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Bourque M, Grégoire L, Patel W, Dickens D, Snodgrass R, Di Paolo T. AV-101, a Pro-Drug Antagonist at the NMDA Receptor Glycine Site, Reduces L-Dopa Induced Dyskinesias in MPTP Monkeys. Cells 2022; 11:cells11223530. [PMID: 36428960 PMCID: PMC9688762 DOI: 10.3390/cells11223530] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/24/2022] [Accepted: 11/02/2022] [Indexed: 11/10/2022] Open
Abstract
N-methyl-D-aspartate (NMDA) receptors have been implicated in L-Dopa-induced dyskinesias (LID) in Parkinson's disease patients, but the use of antagonists that directly inhibit this receptor is associated with severe side effects. L-4-chlorokynurenine (4-Cl-KYN or AV-101) is a pro-drug of 7-chlorokynurenic acid (7-Cl-KYNA), a potent and specific antagonist of the glycine (GlyB) co-agonist site of NMDA receptors. The 7-Cl-KYNA has limited ability to cross the blood-brain barrier, whereas AV-101 readily accesses the brain. We investigated if AV-101 reduces LID in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-lesioned monkeys while maintaining the antiparkinsonian activity of L-Dopa. A first pilot study using three dyskinetic MPTP monkeys showed that acute AV-101 treatment (250 and 450 mg/kg) reduced LID and maintained the antiparkinsonian activity of L-Dopa. The main study using six additional dyskinetic MPTP monkeys showed that repeated AV-101 treatment (250 mg/kg, b.i.d. for 4 consecutive days) maintained their L-Dopa antiparkinsonian response. We measured significantly less LID when AV-101 was combined with L-Dopa treatment. AV-101 alone or with L-Dopa had no non-motor adverse effects in MPTP monkeys. Our study showed antidyskinetic activity of AV-101 in MPTP monkeys was comparable to amantadine tested previously in our laboratory in this model. We observed no adverse effects with AV-101, which is an improvement over amantadine, with its known side effects.
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Affiliation(s)
- Mélanie Bourque
- Centre de Recherche du CHU de Québec, Axe Neurosciences, Québec, QC G1V4G2, Canada
| | - Laurent Grégoire
- Centre de Recherche du CHU de Québec, Axe Neurosciences, Québec, QC G1V4G2, Canada
| | - Waseema Patel
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool L69 3GL, UK
| | - David Dickens
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool L69 3GL, UK
| | - Ralph Snodgrass
- Vistagen Therapeutics, Inc., South San Francisco, CA 94080, USA
| | - Thérèse Di Paolo
- Centre de Recherche du CHU de Québec, Axe Neurosciences, Québec, QC G1V4G2, Canada
- Faculté de Pharmacie, Université Laval, Québec, QC G1V0A6, Canada
- Correspondence:
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Patel W, Rimmer L, Smith M, Moss L, Smith MA, Snodgrass HR, Pirmohamed M, Alfirevic A, Dickens D. Probenecid Increases the Concentration of 7-Chlorokynurenic Acid Derived from the Prodrug 4-Chlorokynurenine within the Prefrontal Cortex. Mol Pharm 2021; 18:113-123. [PMID: 33307708 DOI: 10.1021/acs.molpharmaceut.0c00727] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Recent advances in the understanding of depression have led to increasing interest in ketamine and the role that N-methyl-d-aspartate (NMDA) receptor inhibition plays in depression. l-4-Chlorokynurenine (4-Cl-KYN, AV-101), a prodrug, has shown promise as an antidepressant in preclinical studies, but this promise has not been realized in recent clinical trials. We sought to determine if transporters in the CNS could be playing a role in this clinical response. We used radiolabeled uptake assays and microdialysis studies to determine how 4-Cl-KYN and its active metabolite, 7-chlorokynurenic acid (7-Cl-KYNA), cross the blood-brain barrier (BBB) to access the brain and its extracellular fluid compartment. Our data indicates that 4-Cl-KYN crosses the blood-brain barrier via the amino acid transporter LAT1 (SLC7A5) after which the 7-Cl-KYNA metabolite leaves the brain extracellular fluid via probenecid-sensitive organic anion transporters OAT1/3 (SLC22A6 and SLC22A8) and MRP4 (ABCC4). Microdialysis studies further validated our in vitro data, indicating that probenecid may be used to boost the bioavailability of 7-Cl-KYNA. Indeed, we found that coadministration of 4-Cl-KYN with probenecid caused a dose-dependent increase by as much as an 885-fold increase in 7-Cl-KYNA concentration in the prefrontal cortex. In summary, our data show that 4-Cl-KYN crosses the BBB using LAT1, while its active metabolite, 7-Cl-KYNA, is rapidly transported out of the brain via OAT1/3 and MRP4. We also identify a hitherto unreported mechanism by which the brain extracellular concentration of 7-Cl-KYNA may be increased to produce significant boosting of the drug concentration at its site of action that could potentially lead to an increased therapeutic effect.
