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Structural evidence that alanine racemase from a D-cycloserine-producing microorganism exhibits resistance to its own product.

Alanine racemase (ALR), an enzyme that catalyzes the interconversion of Ala enantiomers, is essential for the synthesis of the bacterial cell wall. We have shown that it is harder to inhibit the catalytic activity of ALR from D-cycloserine (DCS)-producing Streptomyces lavendulae than that from Escherichia coli by DCS. To obtain structural evidence for the fact that Streptomyces ALR displays resistance to DCS, we determined the precise nature of the x-ray crystal structures of the cycloserine-free and cycloserine enantiomer-bound forms of Streptomyces ALR at high resolutions. Streptomyces ALR takes a dimer structure, which is formed by interactions between the N-terminal domain of one monomer with the C-terminal domain of its partner. Each of the two active sites of ALR, which is generated as a result of the formation of the dimer structure, is composed of pyridoxal 5'-phosphate (PLP), the PLP-binding residue Lys(38), and the amino acids in the immediate environment of the pyridoxal cofactor. The current model suggests that each active site of Streptomyces ALR maintains a larger space and takes a more rigid conformation than that of Bacillus stearothermophilus ALR determined previously. Furthermore, we show that Streptomyces ALR results in a slow conversion to a final form of a pyridoxal derivative arising from either isomer of cycloserine, which inhibits the catalytic activity noncompetitively. In fact, the slow conversion is confirmed by the fact that each enzyme bound cycloserine derivative, which is bound to PLP, takes an asymmetric structure.

Alanine Racemase↗

Cognitive and quantified electroencephalographic correlates of cycloserine treatment in Alzheimer's disease.

Cycloserine acts as a potent and selective modulator of the N-methyl-D- aspartate (NMDA) receptor-associated glycine recognition site, which may be a possible mechanism for this compound's positive effects on memory formation and retrieval processes in animals. Studies in normal human volunteers have shown that cycloserine can have significant positive effects on cognitive processing in the elderly and can ameliorate memory deficits induced by subcutaneously administered scopolamine. Based on this profile, a double-blind, placebo controlled, parallel group (three drug dosages) study was conducted as part of a larger study to assess the efficacy and safety, as well as the cognitive and central nervous system (CNS) impact, of 6 months of cycloserine treatment in patients (N = 40) with probable dementia of the Alzheimer type (DAT). The Cognitive Drug Research Computerize Assessment System (CDR System) served as the primary outcome measure of efficacy. CNS activity was assessed using quantified electroencephalography (QEEG). Safety measures included adverse effects documentation and analysis of blood chemistry/hematology. Cycloserine proved to be a safe agent in this population at the doses given but failed to show any statistically significant effects in the areas of cognition and global clinical ratings and did not indicate significant CNS activity on QEEG. These findings suggest that cycloserine has no measurable therapeutic effect on Alzheimer's disease at the doses given.

Aged↗

Phenotypic variability of the sensitivity to cycloserine of Klebsiella aerogenes NCTC 418, growing in chemostat culture.

The susceptibility of Klebsiella aerogenes to cycloserine varied according to the growth conditions. In batch culture, cells were less susceptible to the antibiotic when glycine was present in the medium, presumably due to competition between glycine and cycloserine for the uptake system by which glycine, D-alanine and cycloserine are transported into the cell. In the chemostat at average dilution rates, ammonia-limited cultures were more susceptible to the antibiotic than were glucose-limited cultures. Under phosphate-limiting conditions cultures were at least ten times less susceptible. Under ammonia and phosphate limitation the susceptibility increased with increasing growth rate. The sensitivity of glucose-limited cells was independent of the growth rate. A high-affinity uptake system for cycloserine (as measured by D-alanine transport) was present in ammonia- and glucose-limited cells, but not in phosphate-limited cells. Thus, the phenotypically defined alterations in the susceptibility of the bacterium to cycloserine could be correlated with variations in its uptake system for the antibiotic.

Alanine↗

Effect of L-cycloserine on brain GABA metabolism.

