Neuroinflammation contributes to delayed secondary cell death following
traumatic brain injury (TBI), has the potential to chronically exacerbate the initial insult, and represents a therapeutic target that has largely failed to translate into human efficacy.
Thalidomide-like drugs have effectively mitigated
neuroinflammation across cellular and animal models of TBI and neurodegeneration but are complicated by adverse actions in humans. We hence developed N-adamantyl
phthalimidine (NAP) as a new
thalidomide-like drug to mitigate
inflammation without binding to cereblon, a key target associated with the antiproliferative, antiangiogenic, and teratogenic actions seen in this drug class. We utilized a phenotypic drug discovery approach that employed multiple cellular and animal models and ultimately examined immunohistochemical, biochemical, and behavioral measures following controlled cortical impact (CCI) TBI in mice. NAP mitigated LPS-induced
inflammation across cellular and rodent models and reduced oligomeric α-
synuclein and
amyloid-β mediated
inflammation. Following CCI TBI, NAP mitigated neuronal and synaptic loss,
neuroinflammation, and behavioral deficits, and is unencumbered by cereblon binding, a key
protein underpinning the teratogenic and adverse actions of
thalidomide-like drugs in humans. In summary, NAP represents a new class of
thalidomide-like drugs with anti-inflammatory actions for promising efficacy in the treatment of TBI and potentially longer-term
neurodegenerative disorders.