study evaluated the effects of chronic nicotine treatment in the
prevention of Aβ-induced impairment of learning and short-term memory. Rat AD
model was induced by 14-day i.c.v. osmotic pump infusion of a 1:1 mixture of 300
pmol/day Aβ(1-40)/Aβ(1-42) or Aβ(40-1) (inactive peptide, control). The effect of
nicotine (2 mg/(kg day)) on Aβ-induced spatial learning and memory impairments
was assessed by evaluation of performance in the radial arm water maze (RAWM), in
vivo electrophysiological recordings of early-phase long-term potentiation
(E-LTP) in urethane-anesthetized rats, and immunoblot analysis to determine
changes in the levels of beta-site amyloid precursor protein (APP)-cleaving
enzyme (BACE), Aβ and memory-related proteins. The results indicate that 6 weeks
of nicotine treatment reduced the levels of Aβ(1-40) and BACE1 peptides in
hippocampal area CA1 and prevented Aβ-induced impairment of learning and
short-term memory. Chronic nicotine also prevented the Aβ-induced inhibition of
basal synaptic transmission and LTP in hippocampal area CA1. Furthermore, chronic
nicotine treatment prevented the Aβ-induced reduction of α(7)- and α(4)-nAChR.
These effects of nicotine may be due, at least in part, to upregulation of brain
derived neurotropic factor (BDNF).
7. Front Biosci. 2008 Jan 1;13:492-504.
Neuroprotection via nAChRs: the role of nAChRs in neurodegenerative disorders
such as Alzheimer's and Parkinson's disease.
Epidemiological studies have identified a negative correlation between smoking
and the development of neurodegenerative disorders such as Parkinson's disease,
and in some studies, Alzheimer's disease. These findings have been attributed to
the ability of nicotine to act as a neuroprotective agent. A large number of
studies demonstrate that nicotine can protect against neuronal death in vitro and
in vivo, and the mechanisms underlying the ability of nicotine to protect against
excitotoxicity and amyloid-? toxicity are beginning to be elucidated. Despite the
compelling evidence that nicotine is neuroprotective, it is clear that nicotine
can be toxic under some circumstances. The balance between nicotine
neuroprotection and toxicity depends on dose, developmental stage and regimen of
administration. Therefore, a full understanding of the molecular and cellular
effects of nicotine on signaling pathways relevant to neuronal survival is
critical for informed drug discovery of nicotinic compounds to combat human
neurodegeneration. This review summarizes recent studies related to the
mechanisms underlying nicotine-mediated neuroprotection, and addresses issues
that are relevant to use of nicotine as a neuroprotective agent in vivo.
8. Psychopharmacology (Berl). 2006 Mar;184(3-4):523-39. Epub 2005 Oct 12.
Nicotinic effects on cognitive function: behavioral characterization,
pharmacological specification, and anatomic localization.
RATIONALE: Nicotine has been shown in a variety of studies in humans and
experimental animals to improve cognitive function. Nicotinic treatments are
being developed as therapeutic treatments for cognitive dysfunction.
OBJECTIVES: Critical for the development of nicotinic therapeutics is an
understanding of the neurobehavioral bases for nicotinic involvement in cognitive
function.
METHODS: Specific and diverse cognitive functions affected by nicotinic
treatments are reviewed, including attention, learning, and memory. The neural
substrates for these behavioral actions involve the identification of the
critical pharmacologic receptor targets, in particular brain locations, and how
those incipient targets integrate with broader neural systems involved with
cognitive function.
RESULTS: Nicotine and nicotinic agonists can improve working memory function,
learning, and attention. Both alpha4beta2 and alpha7 nicotinic receptors appear
to be critical for memory function. The hippocampus and the amygdala in
particular have been found to be important for memory, with decreased nicotinic
activity in these areas impairing memory. Nicotine and nicotinic analogs have
shown promise for inducing cognitive improvement. Positive therapeutic effects
have been seen in initial studies with a variety of cognitive dysfunctions,
including Alzheimer's disease, age-associated memory impairment, schizophrenia,
and attention deficit hyperactivity disorder.
