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Hu J, Li Y, Dong C, Wei H, Liao K, Wei J, Zhao C, Chaudhary A, Chen J, Xu H, Zhong K, Liang SH, Wang L, Ye W. Discovery and evaluation of a novel 18F-labeled vasopressin 1a receptor PET ligand with peripheral binding specificity. Acta Pharm Sin B 2024; 14:4014-4027. [PMID: 39309503 PMCID: PMC11413668 DOI: 10.1016/j.apsb.2024.05.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 05/06/2024] [Accepted: 05/13/2024] [Indexed: 09/25/2024] Open
Abstract
The arginine-vasopressin (AVP) hormone plays a pivotal role in regulating various physiological processes, such as hormone secretion, cardiovascular modulation, and social behavior. Recent studies have highlighted the V1a receptor as a promising therapeutic target. In-depth insights into V1a receptor-related pathologies, attained through in vivo imaging and quantification in both peripheral organs and the central nervous system (CNS), could significantly advance the development of effective V1a inhibitors. To address this need, we develop a novel V1a-targeted positron emission tomography (PET) ligand, [18F]V1A-2303 ([18F]8), which demonstrates favorable in vitro binding affinity and selectivity for the V1a receptor. Specific tracer binding in peripheral tissues was also confirmed through rigorous cell uptake studies, autoradiography, biodistribution assessments. Furthermore, [18F]8 was employed in PET imaging and arterial blood sampling studies in healthy rhesus monkeys to assess its brain permeability and specificity, whole-body distribution, and kinetic properties. Our research indicated [18F]8 as a valuable tool for noninvasively studying V1a receptors in peripheral organs, and as a foundational element for the development of next-generation, brain-penetrant ligands specifically designed for the CNS.
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Affiliation(s)
- Junqi Hu
- Center of Cyclotron and PET Radiopharmaceuticals, Department of Nuclear Medicine & Key Laboratory of Basic and Translational Research on Radiopharmaceuticals, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Yinlong Li
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA 30322, USA
| | - Chenchen Dong
- Center of Cyclotron and PET Radiopharmaceuticals, Department of Nuclear Medicine & Key Laboratory of Basic and Translational Research on Radiopharmaceuticals, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Huiyi Wei
- Center of Cyclotron and PET Radiopharmaceuticals, Department of Nuclear Medicine & Key Laboratory of Basic and Translational Research on Radiopharmaceuticals, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Kai Liao
- Center of Cyclotron and PET Radiopharmaceuticals, Department of Nuclear Medicine & Key Laboratory of Basic and Translational Research on Radiopharmaceuticals, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Junjie Wei
- Center of Cyclotron and PET Radiopharmaceuticals, Department of Nuclear Medicine & Key Laboratory of Basic and Translational Research on Radiopharmaceuticals, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Chunyu Zhao
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA 30322, USA
| | - Ahmad Chaudhary
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA 30322, USA
| | - Jiahui Chen
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA 30322, USA
| | - Hao Xu
- Center of Cyclotron and PET Radiopharmaceuticals, Department of Nuclear Medicine & Key Laboratory of Basic and Translational Research on Radiopharmaceuticals, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Ke Zhong
- Department of Pharmacy, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Steven H. Liang
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA 30322, USA
| | - Lu Wang
- Center of Cyclotron and PET Radiopharmaceuticals, Department of Nuclear Medicine & Key Laboratory of Basic and Translational Research on Radiopharmaceuticals, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Weijian Ye
- Center of Cyclotron and PET Radiopharmaceuticals, Department of Nuclear Medicine & Key Laboratory of Basic and Translational Research on Radiopharmaceuticals, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
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Baska F, Bozó É, Szeleczky Z, Szántó G, Vukics K, Szakács Z, Domány-Kovács K, Kurkó D, Vass E, Thán M, Vastag M, Temesvári K, Lévai S, Halász AS, Szondiné Kordás K, Román V, Greiner I, Bata I. Discovery and Characterization of RGH-122, a Potent, Selective, and Orally Bioavailable V1a Receptor Antagonist. J Med Chem 2024; 67:643-673. [PMID: 38165765 DOI: 10.1021/acs.jmedchem.3c01868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
The V1a receptor is a major contributor in mediating the social and emotional effects of arginine-vasopressin (AVP); therefore it represents a promising target in the treatment of several neuropsychiatric conditions. The aim of this research was to design and synthesize novel and selective V1a antagonists with improved in vitro and in vivo profiles. Through optimization and detailed SAR studies, we developed low nanomolar antagonists, and further characterizations led to the discovery of the clinical candidate compound 43 (RGH-122). The CNS activity of the compound was determined in a 3-chamber social preference test of autism in which RGH-122 successfully enhanced social preference with the lowest effective dose of 1.5 mg/kg.
