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Banks WA. Viktor Mutt lecture: Peptides can cross the blood-brain barrier. Peptides 2023; 169:171079. [PMID: 37598757 DOI: 10.1016/j.peptides.2023.171079] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 08/22/2023]
Abstract
The field of peptides exploded in the 1970's and has continued to be a major area of discovery. Among the early discoveries was that peptides administered peripherally could affect brain functions. This led Kastin to propose that peptides could cross the blood-brain barrier (BBB). Although initially very controversial, Kastin, I, and others demonstrated not only that peptides can cross the BBB, but elucidated many fundamental characteristics of that passage. That work was in large part the basis of the 2022 Viktor Mutt Lectureship. Here, we review some of the early work with current updates on topics related to the penetration of peptides across the BBB. We briefly review mechanisms by which peripherally administered peptides can affect brain function without crossing the BBB, and then review the major mechanisms by which peptides and their analogs have been show to cross the BBB: transmembrane diffusion, saturable transport, and adsorptive transcytosis. Saturable transport systems are adaptable to physiologic changes and can be altered by disease states. In particular, the transport across the BBB of insulin and of pituitary adenylate cyclase activating polypeptide (PACAP) illustrate many of the concepts regarding peptide transport across the BBB.
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Affiliation(s)
- William A Banks
- Geriatric Research Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle 98108, WA, USA; Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA 98104, USA
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Ceccanti M, Blum K, Bowirrat A, Dennen CA, Braverman ER, Baron D, Mclaughlin T, Giordano J, Gupta A, Downs BW, Bagchi D, Barh D, Elman I, Thanos PK, Badgaiyan RD, Edwards D, Gold MS. Future Newborns with Opioid-Induced Neonatal Abstinence Syndrome (NAS) Could Be Assessed with the Genetic Addiction Risk Severity (GARS) Test and Potentially Treated Using Precision Amino-Acid Enkephalinase Inhibition Therapy (KB220) as a Frontline Modality Instead of Potent Opioids. J Pers Med 2022; 12:2015. [PMID: 36556236 PMCID: PMC9782293 DOI: 10.3390/jpm12122015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/14/2022] [Accepted: 11/25/2022] [Indexed: 12/12/2022] Open
Abstract
In this nonsystematic review and opinion, including articles primarily selected from PubMed, we examine the pharmacological and nonpharmacological treatments of neonatal abstinence syndrome (NAS) in order to craft a reasonable opinion to help forge a paradigm shift in the treatment and prevention of primarily opioid-induced NAS. Newborns of individuals who use illicit and licit substances during pregnancy are at risk for withdrawal, also known as NAS. In the US, the reported prevalence of NAS has increased from 4.0 per 1000 hospital births in 2010 to 7.3 per 1000 hospital births in 2017, which is an 82% increase. The management of NAS is varied and involves a combination of nonpharmacologic and pharmacologic therapy. The preferred first-line pharmacological treatment for NAS is opioid therapy, specifically morphine, and the goal is the short-term improvement in NAS symptomatology. Nonpharmacological therapies are individualized and typically focus on general care measures, the newborn-parent/caregiver relationship, the environment, and feeding. When used appropriately, nonpharmacologic therapies can help newborns with NAS avoid or reduce the amount of pharmacologic therapy required and the length of hospitalization. In addition, genetic polymorphisms of the catechol-o-methyltransferase (COMT) and mu-opioid receptor (OPRM1) genes appear to affect the length of stay and the need for pharmacotherapy in newborns with prenatal opioid exposure. Therefore, based on this extensive literature and additional research, this team of coauthors suggests that, in the future, in addition to the current nonpharmacological therapies, patients with opioid-induced NAS should undergo genetic assessment (i.e., the genetic addiction risk severity (GARS) test), which can subsequently be used to guide DNA-directed precision amino-acid enkephalinase inhibition (KB220) therapy as a frontline modality instead of potent opioids.
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Affiliation(s)
- Mauro Ceccanti
- Società Italiana per il Trattamento dell’Alcolismo e le sue Complicanze (SITAC), ASL Roma1, Sapienza University of Rome, 00185 Rome, Italy
| | - Kenneth Blum
- The Kenneth Blum Behavioral & Neurogenetic Institute, Austin, TX 78701, USA
- Division of Addiction Research & Education, Center for Mental Health & Sports, Exercise and Global Mental Health, Western University Health Sciences, Pomona, CA 91766, USA
- Institute of Psychology, ELTE Eötvös Loránd University, Egyetem tér 1-3, H-1053 Budapest, Hungary
- Department of Psychiatry, School of Medicine, University of Vermont, Burlington, VT 05405, USA
- Department of Psychiatry, Wright State University Boonshoft School of Medicine and Dayton VA Medical Centre, Dayton, OH 45324, USA
- Reward Deficiency Clinics of America, Austin, TX 78701, USA
- Center for Genomics and Applied Gene Technology, Institute of Integrative Omics and applied Biotechnology (IIOAB), Nonakuri, Purba Medinipur, West Bengal 721172, India
- Department of Precision Behavioral Management, Transplicegen Therapeutics, Inc., LLC., Austin, TX 78701, USA
- Department of Molecular Biology and Adelson School of Medicine, Ariel University, Ariel 40700, Israel
| | - Abdalla Bowirrat
- Department of Molecular Biology and Adelson School of Medicine, Ariel University, Ariel 40700, Israel
| | - Catherine A. Dennen
- Department of Family Medicine, Jefferson Health Northeast, Philadelphia, PA 19107, USA
| | - Eric R. Braverman
- The Kenneth Blum Behavioral & Neurogenetic Institute, Austin, TX 78701, USA
| | - David Baron
- Division of Addiction Research & Education, Center for Mental Health & Sports, Exercise and Global Mental Health, Western University Health Sciences, Pomona, CA 91766, USA
| | | | - John Giordano
- The Kenneth Blum Behavioral & Neurogenetic Institute, Austin, TX 78701, USA
- Ketamine Infusion Clinic of South Florida, Pompano Beach, FL 33062, USA
| | - Ashim Gupta
- Future Biologics, Lawrenceville, GA 30043, USA
| | - Bernard W. Downs
- The Kenneth Blum Behavioral & Neurogenetic Institute, Austin, TX 78701, USA
| | - Debasis Bagchi
- The Kenneth Blum Behavioral & Neurogenetic Institute, Austin, TX 78701, USA
- Department of Pharmaceutical Sciences, Southern University College of Pharmacy, Houston, TX 77004, USA
| | - Debmalya Barh
- Center for Genomics and Applied Gene Technology, Institute of Integrative Omics and applied Biotechnology (IIOAB), Nonakuri, Purba Medinipur, West Bengal 721172, India
- Department of Genetics, Ecology and Evolution, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Igor Elman
- Center for Pain and the Brain (PAIN Group), Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children’s Hospital, Harvard School of Medicine, Boston, MA 02115, USA
| | - Panayotis K. Thanos
- Behavioral Neuropharmacology and Neuroimaging Laboratory, Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA
| | - Rajendra D. Badgaiyan
- Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, Long School of Medicine, University of Texas Medical Center, San Antonio, TX 78229, USA
| | - Drew Edwards
- Neurogenesis Project, Jacksonville, FL 32223, USA
| | - Mark S. Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
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Blum K, Dennen CA, Elman I, Bowirrat A, Thanos PK, Badgaiyan RD, Downs BW, Bagchi D, Baron D, Braverman ER, Gupta A, Green R, McLaughlin T, Barh D, Gold MS. Should Reward Deficiency Syndrome (RDS) Be Considered an Umbrella Disorder for Mental Illness and Associated Genetic and Epigenetic Induced Dysregulation of Brain Reward Circuitry? J Pers Med 2022; 12:1719. [PMID: 36294858 PMCID: PMC9604605 DOI: 10.3390/jpm12101719] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/11/2022] [Accepted: 10/11/2022] [Indexed: 11/30/2022] Open
Abstract
Reward Deficiency Syndrome (RDS) is defined as a breakdown of reward neurotransmission that results in a wide range of addictive, compulsive, and impulsive behaviors. RDS is caused by a combination of environmental (epigenetic) influences and DNA-based (genetic) neurotransmission deficits that interfere with the normal satisfaction of human physiological drives (i.e., food, water, and sex). An essential feature of RDS is the lack of integration between perception, cognition, and emotions that occurs because of (1) significant dopaminergic surges in motivation, reward, and learning centers causing neuroplasticity in the striato-thalamic-frontal cortical loop; (2) hypo-functionality of the excitatory glutamatergic afferents from the amygdala-hippocampus complex. A large volume of literature regarding the known neurogenetic and psychological underpinnings of RDS has revealed a significant risk of dopaminergic gene polymorphic allele overlap between cohorts of depression and subsets of schizophrenia. The suggestion is that instead of alcohol, opioids, gambling disorders, etc. being endophenotypes, the true phenotype is RDS. Additionally, reward deficiency can result from depleted or hereditary hypodopaminergia, which can manifest as a variety of personality traits and mental/medical disorders that have been linked to genetic studies with dopamine-depleting alleles. The carrying of known DNA antecedents, including epigenetic insults, results in a life-long vulnerability to RDS conditions and addictive behaviors. Epigenetic repair of hypodopaminergia, the causative basis of addictive behaviors, may involve precision DNA-guided therapy achieved by combining the Genetic Addiction Risk Severity (GARS) test with a researched neutraceutical having a number of variant names, including KB220Z. This nutraceutical formulation with pro-dopamine regulatory capabilities has been studied and published in peer-reviewed journals, mostly from our laboratory. Finally, it is our opinion that RDS should be given an ICD code and deserves to be included in the DSM-VI because while the DSM features symptomology, it is equally important to feature etiological roots as portrayed in the RDS model.
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Affiliation(s)
- Kenneth Blum
- The Kenneth Blum Behavioral & Neurogenetic Institute, LLC., Austin, TX 78701, USA
- Center for Behavioral Health & Sports, Exercise, Psychiatry, Western University Health Sciences, Pomona, CA 91766, USA
- Institute of Psychology, ELTE Eötvös Loránd University, Kazinczy u. 23–27, 1075 Budapest, Hungary
- Department of Molecular Biology and Adelson School of Medicine, Ariel University, Ariel 40700, Israel
| | - Catherine A. Dennen
- The Kenneth Blum Behavioral & Neurogenetic Institute, LLC., Austin, TX 78701, USA
- Department of Family Medicine, Jefferson Health Northeast, Philadelphia, PA 19140, USA
| | - Igor Elman
- Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
- Cambridge Health Alliance, Harvard Medical School, Cambridge, MA 02139, USA
| | - Abdalla Bowirrat
- Department of Molecular Biology and Adelson School of Medicine, Ariel University, Ariel 40700, Israel
| | - Panayotis K. Thanos
- Behavioral Neuropharmacology and Neuroimaging Laboratory, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, Clinical Research Institute on Addictions, University at Buffalo, Buffalo, NY 14203, USA
- Department of Psychology, University at Buffalo, Buffalo, NY 14260, USA
| | - Rajendra D. Badgaiyan
- Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, Long School of Medicine, University of Texas Medical Center, San Antonio, TX 78229, USA
| | - B. William Downs
- Division of Precision Nutrition, Victory Nutrition International, LLC., Lederoch, PA 19438, USA
| | - Debasis Bagchi
- Division of Precision Nutrition, Victory Nutrition International, LLC., Lederoch, PA 19438, USA
- Department of Pharmaceutical Science, College of Pharmacy & Health Sciences, Texas Southern University, Houston, TX 77004, USA
| | - David Baron
- Center for Behavioral Health & Sports, Exercise, Psychiatry, Western University Health Sciences, Pomona, CA 91766, USA
| | - Eric R. Braverman
- The Kenneth Blum Behavioral & Neurogenetic Institute, LLC., Austin, TX 78701, USA
| | - Ashim Gupta
- Future Biologics, Lawrenceville, GA 30043, USA
| | - Richard Green
- The Kenneth Blum Behavioral & Neurogenetic Institute, LLC., Austin, TX 78701, USA
| | - Thomas McLaughlin
- The Kenneth Blum Behavioral & Neurogenetic Institute, LLC., Austin, TX 78701, USA
| | - Debmalya Barh
- Centre for Genomics and Applied Gene Technology, Institute of Integrative Omics and Applied Biotechnology, Nonakuri, Purba Medinipur 721172, India
| | - Mark S. Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
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Madigan MA, Gupta A, Bowirrat A, Baron D, Badgaiyan RD, Elman I, Dennen CA, Braverman ER, Gold MS, Blum K. Precision Behavioral Management (PBM) and Cognitive Control as a Potential Therapeutic and Prophylactic Modality for Reward Deficiency Syndrome (RDS): Is There Enough Evidence? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116395. [PMID: 35681980 PMCID: PMC9180535 DOI: 10.3390/ijerph19116395] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 12/20/2022]
Abstract
This brief commentary aims to provide an overview of the available and relatively new precision management of reward deficiencies manifested as substance and behavioral disorders. Current and future advances, concepts, and the substantial evidential basis of this potential therapeutic and prophylactic treatment modality are presented. Precision Behavioral Management (PBM), conceptualized initially as Precision Addiction Management (PAM), certainly deserves consideration as an important modality for the treatment of impaired cognitive control in reward processing as manifested in people with neurobiologically expressed Reward Deficiency Syndrome (RDS).
