A predictive in vitro model of the impact of drugs with anticholinergic properties on human neuronal and astrocytic systems.

The link between off-target anticholinergic effects of medications and acute cognitive impairment in older adults requires urgent investigation. We aimed to determine whether a relevant in vitro model may aid the identification of anticholinergic responses to drugs and the prediction of anticholiner...

Full description

Saved in:
Bibliographic Details
Main Authors: Elizabeth K Woehrling, H Rheinallt Parri, Erin H Y Tse, Eric J Hill, Ian D Maidment, G Christopher Fox, Michael D Coleman
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2015-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0118786
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850212913557536768
author Elizabeth K Woehrling
H Rheinallt Parri
Erin H Y Tse
Eric J Hill
Ian D Maidment
G Christopher Fox
Michael D Coleman
author_facet Elizabeth K Woehrling
H Rheinallt Parri
Erin H Y Tse
Eric J Hill
Ian D Maidment
G Christopher Fox
Michael D Coleman
author_sort Elizabeth K Woehrling
collection DOAJ
description The link between off-target anticholinergic effects of medications and acute cognitive impairment in older adults requires urgent investigation. We aimed to determine whether a relevant in vitro model may aid the identification of anticholinergic responses to drugs and the prediction of anticholinergic risk during polypharmacy. In this preliminary study we employed a co-culture of human-derived neurons and astrocytes (NT2.N/A) derived from the NT2 cell line. NT2.N/A cells possess much of the functionality of mature neurons and astrocytes, key cholinergic phenotypic markers and muscarinic acetylcholine receptors (mAChRs). The cholinergic response of NT2 astrocytes to the mAChR agonist oxotremorine was examined using the fluorescent dye fluo-4 to quantitate increases in intracellular calcium [Ca2+]i. Inhibition of this response by drugs classified as severe (dicycloverine, amitriptyline), moderate (cyclobenzaprine) and possible (cimetidine) on the Anticholinergic Cognitive Burden (ACB) scale, was examined after exposure to individual and pairs of compounds. Individually, dicycloverine had the most significant effect regarding inhibition of the astrocytic cholinergic response to oxotremorine, followed by amitriptyline then cyclobenzaprine and cimetidine, in agreement with the ACB scale. In combination, dicycloverine with cyclobenzaprine had the most significant effect, followed by dicycloverine with amitriptyline. The order of potency of the drugs in combination frequently disagreed with predicted ACB scores derived from summation of the individual drug scores, suggesting current scales may underestimate the effect of polypharmacy. Overall, this NT2.N/A model may be appropriate for further investigation of adverse anticholinergic effects of multiple medications, in order to inform clinical choices of suitable drug use in the elderly.
format Article
id doaj-art-a47d81910e0140fc8e08062f8a172760
institution OA Journals
issn 1932-6203
language English
publishDate 2015-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj-art-a47d81910e0140fc8e08062f8a1727602025-08-20T02:09:14ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01103e011878610.1371/journal.pone.0118786A predictive in vitro model of the impact of drugs with anticholinergic properties on human neuronal and astrocytic systems.Elizabeth K WoehrlingH Rheinallt ParriErin H Y TseEric J HillIan D MaidmentG Christopher FoxMichael D ColemanThe link between off-target anticholinergic effects of medications and acute cognitive impairment in older adults requires urgent investigation. We aimed to determine whether a relevant in vitro model may aid the identification of anticholinergic responses to drugs and the prediction of anticholinergic risk during polypharmacy. In this preliminary study we employed a co-culture of human-derived neurons and astrocytes (NT2.N/A) derived from the NT2 cell line. NT2.N/A cells possess much of the functionality of mature neurons and astrocytes, key cholinergic phenotypic markers and muscarinic acetylcholine