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Affiliation(s)
- Ferenc Baska
- Gedeon Richter Plc, PO Box 27, Budapest H-1475, Hungary
| | - Éva Bozó
- Gedeon Richter Plc, PO Box 27, Budapest H-1475, Hungary
| | | | - Gábor Szántó
- Gedeon Richter Plc, PO Box 27, Budapest H-1475, Hungary
| | | | | | | | - Dalma Kurkó
- Gedeon Richter Plc, PO Box 27, Budapest H-1475, Hungary
| | - Elemér Vass
- Institute of Chemistry, Eötvös Loránd University, Pázmány Péter sétány 1/A, Budapest H-1117, Hungary
| | - Márta Thán
- Gedeon Richter Plc, PO Box 27, Budapest H-1475, Hungary
| | - Mónika Vastag
- Gedeon Richter Plc, PO Box 27, Budapest H-1475, Hungary
| | | | - Sándor Lévai
- Gedeon Richter Plc, PO Box 27, Budapest H-1475, Hungary
| | | | | | - Viktor Román
- Gedeon Richter Plc, PO Box 27, Budapest H-1475, Hungary
| | | | - Imre Bata
- Gedeon Richter Plc, PO Box 27, Budapest H-1475, Hungary
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de Miguel L, Ballester P, Egoavil C, Sánchez-Ocaña ML, García-Muñoz AM, Cerdá B, Zafrilla P, Ramos E, Peiró AM. Pharmacogenetics May Prevent Psychotropic Adverse Events in Autism Spectrum Disorder: An Observational Pilot Study. Pharmaceuticals (Basel) 2023; 16:1496. [PMID: 37895967 PMCID: PMC10610471 DOI: 10.3390/ph16101496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/15/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
INTRODUCTION Up to 73% of individuals with autism spectrum disorder (ASD) and intellectual disability (ID) currently have prescriptions for psychotropic drugs. This is explained by a higher prevalence of medical and psychiatric chronic comorbidities, which favors polypharmacy, increasing the probability of the appearance of adverse events (AEs). These could be a preventable cause of harm to patients with ASD and an unnecessary waste of healthcare resources. OBJECTIVE To study the impact of pharmacogenetic markers on the prevention of AE appearance in a population with ASD and ID. METHODS This is a cross-sectional, observational study (n = 118, 72 participants completed all information) in the ASD population. Sociodemographic and pharmacological data were gathered. The Udvalg for Kliniske Undersøgelser Scale (UKU Scale) was used to identify AEs related to the use of psychotropic medication. Polymorphisms of DOP2, ABCB1, and COMT were genotyped and correlated with the AE to find candidate genes. Furthermore, a review of all medications assessed in a clinical trial for adults with autism was performed to enrich the search for potential pharmacogenetic markers, keeping in mind the usual medications. RESULTS The majority of the study population were men (75%) with multiple comorbidities and polypharmacy, the most frequently prescribed drugs were antipsychotics (69%); 21% of the participants had four or more AEs related to psychotropic drugs. The most common were "Neurological" and" Psychiatric" (both 41%). Statistical analysis results suggested a significant correlation between the neurological symptoms and the DOP2 genotype, given that they are not equally distributed among its allelic variants. The final review considered 19 manuscripts of medications for adults with ASD, and the confirmed genetic markers for those medications were consulted in databases. CONCLUSION A possible correlation between neurologic AEs and polymorphisms of DOP2 was observed; therefore, studying this gene could contribute to the safety of this population's prescriptions. The following studies are underway to maximize statistical power and have a better representation of the population.