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Affiliation(s)
- Margaret A. Madigan
- The Kenneth Blum Behavioral & Neurogenetic Institute, LLC., Austin, TX 78701, USA; (M.A.M.); (C.A.D.); (E.R.B.)
| | - Ashim Gupta
- Future Biologics, Lawrenceville, GA 30043, USA;
| | - Abdalla Bowirrat
- Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel 40700, Israel;
| | - David Baron
- Center for Psychiatry, Medicine, & Primary Care (Office of Provost), Division of Addiction Research & Education, Western University Health Sciences, Pomona, CA 91766, USA;
| | - Rajendra D. Badgaiyan
- Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, Long School of Medicine, University of Texas Medical Center, San Antonio, TX 78229, USA;
| | - Igor Elman
- Center for Pain and the Brain (P.A.I.N Group), Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA;
| | - Catherine A. Dennen
- The Kenneth Blum Behavioral & Neurogenetic Institute, LLC., Austin, TX 78701, USA; (M.A.M.); (C.A.D.); (E.R.B.)
| | - Eric R. Braverman
- The Kenneth Blum Behavioral & Neurogenetic Institute, LLC., Austin, TX 78701, USA; (M.A.M.); (C.A.D.); (E.R.B.)
| | - Mark S. Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA;
| | - Kenneth Blum
- The Kenneth Blum Behavioral & Neurogenetic Institute, LLC., Austin, TX 78701, USA; (M.A.M.); (C.A.D.); (E.R.B.)
- Center for Psychiatry, Medicine, & Primary Care (Office of Provost), Division of Addiction Research & Education, Western University Health Sciences, Pomona, CA 91766, USA;
- Institute of Psychology, ELTE Eötvös Loránd University, Egyetem tér 1-3, 1053 Budapest, Hungary
- Department of Psychiatry, School of Medicine, University of Vermont, Burlington, VT 05405, USA
- Department of Psychiatry, Wright State University Boonshoft School of Medicine, Dayton VA Medical Centre, Dayton, OH 45324, USA
- Correspondence:
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Blum K, Steinberg B, Gondre-Lewis MC, Baron D, Modestino EJ, Badgaiyan RD, Downs BW, Bagchi D, Brewer R, McLaughlin T, Bowirrat A, Gold M. A Review of DNA Risk Alleles to Determine Epigenetic Repair of mRNA Expression to Prove Therapeutic Effectiveness in Reward Deficiency Syndrome (RDS): Embracing "Precision Behavioral Management". Psychol Res Behav Manag 2021; 14:2115-2134. [PMID: 34949945 PMCID: PMC8691196 DOI: 10.2147/prbm.s292958] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 11/22/2021] [Indexed: 11/23/2022] Open
Abstract
This is a review of research on "Precision Behavioral Management" of substance use disorder (SUD). America is experiencing a high prevalence of substance use disorder, primarily involving legal and illegal opioid use. A 3000% increase in treatment for substance abuse has occurred between 2000 and 2016. Unfortunately, present day treatment of opioid abuse involves providing replacement therapy with powerful opioids to, at best, induce harm reduction, not prophylaxis. These interventions do not enhance gene expression and restore the balance of the brain reward system's neurotransmitters. We are proposing a generalized approach called "Precision Behavioral Management". This approach includes 1) using the Genetic Addiction Risk Severity (GARS, a 10 candidate polymorphic gene panel shown to predict ASI-alcohol and drug severity) to assess early pre-disposition to substance use disorder; 2) using a validated reward deficiency syndrome (RDS) questionnaire; 3) utilization of the Comprehensive Analysis of Reported Drugs (CARD™) to assess treatment compliance and abstinence from illicit drugs during treatment, and, importantly; 4) utilization of a "Pro-dopamine regulator (KB220)" (via IV or oral [KB220Z] delivery systems) to optimize gene expression, restore the balance of the Brain Reward Cascade's neurotransmitter systems and prevent relapse by induction of dopamine homeostasis, and; 5) utilization of targeted DNA polymorphic reward genes to direct mRNA genetic expression profiling during the treatment process. Incorporation of these events can be applied to not only the under-considered African-American RDS community, but all victims of RDS, as a demonstration of a paradigm shift that uniquely provides a novel putative "standard of care" based on DNA guided precision nutrition therapy to induce "dopamine homeostasis" and rebalance neurotransmitters in the Brain Reward Cascade. We are also developing a Reward Deficiency Syndrome Diagnostic Criteria (RDSDC) to assist in potential tertiary treatment.
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Affiliation(s)
- Kenneth Blum
- Center for Psychiatry, Medicine & Primary Care, Division of Addiction Research & Education, Graduate College, Western University Health Sciences, Pomona, CA, USA
- Eötvös Loránd University, Institute of Psychology, Budapest, Hungary
- Department of Psychiatry, Wright State University Boonshoft School of Medicine and Dayton VA Medical Center, Dayton, OH (IE), USA
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
- Division of Nutrigenomics, The Kenneth Blum Behavioral & Neurogenetic Institute, Austin, TX, USA
| | | | - Marjorie C Gondre-Lewis
- Developmental Neuropsychopharmacology Laboratory, Department of Anatomy, Howard University College of Medicine, Washington, DC, USA
| | - David Baron
- Center for Psychiatry, Medicine & Primary Care, Division of Addiction Research & Education, Graduate College, Western University Health Sciences, Pomona, CA, USA
| | | | - Rajendra D Badgaiyan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, San Antonio, TX, USA
- Long School of Medicine, University of Texas Medical Center, San Antonio, TX, USA
| | - B William Downs
- Division of Nutrigenomics, Victory Nutrition International, Inc., Harleysville, PA, USA
| | - Debasis Bagchi
- Division of Nutrigenomics, Victory Nutrition International, Inc., Harleysville, PA, USA
| | - Raymond Brewer
- Division of Nutrigenomics, The Kenneth Blum Behavioral & Neurogenetic Institute, Austin, TX, USA
| | - Thomas McLaughlin
- Department of Psychopharmacology, Center for Psychiatric Medicine, Lawrence, MA, USA
| | - Abdalla Bowirrat
- Adelson School of Medicine & Department of Molecular Biology, Ariel University, Ariel, Israel
| | - Mark Gold
- Department of Psychiatry, Washington University, School of Medicine, St. Louis, MO, USA
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Reward Deficiency Syndrome (RDS): A Cytoarchitectural Common Neurobiological Trait of All Addictions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111529. [PMID: 34770047 PMCID: PMC8582845 DOI: 10.3390/ijerph182111529] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 02/07/2023]
Abstract
Alcohol and other substance use disorders share comorbidity with other RDS disorders, i.e., a reduction in dopamine signaling within the reward pathway. RDS is a term that connects addictive, obsessive, compulsive, and impulsive behavioral disorders. An estimated 2 million individuals in the United States have opioid use disorder related to prescription opioids. It is estimated that the overall cost of the illegal and legally prescribed opioid crisis exceeds one trillion dollars. Opioid Replacement Therapy is the most common treatment for addictions and other RDS disorders. Even after repeated relapses, patients are repeatedly prescribed the same opioid replacement treatments. A recent JAMA report indicates that non-opioid treatments fare better than chronic opioid treatments. Research demonstrates that over 50 percent of all suicides are related to alcohol or other drug use. In addition to effective fellowship programs and spirituality acceptance, nutrigenomic therapies (e.g., KB220Z) optimize gene expression, rebalance neurotransmitters, and restore neurotransmitter functional connectivity. KB220Z was shown to increase functional connectivity across specific brain regions involved in dopaminergic function. KB220/Z significantly reduces RDS behavioral disorders and relapse in human DUI offenders. Taking a Genetic Addiction Risk Severity (GARS) test combined with a the KB220Z semi-customized nutrigenomic supplement effectively restores dopamine homeostasis (WC 199).
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Blum K, Khalsa J, Cadet JL, Baron D, Bowirrat A, Boyett B, Lott L, Brewer R, Gondré-Lewis M, Bunt G, Kazmi S, Gold MS. Cannabis-Induced Hypodopaminergic Anhedonia and Cognitive Decline in Humans: Embracing Putative Induction of Dopamine Homeostasis. Front Psychiatry 2021; 12:623403. [PMID: 33868044 PMCID: PMC8044913 DOI: 10.3389/fpsyt.2021.623403] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/05/2021] [Indexed: 02/01/2023] Open
Abstract
Over years, the regular use of cannabis has substantially increased among young adults, as indicated by the rise in cannabis use disorder (CUD), with an estimated prevalence of 8. 3% in the United States. Research shows that exposure to cannabis is associated with hypodopaminergic anhedonia (depression), cognitive decline, poor memory, inattention, impaired learning performance, reduced dopamine brain response-associated emotionality, and increased addiction severity in young adults. The addiction medicine community is increasing concern because of the high content of delta-9-tetrahydrocannabinol (THC) currently found in oral and vaping cannabis products, the cognitive effects of cannabis may become more pronounced in young adults who use these cannabis products. Preliminary research suggests that it is possible to induce 'dopamine homeostasis,' that is, restore dopamine function with dopamine upregulation with the proposed compound and normalize behavior in chronic cannabis users with cannabis-induced hypodopaminergic anhedonia (depression) and cognitive decline. This psychological, neurobiological, anatomical, genetic, and epigenetic research also could provide evidence to use for the development of an appropriate policy regarding the decriminalization of cannabis for recreational use.
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Affiliation(s)
- Kenneth Blum
- Western University Health Sciences, Pomona, CA, United States
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Division of Nutrigenomics, Precision Translational Medicine, LLC., San Antonio, TX, United States
- Division of Nutrigenomics, Genomic Testing Center, Geneus Health, LLC., San Antonio, TX, United States
- Department of Psychiatry, University of Vermont, Burlington, VT, United States
- Department of Psychiatry, Wright University Boonshoff School of Medicine, Dayton, OH, United States
| | - Jag Khalsa
- Department of Microbiology, Immunology and Tropical Medicine, George Washington University, School of Medicine, Washington, DC, United States
| | - Jean Lud Cadet
- Molecular Neuropsychiatry Research Branch, DHHS/NIH/NIDA Intramural Research Program, National Institutes of Health, Baltimore, MD, United States
| | - David Baron
- Western University Health Sciences, Pomona, CA, United States
| | - Abdalla Bowirrat
- Department of Neuroscience, Interdisciplinary Center (IDC), Herzliya, Israel
| | - Brent Boyett
- Bradford Health Services, Madison, AL, United States
| | - Lisa Lott
- Division of Nutrigenomics, Genomic Testing Center, Geneus Health, LLC., San Antonio, TX, United States
| | - Raymond Brewer
- Division of Nutrigenomics, Precision Translational Medicine, LLC., San Antonio, TX, United States
- Division of Nutrigenomics, Genomic Testing Center, Geneus Health, LLC., San Antonio, TX, United States
| | - Marjorie Gondré-Lewis
- Department of Psychiatry and Behavioral Sciences, Howard University College of Medicine, Washington, DC, United States
| | - Gregory Bunt
- Good Samaritan/Day Top Treatment Center, and NYU School of Medicine, New York, NY, United States
| | - Shan Kazmi
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, United States
| | - Mark S. Gold
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, United States
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Gold MS, Baron D, Bowirrat A, Blum K. Neurological correlates of brain reward circuitry linked to opioid use disorder (OUD): Do homo sapiens acquire or have a reward deficiency syndrome? J Neurol Sci 2020; 418:117137. [PMID: 32957037 PMCID: PMC7490287 DOI: 10.1016/j.jns.2020.117137] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/19/2020] [Accepted: 09/08/2020] [Indexed: 12/14/2022]
Abstract
The extant literature confirms that an array of polymorphic genes related to- neurotransmitters and second messengers govern the net release of dopamine in the Nucleus Accumbens (NAc) in the mesolimbic region of the brain. They are linked predominantly to motivation, anti-stress, incentive salience (wanting), and wellbeing. Notably, in 2000 the Nobel Prize was awarded to Carlsson, Greengard, and Kandel for their work on the molecular and cellular function of dopaminergic activity at neurons. This historical psychopharmacological work involved neurotransmission of serotonin, endorphins, glutamate, and dopamine, and the seminal work of Blum, Gold, Volkow, Nestler, and others related to neurotransmitter function and related behaviors. Currently, Americans are facing their second and worst opioid epidemic, prescribed opioids, and easy access drive this epidemic of overdoses, and opioid use disorders (OUDs). Presently the clinical consensus is to treat OUD, as if it were an opioid deficiency syndrome, with long-term to life-long opioid substitution therapy. Opioid agonist administration is seen as necessary to replace missing opioids, treat OUD, and prevent overdoses, like insulin is used to treat diabetes. Treatment of OUD and addiction, in general, is similar to the endocrinopathy conceptualization in that it views opioid agonist MATs as an essential core to therapy. Is this approach logical? Other than as harm reduction, is using opioids to treat OUD therapeutic or harmful in the long term? This historical Trieste provides a molecular framework to understand the current underpinnings of endorphinergic/dopaminergic mechanisms related to opioid deficiency syndrome and generalized reward processing depletion. WC 249.