receptors (mAChRs). The cholinergic response of NT2 astrocytes to the mAChR agonist oxotremorine was examined using the fluorescent dye fluo-4 to quantitate increases in intracellular calcium [Ca2+]i. Inhibition of this response by drugs classified as severe (dicycloverine, amitriptyline), moderate (cyclobenzaprine) and possible (cimetidine) on the Anticholinergic Cognitive Burden (ACB) scale, was examined after exposure to individual and pairs of compounds. Individually, dicycloverine had the most significant effect regarding inhibition of the astrocytic cholinergic response to oxotremorine, followed by amitriptyline then cyclobenzaprine and cimetidine, in agreement with the ACB scale. In combination, dicycloverine with cyclobenzaprine had the most significant effect, followed by dicycloverine with amitriptyline. The order of potency of the drugs in combination frequently disagreed with predicted ACB scores derived from summation of the individual drug scores, suggesting current scales may underestimate the effect of polypharmacy. Overall, this NT2.N/A model may be appropriate for further investigation of adverse anticholinergic effects of multiple medications, in order to inform clinical choices of suitable drug use in the elderly.https://doi.org/10.1371/journal.pone.0118786
spellingShingle Elizabeth K Woehrling
H Rheinallt Parri
Erin H Y Tse
Eric J Hill
Ian D Maidment
G Christopher Fox
Michael D Coleman
A predictive in vitro model of the impact of drugs with anticholinergic properties on human neuronal and astrocytic systems.
PLoS ONE
title A predictive in vitro model of the impact of drugs with anticholinergic properties on human neuronal and astrocytic systems.
title_full A predictive in vitro model of the impact of drugs with anticholinergic properties on human neuronal and astrocytic systems.
title_fullStr A predictive in vitro model of the impact of drugs with anticholinergic properties on human neuronal and astrocytic systems.
title_full_unstemmed A predictive in vitro model of the impact of drugs with anticholinergic properties on human neuronal and astrocytic systems.
title_short A predictive in vitro model of the impact of drugs with anticholinergic properties on human neuronal and astrocytic systems.
title_sort predictive in vitro model of the impact of drugs with anticholinergic properties on human neuronal and astrocytic systems
url https://doi.org/10.1371/journal.pone.0118786
work_keys_str_mv AT elizabethkwoehrling apredictiveinvitromodeloftheimpactofdrugswithanticholinergicpropertiesonhumanneuronalandastrocyticsystems
AT hrheinalltparri apredictiveinvitromodeloftheimpactofdrugswithanticholinergicpropertiesonhumanneuronalandastrocyticsystems
AT erinhytse apredictiveinvitromodeloftheimpactofdrugswithanticholinergicpropertiesonhumanneuronalandastrocyticsystems
AT ericjhill apredictiveinvitromodeloftheimpactofdrugswithanticholinergicpropertiesonhumanneuronalandastrocyticsystems
AT iandmaidment apredictiveinvitromodeloftheimpactofdrugswithanticholinergicpropertiesonhumanneuronalandastrocyticsystems
AT gchristopherfox apredictiveinvitromodeloftheimpactofdrugswithanticholinergicpropertiesonhumanneuronalandastrocyticsystems
AT michaeldcoleman apredictiveinvitromodeloftheimpactofdrugswithanticholinergicpropertiesonhumanneuronalandastrocyticsystems
AT elizabethkwoehrling predictiveinvitromodeloftheimpactofdrugswithanticholinergicpropertiesonhumanneuronalandastrocyticsystems
AT hrheinalltparri predictiveinvitromodeloftheimpactofdrugswithanticholinergicpropertiesonhumanneuronalandastrocyticsystems
AT erinhytse predictiveinvitromodeloftheimpactofdrugswithanticholinergicpropertiesonhumanneuronalandastrocyticsystems
AT ericjhill predictiveinvitromodeloftheimpactofdrugswithanticholinergicpropertiesonhumanneuronalandastrocyticsystems
AT iandmaidment predictiveinvitromodeloftheimpactofdrugswithanticholinergicpropertiesonhumanneuronalandastrocyticsystems
AT gchristopherfox predictiveinvitromodeloftheimpactofdrugswithanticholinergicpropertiesonhumanneuronalandastrocyticsystems
AT michaeldcoleman predictiveinvitromodeloftheimpactofdrugswithanticholinergicpropertiesonhumanneuronalandastrocyticsystems