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Graeff FG, Joca S, Zangrossi H. Bradykinin actions in the central nervous system: historical overview and psychiatric implications. Acta Neuropsychiatr 2024; 36:129-138. [PMID: 38178717 DOI: 10.1017/neu.2023.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
Bradykinin (BK), a well-studied mediator of physiological and pathological processes in the peripheral system, has garnered less attention regarding its function in the central nervous system, particularly in behavioural regulation. This review delves into the historical progression of research focused on the behavioural effects of BK and other drugs that act via similar mechanisms to provide new insights into the pathophysiology and pharmacotherapy of psychiatric disorders. Evidence from experiments with animal models indicates that BK modulates defensive reactions associated with panic symptoms and the response to acute stressors. The mechanisms are not entirely understood but point to complex interactions with other neurotransmitter systems, such as opioids, and intracellular signalling cascades. By addressing the existing research gaps in this field, we present new proposals for future research endeavours to foster a new era of investigation regarding BK's role in emotional regulation. Implications for psychiatry, chiefly for panic and depressive disorders are also discussed.
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Affiliation(s)
- Frederico Guilherme Graeff
- Behavioural Neurosciences Institute (INeC), Ribeirão Preto, SP, Brazil
- Department of Psychology, FFCLRP, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Sâmia Joca
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Helio Zangrossi
- Department of Pharmacology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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Vázquez-León P, Miranda-Páez A, Valencia-Flores K, Sánchez-Castillo H. Defensive and Emotional Behavior Modulation by Serotonin in the Periaqueductal Gray. Cell Mol Neurobiol 2022; 43:1453-1468. [PMID: 35902460 DOI: 10.1007/s10571-022-01262-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 07/13/2022] [Indexed: 11/26/2022]
Abstract
Serotonin 5-hydroxytryptamine (5-HT) is a key neurotransmitter for the modulation and/or regulation of numerous physiological processes and psychiatric disorders (e.g., behaviors related to anxiety, pain, aggressiveness, etc.). The periaqueductal gray matter (PAG) is considered an integrating center for active and passive defensive behaviors, and electrical stimulation of this area has been shown to evoke behavioral responses of panic, fight-flight, freezing, among others. The serotonergic activity in PAG is influenced by the activation of other brain areas such as the medial hypothalamus, paraventricular nucleus of the hypothalamus, amygdala, dorsal raphe nucleus, and ventrolateral orbital cortex. In addition, activation of other receptors within PAG (i.e., CB1, Oxytocin, µ-opioid receptor (MOR), and γ-aminobutyric acid (GABAA)) promotes serotonin release. Therefore, this review aims to document evidence suggesting that the PAG-evoked behavioral responses of anxiety, panic, fear, analgesia, and aggression are influenced by the activation of 5-HT1A and 5-HT2A/C receptors and their participation in the treatment of various mental disorders.
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Affiliation(s)
- Priscila Vázquez-León
- Neuropsychopharmacology Laboratory, Psychology School. 1er Piso Edif. B. Cub B001, National Autonomous University of Mexico, Avenida Universidad 3000, Colonia Copilco Universidad. Alcaldía de Coyoacan, Mexico City, Mexico
| | - Abraham Miranda-Páez
- Department of Physiology, National School of Biological Sciences, National Polytechnic Institute, Wilfrido Massieu esq. Manuel Stampa S/N Col. Nueva Industrial Vallejo, Gustavo A. Madero, Mexico City, CP:07738, Mexico
| | - Kenji Valencia-Flores
- Neuropsychopharmacology Laboratory, Psychology School. 1er Piso Edif. B. Cub B001, National Autonomous University of Mexico, Avenida Universidad 3000, Colonia Copilco Universidad. Alcaldía de Coyoacan, Mexico City, Mexico
| | - Hugo Sánchez-Castillo
- Neuropsychopharmacology Laboratory, Psychology School. 1er Piso Edif. B. Cub B001, National Autonomous University of Mexico, Avenida Universidad 3000, Colonia Copilco Universidad. Alcaldía de Coyoacan, Mexico City, Mexico.