CONCLUSIONS: Discovery of the behavioral, pharmacological, and anatomic
specificity of nicotinic effects on learning, memory, and attention not only aids
the understanding of nicotinic involvement in the basis of cognitive function,
but also helps in the development of novel nicotinic treatments for cognitive
dysfunction. Nicotinic treatments directed at specific receptor subtypes and
nicotinic cotreatments with drugs affecting interacting transmitter systems may
provide cognitive benefits most relevant to different syndromes of cognitive
impairment such as Alzheimer's disease, schizophrenia, and attention deficit
hyperactivity disorder. Further research is necessary in order to determine the
efficacy and safety of nicotinic treatments of these cognitive disorders.
9. Neuroscience. 2005;130(4):997-1012.
Repeated nicotine exposure in rats: effects on memory function, cholinergic
markers and nerve growth factor.
A decrease in the number of nicotinic-acetylcholine receptors (nAChRs) in the
brain is thought to contribute to the cognitive dysfunction associated with
diseases as diverse as Alzheimer's disease and schizophrenia. Interestingly,
nicotine and similar compounds have been shown to enhance memory function and
increase the expression of nAChRs and therefore, could have a therapeutic role in
the aforementioned diseases. Nicotine has also been shown to exert positive
effects on certain neurotrophins such as nerve growth factor (NGF), and therefore
could play a role beyond mere symptomatic therapy. However, to date,
comprehensive studies of nicotine's effects on the expression of specific
acetylcholine (ACh) receptor subtypes, key cholinergic proteins (that are
regulated by NGF) such as choline acetyltransferase (ChAT) and the vesicular ACh
transporter (VAChT) are lacking. Studies to further investigate the effects of
nicotine on NGF especially its high- and low-affinity receptors are also needed.
In the present study, male Wistar rats exposed a relatively low dosage of
nicotine (0.35 mg/kg every 12 h) for 14 days demonstrated improved memory
performance (assessed in two separate water maze testing methods) when compared
with controls. Autoradiographic experiments indicated that nicotine increased
[3H]-epibatidine, [125I]-alpha-bungarotoxin and [3H]-AFDX384, but not
[3H]-pirenzepine binding sites in several learning- and memory-related brain
areas. The expression of ChAT, VAChT, as well as tropomyosin-receptor kinase A
(TrkA) NGF receptors and phospho-TrK receptors was increased by nicotine in the
hippocampus. No changes were observed in the levels of the NGF peptide or low
affinity p75 neurotrophin receptors (p75NTR), however. These results suggest that
repeated exposure to nicotine results in positive effects on central cholinergic
markers and memory function, which may be mediated via effects on high-affinity
NGF receptors.
10. Brain Cogn. 2002 Jul;49(2):232-4.
Nicotine and sensory memory in Alzheimer's disease: an event-related potential
study.
The auditory mismatch negativity (MMN) event-related brain potential (ERP)
reflects the storage of information in acoustic sensory memory. Thirteen patients
with probable Alzheimer's disease (AD), 6 receiving treatment with the
cholinesterase inhibitor (ChEI) tacrine (..........aminoacridine, THA) and 7
receiving no treatment, were administered 2 mg of nicotine polacrilex and
placebo. MMNs were recorded with 1- and 3-s interstimulus intervals pre- and
postplacebo/nicotine administration. In nontreated patients, amplitudes were
decreased from pre- to postplacebo recordings but remained stable in THA-treated
patients. Comparison of pre- and postnicotine MMNs found amplitude increases with
nicotine in nontreated but not THA-treated patients. MMN latencies were shortened
by nicotine in both treatment groups. These exploratory findings suggest that
nicotine-improved strength of acoustic sensory memory traces and speed of
acoustic sensory discrimination in AD are differentially affected by chronic ChEI
treatment.
11. Curr Drug Targets CNS Neurol Disord. 2002 Aug;1(4):423-31.
Nicotinic treatment for cognitive dysfunction.
