Author(s):
With the strongest affinity for inhibiting Abelson (c-Abl) and Discoidal Domain Receptors (DDR1/2), nilotinib is a broad-based tyrosine kinase inhibitor. According to preclinical data, nilotinib lowers brain alpha-synuclein levels and lessens inflammation in Parkinson's Disease (PD) animals. As we previously demonstrated, nilotinib crosses the Blood-Brain Barrier (BBB) and may help patients with Parkinson's disease (PD) and Dementia with Lewy Bodies (DLB) achieve better clinical outcomes. With a cohort of 75 PD subjects, we conducted a physiologically based Population Pharmacokinetic/Pharmacodynamic (popPK/PD) study to ascertain the effects of nilotinib. Five groups (n=15) were randomly assigned (1:1:1:1:1) and each group was given an open-label Random Single Dose (RSD) of 150:200:300:400 mg of nilotinib instead of a placebo. After taking nilotinib, samples of plasma and Cerebrospinal Fluid (CSF) were taken 1,2,3 and 4 hours later. The findings indicate that nilotinib penetrates the brain in a manner that is independent of dose and that nilotinib at a dose of 200 mg raises the levels of Homovanillic Acid (HVA) and 3,4-Dihydroxyphenylacetic Acid (DOPAC), which may indicate changes in dopamine metabolism. Both the CSF oligomeric: total alpha-synuclein ratio and plasma total alpha-synuclein are markedly decreased by nilotinib. Moreover, nilotinib dramatically raises the CSF concentration of TREM-2 activating receptors on myeloid cells, indicating an anti-inflammatory impact. When combined, 200 mg of nilotinib seems to be the ideal single dosage for reducing inflammation and activating alpha-synuclein and dopamine metabolism, two surrogate disease indicators.