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Affiliation(s)
- Mark S Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States.
| | - David Baron
- Graduate School of Biomedical Sciences, Western University Health Sciences, Pomona, CA, United States
| | - Abdalla Bowirrat
- Department of Neuroscience and Genetics, Interdisciplinary Center Herzliya, Israel
| | - Kenneth Blum
- Graduate School of Biomedical Sciences, Western University Health Sciences, Pomona, CA, United States
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Blum K, Baron D, McLaughlin T, Gold MS. Molecular neurological correlates of endorphinergic/dopaminergic mechanisms in reward circuitry linked to endorphinergic deficiency syndrome (EDS). J Neurol Sci 2020; 411:116733. [DOI: 10.1016/j.jns.2020.116733] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 01/19/2020] [Accepted: 02/11/2020] [Indexed: 12/20/2022]
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Downs BW, Blum K, Bagchi D, Kushner S, Bagchi M, Galvin JM, Lewis M, Siwicki D, Brewer R, Boyett B, Baron D, Giordano J, Badgaiyan RD. Molecular neuro-biological and systemic health benefits of achieving dopamine homeostasis in the face of a catastrophic pandemic (COVID- 19): A mechanistic exploration. ACTA ACUST UNITED AC 2020; 7. [PMID: 32934824 DOI: 10.15761/jsin.1000228] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
In the face of the global pandemic of COVID 19, approaching 1.75 Million infected worldwide (4/12/2020) and associated mortality (over 108, 000 as of 4/12/2020) as well-as other catastrophic events including the opioid crisis, a focus on brain health seems prudent [1] (https://www.coronavirus.gov). This manuscript reports on the systemic benefits of restoring and achieving dopamine homeostasis to reverse and normalize thoughts and behaviors of Reward Deficiency Syndrome (RDS) dysfunctional conditions and their effects on behavioral physiology; function of reward genes; and focuses on digestive, immune, eye health, and the constellation of symptomatic behaviors. The role of nutrigenomic interventions on restoring normal brain functions and its benefits on these systems will be discussed. We demonstrate that modulation of dopamine homeostasis using nutrigenomic dopamine agonists, instead of pharmaceutical interventions, is achievable. The allied interlinking with diverse chronic diseases and disorders, roles of free radicals and incidence of anaerobic events have been extensively highlighted. In conjunction, the role of dopamine in aspects of sleep, rapid eye movement and waking are extensively discussed. The integral aspects of food indulgence, the influence of taste sensations, and gut-brain signaling are also discussed along with a special emphasis on ocular health. The detailed mechanistic insight of dopamine, immune competence and the allied aspects of autoimmune disorders are also highlighted. Finally, the integration of dopamine homeostasis utilizing a patented gene test and a research-validated nutrigenomic intervention are presented. Overall, a cutting-edge nutrigenomic intervention could prove to be a technological paradigm shift in our understanding of the extent to which achieving dopamine homeostasis will benefit overall health.
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Affiliation(s)
- B W Downs
- Department of Nutrigenomics Research, Victory Nutrition International, Inc., Lederach, PA, USA
| | - K Blum
- Department of Nutrigenomics Research, Victory Nutrition International, Inc., Lederach, PA, USA.,Western University, Health Sciences, Graduate School of Biomedical Sciences, Pomona, CA, USA.,Division of Neuroscience and Addiction Research, Pathway Healthcare, Birmingham, AL, USA.,Eotvos Loránd University, Institute of Psychology, Budapest, Hungary.,Department of Psychiatry, Wright State University Boonshoft School of Medicine and Dayton VA Medical Center, Dayton, OH, USA.,Division of Precision Nutrition, GARS IP., LLC, Hollywood Fl., USA, & Geneus Health, LLC., San Antonio, TX, USA
| | - D Bagchi
- Department of Nutrigenomics Research, Victory Nutrition International, Inc., Lederach, PA, USA.,Department of Pharmacological & Pharmaceutical Sciences, University of Houston College of Pharmacy, Houston, TX, USA
| | - S Kushner
- ALM Research & Development, Oldsmar, FL, USA
| | | | - J M Galvin
- Vitality Medical Wellness Institute, PLLC, Charlotte, NC, USA
| | - McG Lewis
- Departments of Anatomy & Psychiatry, Howard University, School of Medicine, Washington, D., USA
| | - D Siwicki
- Division of Precision Nutrition, GARS IP., LLC, Hollywood Fl., USA, & Geneus Health, LLC., San Antonio, TX, USA
| | - R Brewer
- Division of Precision Nutrition, GARS IP., LLC, Hollywood Fl., USA, & Geneus Health, LLC., San Antonio, TX, USA
| | - B Boyett
- Division of Neuroscience and Addiction Research, Pathway Healthcare, Birmingham, AL, USA
| | - D Baron
- Western University, Health Sciences, Graduate School of Biomedical Sciences, Pomona, CA, USA
| | - J Giordano
- National Institute of Holistic and Addiction Studies, Davie, FL, USA
| | - R D Badgaiyan
- Department of Psychiatry, ICHAN School of Medicine, Mount Sinai, New York, NYC. & Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, San Antonio, TX, Long School of Medicine, University of Texas Medical Center, San Antonio, TX, USA
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11
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McLaughlin T, Blum K, Steinberg B, Modestino EJ, Fried L, Baron D, Siwicki D, Braverman ER, Badgaiyan RD. Pro-dopamine regulator, KB220Z, attenuates hoarding and shopping behavior in a female, diagnosed with SUD and ADHD. J Behav Addict 2018; 7:192-203. [PMID: 29316800 PMCID: PMC6035027 DOI: 10.1556/2006.6.2017.081] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background Addictive-like behaviors (e.g., hoarding and shopping) may be the result of the cumulative effects of dopaminergic and other neurotransmitter genetic variants as well as elevated stress levels. We, therefore, propose that dopamine homeostasis may be the preferred goal in combating such challenging and unwanted behaviors, when simple dopaminergic activation through potent agonists may not provide any resolution. Case presentation C.J. is a 38-year-old, single, female, living with her mother. She has a history of substance use disorder as well as attention deficit hyperactivity disorder, inattentive type. She had been stable on buprenorphine/naloxone combination and amphetamine, dextroamphetamine mixed salts for many years when unexpectedly she lost her job for oversleeping and not calling into work. KB200z (a pro-dopamine compound) was added to her regimen for complaints of low drive and motivation. After taking this nutraceutical for 4 weeks, she noticed a marked improvement in her mental status and many behaviors. She noted that her shopping and hoarding addictions had appreciably decreased. Furthermore, her lifelong history of terrifying lucid dreams was eliminated. Finally, she felt more in control; her locus of control shifted from external to more internal. Discussion The hypothesis is that C.J.'s reported, behavioral, and psychological benefits resulted from the pro-dopamine-regulating effect of KB220Z across the brain reward system. Conclusions This effect, we surmise, could be the result of a new dopamine balance, across C.J.'s brain reward system. Dopamine homeostasis is an effect of KB220Z seen in both animal and human placebo-controlled fMRI experiments.
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Affiliation(s)
- Thomas McLaughlin
- 1 Department of Psychopharmacology, Center for Psychiatric Medicine , Lawrence, MA, USA
| | - Kenneth Blum
- 2 Department of Psychiatry, Boonshoft School of Medicine, Dayton VA Medical Center, Wright State University , Dayton, OH, USA
- 3 Department of Psychiatry, McKnight Brain Institute, University of Florida College of Medicine , Gainesville, FL, USA
- 4 Department of Psychiatry and Behavioral Sciences, Keck Medicine University of Southern California , Los Angeles, CA, USA
- 5 Division of Applied Clinical Research & Education, Dominion Diagnostics, LLC , North Kingstown, RI, USA
- 6 Department of Precision Medicine, Geneus Health LLC , San Antonio, TX, USA
- 7 Department of Addiction Research & Therapy, Nupathways Inc. , Innsbrook, MO, USA
- 8 Department of Clinical Neurology, Path Foundation , New York, NY, USA
- 9 Division of Neuroscience Based Addiction Therapy, The Shores Treatment & Recovery Center , Port Saint Lucie, FL, USA
- 10 Institute of Psychology, Eötvös Loránd University , Budapest, Hungary
| | - Bruce Steinberg
- 11 Department of Psychology, Curry College , Milton, MA, USA
| | | | - Lyle Fried
- 9 Division of Neuroscience Based Addiction Therapy, The Shores Treatment & Recovery Center , Port Saint Lucie, FL, USA
| | - David Baron
- 4 Department of Psychiatry and Behavioral Sciences, Keck Medicine University of Southern California , Los Angeles, CA, USA
| | - David Siwicki
- 6 Department of Precision Medicine, Geneus Health LLC , San Antonio, TX, USA
| | - Eric R Braverman
- 8 Department of Clinical Neurology, Path Foundation , New York, NY, USA
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Blum K, Febo M, Fried L, Li M, Dushaj K, Braverman ER, McLaughlin T, Steinberg B, Badgaiyan RD. Hypothesizing That Neuropharmacological and Neuroimaging Studies of Glutaminergic-Dopaminergic Optimization Complex (KB220Z) Are Associated With "Dopamine Homeostasis" in Reward Deficiency Syndrome (RDS). Subst Use Misuse 2017; 52:535-547. [PMID: 28033474 PMCID: PMC5589271 DOI: 10.1080/10826084.2016.1244551] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND There is need for better treatments of addictive behaviors, both substance and non-substance related, termed Reward Deficiency Syndrome (RDS). While the FDA has approved pharmaceuticals under the umbrella term Medication Assisted Treatment (MAT), these drugs are not optimal. OBJECTIVES It is our contention that these drugs work well in the short-term by blocking dopamine function leading to psychological extinction. However, use of buprenorphine/Naloxone over a long period of time results in unwanted addiction liability, reduced emotional affect, and mood changes including suicidal ideation. METHODS We are thus proposing a paradigm shift in addiction treatment, with the long-term goal of achieving "Dopamine Homeostasis." While this may be a laudable goal, it is very difficult to achieve. Nevertheless, this commentary briefly reviews past history of developing and subsequently, utilizing a glutaminergic-dopaminergic optimization complex [Kb220Z] shown to be beneficial in at least 20 human clinical trials and in a number of published and unpublished studies. RESULTS It is our opinion that, while additional required studies could confirm these findings to date, the cited studies are indicative of achieving enhanced resting state functional connectivity, connectivity volume, and possibly, neuroplasticity. Conclusions/Importance: We are proposing a Reward Deficiency Solution System (RDSS) that includes: Genetic Addiction Risk Score (GARS); Comprehensive Analysis of Reported Drugs (CARD); and a glutaminergic-dopaminergic optimization complex (Kb220Z). Continued investigation of this novel strategy may lead to a better-targeted approach in the long-term, causing dopamine regulation by balancing the glutaminergic-dopaminergic pathways. This may potentially change the landscape of treating all addictions leading us to the promised land.