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Affiliation(s)
- Laura de Miguel
- Pharmacogenetic Unit, Clinical Pharmacology Department, Alicante Institute for Health and Biomedical Research (ISABIAL), General University Hospital of Alicante, c/Pintor Baeza, 12, 03010 Alicante, Spain
- Clinical Pharmacology, Toxicology and Chemical Safety Unit, Institute of Bioengineering, Miguel Hernández University, Avda. de la Universidad s/n, 03202 Elche, Spain
| | - Pura Ballester
- Faculty of Pharmacy and Nutrition, Campus de los Jerónimos, Universidad Católica San Antonio de Murcia (UCAM), Guadalupe, 30107 Murcia, Spain
| | - Cecilia Egoavil
- Pharmacogenetic Unit, Clinical Pharmacology Department, Alicante Institute for Health and Biomedical Research (ISABIAL), General University Hospital of Alicante, c/Pintor Baeza, 12, 03010 Alicante, Spain
- Clinical Pharmacology Unit, Dr. Balmis General University Hospital, 03010 Alicante, Spain
| | - María Luisa Sánchez-Ocaña
- Faculty of Pharmacy and Nutrition, Campus de los Jerónimos, Universidad Católica San Antonio de Murcia (UCAM), Guadalupe, 30107 Murcia, Spain
| | - Ana María García-Muñoz
- Faculty of Pharmacy and Nutrition, Campus de los Jerónimos, Universidad Católica San Antonio de Murcia (UCAM), Guadalupe, 30107 Murcia, Spain
| | - Begoña Cerdá
- Faculty of Pharmacy and Nutrition, Campus de los Jerónimos, Universidad Católica San Antonio de Murcia (UCAM), Guadalupe, 30107 Murcia, Spain
| | - Pilar Zafrilla
- Faculty of Pharmacy and Nutrition, Campus de los Jerónimos, Universidad Católica San Antonio de Murcia (UCAM), Guadalupe, 30107 Murcia, Spain
| | - Enrique Ramos
- Clinical Pharmacology, Toxicology and Chemical Safety Unit, Institute of Bioengineering, Miguel Hernández University, Avda. de la Universidad s/n, 03202 Elche, Spain
| | - Ana M. Peiró
- Pharmacogenetic Unit, Clinical Pharmacology Department, Alicante Institute for Health and Biomedical Research (ISABIAL), General University Hospital of Alicante, c/Pintor Baeza, 12, 03010 Alicante, Spain
- Clinical Pharmacology, Toxicology and Chemical Safety Unit, Institute of Bioengineering, Miguel Hernández University, Avda. de la Universidad s/n, 03202 Elche, Spain
- Clinical Pharmacology Unit, Dr. Balmis General University Hospital, 03010 Alicante, Spain
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Wilczyński KM, Auguściak-Duma A, Stasik A, Cichoń L, Kawalec A, Janas-Kozik M. Association of OXTR, AVPR1a, LNPEP, and CD38 Genes' Expression with the Clinical Presentation of Autism Spectrum Disorder. Curr Issues Mol Biol 2023; 45:8359-8371. [PMID: 37886970 PMCID: PMC10604998 DOI: 10.3390/cimb45100527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023] Open
Abstract
Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder that affects social interactions, communication, and behavior. Although the predominant genetic predisposition to ASD seems beyond doubt, its exact nature remains unclear. In the context of social cognition disorders and the basis of ASD, the oxytocinergic and vasopresynergic systems arouse great interest among researchers. The aim of the present study was to analyze gene expression levels for oxytocin and vasopressin receptors, as well as CD38 protein and oxytocinase, in the context of the clinical picture of autism spectrum disorders. The study included 90 people, of whom 63 were diagnosed with ASD based on anamnesis, mental status testing, and the ADOS-2 protocol. The results obtained in the presented study indicate that the balance between the levels of expression of the CD38 gene and the oxytocinase gene plays a key role in the risk and clinical presentation of ASD. In a hypothetical scenario, an imbalance in the expression of CD38 and LNPEP could potentially lead to alterations in the concentrations of oxytocin and vasopressin. At the same time, the most frequently studied genes-AVPR1a and OXTR-seem to be at best of marginal importance for the risk of ASD.