The administration of L-cycloserine to mice resulted in a dramatic decrease in the activities of 4-aminobutyrate:2-oxoglutarate aminotransferase (GABA-T) and L-alanine:2-oxoglutarate aminotransferase (ALA-T) in both brain and liver. L-Aspartate:2-oxoglutarate aminotransferase was inhibited only slightly, and brain glutamic acid decarboxylase not at all. Liver ALA-T activity returned to near normal levels within 24 h of L-cycloserine administration whereas liver GABA-T and brain ALA-T activities had returned only halfway to normal levels in the same time period. The recovery in the activity of brain GABA-T was even slower. A consequence of the inhibition of brain GABA-T activity was an elevation in the GABA content of the tissue which was maximal 3 h after L-cycloserine administration and which was still noticeable 8 h after the drug treatment. L-Cycloserine was also a potent in vitro inhibitor of brain GABA-T activity. The inhibition was competitive with respect to GABA, the Ki value being 3.1 X 10(-5) M. The prior administration of L-cycloserine to mice significantly delayed the onset of isonicotinic acid hydrazide induced convulsions.

4-Aminobutyrate Transaminase↗

Placebo-controlled trial of D-cycloserine added to conventional neuroleptics, olanzapine, or risperidone in schizophrenia.

OBJECTIVE: The authors investigated the clinical effects of D-cycloserine when added to treatment with conventional neuroleptics, olanzapine, or risperidone for treatment-resistant schizophrenia. METHOD: Twenty-four patients participated in a double-blind, placebo-controlled, 6-week crossover trial with D-cycloserine, 50 mg/day, added to their fixed dose of antipsychotic medication. Clinical ratings were performed every 2 weeks. RESULTS: D-Cycloserine treatment was well tolerated and resulted in a significant reduction in negative symptoms (mean=15%). The degree of improvement did not differ between patients treated with conventional neuroleptics and those treated with olanzapine or risperidone. CONCLUSIONS: These data support the efficacy of the addition of 50 mg/day of D-cycloserine to treatment with conventional neuroleptics and suggest that therapeutic benefits may also be attained when D-cycloserine is added to olanzapine or risperidone.

Adult↗

A pilot study of D-cycloserine in subjects with autistic disorder.

OBJECTIVE: The authors assessed the effects of D-cycloserine on the core symptom of social impairment in subjects with autism. METHOD: Following a 2-week, single-blind placebo lead-in phase, drug-free subjects with autistic disorder were administered three different doses of D-cycloserine during each of three 2-week periods. Measures used for subject ratings included the Clinical Global Impression (CGI) scale and Aberrant Behavior Checklist. RESULTS: Significant improvement was found on the CGI and social withdrawal subscale of the Aberrant Behavior Checklist. d-Cycloserine was well tolerated at most of the doses used in this study. CONCLUSIONS: In this pilot study, D-cycloserine treatment resulted in significant improvement in social withdrawal. Further controlled studies of D-cycloserine in autism appear warranted.

Adolescent↗

Pharmacokinetics of cycloserine under fasting conditions and with high-fat meal, orange juice, and antacids.

STUDY OBJECTIVES: To determine the effect of a high-fat meal, orange juice, and antacids on absorption of a single oral dose of cycloserine and to estimate its population pharmacokinetic parameters. DESIGN: Randomized, four-period, crossover study. SETTING: Clinical research center. PATIENTS: Twelve healthy volunteers. INTERVENTIONS: Subjects received single doses of cycloserine 500 mg after a 12-hour fast (reference), with a high-fat meal, with orange juice, and with antacids. They also received clofazimine 200 mg, ethionamide 500 mg, and p-aminosalicylic acid granules 6000 mg. MEASUREMENTS AND MAIN RESULTS: Plasma samples were collected for 48 hours and assayed by validated high-performance capillary electrophoresis assay. Concentration-time data were analyzed with noncompartmental, one-compartment, and population methods. The maximum concentration (Cmax) of cycloserine was decreased (p=0.02) by the high-fat meal. No other statistically significant differences were observed for Cmax and area under the curve from time zero to infinity across the four treatments. The high-fat meal significantly (p<0.0001) delayed time to maximum concentration by 4.7 times compared with that of the reference (1.1 hr). CONCLUSION: The pharmacokinetics of cycloserine were minimally affected by orange juice and antacids, whereas the high-fat meal delayed absorption. Administering cycloserine without a high-fat meal avoids potential alterations in the pattern of absorption.

Administration, Oral↗

The effect of beta-chloro D-alanine and L-cycloserine on the serine, phosphorus and palmitic acid uptake and metabolism of Tetrahymena lipids.