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Affiliation(s)
- Kenneth Blum
- a Department of Psychiatry & McKnight Brain Institute , University of Florida College of Medicine , Gainesville , Florida , USA.,b Departments of Psychiatry & Behavioral Sciences , Keck School of Medicine of USC , Los Angeles , California , USA.,c Department of Clinical Neurology , PATH Foundation NY , New York , New York , USA.,d Human Integrated Services Unit , University of Vermont Centre for Clinical & Translational Science , Burlington , Vermont , USA.,e Division of Addiction Services , Dominion Diagnostics, LLC , North Kingstown , Rhode Island , USA.,f Division of Neuroscience-Based Therapy , Summit Estate Recovery Center , Los Gatos , California , USA.,g Division of Neuroscience Research and Addiction Therapy , The Shores Treatment and Recovery Center , Port Saint Lucie , Florida , USA.,h Institute of Psychology , Eötvös Loránd University , Budapest , Hungary.,i Department of Psychiatry , Wright State University Boonshoft School of Medicine , Dayton , Ohio, USA
| | - Marcelo Febo
- a Department of Psychiatry & McKnight Brain Institute , University of Florida College of Medicine , Gainesville , Florida , USA
| | - Lyle Fried
- g Division of Neuroscience Research and Addiction Therapy , The Shores Treatment and Recovery Center , Port Saint Lucie , Florida , USA
| | - Mona Li
- b Departments of Psychiatry & Behavioral Sciences , Keck School of Medicine of USC , Los Angeles , California , USA
| | - Kristina Dushaj
- b Departments of Psychiatry & Behavioral Sciences , Keck School of Medicine of USC , Los Angeles , California , USA
| | - Eric R Braverman
- b Departments of Psychiatry & Behavioral Sciences , Keck School of Medicine of USC , Los Angeles , California , USA
| | - Thomas McLaughlin
- j Center for Psychiatric Medicine , North Andover , Massachusetts , USA
| | - Bruce Steinberg
- k Department of Psychology , Curry College , Milton , Massachusetts , USA
| | - Rajendra D Badgaiyan
- i Department of Psychiatry , Wright State University Boonshoft School of Medicine , Dayton , Ohio, USA
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Blum K, Marcelo F, Dushaj K, Fried L, Badgaiyan RD. "Pro-dopamine regulation (KB220Z™)" as a long-term therapeutic modality to overcome reduced resting state dopamine tone in opiate/opioid epidemic in America. JOURNAL OF SYSTEMS AND INTEGRATIVE NEUROSCIENCE 2016; 2:162-165. [PMID: 28491463 PMCID: PMC5421552 DOI: 10.15761/jsin.1000129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Since it is known that relapse, morality, and hospitalizations have been tied to the presence of the Dopamine D2 Receptor A1 allele, as one example, and carriers of this gene variant have a proclivity to favor amino-acid therapy, it seems intuitive that the incorporation of modalities to provide a balance and or restoration of hypodopaminergia should be considered as a front-line tactic to overcome the current American opiate/opioid epidemic, saving millions from death and unwanted locked-in-addiction. If we continue down the prim road path of fighting addiction to narcotics with narcotics, we are doomed to fail. This lesson can also have global interest.
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Affiliation(s)
- K Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, USA
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA
- Division of Applied Clinical Research & Education, Dominion Diagnostics, LLC., North Kingstown, RI, USA
- Synaptamine, Inc., Austin, TX, USA
- Division of Clinical Neurology, PATH Foundation NY, New York, NY, USA
- Division of Personalized Medicine, IGENE, LLC., Austin, TX, USA
- Division of Molecular Neurobiology, LaVitaRDS, Salt Lake City, UT, USA
- Division of Neuroscience Research and Addiction Therapy, Shores Treatment & Recovery Center, Port Saint Lucie, FL, USA
- Department of Clinical Psychology and Addiction, Eötvös Loránd University, Hungary
| | - F Marcelo
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, USA
| | - K Dushaj
- Division of Clinical Neurology, PATH Foundation NY, New York, NY, USA
| | - L Fried
- Division of Neuroscience Research and Addiction Therapy, Shores Treatment & Recovery Center, Port Saint Lucie, FL, USA
| | - R D Badgaiyan
- Department of Psychiatry, Laboratory of Molecular and Functional Imaging, University at Minnesota, Minneapolis, MN, USA
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Blum K, Whitney D, Fried L, Febo M, Waite RL, Braverman ER, Dushaj K, Li M, Giordano J, Demetrovics Z, Badgaiyan RD. Hypothesizing that a Pro-Dopaminergic Regulator (KB220z ™ Liquid Variant) can Induce "Dopamine Homeostasis" and Provide Adjunctive Detoxification Benefits in Opiate/Opioid Dependence. CLINICAL MEDICAL REVIEWS AND CASE REPORTS 2016; 3:125. [PMID: 29034323 PMCID: PMC5638455 DOI: 10.23937/2378-3656/1410125] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In order to explore the initiation of detoxification of addictive patients to opiates/opioids (along with some other anti-withdrawal agents), we developed a protocol to be utilized in treatment centers particularly with heavily dependent opiate/opioid subjects. Out of 17 subjects, only three received Buprenorphine/Naloxone (Bup/nx) along with KB220Z. In this pilot, we first used a dose of KB220Z of 2 oz twice daily before meals along with clonidine and benzodiazepines and other anti-nausea and sleep aids including Gabapentin. The dose of KB220Z was maintained for 6 days in five individuals. In a second scenario, we utilized a higher dose of 4 oz every 6 hours, over a 6-day period. The higher dose was employed in another 12 patients. It is noteworthy that only 3 people have relapsed utilizing these two protocols during the first two weeks of the study, allowing for the remaining 82% to be maintained on KB220Z. The patients have been maintained without any additional Bup/nx for a minimum of 120 days and in one subject, 214 days. We are in the process of testing this hypothesis in multiple treatment centers across the United Sates utilizing data from the Clinical opiate Withdrawal Scale (COWS) pre and post KB220Z. We are in the process of testing this hypothesis in multiple treatment centers across the United Sates. While this does not constitute an acceptable controlled experiment, it does provide some preliminary evidence that agrees with an earlier study. Moreover, because of the utilization of standard detoxifying agents in this detoxification protocol, we cannot make any inference to KB220Z's effects. However, out of 17 subjects, only three required Bup/nx suggesting an interesting finding. If further confirmed in larger studies, the utilization for opiate/opioid detoxification may provide a novel way to eliminate the need for addictive opioids during withdrawal and detoxification. This paradigm shift may translate to a reduction in utilizing powerful and addictive opioids like buprenorphine and methadone (especially in these patients at high genetic risk for addiction) as not only detoxifying agents, but also maintenance drugs. While extensive research is required, this pilot paves the way for future investigations that could assist in the reduction of addictive opiate/opioid use and mortalities amongst both the young and old in America.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, USA
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, USA
- Division of Applied Clinical Research & Education, Dominion Diagnostics, LLC, USA
- Division of Neuroscience-Based Therapy, Summit Estate Recovery Center, USA
- Division of Clinical Neurology, Path Foundation New York, USA
- Division of Personalized Medicine, IGENE, LLC, USA
- Division of Molecular Neurobiology, LaVitaRDS, USA
- National Institute for Holistic Studies in Addiction, USA
- Division of Neuroscience Research and Addiction Therapy, Shores Treatment & Recovery Center, USA
- Department of Clinical Psychology and Addiction, Eotvos Lorand University, Hungary
| | - Debra Whitney
- Division of Clinical Addiction Medicine, Pure Recovery, USA
| | - Lye Fried
- Division of Neuroscience Research and Addiction Therapy, Shores Treatment & Recovery Center, USA
| | - Marcelo Febo
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, USA
| | - Roger L Waite
- National Institute for Holistic Studies in Addiction, USA
| | | | | | - Mona Li
- Division of Personalized Medicine, IGENE, LLC, USA
| | - John Giordano
- National Institute for Holistic Studies in Addiction, USA
| | - Zsolt Demetrovics
- Department of Clinical Psychology and Addiction, Eotvos Lorand University, Hungary
| | - Rajendra D Badgaiyan
- Department of Psychiatry, Laboratory of Molecular and Functional Imaging, University at Minnesota, USA
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Blum K, Febo M, Fahlke C, Archer T, Berggren U, Demetrovics Z, Dushaj K, Badgaiyan RD. Hypothesizing Balancing Endorphinergic and Glutaminergic Systems to Treat and Prevent Relapse to Reward Deficiency Behaviors: Coupling D-Phenylalanine and N-Acetyl-L-Cysteine (NAC) as a Novel Therapeutic Modality. ACTA ACUST UNITED AC 2015; 2. [PMID: 26900600 PMCID: PMC4760695 DOI: 10.23937/2378-3656/1410076] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Kenneth Blum
- Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA; Division of Nutrigenomics, LaVita RDS, LLC, Draper, UT, USA; Division of Applied Clinical Research & Education, Dominion Diagnostics, LLC, North Kingstown, RI, USA; Division of Neuroscience-Based Therapy, Summit Estate Recovery Center, Los Gatos, CA, USA; Division of Clinical Neurology, PATH Foundation NY, New York, NY, USA; Departments of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Marcelo Febo
- Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
| | - Claudia Fahlke
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Trevor Archer
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - U Berggren
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Zsolt Demetrovics
- Department of Clinical Psychology and Addiction, Eotvos Lorand University, Budapest, Hungary
| | - Kristina Dushaj
- Division of Clinical Neurology, PATH Foundation NY, New York, NY, USA
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Blum K, Thompson B, Demotrovics Z, Femino J, Giordano J, Oscar-Berman M, Teitelbaum S, Smith DE, Roy AK, Agan G, Fratantonio J, Badgaiyan RD, Gold MS. The Molecular Neurobiology of Twelve Steps Program & Fellowship: Connecting the Dots for Recovery. JOURNAL OF REWARD DEFICIENCY SYNDROME 2015; 1:46-64. [PMID: 26306329 PMCID: PMC4545669 DOI: 10.17756/jrds.2015-008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
There are some who suggest that alcoholism and drug abuse are not diseases at all and that they are not consequences of a brain disorder as espoused recently by the American Society of Addiction Medicine (ASAM). Some would argue that addicts can quit on their own and moderate their alcohol and drug intake. When they present to a treatment program or enter the 12 Step Program & Fellowship, many addicts finally achieve complete abstinence. However, when controlled drinking fails, there may be successful alternatives that fit particular groups of individuals. In this expert opinion, we attempt to identify personal differences in recovery, by clarifying the molecular neurobiological basis of each step of the 12 Step Program. We explore the impact that the molecular neurobiological basis of the 12 steps can have on Reward Deficiency Syndrome (RDS) despite addiction risk gene polymorphisms. This exploration has already been accomplished in part by Blum and others in a 2013 Springer Neuroscience Brief. The purpose of this expert opinion is to briefly, outline the molecular neurobiological and genetic links, especially as they relate to the role of epigenetic changes that are possible in individuals who regularly attend AA meetings. It begs the question as to whether "12 steps programs and fellowship" does induce neuroplasticity and continued dopamine D2 receptor proliferation despite carrying hypodopaminergic type polymorphisms such as DRD2 A1 allele. "Like-minded" doctors of ASAM are cognizant that patients in treatment without the "psycho-social-spiritual trio," may not be obtaining the important benefits afforded by adopting 12-step doctrines. Are we better off with coupling medical assisted treatment (MAT) that favors combining dopamine agonist modalities (DAM) as possible histone-deacetylase activators with the 12 steps followed by a program that embraces either one or the other? While there are many unanswered questions, at least we have reached a time when "science meets recovery," and in doing so, can further redeem joy in recovery.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry, School of Medicine and McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Addiction Research and Therapy, Malibu Beach Recovery Center, Malibu Beach, CA, USA
- Dominion Diagnostics, Inc., North Kingstown, RI, USA
- IGENE, LLC., Austin, TX, USA
- RDSolutions, Del Mar, CA, USA
- National Institute for Holistic Medicine, North Miami Beach, FL, USA
| | - Benjamin Thompson
- Behavioral Neuroscience Program, Boston University School of Medicine, and Boston VA Healthcare System, Boston, MA, USA
| | - Zsolt Demotrovics
- Eötvös Loránd University, Institute of Psychology, Budapest, Hungary
| | - John Femino
- Dominion Diagnostics, Inc., North Kingstown, RI, USA
- Meadows Edge Recovery Center, North Kingstown, RI, USA
| | - John Giordano
- National Institute for Holistic Medicine, North Miami Beach, FL, USA
| | - Marlene Oscar-Berman