Nicotinic medications may provide beneficial therapeutic treatment for cognitive
dysfunction such as Alzheimer's disease, schizophrenia and attention deficit
hyperactivity disorder (ADHD). For development of nicotinic treatments we are
fortunate to have a well characterized lead compound, nicotine. Transdermal
nicotine patches offer a way to deliver measured doses of nicotine in a
considerably safer fashion than the more traditional means of administration,
tobacco smoking. We have found that transdermal nicotine significantly improves
attentional function in people with Alzheimer's disease, schizophrenia or ADHD as
well as normal nonsmoking adults. To follow-up on this proof of principal that
nicotinic treatment of cognitive dysfunction holds promise, it is important to
use animal models to determine the critical neurobehavioral bases for nicotinic
involvement in cognitive function so that more selective nicotinic analogues that
improve cognitive function with fewer side effects can be developed. We have
found with local infusion in rat studies that the hippocampus and amygdala are
important substrates for nicotinic effects on working memory function. Both
alpha7 and alpha4beta2 nicotinic receptors are involved in working memory.
Nicotinic interactions with dopaminergic and glutaminergic systems are also
important in the basis of cognitive function. Studies of the neural nicotinic
mechanisms underlying cognitive function are key for opening avenues for
development of safe and effective nicotinic treatments for cognitive dysfunction.
12. Biol Psychiatry. 2002 Nov 1;52(9):880-6.
Nicotine breaks down preformed Alzheimer's beta-amyloid fibrils in vitro.
BACKGROUND: Cerebral deposition of amyloid beta-peptide (Abeta) is a major
neuropathologic feature in Alzheimer's disease (AD). A consistent protective
effect of smoking on AD has been documented by many case-control studies. It has
been suggested that nicotine, a major component of cigarette smoke, protects
neurons against Abeta toxicity via the upregulation of nicotinic receptors, as
well as via the inhibition of beta-amyloid fibril (fAbeta) formation from Abeta.
METHODS: We used fluorescence spectroscopy with thioflavin T and electron
microscopy to examine the effects of nicotine, pyridine, and N-methylpyrrolidine
on the formation, extension, and disruption of fAbeta(1-40) and fAbeta(1-42) at
pH 7.5 at 37 degrees C in vitro.
RESULTS: Nicotine dose-dependently inhibited fAbeta(1-40) and fAbeta(1-42)
formation from fresh Abeta(1-40) and Abeta(1-42), respectively, as well as the
extension reaction of both fAbetas. Moreover, nicotine disrupted preformed
fAbeta(1-40) and fAbeta(1-42). These effects of nicotine were observed at
concentrations above 10 mmol/L and were similar to those of N-methylpyrrolidine.
CONCLUSIONS: The antiamyloidogenic effect of nicotine may be exerted not only by
the inhibition of fAbeta formation but also by the disruption of preformed
fAbeta. Additionally, this effect may be attributed to N-methylpyrrolidine
moieties of nicotine.
13. Aging Ment Health. 2002 May;6(2):129-38.
Nicotine's effect on neural and cognitive functioning in an aging population.
Tobacco is a dangerous and addictive drug being consumed by more than 13% of
Americans over the age of 65. Of the people in this cohort it has been estimated
that between 24% and 85% experience some form of age related cognitive decline
and 30-50% of the population will be diagnosed with Alzheimer's disease by the
age of 85. Recent advances in nicotine research have pointed to a number of
cognitive and neurological benefits that have been linked to the ingestion of
nicotine. These discoveries hold the potential of new drugs and therapies that
retain and improve upon nicotine's benefits while eliminating the negative impact
that both nicotine and tobacco possess. This article examines cognitive decline
in the elderly and looks at nicotine's potential role in ameliorating this
decline. In service to this, the neurological and cognitive actions of nicotine
are reviewed, as are theories on the neurological degeneration associated with
Alzheimer's disease (AD).
14. Eur J Pharmacol. 2000 Mar 30;393(1-3):141-6.
Development of nicotinic drug therapy for cognitive disorders.