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Affiliation(s)
- Waseema Patel
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool L69 3GL, U.K
| | - Lara Rimmer
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool L69 3GL, U.K
| | - Martin Smith
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool L69 3GL, U.K
| | - Lucie Moss
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool L69 3GL, U.K
| | - Mark A Smith
- VistaGen Therapeutics, Inc., 343 Allerton Ave, South San Francisco, California 94080, United States
- Medical College of Georgia, 1120 15th Street, Augusta, Georgia 30912, United States
| | - H Ralph Snodgrass
- VistaGen Therapeutics, Inc., 343 Allerton Ave, South San Francisco, California 94080, United States
| | - Munir Pirmohamed
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool L69 3GL, U.K
| | - Ana Alfirevic
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool L69 3GL, U.K
| | - David Dickens
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool L69 3GL, U.K
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Venkatesan D, Iyer M, Narayanasamy A, Siva K, Vellingiri B. Kynurenine pathway in Parkinson's disease-An update. eNeurologicalSci 2020; 21:100270. [PMID: 33134567 PMCID: PMC7585940 DOI: 10.1016/j.ensci.2020.100270] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/05/2020] [Accepted: 08/26/2020] [Indexed: 12/24/2022] Open
Abstract
Parkinson's disease (PD) is a complex multi-factorial neurodegenerative disorder where various altered metabolic pathways contribute to the progression of the disease. Tryptophan (TRP) is a major precursor in kynurenine pathway (KP) and it has been discussed in various in vitro studies that the metabolites quinolinic acid (QUIN) causes neurotoxicity and kynurenic acid (KYNA) acts as neuroprotectant respectively. More studies are also focused on the effects of other KP metabolites and its enzymes as it has an association with ageing and PD pathogenesis. Until now, very few studies have targeted the role of genetic mutations in abnormal KP metabolism in adverse conditions of PD. Therefore, the present review gives an updated research studies on KP in connection with PD. Moreover, the review emphasizes on the urge for the development of biomarkers and also this would be an initiative in generating an alternative therapeutic approach for PD.
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Key Words
- 3-HAA, 3-hydroxyanthranilic acid
- 3-HK, 3-hydroxykynurenine
- 6-OHDA, 6-hydroxydopamine
- AA, anthranilic acid
- ACMSD, amino-carboxymuconatesemialdehyde decarboxylase
- AD, Alzheimer's disease
- ATP, adenosine triphosphate
- Ageing
- AhR, aryl hydrocarbon receptor
- Biomarkers
- CNS, central nervous system
- CSF, cerebrospinal fluid
- DA, dopaminergic
- FAM, formamidase
- IDO-1, indoleamine-2,3-dioxygenases
- IFN-γ, interferon-γ
- KATs, kynurenine aminotransferases
- KMO, kynurenine −3-monooxygenase
- KP, Kynurenine pathway
- KYN, kynurenine
- KYNA, kynurenic acid
- Kynurenine pathway (KP)
- L-DOPA, L-dopamine
- LID, L-DOPA-induced dyskinesia
- MPTP, 1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine
- NAD+, nicotinamide adenine dinucleotide
- NADPH, nicotinamide adenine dinucleotide phosphate
- NFK, N′-formylkynurenine
- NMDA, N-methyl-d-aspartate
- PA, picolinic acid
- PD, Parkinson's disease
- Parkinson's disease (PD)
- QUIN, quinolinic acid
- RBCs, red blood cells
- SNpc, substantianigra pars compacta
- TDO, tryptophan 2,3-dioxygenase
- TRP, tryptophan
- Therapeutics
- XA, xanthurenic acid
- ZNS, zonisamide
- α-synuclein, αSyn
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Affiliation(s)
- Dhivya Venkatesan
- Human Molecular Cytogenetics and Stem Cell Laboratory, Department of Human Genetics and Molecular Biology, Bharathiar University, Coimbatore 641 046, Tamil Nadu, India
| | - Mahalaxmi Iyer
- Department of Zoology, Avinashilingam Institute for Home Science and Higher Education for Women, Coimbatore 641 043, Tamil Nadu, India
| | - Arul Narayanasamy
- Disease Proteomics Laboratory, Department of Zoology, Bharathiar University, Coimbatore 641 046, Tamil Nadu, India
