Protein kinase Cθ (PKCθ) is a member of a large family of serine/threonine kinases that are involved in diverse cellular functions. PKCθ has roles in T-cell activation and survival, where the dependency of T-cell responses on this enzyme appears to be dictated by both the nature of the antigen and by the inflammatory environment. Studies in PKCθ-deficient mice have demonstrated that although anti-viral responses are PKCθ-independent, T-cell responses associated with autoimmune diseases are PKCθ-dependent. PKCθ-deficient mice are either resistant to or show markedly reduced symptoms in models of MS (multiple sclerosis), IBD (inflammatory bowel disease), arthritis and asthma. Thus potent and selective inhibition of PKCθ has the potential to block T-cell-mediated autoimmunity without compromising anti-viral responses. The present review describes the design and optimization of potent and selective PKCθ inhibitors and their efficacy in both in vitro and in vivo studies. First, our compounds confirm the critical role for PKCθ in T-cell activation and proliferation and secondly they help to demonstrate that murine and human memory T-cell function continues to be dependent on this enzyme. In addition, these inhibitors demonstrate impressive efficacy in treating established autoimmune disease in murine models of IBD and MS.

PKCθ plays an important role in T cell biology and is a validated target for a number of disease states. A series of potent and selective PKCθ inhibitors were designed and synthesized starting from a HTS hit compound. Cell activity, while initially a challenge to achieve, was built into the series by transforming the nitrile unit of the scaffold into a primary amine, the latter predicted to form a new hydrogen bond to Asp508 near the entrance of the ATP binding site of PKCθ. Significant improvements in physiochemical parameters were observed on introduction of an oxetane group proximal to a primary amine leading to compound 22, which demonstrated a reduction of symptoms in a mouse model of multiple sclerosis.

Within the last few years, research into the cause and progression of Alzheimer's disease has made significant advances. Although there is still no preventative treatment or cure for this neurodegenerative illness, the development of drugs that may alleviate some of the cognitive symptoms associated with it is advancing. Cholinesterase inhibitors are at present the most effective form of treatment and have shown significant overall response rates in clinical trials. However, although some patients show substantial improvement when treated with this class of drugs, there is considerable variability in the amount of benefit gained in different individuals in terms of their cognitive and behavioural functioning. Furthermore, unfortunately some patients gain little or no benefit from these drugs. It would therefore be of great advantage to explore alternative therapeutic possibilities. This article reviews the potential involvement of the nicotinic cholinergic system in Alzheimer's disease and discusses the possibility of nicotinic pharmacotherapy. Substantial evidence indicates the involvement of the nicotinic cholinergic system in the pathology of Alzheimer's disease. Drugs targeting these sites may not only have a positive effect on cognitive function, but also have additional therapeutic benefits in terms of restoring the hypoactivity in the excitatory amino acid pyramidal system and even slowing the emergence of Alzheimer's disease pathology. The conclusion of this review is that nicotinic treatments are an important potential source of new therapeutic interventions in Alzheimer's disease.

The original reports of anti-myelin oligodendrocyte glycoprotein (MOG) antibodies describe a predominant association with acute disseminated encephalomyelitis in children and with neuromyelitis optica spectrum disease (NMOSD) in adults. More recent studies broaden the spectrum of associated disorders to include recurrent optic neuritis and a picture similar to CLIPPERS (chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids).We performed a retrospective case note review of the presentation, imaging, laboratory findings and response to treatment of a group of 12 patients, aged 3–55 years, with CNS demyelinating disease, who tested positive (out of 117 tests) at a single centre. Our series shows a frequent biphasic pattern of illness. In over 75% there was an acute, often multifocal and highly steroid responsive first phase. In over half this was followed by a second phase, typically single or recurrent episodes of optic neuritis. Adult patients appear more likely to develop limited forms of the disease such as isolated recurrent optic neuritis or monophasic forms, though with significantly adverse outcomes in some cases. This pattern of disease following a suggestive initial presentation may have important implications for guiding both when to test for anti-MOG antibody and decisions on further therapy.