The serine palmitoyltransferase inhibitors beta-chloro-D-alanine and L-cycloserine resulted in the uptake and metabolism of 3H-serine, 3H-palmitic acid and 32P significant alterations in the unicellular Tetrahymena pyriformis GL as compared to the untreated cells. In contrast with the higher eukariotic cells, by these treatments - except 5 mM L-cycloserine - the ceramide formation were not inhibited in Tetrahymena. L-cycloserine inhibited the conversion of phosphatidylserine (PS) to phosphatidyl-ethanolamine (PE) by decarboxylation, and the conversion of PE to phosphatidylcoline (PC) by methylation. The shorter L-cycloserine treatments caused lower, and the longer treatments higher label in glycerophospholipids. beta-chloro-D-alanine resulted in the glycerophospholids higher lipid precursor incorporation both in the shorter and longer treatments. Presumably beta-chloro-D-alanine treatments inhibit the transaminase activity, and the higher concentration (5 and 10 mM) proved to be toxic for Tetrahymena. We found differences between the metabolism of serine and palmitic acid labeled lipids in the beta-chloro-D-alanine and L-cycloserine treated groups. This phenomenon is probably due to a difference in the uptake of phospholipid head group component serine and hydrophobic tail precursor palmitic acid: the incorporation of palmitic acid in Tetrahymena is extremely quick, on the other hand, the uptake of serine is slower, a clear time dependence was measured.

Acyltransferases↗

[Evaluation of cycloserine in the treatment of infections caused by nontuberculous mycobacteria viewed from in vitro experiments].

Evaluation of cycloserine as a drug in the treatment of infections caused by nontuberculous mycobacteria was made from in-vitro studies, in which Mycobacterium tuberculosis strains were used as the standard of the evaluation. The susceptibility testing to cycloserine was made using Ogawa egg medium. Bacterial suspensions, 10 mg wet weight/ml, prepared from 10 day-old cultures (M. tuberculosis, 14 day-old cultures) growing on Ogawa egg medium were used as the source of inoculation. A 0.02 ml-sample of the suspensions was inoculated onto Ogawa egg medium containing cycloserine or containing no drug, and the media inoculated were incubated at 37 degrees C. The minimal inhibitory concentration (MIC) was determined after incubation for 14 days (M. tuberculosis, for 21 days). The MIC was determined as the lowest concentration of the drug, on which the growth of test strains was completely inhibited. However, residual growth was sometimes observed. This was regarded as growth inhibition, because control medium containing no drug showed always abundant, membraneous growth. The results are shown in Fig.. The growth of M. tuberculosis strains was inhibited by the concentrations of 6.25 to 25 micrograms/ml. However, considering our previous observations on the relationship between the cycloserine resistance and the drug efficacy (reference 1), we regarded the MIC 12.5 micrograms/ml as critical concentration for presumable clinical efficacy. The ratios of strains of various mycobacterial species showing the MICs lower than the critical concentration are shown in Table. As seen in this table, clinical efficacy of cycloserine was expected in the treatment of infections caused by Mycobacterium kansasii, M. malmoense, M. simiae, M. scrofulaceum and M. marinum.(ABSTRACT TRUNCATED AT 250 WORDS)

Cycloserine↗

Pyruvate decarboxylating action of L-cycloserine. The significance of this in understanding its metabolic inhibitory action.

We present evidence which demonstrates that L-cycloserine, structural analog of L-alanine, which is known to be an effective aminotransferase inhibitor, is also a potent inhibitor of cellular pyruvate metabolism. This effect was found to be related to its almost instantaneous action in decreasing pyruvate concentrations in a dose-dependent manner. 1H nuclear magnetic resonance studies clearly demonstrate that the irreversible removal of pyruvate induced by L-cycloserine is caused by the decarboxylating action of the latter. Pyruvate disappearance induced by L-cycloserine can be stoichiometrically accounted for as acetate. The process does not involve any chemically detected transformation of L-cycloserine. These observations lead to two main considerations regarding the known action of L-cycloserine. First, its inhibitory effect on gluconeogenesis from lactate could be explained only on the basis of its ability to reduce pyruvate availability with no apparent need for transaminase inhibition. Second, its ability as a transaminase inhibitor should be reconsidered in view of its potent decarboxylating action on pyruvate and probably other oxoacids.