Nicotine, as well as other nicotinic drugs, may provide useful therapeutic
treatment for a variety of cognitive impairments including those found in
Alzheimer's disease, schizophrenia and attention deficit hyperactivity disorder
(ADHD). We have found that nicotine skin patches significantly improve
attentional performance in people with these disease states as well as normal
nonsmoking adults. Animal models are critical for determining the neurobehavioral
bases for nicotinic effects on cognitive function. We have found in lesion and
local infusion studies with rats that the hippocampus is an important substrate
for nicotinic effects on working memory function. Both alpha7 and alpha4beta2
nicotinic receptors in the hippocampus are involved. Further work has
investigated the relationship of nicotinic systems with dopaminergic and
glutaminergic systems in the basis of cognitive function. Nicotine has proven to
be a useful prototypic compound for the family of nicotinic compounds. It
produces cognitive improvements in both animal models and clinical populations.
Recent work with more selective nicotinic receptor agonists and antagonists in
animal models is providing important information concerning the neural mechanisms
for nicotinic involvement in cognitive function and opening avenues for
development of safe and effective nicotinic treatments for clinical use.
15. Psychopharmacology (Berl). 1999 Apr;143(2):158-65.
Four-week nicotine skin patch treatment effects on cognitive performance in
Alzheimer's disease.
RATIONALE: Acute nicotine injections have been found to improve attentional
performance in patients with Alzheimer's disease (AD), but little is known about
chronic nicotine effects.
OBJECTIVE: The present study was undertaken to evaluate the clinical and
neuropsychological effects of chronic transdermal nicotine in Alzheimer's disease
subjects over a 4-week period.
METHODS: The double-blind, placebo controlled, cross-over study consisted of two
4-week periods separated by a 2-week washout period. Patients wore the nicotine
patch (Nicotrol) for 16 h a day at the following doses: 5 mg/day during week 1,
10 mg/day during weeks 2 and 3 and 5 mg/day during week 4. The eight subjects had
mild to moderate AD and were otherwise healthy.
RESULTS: Nicotine significantly improved attentional performance as measured by
the Conners' continuous performance test (CPT). There was a significant reduction
in errors of omission on the CPT which continued throughout the period of chronic
nicotine administration. The variability of hit reaction time (reaction time for
correct responses) on the CPT was also significantly reduced by chronic nicotine.
Nicotine did not improve performance on other tests measuring motor and memory
function.
CONCLUSIONS: The sustained improvement in attention found in this study with
nicotine dermal patches is encouraging. However, the lack of detected effects of
nicotine treatment on other cognitive and behavioral domains in this study leaves
questions concerning the clinical impact of nicotinic treatment in Alzheimer's
disease. The modest size of this study limited statistical power which may have
been needed to detect more subtle but clinically significant cognitive effects.
Higher doses of nicotine, other nicotinic ligands or combination treatment of
nicotine with other therapies may be efficacious for producing broader
therapeutic effects.
16. Biochemistry. 1996 Oct 22;35(42):13568-78.
Nicotine inhibits amyloid formation by the beta-peptide.
The 42-residues beta-(1-42) peptide is the major protein component of amyloid
plaque cores in Alzheimer's disease. In aqueous solution at physiological pH, the
synthetic beta-(1-42) peptide readily aggregates and precipitates as oligomeric
beta-sheet structures, a process that occurs during amyloid formation in
Alzheimer's disease. Using circular dichroism (CD) and ultraviolet spectroscopic
techniques, we show that nicotine, a major component in cigarette smoke, inhibits
amyloid formation by the beta-(1-42) peptide. The related compound cotinine, the
major metabolite of nicotine in humans, also slows down amyloid formation, but to
a lesser extent than nicotine. In contrast, control substances pyridine and
N-methylpyrrolidine accelerate the aggregation process. Nuclear magnetic
resonance (NMR) studies demonstrate that nicotine binds to the 1-28 peptide
region when folded in an alpha-helical conformation. On the basis of chemical
shift data, the binding primarily involves the N-CH3 and 5'CH2 pyrrolidine
moieties of nicotine and the histidine residues of the peptide. The binding is in
fast exchange, as shown by single averaged NMR peaks and the lack of nuclear
Overhauser enhancement data between nicotine and the peptide in two-dimensional
NOESY spectra. A mechanism is proposed, whereby nicotine ......s amyloidosis by
preventing an alpha-helix-->beta-sheet conformational transformation that is
important in the pathogenesis of Alzheimer's disease.
