Results from 2 randomized, double-blind, placebo-controlled studies of the novel NK1 receptor antagonist casopitant in patients with major depressive disorder

Are biological actions of neurokinin A in the adult brain mediated by a cross-talk between the NK1 and NK2 receptors?

Mice lacking the NK(1) receptor (NK(1)R-/- mice) and selective, high-affinity, non-peptide, NK(1), NK(2) and NK(3) receptor antagonists were used to identify the tachykinin receptor subtype(s) mediating the central responses induced by neurokinin A (NKA). The peptides, substance P (SP), NKA and senktide and the antagonists were injected intracerebroventricularly (ICV) through an implanted cannula. NKA (50 pmol) was as potent as SP (50 pmol) in inducing grooming behaviour (face washing and hind limb grooming) in wild-type mice, but both peptides failed to induce behavioural responses in NK(1)R-/- mice. In wild-type mice, the NK(1) receptor antagonist, RP 67580 (2 nmol), effectively inhibited grooming behaviour elicited by SP, but was inactive against grooming induced by NKA, which in turn was abolished after pre-treatment with the selective NK(2) receptor agonist, SR 48968 (2 nmol). Unlike NKA, the selective NK(2) receptor agonists, (β Ala(8)) NKA 4-10 and (NLeu(10)) NKA 4-10, injected ICV at doses of 50 or 100 pmol did not elicit any behavioural response in wild-type mice. The NK(3) receptor antagonist, SR 142801, inhibited behaviours induced by the NK(3) receptor agonist, senktide, but did not alter behavioural responses to either SP or NKA in wild-type mice. The present findings demonstrate that central biological actions of SP and senktide are mediated by activation of NK(1) and NK(3) receptors, respectively. Our results also indicate that NK(1) receptors are essential for generating central actions induced by NKA, which are most probably mediated by a cross-talk between the NK(1) and NK(2) receptors.

Neuropeptide receptor ligands as drugs for psychiatric diseases: the end of the beginning?

The search for novel drugs for treating psychiatric disorders is driven by the growing medical need to improve on the effectiveness and side-effect profile of currently available therapies. Given the wealth of preclinical data supporting the role of neuropeptides in modulating behaviour, pharmaceutical companies have been attempting to target neuropeptide receptors for over two decades. However, clinical studies with synthetic neuropeptide ligands have been unable to confirm the promise predicted by studies in animal models. Here, we analyse preclinical and clinical results for neuropeptide receptor ligands that have been studied in clinical trials for psychiatric diseases, including agents that target the receptors for tachykinins, corticotropin-releasing factor, vasopressin and neurotensin, and suggest new ways to exploit the full potential of these candidate drugs.