- Research Unit of Psychobiology and Neurosciences (UIPyN), Psychology School, UNAM, CDMX Mexico, CP 04510, Mexico.
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Gavcar EG, Kabukçu Başay B, Avci E, Başay Ö. Relationship between saliva opiorphin levels, pain threshold, and cutting number in adolescents with non suicidal self injury. J Psychiatr Res 2022; 151:611-618. [PMID: 35636040 DOI: 10.1016/j.jpsychires.2022.05.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/22/2022] [Accepted: 05/20/2022] [Indexed: 11/18/2022]
Abstract
Various opinions have been suggested regarding non suicidal self-injury (NSSI) and pain relationship. Opiorphin is a recently found peptide that inhibits enkephaline-catabolizing enzymes. Analgesia caused by opiorphine has been demonstrated in animal experiments. No studies have examined the relationship between opiorphin and pain sensation until today. We aimed to investigate opiorphine and pain threshold among self-injuring adolescents. Adolescents aged 14-18 years were included in the study. The NSSI group consisted of 37 adolescents diagnosed with NSSI according to DSM-V Section 3, and the non-NSSI group consisted of 36 adolescents without any psychiatric disorder. We measured pain threshold with a pressure sensitive algometer device and analyzed saliva opiorphin levels by ELISA method. Mediation analysis was performed using Process Macro developed by Hayes. NSSI group had statistically significantly higher pain threshold and opiorphin levels than the non-NSSI group. There was a positive correlation between pain threshold values and opiorphin levels in the NSSI group. Also, a positive correlation between opiorphin levels and total cutting episode number was found. We searched for a probable relationship of pain threshold with episode number of each type of NSSI act. Accordingly, a positive correlation with two major act and a negative correlation with two minor act was shown. The opiorphine was found to be a mediator variable in the relationship between the pain threshold and the cutting number. The relationship between opiorphin, pain threshold and cutting number and their mediating effects with each other may highlight the pain-based biological origins of NSSI.
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Affiliation(s)
- Erdal Görkem Gavcar
- Department of Child and Adolescent Psychiatry, School of Medicine, Pamukkale University, Denizli, Turkey
| | - Bürge Kabukçu Başay
- Department of Child and Adolescent Psychiatry, School of Medicine, Pamukkale University, Denizli, Turkey.
| | - Esin Avci
- Department of Medical Biochemistry, School of Medicine, Pamukkale University, Denizli, Turkey
| | - Ömer Başay
- Department of Child and Adolescent Psychiatry, School of Medicine, Pamukkale University, Denizli, Turkey
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Maraschin JC, Frias AT, Hernandes PM, Batistela MF, Martinez LM, Joca SRL, Graeff FG, Audi EA, Spera de Andrade TGC, Zangrossi H. Antipanic-like effect of esketamine and buprenorphine in rats exposed to acute hypoxia. Behav Brain Res 2021; 418:113651. [PMID: 34732354 DOI: 10.1016/j.bbr.2021.113651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 10/19/2021] [Accepted: 10/29/2021] [Indexed: 12/26/2022]
Abstract
The antidepressant effect of ketamine has been widely acknowledged and the use of one of its enantiomers, S-ketamine (esketamine), has recently been approved for the clinical management of treatment-resistant depression. As with ketamine, the non-selective opioid receptor-interacting drug buprenorphine is reported to have antidepressant and anxiolytic properties in humans and rodents. Given the fact that antidepressant drugs are also first line treatment for panic disorder, it is surprising that the potential panicolytic effect of these compounds has been scarcely (ketamine), or not yet (buprenorphine) investigated. We here evaluated the effects of ketamine (the racemic mixture), esketamine, and buprenorphine in male Wistar rats submitted to a panicogenic challenge: acute exposure to hypoxia (7% O2). We observed that esketamine (20 mg/kg), but not ketamine, decreased the number of escape attempts made during hypoxia, and this effect could be observed even 7 days after the drug administration. A panicolytic-like effect was also observed with MK801, which like esketamine, antagonizes NMDA glutamate receptors. Buprenorphine (0.3 mg/kg) also impaired hypoxia-induced escape, an effect blocked by the non-selective opioid receptor antagonist naloxone, indicating an interaction with classical ligand sites, such as µ and kappa receptors, but not with nociception/orphanin FQ receptors. Altogether, the results suggest that esketamine and buprenorphine cause rapid-onset panicolytic-like effects, and may be alternatives for treating panic disorder, particularly in patients who are refractory to standard pharmacological treatment.
