Long-term sensitization to the behavioral effects of naltrexone is associated with regionally specific changes in the number of mu and delta opioid receptors in rat brain

Optimization binding studies of opioid receptors, saturation and competition, using [3H]-DAMGO

BACKGROUND

Opioid analgesics are prescribed for the moderate to severe pain in the clinic. New analogs of µ-opioid receptors are introduced because they may have less adverse effects and better efficacy. However, these new analogs have to be screened for their receptor affinity before entering clinical trial phases. A common method to do such screening is using radioligand-binding-assay, which is a fast and precise screening technique if the assays are done at an optimum condition. One of the main challenges in this type of screening is to separate free/unbound radioligands from bound radioligands. In this study, we applied a centrifugation method instead of a filtration method to separate free radioligands from bound radioligands, and also optimized the conditions for radioligand receptor binding studies of µ-opioid receptors, saturation, and the competition.

METHODS

We used the midbrain and brainstem of naltrexone-treated rats as a source of µ-opioid receptors, and [³H]-DAMGO as the radioligand. Naloxone was also used to determine non-specific binding. A given amount of membrane protein was incubated with an increasing amount of radioligand at 37 °C to saturate the receptors at equilibrium and the amount of radioligand saturated in the receptors were used in competition studies.

RESULTS

160 µg membrane protein saturated with 20 nM [³H]-DAMGO at 37 °C for 35 min with K_d (15.06 nM, 95% CI 8.117-22.00) and B_max (0.4750 pmol/mg, 95% CI 0.3839-0.5660).

CONCLUSION

Applying the centrifugation method instead of the filtration to separate free from bound radioligand produced repeatable and reliable results. The optimum conditions for radioligand binding were used in competition studies which resulted in the expected outcomes.

Mobile alcohol biosensors and pharmacotherapy development research

Recent advances in biosensor technology herald a major shift in the way alcohol use will be tracked in humans. Wearable biosensors can passively and continuously monitor wearers' alcohol consumption in real time. An important application of these biosensors is to improve the way medication for alcohol use disorder (AUD) is tested in clinical research. Both laboratory-based screening paradigms and clinical trials have methodological problems that impact their efficiency and predictive validity. Medication screening using laboratory-based methods is a resource-intensive assessment of a single episode of behavior in a non-representative setting. Clinical trials rely on participant self-report to document medication-induced changes in drinking behavior. This review describes how mobile biosensors can be leveraged to improve AUD medication development research. We first review the current state of alcohol biosensor technology with a focus on strengths and limitations of the devices. We describe how multiple biosensors can be combined to create a far more detailed record of drinking compared to single biosensor platforms. We then discuss each phase of the medication development pipeline in turn (i.e., phases 1-4) and describe how mobile biosensors can be incorporated in standard medication testing paradigms to improve efficiency and predictive validity. We conclude with discussion of challenges associated with using currently available biosensors for medication testing and recommendations for researchers wishing to incorporate alcohol biosensors into their own research.

Opposite effects of acute versus chronic naltrexone administration on ethanol-induced locomotion

Several studies have pointed out that the mu opioid receptor (MOR) can play a key role in some of the behavioural effects of ethanol. In the present study, the implication of the MOR in ethanol-induced locomotion in mice was assessed. First, the effects of the administration of different naltrexone doses (0.001-1.000 mg/kg) on the locomotor changes produced by ethanol (2.5 g/kg) were evaluated. In a second set of experiments, the ability of repeated naltrexone (6 mg/kg) administrations to modify the effects of ethanol was also assessed on mice locomotion. The results of the present study revealed that an acute naltrexone administration reduced dose-dependently ethanol-induced locomotion. Conversely, after repeated naltrexone injections, a transient boost of ethanol induced locomotor activity was observed. Thus, the results of the present study revealed that the effects of these naltrexone pretreatments on ethanol-induced locomotion are similar to the previously described changes on MOR activity. Moreover, the same (acute and chronic) naltrexone pretreatments produced similar changes on the locomotion of mice after a challenge with morphine (a MOR agonist), but not after tert-butanol (an alcohol which does not release beta-endorphins) administration. Therefore, our results are discussed in terms of the proved ability of ethanol to promote the release of beta-endorphins and, consequently, to activate the MOR.