| | - Kamalakannan Siva
- National Centre for Disease Control, Ministry of Health and Family Welfare, Government of India, New Delhi 110054, India
| | - Balachandar Vellingiri
- Human Molecular Cytogenetics and Stem Cell Laboratory, Department of Human Genetics and Molecular Biology, Bharathiar University, Coimbatore 641 046, Tamil Nadu, India
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Randomized, double-blind, placebo-controlled, dose-escalation study: Investigation of the safety, pharmacokinetics, and antihyperalgesic activity of l-4-chlorokynurenine in healthy volunteers. Scand J Pain 2017; 17:243-251. [PMID: 29229209 DOI: 10.1016/j.sjpain.2017.05.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 05/16/2017] [Accepted: 05/17/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS Neuropathic pain is a significant medical problem needing more effective treatments with fewer side effects. Overactive glutamatergic transmission via N-methyl-d-aspartate receptors (NMDARs) are known to play a role in central sensitization and neuropathic pain. Although ketamine, a NMDAR channel-blocking antagonist, is often used for neuropathic pain, its side-effect profile and abusive potential has prompted the search for a safer effective oral analgesic. A novel oral prodrug, AV-101 (l-4 chlorokynurenine), which, in the brain, is converted into one of the most potent and selective GlyB site antagonists of the NMDAR, has been demonstrated to be active in animal models of neuropathic pain. The two Phase 1 studies reported herein were designed to assess the safety and pharmacokinetics of AV-101, over a wide dose range, after daily dosing for 14-days. As secondary endpoints, AV-101 was evaluated in the capsaicin-induced pain model. METHODS The Phase 1A study was a single-site, randomized, double-blind, placebo-controlled, single oral ascending dose (30-1800mg) study involving 36 normal healthy volunteers. The Phase 1B study was a single-site randomized, double-blind, placebo-controlled, study of multiple ascending doses (360, 1080, and 1440mg/day) of AV-101 involving 50 normal healthy volunteers, to whom AV-101 or placebo were administered orally daily for 14 consecutive days. Subjects underwent PK blood analyses, laboratory assessments, physical examination, 12-lead ECG, ophthalmological examination, and various neurocognitive assessments. The effect of AV-101 was evaluated in the intradermally capsaicin-induced pain model (ClinicalTrials.gov Identifier: NCT01483846). RESULTS Two Phase 1, with an aggregate of 86 subjects, demonstrated that up to 14 days of oral AV-101, up to 1440mg per day, was safe and very well tolerated with AEs quantitively and qualitatively like those observed with placebo. Mean half-life values of AV-101 were consistent across doses, ranging with an average of 1.73h, with the highest Cmax (64.4μg/mL) and AUC0-t (196μgh/mL) values for AV-101 occurring in the 1440-mg dose group. In the capsaicin induce-pain model, there was no significant change in the area under the pain time curve (AUPC) for the spontaneous pain assessment between the treatment and the placebo groups on Day 1 or 14 (the primary endpoint). In contrast, there were consistent reductions at 60-180min on Day 1 after dosing for allodynia, mechanical hyperalgesia, heat hyperalgesia, and spontaneous pain, and on Day 14 after dosing for heat hyperalgesia. CONCLUSIONS Although, AV-101 did not reach statistical significance in reducing pain, there were consistent reductions, for allodynia pain and mechanical and heat hyperalgesia. Given the excellent safety profile and PK characteristics demonstrated by this study, future clinical trials of AV-101 in neuropathic pain are justified. IMPLICATIONS This article presents the safety and PK of AV-101, a novel oral prodrug producing a potent and selective GlyB site antagonist of the NMDA receptor. These data indicate that AV-101 has excellent safety and PK characteristics providing support for advancing AV-101 into Phase 2 studies in neuropathic pain, and even provides data suggesting that AV-101 may have a role in treating depression.
