Diabetes drugs could be used to lower intracranial pressure

Repurposing existing GLP-1R agonists used to treat diabetes could be an alternative treatment option for reducing raised intracranial pressure, researchers find.

CT scan of brain suffering from hydrocephalus

There are few therapeutic options for reducing raised intracranial pressure (ICP), in conditions such as idiopathic intracranial hypertension or hydrocephalus.

In a study in Science Translational Medicine (23 August 2017), researchers explored whether glucagon-like peptide-1 receptor (GLP-1R) agonists, which are used to treat diabetes and promote weight loss and are known to modulate fluid balance in the kidney, are also able to modulate cerebrospinal fluid (CSF) secretion[1]
.

Using tissue samples and cell cultures, they showed that the GLP-1R is expressed in the human and rodent choroid plexus, where CSF is produced, and can be activated by administration of the GLP-1R agonist exendin-4. Exendin-4 also reduced activity of the Na+ K+ ATPase pump, a marker of CSF secretion. Furthermore, exendin-4 administration was able to significantly lower ICP in a rat model of hydrocephalus.

Repurposing existing GLP-1R agonists could provide potential alternative treatment options for lowering ICP and warrants clinical investigation, the researchers concluded.

References

[1] Botfield H, Uldall M, Westgate C et al. A glucagon-like peptide-1 receptor agonist reduces intracranial pressure in a rat model of hydrocephalus. Sci Trans Med 2017;9:eaan0972. doi: 10.1126/scitranslmed.aan0972

Last updated
Citation
Clinical Pharmacist, CP, October 2017, Vol 9, No 10;():DOI:10.1211/PJ.2017.20203591