It has been previously reported that galantamine exerts neuroprotective effects in rat cortical neurons exposed to β-amyloid (Kihara et al. 2004; Melo et al. 2009) or to glutamate (Takada et

al. 2003). Galantamine also halts in vivo apoptosis in ischemic rat brains (Lorrio et al. 2007). In this study, we have shown that galantamine Inhibitors,research,lifescience,medical was effective against NMDA-induced death in primary rat cortical neurons by a mechanism involving α7 and α4β2 nAChRs, in agreement with previously published results (Takada-Takatori et al. 2006). It is noteworthy that galantamine has been shown to selectively potentiate NMDA receptor activity (Moriguchi et al. 2004). Conversely, in a combined treatment with the two drugs, Inhibitors,research,lifescience,medical memantine was able to block tonic NMDA currents and Ca2+ influx promoted by galantamine, seemingly acting on the extrasynaptic NMDA channels, while synaptic NMDA

currents were spared (Zhao et al. 2006). Therefore, the combined treatment should prevent the extrasynaptic NMDA overexcitation while promoting synaptic Inhibitors,research,lifescience,medical glutamatergic signaling in patients. When we evaluated the effect of the memantine/galantamine combination against NMDA-induced neurotoxicity, we observed a substantial increase of potency with respect to each compound administered separately, suggesting a reciprocal potentiation. This effect was replicated when memantine was replaced with ifenprodil, a selective antagonist of Fulvestrant ic50 NR2B-containing NMDARs. The mechanism by which memantine (or ifenprodil) and galantamine potentiate each other’s efficacy in the NMDA-induced rat cortical neuronal death is yet to be elucidated. Our Inhibitors,research,lifescience,medical findings are consistent Inhibitors,research,lifescience,medical with the hypothesis that extrasynaptic

NMDA receptors (i.e., N2RB-enriched NMDA receptors) and nAChRs are the molecular targets for such a potentiation. Both receptors are likely to be present on the same cellular neurotoxic path, and both nAChRs activation (Akaike et al. 2010) and NR2B blockade (Liu et al. 2007) lead to the increase of phosphorylated Akt levels and prevention of neuronal death. This could therefore account for the fact that galantamine can turn off NMDA-mediated neurotoxicity and, most importantly, that the simultaneous administration of galantamine and an NMDAR antagonist Resveratrol can provide a significantly greater inhibition of the neurotoxic path, as compared with each single compound given separately. We hypothesize that galantamine and memantine can tackle neurotoxicity at two different levels within the same cascade. Despite the limitations of the present cell-based experiments, our findings could also help to elucidate the potentiation observed in AD patients treated with a combination of the two drugs (Grossberg et al. 2006).