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Affiliation(s)
- Jhonatan Christian Maraschin
- Department of Pharmacology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Alana Tercino Frias
- Department of Pharmacology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Paloma Molina Hernandes
- Department of Pharmacology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Matheus Fitipaldi Batistela
- Department of Pharmacology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Lucas Motta Martinez
- Department of Pharmacology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Sâmia Regiane Lourenço Joca
- Department of Biomolecular Sciences, School of Pharmaceutical Sciences, University of São Paulo, Ribeirão Preto, SP, Brazil; Aarhus Institute of Advanced Studies (AIAS), Aarhus University, Aarhus, Denmark
| | | | - Elisabeth Aparecida Audi
- Department of Pharmacology and Therapeutics, State University of Maringá (UEM), Maringá, PR, Brazil
| | | | - Hélio Zangrossi
- Department of Pharmacology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil; Behavioural Neurosciences Institute (INeC), Ribeirão Preto, SP, Brazil.
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Clark AE, Goodwin SR, Marks RM, Belcher AM, Heinlein E, Bennett ME, Roche DJO. A Narrative Literature Review of the Epidemiology, Etiology, and Treatment of Co-Occurring Panic Disorder and Opioid Use Disorder. J Dual Diagn 2021; 17:313-332. [PMID: 34582313 PMCID: PMC9487392 DOI: 10.1080/15504263.2021.1965407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Panic disorder is a debilitating psychiatric disorder that often co-occurs with substance use disorders. Given the current opioid epidemic, the high reported rates of comorbid panic disorder and opioid use disorder are particularly concerning. In this narrative review, we describe the literature on panic disorder and opioid use disorder co-occurrence. METHODS 86 studies, 26 reviews, 2 commentaries, and 5 guidelines pertaining to opioid use disorder, panic disorder, and their comorbidity were identified using all EBSCO databases, PubMed, and Google Scholar. RESULTS First, we review epidemiological literature on the prevalence of the comorbid condition above and beyond each disorder on its own. Additionally, we discuss the challenges that complicate the differential diagnosis of panic disorder and opioid use disorder and contribute to difficulties establishing rates of comorbidity. Second, we review three theoretical models that have been proposed to explain high rates of co-occurring panic disorder and opioid use disorder: the precipitation hypothesis, the self-medication hypothesis, and the shared vulnerability hypothesis. Third, we outline how co-occurring panic and opioid use disorder may impact treatment for each condition. CONCLUSION Based on findings in the field, we provide recommendations for future research as well as treatment considerations for co-occurring panic and opioid use disorders.
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Affiliation(s)
- Ashton E Clark
- Department of Psychiatry, University of Maryland, Baltimore, Maryland, USA
| | - Shelby R Goodwin
- Department of Psychiatry, University of Maryland, Baltimore, Maryland, USA
| | | | | | - Emily Heinlein
- Department of Psychiatry, University of Maryland, Baltimore, Maryland, USA
| | - Melanie E Bennett
- Department of Psychiatry, University of Maryland, Baltimore, Maryland, USA.,Baltimore VA Medical Center, Baltimore, Maryland, USA
| | - Daniel J O Roche
- Department of Psychiatry, University of Maryland, Baltimore, Maryland, USA
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