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Affiliation(s)
- Krzysztof Maria Wilczyński
- Department of Developmental Age Psychiatry and Psychotherapy, Medical University of Silesia, 40-061 Katowice, Poland
- John Paul II Children’s and Family Health Center in Sosnowiec sp. z o.o., Gabrieli Zapolskiej 3, 41-218 Sosnowiec, Poland
| | - Aleksandra Auguściak-Duma
- Department of Molecular Biology and Genetics, Medical University of Silesia, 40-061 Katowice, Poland
| | - Aleksandra Stasik
- John Paul II Children’s and Family Health Center in Sosnowiec sp. z o.o., Gabrieli Zapolskiej 3, 41-218 Sosnowiec, Poland
| | - Lena Cichoń
- Department of Developmental Age Psychiatry and Psychotherapy, Medical University of Silesia, 40-061 Katowice, Poland
- John Paul II Children’s and Family Health Center in Sosnowiec sp. z o.o., Gabrieli Zapolskiej 3, 41-218 Sosnowiec, Poland
| | - Alicja Kawalec
- Department of Developmental Age Psychiatry and Psychotherapy, Medical University of Silesia, 40-061 Katowice, Poland
| | - Małgorzata Janas-Kozik
- Department of Developmental Age Psychiatry and Psychotherapy, Medical University of Silesia, 40-061 Katowice, Poland
- John Paul II Children’s and Family Health Center in Sosnowiec sp. z o.o., Gabrieli Zapolskiej 3, 41-218 Sosnowiec, Poland
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Iffland M, Livingstone N, Jorgensen M, Hazell P, Gillies D. Pharmacological intervention for irritability, aggression, and self-injury in autism spectrum disorder (ASD). Cochrane Database Syst Rev 2023; 10:CD011769. [PMID: 37811711 PMCID: PMC10561353 DOI: 10.1002/14651858.cd011769.pub2] [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: 10/10/2023]
Abstract
BACKGROUND Pharmacological interventions are frequently used for people with autism spectrum disorder (ASD) to manage behaviours of concern, including irritability, aggression, and self-injury. Some pharmacological interventions might help treat some behaviours of concern, but can also have adverse effects (AEs). OBJECTIVES To assess the effectiveness and AEs of pharmacological interventions for managing the behaviours of irritability, aggression, and self-injury in ASD. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, 11 other databases and two trials registers up to June 2022. We also searched reference lists of relevant studies, and contacted study authors, experts and pharmaceutical companies. SELECTION CRITERIA We included randomised controlled trials of participants of any age with a clinical diagnosis of ASD, that compared any pharmacological intervention to an alternative drug, standard care, placebo, or wait-list control. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Primary outcomes were behaviours of concern in ASD, (irritability, aggression and self-injury); and AEs. Secondary outcomes were quality of life, and tolerability and acceptability. Two review authors independently assessed each study for risk of bias, and used GRADE to judge the certainty of the evidence for each outcome. MAIN RESULTS We included 131 studies involving 7014 participants in this review. We identified 26 studies as awaiting classification and 25 as ongoing. Most studies involved children (53 studies involved only children under 13 years), children and adolescents (37 studies), adolescents only (2 studies) children and adults (16 studies), or adults only (23 studies). All included studies compared a pharmacological intervention to a placebo or to another pharmacological intervention. Atypical antipsychotics versus placebo At short-term follow-up (up to 6 months), atypical antipsychotics probably reduce irritability compared to placebo (standardised mean difference (SMD) -0.90, 95% confidence interval (CI) -1.25 to -0.55, 12 studies, 973 participants; moderate-certainty evidence), which may indicate a large effect. However, there was no clear evidence of a difference in aggression between groups (SMD -0.44, 95% CI -0.89 to 0.01; 1 study, 77 participants; very low-certainty evidence). Atypical antipsychotics may also reduce self-injury (SMD -1.43, 95% CI -2.24 to -0.61; 1 study, 30 participants; low-certainty evidence), possibly indicating a large effect. There may be higher rates of neurological AEs (dizziness, fatigue, sedation, somnolence, and tremor) in the intervention group (low-certainty evidence), but there was no clear