17. Br J Nurs. 1996 Oct 24-Nov 13;5(19):1195-202.
Does nicotine have beneficial effects in the treatment of certain diseases?
Although tobacco smoking has long been associated with diseases of the lungs and
cardiovascular system, numerous studies have demonstrated a negative association
between tobacco smoking and ulcerative colitis, and the neurodegenerative
diseases, Alzheimer's disease (AD) and Parkinson's disease (PD). The evidence
suggests that nicotine--the main pharmacologically active ingredient of
tobacco--appears to be responsible for this effect. Pure nicotine has no known
carcinogenic properties and can be administered in numerous ways including
transdermal patches and tablets. As a therapeutic agent, its association with
tobacco can be likened to morphine and opium smoking. There is ample clinical
evidence to suggest that nicotine could be beneficial in the treatment of some
patients with diseases. Pharmacologically, nicotine acts on cholinergic
(nicotinic-specific) receptors which are depleted in AD and PD. Nicotinic
receptors also interact closely with several neurotransmitters including
dopamine, which is implicated in both PD and Gilles de la Tourettes's syndrome.
There is no doubt that tobacco smoking can be harmful and no-one should be
encouraged to smoke. However, although nicotine has many harmful side-effects, it
may have therapeutic value or at the very least be a useful tool for future drug
development.
18. Pharmacol Ther. 1996;72(1):51-81.
Pharmacology of nicotine and its therapeutic use in smoking cessation and
neurodegenerative disorders.
During the last decade, nicotine has been used increasingly as an aid to smoking
cessation and has been found to be a safe and efficacious treatment for the
symptoms of nicotine withdrawal. This period has also seen significant advances
in our understanding of the mechanisms underlying the psychopharmacological
responses to nicotine, including, particularly, those that have been implicated
in nicotine addiction. This paper reviews this decade of progress in the specific
context of the therapeutic application of nicotine to the treatment of smoking
cessation. Other putative future applications, particularly in the treatment of
neurodegenerative disorders, are also reviewed.
19. Alzheimer Dis Assoc Disord. 1995;9 Suppl 2:43-9.
Alzheimer disease, attention, and the cholinergic system.
Recent neuropsychological studies suggest that, in addition to prominent mnemonic
dysfunction, attentional impairments are a core feature of Alzheimer disease
(AD). As is the case for memory, attention is not a unitary process, and only
certain components of attention are disrupted in mild AD, particularly sustained
and spatial attention. In this article we review evidence from both human and
nonhuman neuropsychopharmacology that leads us to suggest that (at least some of)
the attentional impairments seen in AD can be related to damage to the basal
forebrain cholinergic system (BFCS), in particular the nucleus basalis of Meynert
(nbM), which undergoes significant neuronal loss in AD. The BFCS provides the
major cholinergic innervation to the cortex and innervates brain regions such as
the thalamus, prefrontal cortex, and parietal lobes known to be involved in
attentional operations. In addition, studies conducted by our group suggest that
drugs acting to stimulate the cholinergic system, in particular tacrine and
nicotine, can significantly improve attentional function in patients with AD as
measured by improved performance on objective computerised cognitive tasks.
Furthermore, cholinergic drugs may also have some utility in other disorders with
attentional pathology, such as Parkinson's disease.
20. Neuroepidemiology. 1994;13(4):131-44.
Smoking and Alzheimer's disease: a review of the epidemiological evidence.
Overall evidence from 19 case-control studies of Alzheimer's disease (AD) and
smoking shows a highly significant (p < 0.001) negative association [ever/never
smokers, relative risk (RR) 0.64, 95% confidence interval (CI) 0.54-0.76]. Some
studies have apparent design faults but the association is clearly evident in
those which do not (RR 0.60, 95% CI 0.46-0.78). A report of a positive
relationship from a prospective study can be dismissed due to unreliability of AD
diagnosis on death certificates, and other study weaknesses. Although more data
are needed on dose response and to rule out possible confounding, the negative
association is consistent with other data suggesting nicotine protects against
AD.