PT  - JOURNAL ARTICLE
AU  - Michael Dietrich
AU  - Hans-Peter Hartung
AU  - Philipp Albrecht
TI  - Neuroprotective Properties of 4-Aminopyridine
AID  - 10.1212/NXI.0000000000000976
DP  - 2021 May 01
TA  - Neurology - Neuroimmunology Neuroinflammation
PG  - e976
VI  - 8
IP  - 3
4099  - http://nn.neurology.org/content/8/3/e976.short
4100  - http://nn.neurology.org/content/8/3/e976.full
SO  - Neurol Neuroimmunol Neuroinflamm2021 May 01; 8
AB  - As an antagonist of voltage-gated potassium (Kv) channels, 4-aminopyridine (4-AP) is used as symptomatic therapy in several neurologic disorders. The improvement of visual function and motor skills and relieve of fatigue in patients with MS have been attributed to 4-AP. Its prolonged release formulation (fampridine) has been approved for the symptomatic treatment of walking disability in MS. The beneficial effects were explained by the blockade of axonal Kv channels, thereby enhancing conduction along demyelinated axons. However, an increasing body of evidence suggests that 4-AP may have additional properties beyond the symptomatic mode of action. In this review, we summarize preclinical and clinical data on possible neuroprotective features of 4-AP.3,4-DAP=3,4-diaminopyridine; 4-AP=4-aminopyridine; BDNF=brain-derived neurotrophic factor; EAE=experimental autoimmune encephalomyelitis; EAEON=experimental optic neuritis; EMA=European Medicines Agency; Kv channel=voltage-gated potassium channel; MN=motor neuron; MOG=myelin oligodendrocyte glycoprotein; MSWS-12=12-Item Multiple Sclerosis Walking Scale; NFAT=nuclear factor of activated T-cells; OCT=optical coherence tomography; PGIC=Patient Global Impression of Change; SR-4-AP=sustained-release formulation of 4-AP; T25FW=Timed 25 Foot Walk Test; TUG=Timed Up and Go