evidence of an effect on other neurological AEs. Increased appetite may be higher in the intervention group (low-certainty evidence), but we found no clear evidence of an effect on other metabolic AEs. There was no clear evidence of differences between groups in musculoskeletal or psychological AEs. Neurohormones versus placebo At short-term follow-up, neurohormones may have minimal to no clear effect on irritability when compared to placebo (SMD -0.18, 95% CI -0.37 to -0.00; 8 studies; 466 participants; very low-certainty evidence), although the evidence is very uncertain. No data were reported for aggression or self -injury. Neurohormones may reduce the risk of headaches slightly in the intervention group, although the evidence is very uncertain. There was no clear evidence of an effect of neurohormones on any other neurological AEs, nor on any psychological, metabolic, or musculoskeletal AEs (low- and very low-certainty evidence). Attention-deficit hyperactivity disorder (ADHD)-related medications versus placebo At short-term follow-up, ADHD-related medications may reduce irritability slightly (SMD -0.20, 95% CI -0.40 to -0.01; 10 studies, 400 participants; low-certainty evidence), which may indicate a small effect. However, there was no clear evidence that ADHD-related medications have an effect on self-injury (SMD -0.62, 95% CI -1.63 to 0.39; 1 study, 16 participants; very low-certainty evidence). No data were reported for aggression. Rates of neurological AEs (drowsiness, emotional AEs, fatigue, headache, insomnia, and irritability), metabolic AEs (decreased appetite) and psychological AEs (depression) may be higher in the intervention group, although the evidence is very uncertain (very low-certainty evidence). There was no evidence of a difference between groups for any other metabolic, neurological, or psychological AEs (very low-certainty evidence). No data were reported for musculoskeletal AEs. Antidepressants versus placebo At short-term follow-up, there was no clear evidence that antidepressants have an effect on irritability (SMD -0.06, 95% CI -0.30 to 0.18; 3 studies, 267 participants; low-certainty evidence). No data for aggression or self-injury were reported or could be included in the analysis. Rates of metabolic AEs (decreased energy) may be higher in participants receiving antidepressants (very low-certainty evidence), although no other metabolic AEs showed clear evidence of a difference. Rates of neurological AEs (decreased attention) and psychological AEs (impulsive behaviour and stereotypy) may also be higher in the intervention group (very low-certainty evidence) although the evidence is very uncertain. There was no clear evidence of any difference in the other metabolic, neurological, or psychological AEs (very low-certainty evidence), nor between groups in musculoskeletal AEs (very low-certainty evidence). Risk of bias We rated most of the studies across the four comparisons at unclear overall risk of bias due to having multiple domains rated as unclear, very few rated as low across all domains, and most having at least one domain rated as high risk of bias. AUTHORS' CONCLUSIONS Evidence suggests that atypical antipsychotics probably reduce irritability, ADHD-related medications may reduce irritability slightly, and neurohormones may have little to no effect on irritability in the short term in people with ASD. There was some evidence that atypical antipsychotics may reduce self-injury in the short term, although the evidence is uncertain. There was no clear evidence that antidepressants had an effect on irritability. There was also little to no difference in aggression between atypical antipsychotics and placebo, or self-injury between ADHD-related medications and placebo. However, there was some evidence that atypical antipsychotics may result in a large reduction in self-injury, although the evidence is uncertain. No data were reported (or could be used) for self-injury or aggression for neurohormones versus placebo. Studies reported a wide range of potential AEs. Atypical antipsychotics and ADHD-related medications in particular were associated with an increased risk of metabolic and neurological AEs, although the evidence is uncertain for atypical antipsychotics and very uncertain for ADHD-related medications. The other drug classes had minimal or no associated AEs.