Animals↗

Inhibition of cerebroside synthesis in the brains of mice treated with L-cycloserine.

Subcutaneous injection of L-cycloserine resulted in a 28% reduction in cerebroside levels in mouse brain but had no effect on the levels of gangliosides. In contrast, intraperitoneal injection results in a reduction of ganglioside as well as cerebroside + sulfatide levels. The route of injection influenced the degree of 3-ketodihydrosphingosine synthase inhibition. Intraperitoneal injection caused a rapid decrease in synthase activity followed by recovery over 48 hr, whereas subcutaneous injection resulted in no inhibition over this time; only after daily injection for a week was synthase activity reduced 35%. One week following cessation of L-cycloserine administration, enzyme activity had recovered, whereas the cerebroside level continued to fall. All lipids and enzymes showed normal levels 3 weeks post-cycloserine administration. L-[3H]serine incorporation into glycolipids showed that cerebroside synthesis was most affected, whereas sulfatide synthesis was less affected. One week after cessation of cycloserine treatment, cerebroside synthesis was still severely inhibited, whereas sulfatide levels were near normal. Two weeks after cessation of L-cycloserine administration, synthesis of these glycolipids was similar to that of controls.

Animals↗

The effect of cycloserine on pyridoxine-dependent metabolism in tuberculosis.

Measurements were made of urinary tryptophan metabolites of 13 tuberculosis patients in order to reveal characteristics of pyridoxine-dependent metabolism before and during cycloserine treatment. The abnormally high level of xanthurenic acid excretion in untreated patients suggests a decreased availability of pyridoxal phosphate related to the disease process. Although plasma cycloserine levels were kept high once therapy began, xanthurenic acid excretion before and after tryptophan load became progressively more normal as symptoms diminished. This observation suggests that the convulsions which may sometimes accompany cycloserine administration are not due to a direct pyridoxine antagonism by the drug. Throughout the study, no significant changes in 5-hydroxyindoleacetic acid excretion were observed. Presumably, the metabolic pathway of serotonin is unaffected by tryptophan loading, cycloserine administration, or the apparent pyridoxine depletion associated with tuberculosis.

Cycloserine↗

The long-term administration of L-cycloserine to mice: specific reduction of cerebroside level.

Short-term experiments in which L-cycloserine, the inhibitor of 3-ketodihydrosphinogosine synthase, was injected subcutaneously in young mice have shown that cerebroside synthesis is inhibited specifically. Studies on the effect of long term L-cycloserine treatment on sphingolipid synthesis were performed to determine whether mice could tolerate continued cerebroside reduction and whether or not the synthesis of other sphingolipids would be inhibited. L-cycloserine, when injected at a low dose for a period of two months resulted in significantly reduced brain cerebroside level with little or no reduction in sulfatide, ganglioside, or sphingomyelin levels; liver and spleen glucocerebroside levels were also significantly reduced. The rate of cerebroside synthesis in brain was greatly reduced, whereas synthesis of sulfatides was much less affected by L-cycloserine indicating that a portion of newly synthesized galactocerebroside is shunted to synthesis of sulfatides.

Animals↗

Effect of L-cycloserine on cortical neurons in the rat.

L-Cycloserine but not D-cycloserine, depressed the firing of neurons in the sensorimotor cortex of the rat with a relatively slow time course when administered by microionophoresis or i.p. injection. The effects of GABA applied by microionophoresis or released synaptically were not modified by i.p. injections and microionophoretic administration of L-cycloserine. It is concluded that L-cycloserine depresses cell firing not by potentiation of the action of GABA but by elevating GABA-levels.

Animals↗

d-Cycloserine, a partial agonist at the glycine site, enhances the excitability of dentate granule cells in vivo in rats.

