Amelioration of visual deficits and visual system pathology after mild TBI via the cannabinoid Type-2 receptor inverse agonism of raloxifene

Marcia Honig, Nobel A. Del Mar, Desmond L. Henderson, Tyler D. Ragsdale, John B. Doty, Jake H. Driver, Chunyan Li, Andrew P. Fortugno, William M. Mitchell, Aaron M. Perry, Bob Moore, Anton Reiner

Research output: Contribution to journalArticle

Abstract

Visual deficits after traumatic brain injury (TBI) are common, but interventions that limit the post-trauma impairments have not been identified. We have found that treatment with the cannabinoid type-2 receptor (CB2) inverse agonist SMM-189 for 2 weeks after closed-head blast TBI greatly attenuates the visual deficits and retinal pathology this otherwise produces in mice, by modulating the deleterious role of microglia in the injury process after trauma. SMM-189, however, has not yet been approved for human use. Raloxifene is an FDA-approved estrogen receptor drug that is used to treat osteoporosis, but it was recently found to also show noteworthy CB2 inverse agonism. In the current studies, we found that a high pressure air blast in the absence of raloxifene treatment yields deficits in visual acuity and contrast sensitivity, reductions in the A-wave and B-wave of the scotopic electroretinogram (ERG), light aversion, and increased pupil constriction to light. Raloxifene delivered daily for two weeks after blast at 5–10 mg/kg mitigates or eliminates these abnormalities (with the higher dose generally more effective). This functional rescue with raloxifene is accompanied by a biasing of microglia from the harmful M1 to the helpful M2 state, and reductions in retinal, optic nerve, and oculomotor nucleus pathology. We also found that raloxifene treatment is still effective even when delayed until 48 h after TBI, and that raloxifene benefit appears attributable to its CB2 inverse agonism rather than its estrogenic actions. Our studies show raloxifene is effective in treating visual injury after brain and/or eye trauma, and they provide basis for phase-2 efficacy testing in human clinical trials.

Original languageEnglish (US)
Article number113063
JournalExperimental Neurology
Volume322
DOIs
StatePublished - Dec 1 2019

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Brain Concussion
Cannabinoids
Pathology
Wounds and Injuries
Microglia
Cannabinoid Receptor CB2
Air Pressure
Eye Injuries
Light
Contrast Sensitivity
Pupil
Optic Nerve
Raloxifene Hydrochloride
Constriction
Estrogen Receptors
Brain Injuries
Osteoporosis
Visual Acuity
Head
Clinical Trials

All Science Journal Classification (ASJC) codes

  • Neurology
  • Developmental Neuroscience

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Amelioration of visual deficits and visual system pathology after mild TBI via the cannabinoid Type-2 receptor inverse agonism of raloxifene. / Honig, Marcia; Del Mar, Nobel A.; Henderson, Desmond L.; Ragsdale, Tyler D.; Doty, John B.; Driver, Jake H.; Li, Chunyan; Fortugno, Andrew P.; Mitchell, William M.; Perry, Aaron M.; Moore, Bob; Reiner, Anton.

In: Experimental Neurology, Vol. 322, 113063, 01.12.2019.

Research output: Contribution to journalArticle

Honig, Marcia ; Del Mar, Nobel A. ; Henderson, Desmond L. ; Ragsdale, Tyler D. ; Doty, John B. ; Driver, Jake H. ; Li, Chunyan ; Fortugno, Andrew P. ; Mitchell, William M. ; Perry, Aaron M. ; Moore, Bob ; Reiner, Anton. / Amelioration of visual deficits and visual system pathology after mild TBI via the cannabinoid Type-2 receptor inverse agonism of raloxifene. In: Experimental Neurology. 2019 ; Vol. 322.
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