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Yaksh TL, Schwarcz R, Snodgrass HR. Characterization of the Effects of L-4-Chlorokynurenine on Nociception in Rodents. THE JOURNAL OF PAIN 2017; 18:1184-1196. [PMID: 28428091 DOI: 10.1016/j.jpain.2017.03.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 03/16/2017] [Accepted: 03/30/2017] [Indexed: 10/19/2022]
Abstract
Upon systemic administration in rats, the prodrug L-4-chlorokynurenine (4-Cl-KYN; AV-101; VistaGen Therapeutics, Inc, South San Francisco, CA) is rapidly absorbed, actively transported across the blood-brain barrier, and converted in astrocytes to 7-chlorokynurenic acid (7-Cl-KYNA), a potent and specific antagonist of the glycine B coagonist site of the N-methyl-D-aspartate (NMDA) receptor. We examined the effects of 4-Cl-KYN in several rat models of hyperalgesia and allodynia and determined the concentrations of 4-Cl-KYN and newly produced 7-Cl-KYNA in serum, brain, and spinal cord. Adult male rats were given 4-Cl-KYN (56, 167, 500 mg/kg), the NMDA receptor antagonist MK-801 (.1, .3, 1.0 mg/kg), or gabapentin (33, 100, 300 mg/kg) intraperitoneally, and were then examined on rotarod, intraplantar formalin-evoked flinching, thermal escape in the normal and carrageenan-inflamed paw, and allodynia after sciatic nerve ligation. Our conclusions show that after systemic delivery, the highest 2 doses (167 and 500 mg/kg) of 4-Cl-KYN yielded brain concentrations of 7-Cl-KYNA exceeding its half maximal inhibitory concentration (IC50) at the glycine B site and resulted in dose-dependent antihyperalgesia in the 4 models of facilitated processing associated with tissue inflammation and nerve injury. On the basis of the relative dose requirements for analgesic actions and side effect profiles from these experiments, 4-Cl-KYN is predicted to have antihyperalgesic efficacy and a therapeutic ratio equal to gabapentin and superior to MK-801. PERSPECTIVE These studies show that systemic administration of the prodrug 4-Cl-KYN produces high central nervous system levels of 7-Cl-KYNA, a potent and highly selective antagonist of the NMDA receptor. Compared with other drugs tested, 4-Cl-KYN has robust antinociceptive effects with a better side effect profile, highlighting its potential for treating hyperpathic pain states.
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Affiliation(s)
- Tony L Yaksh
- Department of Anesthesiology, University of California, San Diego, La Jolla, California.
| | - Robert Schwarcz
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland
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Zanos P, Piantadosi SC, Wu HQ, Pribut HJ, Dell MJ, Can A, Snodgrass HR, Zarate CA, Schwarcz R, Gould TD. The Prodrug 4-Chlorokynurenine Causes Ketamine-Like Antidepressant Effects, but Not Side Effects, by NMDA/GlycineB-Site Inhibition. J Pharmacol Exp Ther 2015; 355:76-85. [PMID: 26265321 DOI: 10.1124/jpet.115.225664] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 07/29/2015] [Indexed: 12/11/2022] Open
Abstract
Currently approved antidepressant drug treatment typically takes several weeks to be effective. The noncompetitive N-methyl-d-aspartate (NMDA) receptor antagonist ketamine has shown efficacy as a rapid-acting treatment of depression, but its use is associated with significant side effects. We assessed effects following blockade of the glycineB co-agonist site of the NMDA receptor, located on the GluN1 subunit, by the selective full antagonist 7-chloro-kynurenic acid (7-Cl-KYNA), delivered by systemic administration of its brain-penetrant prodrug 4-chlorokynurenine (4-Cl-KYN) in mice. Following administration of 4-Cl-KYN, 7-Cl-KYNA was promptly recovered extracellularly in hippocampal microdialysate of freely moving animals. The behavioral responses of the animals were assessed using measures of ketamine-sensitive antidepressant efficacy (including the 24-hour forced swim test, learned helplessness test, and novelty-suppressed feeding test). In these tests, distinct from fluoxetine, and similar to ketamine, 4-Cl-KYN administration resulted in rapid, dose-dependent and persistent antidepressant-like effects following a single treatment. The antidepressant effects of 4-Cl-KYN were prevented by pretreatment with glycine or the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor antagonist 2,3-dihydroxy-6-nitro-7-sulfamoyl-benzo[f]quinoxaline-2,3-dione (NBQX). 4-Cl-KYN administration was not associated with the rewarding and psychotomimetic effects of ketamine, and did not induce locomotor sensitization or stereotypic behaviors. Our results provide further support for antagonism of the glycineB site for the rapid treatment of treatment-resistant depression without the negative side effects seen with ketamine or other channel-blocking NMDA receptor antagonists.