The present study investigated the dose-dependent effects of d-cycloserine, a partial agonist at the glycine modulatory site associated with the NMDA receptor complex, on the hippocampal field potentials of dentate granule cells in awake, freely moving rats. Five sequential field potentials were recorded from the dentate gyrus of the dorsal hippocampus, by stimulating the perforant path in the entorhinal cortex at 30-s intervals. The slope of the population excitatory postsynaptic potential (e.p.s.p.) and the amplitude of the population spike of these field potentials were analysed and averaged with a computer. The effects of d-cycloserine (1.0, 3.0, 9.0 mg/kg) were recorded 40 min and 24 h after the i.p. injection. Although the slope of the population e.p.s.p. showed no significant change after the administration of d-cycloserine, the high doses produced a substantial increase in the amplitude of the population spike. This increase was observed 40 min but not 24 h after the injection. These findings indicate that d-cycloserine does not change the synaptic input from the perforant path to the granule cells but dose dependently enhances the excitability of the hippocampal dentate granule cells. In addition, the data give further support to the suggestion that in the brain area where NMDA receptor density is relatively high, the glycine site of the NMDA receptor may not be fully saturated by endogenous glycine in normal in vivo conditions. This suggests that there is a possibility for pharmacological modulation of NMDA receptor-mediated synaptic events by exogenous glycine or glycine analogues.

Action Potentials↗

Functional magnetic resonance imaging studies of schizophrenic patients during word production: effects of D-cycloserine.

The objective of the present study was to examine patterns of cortical activation underlying D-cycloserine's therapeutic efficacy in schizophrenic patients using functional magnetic resonance imaging (fMRI). We measured frontal and temporal lobe activation following a word fluency task in 12 subjects meeting DSM-IV criteria for schizophrenia at baseline and after 8 weeks of supervised treatment, using a double-blind, placebo-controlled design. Half of the patients received D-cycloserine (n = 6) as a supplement to their conventional neuroleptic treatment while the other half (n = 6) was augmented with placebo. Patients receiving D-cycloserine, but not placebo, demonstrated a significant increase in temporal lobe activation. This increased activation was significantly associated with a reduction in negative symptoms. These results suggest that the addition of D-cycloserine to conventional neuroleptics may improve negative symptoms through enhanced temporal lobe function.

Antipsychotic Agents↗

A placebo-controlled crossover trial of D-cycloserine added to clozapine in patients with schizophrenia.

BACKGROUND: D-Cycloserine, a partial agonist at the glycine recognition site of the NMDA receptor, has previously been shown to improve negative symptoms when added to conventional antipsychotics and, in one preliminary dose-finding study, worsened negative symptoms when added to clozapine. METHODS: Seventeen schizophrenia outpatients treated with clozapine were assigned in random order to 6-week trials of D-cycloserine 50 mg/day and placebo in a crossover design separated by a 1 week placebo washout. RESULTS: Eleven patients competed the 13-week study. D-Cycloserine significantly worsened ratings of negative symptoms compared to placebo but did not significantly affect ratings of psychotic symptoms. CONCLUSIONS: The differing effects of D-cycloserine on negative symptoms when added to clozapine compared to conventional antipsychotics suggests that activation of the glycine recognition site may play a role in clozapine's efficacy for negative symptoms.

Adult↗

Antidepressant-like effects of 1-aminocyclopropanecarboxylic acid and D-cycloserine in an animal model of depression.

Antidepressant activity of partial agonists at strychnine-insensitive glycine receptors, 1-aminocyclopropanecarboxylic acid (ACPC) and D-cycloserine, was studied in a chronic mild stress model of depression. In this model, a substantial decrease in consumption of a palatable sucrose solution is observed over time in rats subjected to a variety of mild stressors. This decrement can be reversed by chronic administration of antidepressant drugs. Chronic (5 weeks) treatment with ACPC gradually reversed chronic mild stress-induced reductions in sucrose consumption, and the magnitude of this effect was comparable to that observed following similar administration of imipramine (10 mg/kg). The time-course for reversal of chronic mild stress-induced deficits in sucrose consumption by ACPC was dose-dependent. Thus, the first statistically significant effect of the low dose of ACPC (100 mg/kg) was observed after four weeks of treatment (comparable to the 3-5 weeks required for imipramine), while only two weeks of treatment was required in the group receiving a higher dose (200 mg/kg) of ACPC. Like imipramine, reversal of chronic mild stress-induced deficits in sucrose consumption by ACPC persisted for at least one week following cessation of treatment. The effects of chronic D-cycloserine were variable, and apparently not dose-related in the chronic mild stress model. D-cycloserine (10 mg/kg) increased sucrose intake in stressed animals, but the magnitude of this effect was smaller than in either imipramine or ACPC treated animals. Lower (2.5 mg/kg) and higher (40, 100 mg/kg) doses of D-cycloserine were ineffective. These results suggest that ACPC may have antidepressant properties comparable to conventional drugs, but with a faster onset of action.

Animals↗