- Departments of Psychiatry, Neurology, and Anatomy & Neurobiology, Boston University School of Medicine, and Boston VA Healthcare System, Boston, MA, USA
| | - Scott Teitelbaum
- Department of Psychiatry, School of Medicine and McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - David E. Smith
- Dominion Diagnostics, Inc., North Kingstown, RI, USA
- Institute of Health & Aging, University of California at San Francisco, San Francisco, CA, USA
| | | | - Gozde Agan
- Dominion Diagnostics, Inc., North Kingstown, RI, USA
| | | | - Rajendra D. Badgaiyan
- Department of Psychiatry, University of Minnesota College of Medicine, Minneapolis, MN, USA
| | - Mark S. Gold
- Director of Research, Drug Enforcement Administration (DEA) Educational Foundation, Washington, D.C, USA
- Departments of Psychiatry & Behavioral Sciences at the Keck, University of Southern California, School of Medicine, CA, USA
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Miller DK, Bowirrat A, Manka M, Miller M, Stokes S, Manka D, Allen C, Gant C, Downs BW, Smolen A, Stevens E, Yeldandi S, Blum K. Acute Intravenous Synaptamine Complex Variant KB220™ “Normalizes” Neurological Dysregulation in Patients during Protracted Abstinence from Alcohol and Opiates as Observed Using Quantitative Electroencephalographic and Genetic Analysis for Reward Polymorphisms: Part 1, Pilot Study with 2 Case Reports. Postgrad Med 2015; 122:188-213. [DOI: 10.3810/pgm.2010.11.2236] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Potentiation of [Met5]enkephalin-induced antinociception by mixture of three peptidase inhibitors in rat. J Anesth 2014; 28:708-15. [DOI: 10.1007/s00540-014-1819-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Accepted: 03/10/2014] [Indexed: 10/25/2022]
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Blum K, Oscar-Berman M, Waite RL, Braverman ER, Kreuk F, Li M, Dushaj K, Madigan MA, Hauser M, Simpatico T, Barh D. A Multi-Locus Approach to Treating Fibromyalgia by Boosting Dopaminergic Activity in the Meso-Limbic System of the Brain. JOURNAL OF GENETIC SYNDROMES & GENE THERAPY 2014; 5:213. [PMID: 24883230 PMCID: PMC4039556 DOI: 10.4172/2157-7412.1000213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Kenneth Blum
- Department of Psychiatry and McKnight Brain Institute, University of Florida College of Medicine, Gainesville, Florida, USA
- Department of Nutrigeenomics, BioClarity, Inc. LaJolla, California, USA
- Department of Clinical Neurology, Path Foundation, NY, New York, New York, USA
- Department of Personalized Medicine, IGENE, LLC. Austin, Texas, USA
- Dominion Diagnostics, LLC, North Kingstown, Rhode Island, USA
- Human Integrated Services Unit University of Vermont Center for Clinical & Translational Science, College of Medicine, Burlington, Vermont, USA
- Institute of Integrative Omics & Applied Biotechnology, Nonakuri, Purba Medinipur, West Bengal, India
- Department of Addiction Research & Therapy, Malibu Beach Recovery Center, Malibu Beach, California, USA
| | - Marlene Oscar-Berman
- Departments of Psychiatry, Neurology, and Anatomy & Neurobiology, Boston University School of Medicine, and Boston VA Healthcare System, Boston, Massachusetts, USA
| | - Roger L Waite
- Department of Nutrigeenomics, BioClarity, Inc. LaJolla, California, USA
| | - Eric R Braverman
- Department of Psychiatry and McKnight Brain Institute, University of Florida College of Medicine, Gainesville, Florida, USA
- Department of Clinical Neurology, Path Foundation, NY, New York, New York, USA
| | - Florian Kreuk
- Department of Clinical Neurology, Path Foundation, NY, New York, New York, USA
| | - Mona Li
- Department of Clinical Neurology, Path Foundation, NY, New York, New York, USA
| | - Kristina Dushaj
- Department of Clinical Neurology, Path Foundation, NY, New York, New York, USA
| | | | - Mary Hauser
- Dominion Diagnostics, LLC, North Kingstown, Rhode Island, USA
| | - Thomas Simpatico
- Human Integrated Services Unit University of Vermont Center for Clinical & Translational Science, College of Medicine, Burlington, Vermont, USA
| | - Debmalya Barh
- Institute of Integrative Omics & Applied Biotechnology, Nonakuri, Purba Medinipur, West Bengal, India
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Blum K, Simpaatico T, Waite RL, Blum SH, Dushaj K, Madigan MA, Braverman ER, Oscar-Bermanm M. Hypothesizing “Reward” Gene Polymorphisms May Predict High Rates of Injury and Addiction in the Workforce: A Nutrient and Electrotherapeutic Based Solution. Health (London) 2014. [DOI: 10.4236/health.2014.616262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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McMillen BA, Lommatzsch CL, Sayonh MJ, Williams HL. Interactions of a Dopamine D1 Receptor Agonist with Glutamate NMDA Receptor Antagonists on the Volitional Consumption of Ethanol by the mHEP Rat. Pharmaceuticals (Basel) 2013; 6:469-79. [PMID: 24276118 PMCID: PMC3816701 DOI: 10.3390/ph6040469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2012] [Revised: 02/23/2013] [Accepted: 03/15/2013] [Indexed: 12/15/2022] Open
Abstract
Stimulation of the dopamine D1 receptor is reported to cause the phosphorylation of DARPP-32 at the thre34 position and activates the protein. If intracellular Ca2+ is increased, such as after activation of the glutamate NMDA receptor, calcineurin activity increases and the phosphates will be removed. This balance of phosphorylation control suggests that a D1 receptor agonist and a NMDA glutamate receptor antagonist should have additive or synergistic actions to increase activated DARPP-32 and consequent behavioral effects. This hypothesis was tested in a volitional consumption of ethanol model: the selectively bred Myers’ high ethanol preferring (mHEP) rat. A 3-day baseline period was followed by 3-days of twice daily injections of drug(s) or vehicle(s) and then a 3-day post-treatment period. Vehicle, the D1 agonist SKF 38393, the non-competitive NMDA receptor antagonist memantine, or their combination were injected 2 h before and after lights out. The combination of 5.0 mg/kg SKF 38393 with either 3.0 or 10 mg/kg memantine did not produce an additive or synergistic effect. For example, 5.0 mg/kg SKF reduced consumption of ethanol by 27.3% and 10 mg/kg memantine by 39.8%. When combined, consumption declined by 48.2% and the proportion of ethanol solution to total fluids consumed declined by 17%. However, the consumption of food also declined by 36.6%. The latter result indicates that this dose combination had a non-specific effect. The combination of SKF 38393 with (+)-MK-801, another NMDA receptor antagonist, also failed to show an additive effect. The lack of additivity and specificity suggests that the hypothesis may not be correct for this in vivo model. The interaction of these different receptor systems with intraneuronal signaling and behaviors needs to be studied further.
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Affiliation(s)
- Brian A McMillen
- Department of Pharmacology & Toxicology, Brody School of Medicine at East Carolina University, Greenville, NC 27834, USA.
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Blum K, Oscar-Berman M, Stuller E, Miller D, Giordano J, Morse S, McCormick L, Downs WB, Waite RL, Barh D, Neal D, Braverman ER, Lohmann R, Borsten J, Hauser M, Han D, Liu Y, Helman M, Simpatico T. Neurogenetics and Nutrigenomics of Neuro-Nutrient Therapy for Reward Deficiency Syndrome (RDS): Clinical Ramifications as a Function of Molecular Neurobiological Mechanisms. ACTA ACUST UNITED AC 2013; 3:139. [PMID: 23926462 DOI: 10.4172/2155-6105.1000139] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In accord with the new definition of addiction published by American Society of Addiction Medicine (ASAM) it is well-known that individuals who present to a treatment center involved in chemical dependency or other documented reward dependence behaviors have impaired brain reward circuitry. They have hypodopaminergic function due to genetic and/or environmental negative pressures upon the reward neuro-circuitry. This impairment leads to aberrant craving behavior and other behaviors such as Substance Use Disorder (SUD). Neurogenetic research in both animal and humans revealed that there is a well-defined cascade in the reward site of the brain that leads to normal dopamine release. This cascade has been termed the "Brain Reward Cascade" (BRC). Any impairment due to either genetics or environmental influences on this cascade will result in a reduced amount of dopamine release in the brain reward site. Manipulation of the BRC has been successfully achieved with neuro-nutrient therapy utilizing nutrigenomic principles. After over four decades of development, neuro-nutrient therapy has provided important clinical benefits when appropriately utilized. This is a review, with some illustrative case histories from a number of addiction professionals, of certain molecular neurobiological mechanisms which if ignored may lead to clinical complications.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry, University of Florida, McKnight Brain Institute, Gainesville, Fl, 100183, USA ; Department of Nutrigenomic, LifeGen, Inc. San Diego, CA, 92101, USA ; Department of Holistic Medicine, G&G Holistic Addiction Treatment Center, North Miami Beach, Fl, 33162, USA ; Center for Genomics and Applied Gene Technology, Institute of Integrative Omics and applied Biotechnology (IIOAB), Nonakuri, Purbe Medinpur, West Bengal, 721172, India ; Path Foundation NY, New York, 10001, New York USA ; Malibu Beach Recovery Center, Malibu Beach, California, 9026, USA ; Dominion Diagnostics, North Kingstown Rhode Island, 02852, USA ; Global Integrated Services Unit University of Vermont Center for Clinical & Translational Science, College of Medicine, Burlington, VT, USA
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Miller M, Chen ALC, Stokes SD, Silverman S, Bowirrat A, Manka M, Manka D, Miller DK, Perrine K, Chen TJH, Bailey JA, Downs W, Waite RL, Madigan MA, Braverman ER, Damle U, Kerner M, Giordano J, Morse S, Oscar-Berman M, Barh D, Blum K. Early intervention of intravenous KB220IV--neuroadaptagen amino-acid therapy (NAAT) improves behavioral outcomes in a residential addiction treatment program: a pilot study. J Psychoactive Drugs 2012; 44:398-409. [PMID: 23457891 PMCID: PMC4074362 DOI: 10.1080/02791072.2012.737727] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Substance use disorders (SUD) are inheritable and the culprit is hypodopaminergic function regulated by reward genes. We evaluated a natural dopaminergic agonist; KB220 intravenous (IV) and oral variants, to improve dopaminergic function in SUD. Our pilot experiment found a significant reduction of chronic symptoms, measured by the Chronic Abstinence Symptom Severity (CASS) Scale. The combined group (IV and oral) did significantly better than the oral-only group over the first week and 30-day follow-up period. Next, the combination was given to 129 subjects and three factors; Emotion, Somatic, and Impaired Cognition, with eigenvalues greater than one were extracted for baseline CASS-Revised (CASS-R) variables. Paired sample t-tests for pre and post-treatment scales showed significant declines (p = .00001) from pre- to post-treatment: t = 19.1 for Emotion, t = 16.1 for Somatic, and t = 14.9 for Impaired Cognition. In a two-year follow-up of 23 subjects who underwent KB220IV therapy (at least five IV treatments over seven days) plus orals for 30+ days: 21 (91%) were sober at six months, 19 (82%) having no relapse; 19 (82%) were sober at one year, 18 (78%) having no relapse; and 21 (91%) were sober two-years post-treatment, 16(70%) having no relapse. We await additional research and advise caution in interpreting these encouraging results.
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Acute ethanol administration differentially alters enkephalinase and aminopeptidase N activity and mRNA levels in regions of the nigrostriatal pathway. J Mol Neurosci 2012; 49:289-300. [PMID: 22688357 DOI: 10.1007/s12031-012-9823-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 05/28/2012] [Indexed: 10/28/2022]
Abstract
Opioid peptides play a key role in ethanol reinforcement and may also represent important determinants in brain sensitivity to ethanol through modulation of nigrostriatal dopaminergic activity. Regulation of opioid levels by peptidase-degrading enzymes could be relevant in ethanol's actions. The aim of this work was to study the acute ethanol (2.5 g/kg) effects on the activity and mRNA expression of enkephalinase (NEP) and aminopeptidase N (APN) in the rat substantia nigra (SN) and the anterior-medial (amCP) and medial-posterior (mpCP) regions of the caudate-putamen (CP). Enzymatic activities were measured by fluorometric assays and mRNA expression by reverse transcriptase polymerase chain reaction. Acute ethanol administration differentially altered peptidase activities and mRNA expression with different kinetics. Ethanol increased and decreased NEP mRNA levels in the SN and amCP, respectively, but produced biphasic effects in the mpCP. APN mRNA levels were increased by ethanol in all brain regions. Ethanol induced a transient and long-lasting increase in NEP (mpCP) and APN (amCP) activities, respectively. Peptidase activities were not changed by ethanol in the SN. Our results indicate that striatal NEP and APN are important ethanol targets. Ethanol-induced changes in these neuropeptidases in the CP could contribute to the mechanisms involved in brain sensitivity to ethanol.
