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== Effects on ALS ==
 
== Effects on ALS ==
  
Dextromethorphan (DM) is a dextrorotary morphinan and a widely used component of cough medicine.  Relatively high doses of DM in combination with quinidine are used for the treatment of mood disorders for patients with multiple sclerosis (MS). However, at lower doses, morphinans exert anti-inflammatory activities through the inhibition of NOX2-dependent superoxide production in activated microglia. {{#pmid:21704706|chechneva2011}}
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Dextromethorphan (DM) is a dextrorotary morphinan and a widely used component of cough medicine.  Relatively high doses of DM in combination with quinidine are used for the treatment of mood disorders for patients with multiple sclerosis (MS). However, at lower doses, morphinans exert anti-inflammatory activities through the inhibition of NOX2-dependent superoxide production in activated microglia. [1]
  
 
Dextromethorphan is quickly metabolized and the resulting dextrorphan is unable to pass the blood brain barrier and enter the CNS. Adding the heart medicine quinidine 50 % of the weight of dextromethorphan will slow down the decay and significantly improve bioavailability. [source needed]
 
Dextromethorphan is quickly metabolized and the resulting dextrorphan is unable to pass the blood brain barrier and enter the CNS. Adding the heart medicine quinidine 50 % of the weight of dextromethorphan will slow down the decay and significantly improve bioavailability. [source needed]
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== References ==
 
== References ==
  
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[1]
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<bibtex>
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@article{Chechneva2011,
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abstract = {Dextromethorphan (DM) is a dextrorotary morphinan and a widely used component of cough medicine. Relatively high doses of DM in combination with quinidine are used for the treatment of mood disorders for patients with multiple sclerosis (MS). However, at lower doses, morphinans exert anti-inflammatory activities through the inhibition of NOX2-dependent superoxide production in activated microglia. Here we investigated the effects of high (10 mg/kg, i.p., "DM-10") and low (0.1 mg/kg, i.p., "DM-0.1") doses of DM on the development and progression of mouse experimental autoimmune encephalomyelitis (EAE), an animal model of MS. We found no protection by high dose DM treatment. Interestingly, a minor late attenuation by low dose DM treatment was seen in severe EAE that was characterized by a chronic disease course and a massive spinal cord infiltration of CD45(+) cells including T-lymphocytes, macrophages and neutrophils. Furthermore, in a less severe form of EAE, where lower levels of CD4(+) and CD8(+) T-cells, Iba1(+) microglia/macrophages and no significant infiltration of neutrophils were seen in the spinal cord, the treatment with DM-0.1 was remarkably more beneficial. The effect was the most significant at the peak of disease and was associated with an inhibition of NOX2 expression and a decrease in infiltration of monocytes and lymphocytes into the spinal cord. In addition, chronic treatment with low dose DM resulted in decreased demyelination and reduced axonal loss in the lumbar spinal cord. Our study is the first report to show that low dose DM is effective in treating EAE of moderate severity. Our findings reveal that low dose morphinan DM treatment may represent a new promising protective strategy for treating MS.},
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author = {Chechneva, Olga V and Mayrhofer, Florian and Daugherty, Daniel J and Pleasure, David E and Hong, Jau-Shyong and Deng, Wenbin},
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doi = {10.1016/j.nbd.2011.06.004},
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file = {:C$\backslash$:/Users/riku/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Chechneva et al. - 2011 - Low dose dextromethorphan attenuates moderate experimental autoimmune encephalomyelitis by inhibiting NOX2 and.pdf:pdf},
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issn = {1095-953X},
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journal = {Neurobiology of disease},
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keywords = {Animals,CD4 Lymphocyte Count,CD8-Positive T-Lymphocytes,CD8-Positive T-Lymphocytes: drug effects,Demyelinating Diseases,Demyelinating Diseases: pathology,Dextromethorphan,Dextromethorphan: administration \& dosage,Dextromethorphan: pharmacology,Dose-Response Relationship, Drug,Encephalomyelitis, Autoimmune, Experimental,Encephalomyelitis, Autoimmune, Experimental: drug ,Encephalomyelitis, Autoimmune, Experimental: enzym,Encephalomyelitis, Autoimmune, Experimental: patho,Excitatory Amino Acid Antagonists,Excitatory Amino Acid Antagonists: administration ,Excitatory Amino Acid Antagonists: pharmacology,Glycoproteins,Glycoproteins: biosynthesis,Immunohistochemistry,Lymphocyte Count,Macrophages,Macrophages: drug effects,Macrophages: immunology,Male,Membrane Glycoproteins,Membrane Glycoproteins: antagonists \& inhibitors,Mice,Mice, Inbred C57BL,Microglia,Microglia: drug effects,Myelin-Oligodendrocyte Glycoprotein,NADPH Oxidase,NADPH Oxidase: antagonists \& inhibitors,Neuroprotective Agents,Neutrophil Infiltration,Neutrophil Infiltration: drug effects,Peptide Fragments,Peptide Fragments: biosynthesis,RNA,RNA: biosynthesis,RNA: isolation \& purification,Reverse Transcriptase Polymerase Chain Reaction,Spinal Cord,Spinal Cord: drug effects,Spinal Cord: metabolism,Spinal Cord: pathology,Superoxides,Superoxides: metabolism,T-Lymphocytes,T-Lymphocytes: drug effects,T-Lymphocytes: immunology},
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mendeley-groups = {dextromethorphan},
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month = oct,
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number = {1},
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pages = {63--72},
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pmid = {21704706},
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title = {{Low dose dextromethorphan attenuates moderate experimental autoimmune encephalomyelitis by inhibiting NOX2 and reducing peripheral immune cells infiltration in the spinal cord.}},
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url = {http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3153572\&tool=pmcentrez\&rendertype=abstract},
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volume = {44},
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year = {2011}
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}
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</bibtex>
  
 
[[Category:Supplement data pages]]
 
[[Category:Supplement data pages]]

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