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Affiliation(s)
- Panos Zanos
- Department of Psychiatry (P.Z., S.C.P., H.-Q.W., H.J.P., M.J.D., A.C., R.S., T.D.G.), Maryland Psychiatric Research Center (H.-Q.W., R.S.), Department of Pharmacology (R.S., T.D.G.), Department of Anatomy and Neurobiology (T.D.G.), University of Maryland School of Medicine, Baltimore, Maryland; VistaGen Therapeutics, Inc., San Francisco, California (H.R.S.); Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.)
| | - Sean C Piantadosi
- Department of Psychiatry (P.Z., S.C.P., H.-Q.W., H.J.P., M.J.D., A.C., R.S., T.D.G.), Maryland Psychiatric Research Center (H.-Q.W., R.S.), Department of Pharmacology (R.S., T.D.G.), Department of Anatomy and Neurobiology (T.D.G.), University of Maryland School of Medicine, Baltimore, Maryland; VistaGen Therapeutics, Inc., San Francisco, California (H.R.S.); Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.)
| | - Hui-Qiu Wu
- Department of Psychiatry (P.Z., S.C.P., H.-Q.W., H.J.P., M.J.D., A.C., R.S., T.D.G.), Maryland Psychiatric Research Center (H.-Q.W., R.S.), Department of Pharmacology (R.S., T.D.G.), Department of Anatomy and Neurobiology (T.D.G.), University of Maryland School of Medicine, Baltimore, Maryland; VistaGen Therapeutics, Inc., San Francisco, California (H.R.S.); Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.)
| | - Heather J Pribut
- Department of Psychiatry (P.Z., S.C.P., H.-Q.W., H.J.P., M.J.D., A.C., R.S., T.D.G.), Maryland Psychiatric Research Center (H.-Q.W., R.S.), Department of Pharmacology (R.S., T.D.G.), Department of Anatomy and Neurobiology (T.D.G.), University of Maryland School of Medicine, Baltimore, Maryland; VistaGen Therapeutics, Inc., San Francisco, California (H.R.S.); Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.)
| | - Matthew J Dell
- Department of Psychiatry (P.Z., S.C.P., H.-Q.W., H.J.P., M.J.D., A.C., R.S., T.D.G.), Maryland Psychiatric Research Center (H.-Q.W., R.S.), Department of Pharmacology (R.S., T.D.G.), Department of Anatomy and Neurobiology (T.D.G.), University of Maryland School of Medicine, Baltimore, Maryland; VistaGen Therapeutics, Inc., San Francisco, California (H.R.S.); Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.)
| | - Adem Can
- Department of Psychiatry (P.Z., S.C.P., H.-Q.W., H.J.P., M.J.D., A.C., R.S., T.D.G.), Maryland Psychiatric Research Center (H.-Q.W., R.S.), Department of Pharmacology (R.S., T.D.G.), Department of Anatomy and Neurobiology (T.D.G.), University of Maryland School of Medicine, Baltimore, Maryland; VistaGen Therapeutics, Inc., San Francisco, California (H.R.S.); Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.)
| | - H Ralph Snodgrass
- Department of Psychiatry (P.Z., S.C.P., H.-Q.W., H.J.P., M.J.D., A.C., R.S., T.D.G.), Maryland Psychiatric Research Center (H.-Q.W., R.S.), Department of Pharmacology (R.S., T.D.G.), Department of Anatomy and Neurobiology (T.D.G.), University of Maryland School of Medicine, Baltimore, Maryland; VistaGen Therapeutics, Inc., San Francisco, California (H.R.S.); Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.)
| | - Carlos A Zarate
- Department of Psychiatry (P.Z., S.C.P., H.-Q.W., H.J.P., M.J.D., A.C., R.S., T.D.G.), Maryland Psychiatric Research Center (H.-Q.W., R.S.), Department of Pharmacology (R.S., T.D.G.), Department of Anatomy and Neurobiology (T.D.G.), University of Maryland School of Medicine, Baltimore, Maryland; VistaGen Therapeutics, Inc., San Francisco, California (H.R.S.); Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.)
| | - Robert Schwarcz
- Department of Psychiatry (P.Z., S.C.P., H.-Q.W., H.J.P., M.J.D., A.C., R.S., T.D.G.), Maryland Psychiatric Research Center (H.-Q.W., R.S.), Department of Pharmacology (R.S., T.D.G.), Department of Anatomy and Neurobiology (T.D.G.), University of Maryland School of Medicine, Baltimore, Maryland; VistaGen Therapeutics, Inc., San Francisco, California (H.R.S.); Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.)
| | - Todd D Gould
- Department of Psychiatry (P.Z., S.C.P., H.-Q.W., H.J.P., M.J.D., A.C., R.S., T.D.G.), Maryland Psychiatric Research Center (H.-Q.W., R.S.), Department of Pharmacology (R.S., T.D.G.), Department of Anatomy and Neurobiology (T.D.G.), University of Maryland School of Medicine, Baltimore, Maryland; VistaGen Therapeutics, Inc., San Francisco, California (H.R.S.); Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.)
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