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Morganstern I, Barson JR, Leibowitz SF. Regulation of drug and palatable food overconsumption by similar peptide systems. ACTA ACUST UNITED AC 2012; 4:163-73. [PMID: 21999690 DOI: 10.2174/1874473711104030163] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Revised: 08/04/2011] [Accepted: 08/04/2011] [Indexed: 11/22/2022]
Abstract
This review is aimed at understanding some of the common neurochemical, behavioral and physiological determinants of drug and food overconsumption. Much current work has been devoted to determining the similarities between the brain circuits controlling excessive use of addictive drugs and the overconsumption of palatable foods. The brain systems involved likely include peptides of both mesolimbic and hypothalamic origin. Evidence gathered from expression and injection studies suggests that the consumption of drugs, such as ethanol and nicotine, and also of palatable foods rich in fat is stimulated by different orexigenic peptides, such as enkephalin, galanin, orexin, and melaninconcentrating hormone, acting within the hypothalamus or various limbic structures, while another peptide, neuropeptide Y, is closely related to carbohydrate consumption and shows an inverse relationship with ethanol and nicotine consumption. Moreover, studies in animal models suggest that a propensity to overconsume these reinforcing substances may result from preexisting disturbances in these same peptide systems. These neurochemical disturbances, in turn, may also be closely linked to specific behaviors associated with excessive consummatory behavior, such as hyperactivity or novelty-seeking, palatable food preference, and also fluctuations in circulating lipid levels. Clear understanding of the relationship between these various determinants of consummatory behavior will allow researchers to effectively predict and examine at early stages of exposure animals that are prone to drug and food overconsumption. This work may ultimately aid in the identification of inherent traits that increase the risk for drug abuse and palatable food overconsumption.
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Affiliation(s)
- Irene Morganstern
- Laboratory of Behavioral Neurobiology, The Rockefeller University, New York, NY 10065, USA
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Barson JR, Morganstern I, Leibowitz SF. Neurobiology of consummatory behavior: mechanisms underlying overeating and drug use. ILAR J 2012; 53:35-58. [PMID: 23520598 PMCID: PMC3954603 DOI: 10.1093/ilar.53.1.35] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Consummatory behavior is driven by both caloric and emotional need, and a wide variety of animal models have been useful in research on the systems that drive consumption of food and drugs. Models have included selective breeding for a specific trait, manipulation of gene expression, forced or voluntary exposure to a substance, and identification of biomarkers that predict which animals are prone to overconsuming specific substances. This research has elucidated numerous brain areas and neurochemicals that drive consummatory behavior. Although energy homeostasis is primarily mediated by the hypothalamus, reinforcement is more strongly mediated by nuclei outside the hypothalamus, in mesocorticolimbic regions. Orexigenic neurochemicals that control food intake can provide a general signal for promoting caloric intake or a more specific signal for stimulating consumption of a particular macronutrient, fat, carbohydrate, or protein. The neurochemicals involved in controlling fat ingestion--galanin, enkephalin, orexin, melanin-concentrating hormone, and the endocannabinoids--show positive feedback with this macronutrient, as these peptides both increase fat intake and are further stimulated by its intake. This positive association offers some explanation for why foods high in fat are so often overconsumed. Consumption of ethanol, a drug of abuse that also contains calories, is similarly driven by the neurochemical systems involved in fat intake, according to evidence that closely relates fat and ethanol consumption. Further understanding of the systems involved in consummatory behavior will enable the development of effective therapies for the treatment of both overeating and drug abuse.
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Affiliation(s)
- Jessica R Barson
- Laboratory of Behavioral Neurobiology, The Rockefeller University, New York, New York 10065, USA
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27
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Activity and expression of enkephalinase and aminopeptidase N in regions of the mesocorticolimbic system are selectively modified by acute ethanol administration. J Mol Neurosci 2011; 46:58-67. [PMID: 21870155 DOI: 10.1007/s12031-011-9623-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Accepted: 08/08/2011] [Indexed: 10/17/2022]
Abstract
Opioid peptides play a key role in ethanol reinforcement and alcohol drinking behavior. However, regulation of opioid levels by peptidase-degrading activities in ethanol's actions in brain is still unclear. The aim of this work was to study the acute effects of ethanol (2.5 g/kg) on enkephalinase (NEP) and aminopeptidase N (APN) activities and expression in regions of the mesocorticolimbic system, as well as on corticosterone levels in serum for up to 24 h after administration. Enzymatic activities were measured by fluorometric assays, mRNA's expression by reverse transcriptase polymerase chain reaction (RT-PCR) and corticosterone levels by radioimmunoassay. Acute ethanol administration modified peptidase activity and expression with different kinetics. Ethanol induced a transitory increase and decrease in NEP and APN activities in the frontal cortex (FC) and ventral tegmental area (VTA), whereas only increases in these activities were observed in the nucleus accumbens (NAcc). Ethanol induced an increase in NEP mRNA in the FC and decreases in APN mRNA in the FC and NAcc. In contrast, ethanol produced biphasic effects on both enzymes expression in the VTA. Corticosterone levels were not changed by ethanol. Our results suggest that NEP and APN could play a main role in ethanol reinforcement through regulation of opioid levels in mesolimbic areas.
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Neuro-chemical activation of brain reward meso-limbic circuitry is associated with relapse prevention and drug hunger: A hypothesis. Med Hypotheses 2011; 76:576-84. [DOI: 10.1016/j.mehy.2011.01.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2010] [Revised: 11/22/2010] [Accepted: 01/06/2011] [Indexed: 12/31/2022]
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Chen TJ, Blum K, Chen AL, Bowirrat A, Downs WB, Madigan MA, Waite RL, Bailey JA, Kerner M, Yeldandi S, Majmundar N, Giordano J, Morse S, Miller D, Fornari F, Braverman ER. Neurogenetics and Clinical Evidence for the Putative Activation of the Brain Reward Circuitry by a Neuroadaptagen: Proposing an Addiction Candidate Gene Panel Map. J Psychoactive Drugs 2011; 43:108-27. [DOI: 10.1080/02791072.2011.587393] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Shaw W. Increased urinary excretion of a 3-(3-hydroxyphenyl)-3-hydroxypropionic acid (HPHPA), an abnormal phenylalanine metabolite of Clostridia spp. in the gastrointestinal tract, in urine samples from patients with autism and schizophrenia. Nutr Neurosci 2010; 13:135-43. [PMID: 20423563 DOI: 10.1179/147683010x12611460763968] [Citation(s) in RCA: 104] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
A compound identified as 3-(3-hydroxyphenyl)-3-hydroxypropionic acid (HPHPA) was found in higher concentrations in urine samples of children with autism compared to age and sex appropriate controls and in an adult with recurrent diarrhea due to Clostridium difficile infections. The highest value measured in urine samples was 7500 mmol/mol creatinine, a value 300 times the median normal adult value, in a patient with acute schizophrenia during an acute psychotic episode. The psychosis remitted after treatment with oral vancomycin with a concomitant marked decrease in HPHPA. The source of this compound appears to be multiple species of anaerobic bacteria of the Clostridium genus. The significance of this compound is that it is a probable metabolite of m-tyrosine (3-hydroxyphenylalanine), a tyrosine analog which depletes brain catecholamines and causes symptoms of autism (stereotypical behavior, hyperactivity, and hyper-reactivity) in experimental animals.
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Affiliation(s)
- William Shaw
- The Great Plains Laboratory, Inc., Lenexa, Kansas 66214, USA.
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31
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Chen TJH, Blum K, Waite RL, Meshkin B, Schoolfield J, Downs BW, Braverman EE, Arcuri V, Varshavskiy M, Blum SH, Mengucci J, Reuben C, Palomo T. Gene \Narcotic Attenuation Program attenuates substance use disorder, a clinical subtype of reward deficiency syndrome. Adv Ther 2007; 24:402-14. [PMID: 17565932 DOI: 10.1007/bf02849910] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study evaluated the effects of a putative activator of brain reward circuitry on outcomes in a 1-y prospective comprehensive outpatient clinical program. As part of the Gene Narcotic Attenuation Program, Haveos (Synaptamine)(TM) was administered for the treatment of substance use disorder. Seventy-six patients (45 males and 31 females; mean age, 33 y [standard deviation, 7.0]) who had been given a diagnosis of serious substance use disorder were recruited. After exclusion of 15 patients who dropped out before the end of the study, self-reported craving decreased from program entrance to 12 wk (visual analog scale whereby 0 represents no craving and 5, the strongest craving) for 61 compliant patients (mean decrease, 2.85, 95% confidence interval [CI], 2.65, 3.05); this improvement was significant (P<.001). Building up to relapse scores (each of 5 individual items and summary value) showed similar improvement after 1 y of treatment; the mean decrease in scores was significant for stress (t=3.3; P=.002), depression (t=4.0; P<.001), anger (t=4.4; P<.001), anxiety (t=4.5, P<.001), drug craving (t=5.4, P<.001), and summary building up to relapse (t=4.1; P<.001). Also, recovery score measures of energy level (t=8.4; P<.001) and ability to refrain from drug-seeking behavior (t=7.4; P<.001) showed significant mean increases from entry to 1 y. During the study, the alcoholic dropout rate was only 7% (4 of 57), which was significantly (Fisher's exact test, P<.001) lower than the 73% (11 of 15) dropout rate reported for psychostimulant users. Although these results are significant, any interpretation must await the performance of rigorous double-blind studies.
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Affiliation(s)
- Thomas J H Chen
- Chang Jung Christian University, Tainan, Taiwan, Republic of China
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32
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Blum K, Chen TJH, Meshkin B, Downs BW, Gordon CA, Blum S, Mengucci JF, Braverman ER, Arcuri V, Varshavskiy M, Deutsch R, Martinez-Pons M. Reward deficiency syndrome in obesity: a preliminary cross-sectional trial with a Genotrim variant. Adv Ther 2006; 23:1040-51. [PMID: 17276971 DOI: 10.1007/bf02850224] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Obesity is the second largest preventable cause of death in the United States. Even though it was classified as a disease in 1985, traditionally, obesity has been treated primarily as a behavioral problem that requires only modifications in diet and exercise. Similar to research on obesity, clinical studies have elucidated the role of biologic and genetic factors in alcoholism and other conditions previously classified as behavioral. These studies showed that behavioral adjustments alone may not address underlying genetic causes. We hypothesize that biologic and genetic factors must be addressed synergistically while behavioral modifications are implemented to adequately treat obese patients. We hypothesize that a predisposition to glucose craving and obesity is due to inadequate dopaminergic activity in the reward center of the brain. This defect drives individuals to engage in activities of behavioral excess, which, in turn, enhance brain dopamine function. Consumption of large quantities of alcohol or carbohydrates (carbohydrate bingeing) stimulates production and usage of dopamine within the brain; the term reward deficiency syndrome (RDS) may be used to categorize such biologic influences on behavior. We propose that a novel approach to nutritional supplementation may be required to target the role of RDS in obesity. In this regard, GenoTrim, a DNA-customized nutritional solution, has been developed and is currently under investigation in several clinical studies. Through its mechanism of action, GenoTrim addresses the genetic influence of RDS on obesity. In this cross-sectional study, 24 subjects were studied after they had completed a case report format questionnaire. For this assessment, we used a novel assessment tool-a path analysis. This statistical regression model is used to (1) examine the effectual relationships between various systems within a multisystem matrix, and (2) measure the contributory roles of those relationships in obesity, enabling the development of targeted and effective therapeutic interventions.
