Tuesday, September 10, 2024

Question about an older drug that is no longer marketed in the USA and which might help combat aging-related inflammation

 As we age, a lot of inflammation-related ailments start to occur. A promising pathway to target to combat aging-related ills is inhibition of IKKβ activity. 

Constitutive NF-κB activation is associated with cellular senescence and stem cell dysfunction and rare variants in NF-κB family members are enriched in centenarians. We recently identified a novel small molecule (SR12343) that inhibits IKK/NF-κB activation by disrupting the association between IKKβ and NEMO....Taken together, these results demonstrate that IKK/NF-κB signaling pathway represents a promising target for reducing markers of cellular senescence, extending healthspan and treating age-related diseases."

"Novel small molecule inhibition of IKK/NF-κB activation reduces markers of senescence and improves healthspan in mouse models of aging," 2021, online at https://onlinelibrary.wiley.com/doi/10.1111/acel.13486.

Also see "Inhibition of IKKβ/NF-κB signaling facilitates tendinopathy healing by rejuvenating inflamm-aging induced tendon-derived stem/progenitor cell senescence," 2022, online at https://www.cell.com/molecular-therapy-family/nucleic-acids/fulltext/S2162-2531(21)00329-2

One inhibitor of  IKKβ that has been recently shown to be anti-inflammation is thioridazine, which used to be marketed in the USA for schizophrenia. 

"Nuclear factor-kB (NF-kB) is a crucial transcription factor in the signal transduction cascade of the inflammatory signaling. Activation of NF-κB depends on the phosphorylation of IκBα by IκB kinase (IKKβ) followed by subsequent ubiquitination and degradation....A computer-aided drug identification protocol was followed to identify novel IKKβ inhibitors from a database of over 1500 Food and Drug Administration (FDA) drugs. The best scoring compounds were compared with the already known high-potency IKKβ inhibitors for their ability to bind and inhibit IKKβ by evaluating their docking energy. Finally, Thioridazinehydrochloride (TDZ), a potent antipsychotic drug against [s]chizophrenia was selected and its efficiency in inhibiting IκBα protein degradation and NF-κB activation was experimentally validated. Our study has demonstrated that TDZ blocks IκBα protein degradation and subsequent NF-κB activation to inhibit inflammation. Thus, it is a potential repurposed drug against inflammation."

"Repurposing Thioridazine (TDZ) as an anti-inflammatory agent," 2018, https://www.nature.com/articles/s41598-018-30763-5.

Since thioridazine used to be marketed in the USA, perhaps there is some data in this country or in a neighboring country that could be analyzed to see if the diseases that fall under the category of "inflamm-aging" (see "Inflammation and aging: signaling pathways and intervention therapies, 2023, online at  https://www.nature.com/articles/s41392-023-01502-8) were less common in people who were taking thioridazine. There must be some long-range studies that tracked medications and health outcomes during the years that thioridazine was being used the most--perhaps the Framingham Heart Study in the USA or the SEDAP (Social and Economic Dimensions of an Aging Population) in Canada.

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