Uncoupling of proopiomelanocortin (POMC) fragments is related to self-injury

Proopiomelanocortin (POMC) contains several interesting, behaviorally active peptides. Release patterns of these fragments have been related to bizarre episodes of self-injurious behavior (SIB) among autistic individuals. Moreover, elevation in beta-endorphin (betaE) but not ACTH levels was associated with a positive response to an acutely administered, centrally acting opioid blocker among autistic individuals exhibiting SIB. In the present study, POMC fragments were measured in 12 self-injurious patients before and after long term (3 month) treatment with an opiate blocker naltrexone (NTX). POMC fragments were sampled from blood collected at the beginning of the baseline and placebo-controlled treatment phases of the study. Results indicated that the co-release (coupling) of POMC fragments were stable over time and the profile of POMC fragments in plasma predicted the effectiveness of a CNS acting drug in autistic subjects who self-injure.

Regulation of opioid receptors by opioid antagonists: implications for rapid opioid detoxification

Opioid receptor antagonists have long been used in the diagnosis of opioid dependence and in the treatment of both opioid overdose and addiction. More recently they have been used in rapid opioid detoxification, a technique which has generated much ethical and scientific controversy. Because of this, the present review aims to integrate and summarize the current state of knowledge on adaptational changes to opioid systems as a result of antagonist administration. It is generally accepted that chronic treatment with an opioid antagonist results in opioid receptor upregulation. However, the mechanism(s) underlying this resultant opioid supersensitivity remain unresolved. In addition, there is not yet consensus regarding whether changes in opioid receptor number are directly responsible for the functional changes observed after chronic opioid antagonist treatment. Moreover, changes in opioid receptor number and sensitivity to opioid agonists and antagonists after chronic opioid antagonist treatment are dependent on dosing regimes as well as the kinetic properties of the antagonist itself. The role of these variables is appraised critically given the implication that an opioid antagonist can enhance functional responses. For example, such responses are an important consideration in the use of opioids because of possible adverse outcomes, such as overdose, after cessation of administration. Based on the literature discussed in this review it is concluded that caution is essential in the use of opioid antagonists for rapid opioid detoxification.

Ultra-rapid, antagonist-precipitated opiate detoxification under general anaesthesia or sedation

Ultra-rapid opiate withdrawal precipitated by naloxone or naltrexone during general anaesthesia or varying degrees of sedation, usually with the addition of α-2 adrenergic agonists, is an increasingly popular technique. As with anaesthesia or effective analgesia for dentistry or obstetrics, it can be justified on general humane principles. It also simplifies and speeds the transition to treatment programmes involving naltrexone. This paper reviews its development and the current range of techniques, including the use of octreotide to prevent diarrhoea. The prospect of avoiding or shortening the worst discomforts of withdrawal may encourage more opiate addicts to attempt detoxification and opiate-free management, including patients who have been successfully rehabilitated on long-term methadone maintenance treatment (MMT). Despite good motivation and preparation, a significant minority of MMT patients consistently fail to complete conventional withdrawal programmes because of increasing physical discomfort. It is emphasized that there is usually more to the treatment of opiate dependence than withdrawal.

Rapid opioid detoxification using opioid antagonists: history, theory and the state of the art

Rapid opioid detoxification is a technique for detoxifying patients addicted to narcotics which is increasing in popularity. This technique is potentially useful in getting some patients through the withdrawal phase of substance abuse therapy so that they may engage in further treatment earlier in the course of their disease. However, this procedure, which can and should be done safely, has in the past been pushed to limits which approach boundaries outside of the provider's area of expertise. This paper attempts to present a critical review of previous publications relating to rapid opioid detoxification to address these and other issues. There appears to be a pharmacologic basis for the efficacy of this treatment on a longer-term basis which centers around upregulation of opioid receptors induced by opioid antagonists. This paper also attempts to offer evidence in support of this theory.

Endogenous opiates: 1995

This article is the eighteenth installment of our annual review of research concerning the opiate system. It includes articles published during 1995 reporting the behavioral effects of the opiate peptides and antagonists, excluding the purely analgesic effects. The specific topics covered this year include stress: tolerance and dependence; eating; drinking; gastrointestinal, renal, and hepatic function; mental illness and mood; learning, memory, and reward; cardiovascular responses; respiration and thermoregulation; seizures and other neurological disorders; electrical-related activity; general activity and locomotion; sex, pregnancy, and development; immunological responses; and other behaviors.