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Affiliation(s)
- Kenneth Blum
- Department of Physiology & Pharmacology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1083, USA
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Abstract
Most evidence agrees that levels of methionine enkephalin (Met-Enk) in brain are inversely correlated with ethanol drinking and withdrawal seizures. One area of discrepancy is the effect of chronic ethanol administration on the level of immunoactive Met-Enk in brain, with some authors reporting increased and others reporting decreased levels. These reports differed greatly in terms of method of ethanol administration, species used, length of time ethanol was administered, and the region of brain examined. We found that all studies could be resolved by considering only length of time ethanol was administered, with Met-Enk levels first increasing and then decreasing. We tested this finding by determining the effect of 4-56 days of ethanol delivered in liquid feed on levels of brain Met-Enk. We found that brain levels of Met-Enk peaked after 7 days of ethanol ingestion and declined to levels lower than control by 28 days. Exposure to ethanol abolished a correlation between brain and serum levels of Met-Enk which occurred in controls. HPLC showed that whereas 100% of immunoactivity eluted in the position of Met-Enk in controls, only about 50% eluted as Met-Enk in mice exposed to ethanol. These results support the hypothesis that exposure to ethanol alters brain Met-Enk in a way consistent with the reinforcement of physical dependence.
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Affiliation(s)
- William A Banks
- GRECC, Department of Internal Medicine, Saint Louis University School of Medicine, Veterans Affairs Medical Center at St. Louis, Division of Geriatrics, 915 N. Grand Blvd, St. Louis, MO 63106, USA.
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Méndez M, Leriche M, Calva JC. Acute ethanol administration differentially modulates mu opioid receptors in the rat meso-accumbens and mesocortical pathways. BRAIN RESEARCH. MOLECULAR BRAIN RESEARCH 2001; 94:148-56. [PMID: 11597775 DOI: 10.1016/s0169-328x(01)00232-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Biochemical and pharmacological evidence suggest that the dopaminergic mesolimbic system plays a key role in mediating the reinforcing properties of alcohol and other drugs of abuse. Alcohol reinforcement and high alcohol drinking behavior have been postulated to be partially mediated by a neurobiological mechanism involving the alcohol-induced activation of the endogenous opioid system. The aim of this work was to study the effect of the in vivo acute administration of ethanol on mu (mu) opioid receptors in the rat dopaminergic meso-accumbens and mesocortical pathways by quantitative receptor autoradiography. [(3)H]DAMGO binding was significantly decreased in the ventral tegmental area (VTA) 30 min after ethanol administration. A small ethanol-induced reduction was observed in the shell region of the nucleus accumbens 1 h after exposure. In contrast, 2 h after ethanol administration, [(3)H]DAMGO binding was significantly increased in the frontal and prefrontal cortices. The observed changes correlated well with high ethanol plasma levels. Our results suggest that the reinforcing properties of ethanol may be partially mediated by mechanisms involving the ethanol-induced down- and up-regulation of mu receptors in the dopaminergic mesolimbic system. Mu receptors in the VTA and the frontal and prefrontal cortices may be involved in the in vivo acute responses to ethanol and could play a key role in modulating the dopaminergic activity of the mesocortical pathway in response to the drug. In contrast, the contribution of both mu and delta receptors in the nucleus accumbens might be relevant in these processes.
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Affiliation(s)
- M Méndez
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Subdirección de Investigaciones Clínicas, Calzada México Xochimilco 101, Col. San Lorenzo Huipulco, 14370 D.F., México, Mexico.
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Blum K, Braverman ER, Holder JM, Lubar JF, Monastra VJ, Miller D, Lubar JO, Chen TJ, Comings DE. Reward deficiency syndrome: a biogenetic model for the diagnosis and treatment of impulsive, addictive, and compulsive behaviors. J Psychoactive Drugs 2000; 32 Suppl:i-iv, 1-112. [PMID: 11280926 DOI: 10.1080/02791072.2000.10736099] [Citation(s) in RCA: 542] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The dopaminergic system, and in particular the dopamine D2 receptor, has been implicated in reward mechanisms. The net effect of neurotransmitter interaction at the mesolimbic brain region induces "reward" when dopamine (DA) is released from the neuron at the nucleus accumbens and interacts with a dopamine D2 receptor. "The reward cascade" involves the release of serotonin, which in turn at the hypothalmus stimulates enkephalin, which in turn inhibits GABA at the substania nigra, which in turn fine tunes the amount of DA released at the nucleus accumbens or "reward site." It is well known that under normal conditions in the reward site DA works to maintain our normal drives. In fact, DA has become to be known as the "pleasure molecule" and/or the "antistress molecule." When DA is released into the synapse, it stimulates a number a DA receptors (D1-D5) which results in increased feelings of well-being and stress reduction. A consensus of the literature suggests that when there is a dysfunction in the brain reward cascade, which could be caused by certain genetic variants (polygenic), especially in the DA system causing a hypodopaminergic trait, the brain of that person requires a DA fix to feel good. This trait leads to multiple drug-seeking behavior. This is so because alcohol, cocaine, heroin, marijuana, nicotine, and glucose all cause activation and neuronal release of brain DA, which could heal the abnormal cravings. Certainly after ten years of study we could say with confidence that carriers of the DAD2 receptor A1 allele have compromised D2 receptors. Therefore lack of D2 receptors causes individuals to have a high risk for multiple addictive, impulsive and compulsive behavioral propensities, such as severe alcoholism, cocaine, heroin, marijuana and nicotine use, glucose bingeing, pathological gambling, sex addiction, ADHD, Tourette's Syndrome, autism, chronic violence, posttraumatic stress disorder, schizoid/avoidant cluster, conduct disorder and antisocial behavior. In order to explain the breakdown of the reward cascade due to both multiple genes and environmental stimuli (pleiotropism) and resultant aberrant behaviors, Blum united this hypodopaminergic trait under the rubric of a reward deficiency syndrome.
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Affiliation(s)
- K Blum
- Department of Biological Sciences, University of North Texas, Denton, Texas, USA
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Myers RD, Robinson DE. Mmu and D2 receptor antisense oligonucleotides injected in nucleus accumbens suppress high alcohol intake in genetic drinking HEP rats. Alcohol 1999; 18:225-33. [PMID: 10456575 DOI: 10.1016/s0741-8329(99)00015-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Numerous pharmacological and other studies have implicated both Mmu and dopamine receptor subtypes in alcohol consumption. In the genetic drinking rat as well as those chemically induced to drink, evidence has accrued that the abnormal intake of alcohol is underpined by these receptors in the brain. The purpose of this investigation was to demonstrate unequivocally that a biological impairment by antisense oligodeoxynucleotide (ODN) targeted specifically to these two receptor subtypes would disrupt ongoing alcohol drinking. In this project, a new strain of female and male high-ethanol preferring (HEP) rats was used that had free access to preferred concentrations of alcohol over water in a two choice paradigm. A guide cannula for a microinjection needle was first implanted bilaterally above the nucleus accumbens (NAC) of each rat. Following recovery, a dose of either 250 or 500 ng of the Mmu ODN or 500 ng D2ODN was microinjected into the NAC of the rat in a volume of 0.8-1.0 microl. A standard temporal sequence was used in which microinjections were given four times at successive 12-h intervals over a 2-day interval. The control mismatch ODNs corresponding to both the Mmu or D2 receptor antisense were microinjected identically at homologous sites in the NAC. Following the experiments, the brain of each rat was removed and sectioned in the coronal plane for histological analysis so that each microinjection site was identified. The results showed that the Mmu receptor antisense caused a significant dose dependent fall in free access alcohol drinking within 12 to 24 h following the initial microinjection. This decline often persisted for 1 to 2 days in terms of both g/kg intake and proportion of alcohol to water consumed. Similarly, the D2 receptor ODN likewise induced an intense and significant decline in both g/kg and proportion measures of alcohol intake. Since the corresponding mismatch ODN for both Mmu and D2 receptors exerted no effect on either of these measures of alcohol consumption, the specificity of molecular action of the respective antisense molecules on drinking behavior of the HEP rats was confirmed. Thus, these results provide the first unequivocal evidence that the genes for D2 and Mmu receptors are fundamentally involved in abnormal alcohol drinking in the genetically predisposed individual. Finally, important new anatomical evidence is introduced for the critical role of the NAC in the genetic basis of aberrant drinking of alcohol.
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Affiliation(s)
- R D Myers
- Department of Pharmacology, School of Medicine, East Carolina University, Greenville, NC 27858, USA
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Myers RD, Robinson DE. Tetrahydropapaveroline injected in the ventral tegmental area shifts dopamine efflux differentially in the shell and core of nucleus accumbens in high-ethanol-preferring (HEP) rats. Alcohol 1999; 18:83-90. [PMID: 10386670 DOI: 10.1016/s0741-8329(99)00008-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Since the 1970s tetrahydropapaveroline (THP) and other tetrahydroisoquinoline alkaloids have been implicated in the etiology of alcoholism. When injected into the cerebral ventricle or at specific sites in the mesolimbic system such as the ventral tegmental area (VTA), THP evokes spontaneous and intense intake of alcohol in the nondrinking animal. Further, THP evokes the extracellular efflux of dopamine in the nucleus accumbens (NAC), which comprises, in part, the postulated alcohol drinking "circuit" of neurons. The purpose of this study was to characterize the action of a THP reactive structure, the VTA, on the activity of dopamine and its metabolism in the NAC. In the anesthetized high-ethanol-preferring (HEP) rat, artificial CSF was perfused for 10 min at a rate of 10 microl per min specifically in either the core or shell of the NAC. A microbore push-pull cannula system was selected over a microdialysis probe because of its superior recovery of neurotransmitters and tip exposure of less than 1.0 mm. After a series of 5-min perfusions, a single microinjection of 5.0 microg/microl of THP was made in the ipsilateral VTA while the NAC was perfused simultaneously. Sequential samples of the NAC perfusate were assayed by an HPLC coulometric system to quantitate the concentrations of dopamine and its metabolites, DOPAC and HVA, as well as the 5-HT metabolite, 5-HIAA. The results showed that THP injected in the VTA caused a significant increase by 94 +/- 23% in the efflux of dopamine from the core of the NAC. Conversely, the THP injected identically in the VTA suppressed the efflux of dopamine within the shell of the NAC by 51 +/- 10%. The levels of DOPAC, HVA and 5-HIAA within the core and shell of the NAC generally paralleled the increase and decrease in efflux, respectively, of dopamine. CSF control injections in the VTA as well as injections outside of the VTA failed to alter dopamine or metabolite activity in the NAC. These results demonstrate that the presence of THP in the VTA alters directly the function of the pathway of mesolimbic neurons generally and the dopaminergic system specifically. That such a perturbation could account for the induction of alcohol preference is proposed in relation to a reinforcing mechanism involving opioidergic and dopaminergic elements.
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Affiliation(s)
- R D Myers
- Department of Pharmacology and Center for Alcohol and Drug Abuse Studies, School of Medicine, East Carolina University, Greenville, NC 27858, USA
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Li XW, Li TK, Froehlich JC. Enhanced sensitivity of the nucleus accumbens proenkephalin system to alcohol in rats selectively bred for alcohol preference. Brain Res 1998; 794:35-47. [PMID: 9630499 DOI: 10.1016/s0006-8993(98)00191-7] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Evidence suggests that alcohol-induced activation of the endogenous opioid system is part of a neurobiological mechanism that may be functionally involved in alcohol reinforcement and high alcohol drinking behavior. We postulate that a genetic predisposition toward alcohol drinking is accompanied by increased responsiveness of the opioid system to alcohol. To test this hypothesis, the present study compared the effect of an acute alcohol challenge on enkephalin gene expression in discrete brain regions which are high in preproenkephalin (PPENK) mRNA content and/or are important in mediating alcohol reward in rats selectively bred for alcohol preference (P) or nonpreference (NP). PPENK mRNA content was measured by in situ hybridization performed with a 36 base oligonucleotide probe for PPENK mRNA and was quantified using a computerized image-analysis system. Blood alcohol concentration (BAC) and rate of alcohol elimination following alcohol infusion were similar in P and NP rats. P and NP rats did not differ in basal content of PPENK mRNA in any of the brain areas examined prior to onset of infusion. An intragastric (I.G.) infusion of alcohol (2.5 g/kg b.wt) produced a significant increase in PPENK mRNA in the nucleus accumbens (both shell and core) of P but not NP rats at 1 h after the onset of infusion which coincided with the time at which peak BAC was attained. In contrast, at 8 h after the onset of the alcohol infusion, when BAC was falling toward baseline, PPENK mRNA was decreased in the nucleus accumbens of both P and NP rats and in the anterior striatum and amygdala of NP rats. The results suggest that enhanced responsiveness of the enkephalinergic system to alcohol is associated with, and may be functionally involved in, mediating high alcohol drinking behavior.
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Affiliation(s)
- X W Li
- Department of Physiology and Biophysics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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Winkler A, Rottmann M, Heder G, Hyytiä P, Siems WE, Melzig MF. Gene expression and activity of specific opioid-degrading enzymes in different brain regions of the AA and ANA lines of rats. BIOCHIMICA ET BIOPHYSICA ACTA 1998; 1406:219-27. [PMID: 9630637 DOI: 10.1016/s0925-4439(97)00041-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
There is increasing evidence that alcoholism runs in families suggesting that genetic factors may play a role. In support of this hypothesis, the alcohol-preferring (AA) and the alcohol-avoiding (ANA) rat lines have been developed through selective outbreeding. Numerous studies indicate that the endogenous opioid system may be involved in controlling ethanol consumption. Changes in opioid peptides and opioid receptors have been described after ethanol intake. But, the influence of ethanol on peptidolytic degradation of opioid peptides has been largely ignored, although the peptidase-mediated metabolism of neuropeptides is known as an important regulatory site of peptidergic transmission. Neutral endopeptidase 24.11 (NEP) and angiotensin-converting enzyme (ACE) degrade neuropeptides, including enkephalin and are expressed in the brain. Furthermore, a good correspondence between the regional distribution of NEP and opioid receptors in rat brain has already been reported pointing to a possible role of NEP in regulating opioid peptides. For both enzymes studied, the gene expression pattern was found to be in good agreement with the corresponding enzyme activities in the brain regions investigated, showing the highest levels for both specific mRNAs and enzyme activities in the striatum. Differences in both measured parameters were detected in distinct brain regions of AA and ANA rats. Furthermore, in some brain regions discrepancies between ACE and NEP mRNA levels and the corresponding enzyme activities were observed. For example, in olfactory bulb and striatum such discrepancies were found for both enzymes studied. In tegmentum/colliculi a higher NEP gene expression in AA rats was associated with a higher NEP enzyme activity compared to the amounts found in ANA rats.
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Affiliation(s)
- A Winkler
- MPI of Psychiatry, Kraepelinst. 2, 80804 Munich, Germany.
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Plotkin SR, Banks WA, Kastin AJ. Enkephalin, PPE mRNA, and PTS-1 in alcohol withdrawal seizure-prone and -resistant mice. Alcohol 1998; 15:25-31. [PMID: 9426834 DOI: 10.1016/s0741-8329(97)00083-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Inbred animal strains provide an opportunity to study genetic factors in alcoholism in the absence of environmental factors. Although the concentration of methionine enkephalin (Met-enkephalin) in whole brain has been implicated in the consumption of ethanol, it has not been studied in the brains of alcohol withdrawal seizure-prone (WSP) and withdrawal seizure-resistant (WSR) mice. We compared these concentrations with the levels of preproenkephalin (PPE) mRNA and with the activity of peptide transport system-1 (PTS-1), a brain-to-blood transport system for Met-enkephalin that is affected by ethanol. The concentrations of Met-enkephalin were significantly greater in WSP mice than in WSR mice, whereas synthesis of Met-enkephalin, as reflected by PPE mRNA levels, and transport out of the brain by PTS-1 was not different. These results support a direct link between elevated concentrations of Met-enkephalin in whole brain and proneness to withdrawal-induced seizures. We suggest that the inverse relationship between the consumption of ethanol and proneness to seizures in inbred mice can be explained through their opposite relationships to Met-enkephalin.
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Affiliation(s)
- S R Plotkin
- Tulane Neuroscience Interdisciplinary Program, Veterans Affairs Medical Center, New Orleans, LA 70146, USA
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Abstract
Previous research has shown that activation of a subset of peripheral opioid receptors located in the gut produce aversive effects as measured in the place and taste conditioning (CTA) paradigms. Endogenous opioid activity and tetrahydroisoquinolines (TIQs) are stimulated or formed after ethanol (EtOH) administration and both are known to activate opioid receptors. We therefore examined the hypothesis that a portion of the aversive effects of EtOH may be mediated through peripheral opioid receptors, activated by EtOH-induced opioids or TIQs. EtOH CTAs were slightly attenuated when animals were pretreated with the putative peripheral opioid receptor antagonist methylnaltrexone. By itself MNTX did not condition a taste preference or aversion. However, blood EtOH levels (BELs) in animals pretreated with MNTX were lower than those of saline-pretreated subjects, an effect that just reached statistical significance and was not present at specific EtOH doses. The results indicate that a portion of the aversive conditioning effects of EtOH (using a two-bottle CTA paradigm) may be receptor-mediated effects, exerted by an action on peripheral opioid receptors, but the specific mechanism of attenuation is unclear.
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Affiliation(s)
- J B Bedingfield
- University of Oklahoma Health Sciences Center, Department of Psychiatry and Behavioral Sciences, Oklahoma City 73190-3000, USA
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Culliton PD, Kiresuk TJ. Overview of substance abuse acupuncture treatment research. J Altern Complement Med 1997; 2:149-59; discussion 161-5. [PMID: 9395651 DOI: 10.1089/acm.1996.2.149] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The research on the efficacy of acupuncture substance abuse treatment is generally still in an early stage. The methodological weaknesses found in the acupuncture research can be found in most substance abuse research. Sufficient early trial, empirical findings suggest that there are positive treatment effects. Certainly, use of the treatment is popular and widespread. Overall, the research has progressed beyond early clinical trials, and the method has been documented to be safe and potentially useful.
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Affiliation(s)
- P D Culliton
- Hennepin Faculty Associates, Acupuncture and Alternative Medicine Program, Minneapolis, MN, USA
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TAMPIER LUTSKE, GUIVERNAU MAURICIO, MARDONES JORGE. Effect of captopril on voluntary consumption of ethanol, water and solid food by UChA and UChB rats. Addict Biol 1997; 2:439-44. [PMID: 26735949 DOI: 10.1080/13556219772499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Angiotensin converting enzyme inhibitors (ACEI) have been reported to reduce ethanol consumption in rats, but it is unclear whether this effect is specific for ethanol or secondary to effects on appetite or satiation for calories or water. In the present study we assessed the effect of captopril, an ACEI, on the voluntary consumption of 10% ethanol solution, water and solid food in our strain of rats genetically selected for their voluntary consumption of ethanol, namely UChA (low consumer) and UChB (high consumer). Captopril (30 mg/kg) was injected intraperitoneally for 3 consecutive days to UChA and UChB rats and ethanol, water and food intake were measured before, during and after captopril treatment; these results were compared with those produced by a control saline solution. Results showed that captopril produced a significant reduction of alcohol voluntary consumption in UChB but not in UChA rats. However, this effect was not specific for ethanol since captopril also induced a significant decrease in food intake leading to a loss of weight in both rat strains, suggesting that it seems to be secondary to changes in appetite for calories.
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Blum K, Cull JG, Chen TJ, Garcia-Swan S, Holder JM, Wood R, Braverman ER, Bucci LR, Trachtenberg MG. Clinical evidence for effectiveness of Phencal™ in maintaining weight loss in an open-label, controlled, 2-year study. Curr Ther Res Clin Exp 1997. [DOI: 10.1016/s0011-393x(97)80108-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Plotkin SR, Banks WA, Waguespack PJ, Kastin AJ. Ethanol alters the concentration of Met-enkephalin in brain by affecting peptide transport system-1 independent of preproenkephalin mRNA. J Neurosci Res 1997. [DOI: 10.1002/(sici)1097-4547(19970501)48:3<273::aid-jnr10>3.0.co;2-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Honkanen A, Vilamo L, Wegelius K, Sarviharju M, Hyytiä P, Korpi ER. Alcohol drinking is reduced by a mu 1- but not by a delta-opioid receptor antagonist in alcohol-preferring rats. Eur J Pharmacol 1996; 304:7-13. [PMID: 8813578 DOI: 10.1016/0014-2999(96)00118-5] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
To assess the roles of opioid receptor subtypes in voluntary alcohol drinking, alcohol-preferring AA (Alko, Alcohol) rats, non-deprived of food or water, were used in a paradigm where access to 10% alcohol solution was limited to 1-4-h sessions on every 2nd working day. The delta-opioid receptor antagonist naltrindole (1-5 mg/kg i.p. 15 min before the session) had no effect on alcohol drinking, while it attenuated the delta-opioid receptor agonist [D-Pen2, D-Pen5]enkephalin-induced locomotor stimulation. The mu1-opioid receptor antagonist naloxonazine (1-15 mg/kg i.p. 20 h before the session), at the largest dose, decreased alcohol drinking. It also decreased food intake. When naltrindole (1 mg/kg) and naloxonazine (15 mg/kg) were given prior to 3 consecutive sessions, the former had no effects at any session. Naloxonazine decreased alcohol consumption only in the 1st session, although the reduction of daily water intake became stronger during repeated administration. 4 days after the last drug administration, naloxonazine-treated animals consumed alcohol nearly twice as much as in the control session before any drug treatment. These data suggest that delta-opioid receptors are not involved in the regulation of alcohol drinking in AA rats. mu1-Opioid receptors may be involved in alcohol drinking, although the data suggest that even their prolonged blockade alone is insufficient to induce a sustained decrease in alcohol drinking.
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Affiliation(s)
- A Honkanen
- Department of Pharmacy, University of Helsinki, Finland
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Di Chiara G, Acquas E, Tanda G. Ethanol as a neurochemical surrogate of conventional reinforcers: the dopamine-opioid link. Alcohol 1996; 13:13-7. [PMID: 8837928 DOI: 10.1016/0741-8329(95)02034-9] [Citation(s) in RCA: 100] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Various lines of evidence support the view that ethanol is a neurochemical surrogate of conventional reinforcers, such as food and sex. In fact, ethanol activates central neuronal systems that utilize dopamine, opioids, and gamma-aminobutyric acid (GABA) as neurotransmitters and also are activated by conventional reinforcers. These neurotransmitter systems are likely to mediate specific aspects of ethanol's reinforcing properties. Activation of the mesolimbic dopamine and endogenous opioid systems might be the substrate of the incentive and rewarding (ergotropic) properties of ethanol (arousal, euphoria, motor stimulation) and of the process of acquiring ethanol-related secondary reinforcers (incentive learning) and ethanol self-administration habits. Stimulation of the endogenous GABAergic system might mediate the sedative and drive-reducing (trophotropic) properties of ethanol. The dopamine and opioid systems are largely interconnected. Thus, pharmacological blockade of the endogenous opioid system by mu- or delta-opioid receptor antagonists prevents ethanol's activation of the dopamine system and reduces ethanol consumption. This interaction might contribute to naltrexone's effectiveness in reducing alcohol craving in humans.
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Affiliation(s)
- G Di Chiara
- Department of Toxicology, University of Cagliari, Italy
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Aguirre JC, del Arbol JL, Rico J, Raya J, Ruiz-Requena ME. Effect of acute alcohol intoxication on the opioid system in humans. Alcohol 1995; 12:559-62. [PMID: 8590619 DOI: 10.1016/0741-8329(95)02002-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
We investigated the possible relations between the endogenous opioid system and acute alcoholic intoxication in 21 subjects, of whom 13 were drinkers who came to the emergency service with evident symptoms of drunkenness, and 8 were nondrinkers who consumed 1 g alcohol per kg body weight over a short period. Different patterns of changes were found in the two groups for plasma concentrations of beta-endorphin and adrenocorticotropic hormone. In drinkers, plasma levels of both substances increased, whereas in nondrinkers both concentrations decreased, the declines being especially notable 15, 30, and 45 min after ingestion. We found no differences between the two groups in plasma cortisol concentrations. The different levels of these substances may reflect differences in drinking behavior between the two groups.
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Affiliation(s)
- J C Aguirre
- Department of Medicine, School of Medicine, University of Granada, Spain
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Abstract
Brain-to-blood transport, or efflux, systems play important roles in brain functions and can affect the CNS uptake and activity of endogenous and exogenous blood-borne substances. Several efflux systems have been described for peptides. These efflux systems may play important roles in communication between the CNS and peripheral tissues and may be important in conditions such as alcoholism.
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Affiliation(s)
- W A Banks
- Veterans Affairs Medical Center, New Orleans, Louisiana
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Yukhananov RY, Klodt PM, Shemanov AY, Rat'kin AE, Nyberg F, Maiskii AI. Dynorphin A (1-17), Met-enkephalin-Arg6-Phe7 and substance P (1-11) levels in the brain of mice with different levels of ethanol consumption. Bull Exp Biol Med 1993. [DOI: 10.1007/bf00786075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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