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Affiliation(s)
- Michelle Iffland
- Senior Practitioner Branch, NDIS Quality and Safeguards Commission, Penrith, Australia
| | - Nuala Livingstone
- Cochrane Evidence Production and Methods Directorate , Cochrane, London, UK
| | - Mikaela Jorgensen
- Senior Practitioner Branch, NDIS Quality and Safeguards Commission, Penrith, Australia
| | - Philip Hazell
- Speciality of Psychiatry, University of Sydney School of Medicine, Sydney, Australia
| | - Donna Gillies
- Senior Practitioner Branch, NDIS Quality and Safeguards Commission, Penrith, Australia
- Sydney, Australia
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László K, Vörös D, Correia P, Fazekas CL, Török B, Plangár I, Zelena D. Vasopressin as Possible Treatment Option in Autism Spectrum Disorder. Biomedicines 2023; 11:2603. [PMID: 37892977 PMCID: PMC10603886 DOI: 10.3390/biomedicines11102603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/13/2023] [Accepted: 09/21/2023] [Indexed: 10/29/2023] Open
Abstract
Autism spectrum disorder (ASD) is rather common, presenting with prevalent early problems in social communication and accompanied by repetitive behavior. As vasopressin was implicated not only in salt-water homeostasis and stress-axis regulation, but also in social behavior, its role in the development of ASD might be suggested. In this review, we summarized a wide range of problems associated with ASD to which vasopressin might contribute, from social skills to communication, motor function problems, autonomous nervous system alterations as well as sleep disturbances, and altered sensory information processing. Beside functional connections between vasopressin and ASD, we draw attention to the anatomical background, highlighting several brain areas, including the paraventricular nucleus of the hypothalamus, medial preoptic area, lateral septum, bed nucleus of stria terminalis, amygdala, hippocampus, olfactory bulb and even the cerebellum, either producing vasopressin or containing vasopressinergic receptors (presumably V1a). Sex differences in the vasopressinergic system might underline the male prevalence of ASD. Moreover, vasopressin might contribute to the effectiveness of available off-label therapies as well as serve as a possible target for intervention. In this sense, vasopressin, but paradoxically also V1a receptor antagonist, were found to be effective in some clinical trials. We concluded that although vasopressin might be an effective candidate for ASD treatment, we might assume that only a subgroup (e.g., with stress-axis disturbances), a certain sex (most probably males) and a certain brain area (targeting by means of virus vectors) would benefit from this therapy.
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Affiliation(s)
- Kristóf László
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
| | - Dávid Vörös
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
| | - Pedro Correia
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
- Hungarian Research Network, Institute of Experimental Medicine, 1083 Budapest, Hungary
| | - Csilla Lea Fazekas
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
- Hungarian Research Network, Institute of Experimental Medicine, 1083 Budapest, Hungary
| | - Bibiána Török
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
- Hungarian Research Network, Institute of Experimental Medicine, 1083 Budapest, Hungary
| | - Imola Plangár
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
| | - Dóra Zelena
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
- Hungarian Research Network, Institute of Experimental Medicine, 1083 Budapest, Hungary
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Wall CA, Sabatos-DeVito M, Franz L, Howard J, Major S, Bey A, Dawson G. Eye-tracking measures of social versus nonsocial attention are related to level of social engagement during naturalistic caregiver-child interactions in autistic children. Autism Res 2023; 16:1052-1062. [PMID: 36942384 DOI: 10.1002/aur.2920] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/11/2023] [Indexed: 03/23/2023]
Abstract
Eye-tracking (ET) measures indexing social attention have been proposed as sensitive measures related to autism, but less is known about the relationship between social and nonsocial attention and naturalistic measures of social engagement and whether sex moderates this relationship. This study investigated ET measures of social attention as predictors of social engagement during a naturalistic caregiver-child interaction (CCI). Participants included 132, 2-7-year-old autistic children (77% male) and their caregivers. Participants engaged in a CCI and an ET task in which they viewed a video of an actor making dyadic bids toward the child with toys in the background. Pearson correlations and multiple regression analyzes revealed that ET measures correlated with social engagement behaviors, including degree of attention to the caregiver and objects, joint engagement with the caregiver, and language-based joint engagement. Children who spent more time looking at toys were more likely to be unengaged during social interaction. Those who spent more time looking at the actor's mouth were more likely to engage in coordinated play with and without language. Sex moderated the relationship between time looking at toys and unengagement during play; males who spent more time looking at toys spent more time unengaged during play, whereas females who spent more time looking at toys spent less time unengaged during play. Overall, ET measures of social and nonsocial attention correlated with the level of social engagement during naturalistic play, with some sex differences. Eye-tracking measures that predict interaction patterns may provide insight into promoting social engagement between caregivers and their autistic children and can inform outcome monitoring and intervention development.
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Affiliation(s)
- Carla A Wall
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
| | - Maura Sabatos-DeVito
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
| | - Lauren Franz
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
| | - Jill Howard
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
| | - Samantha Major
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
| | - Alexandra Bey
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
| | - Geraldine Dawson
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
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Salazar de Pablo G, Pastor Jordá C, Vaquerizo-Serrano J, Moreno C, Cabras A, Arango C, Hernández P, Veenstra-VanderWeele J, Simonoff E, Fusar-Poli P, Santosh P, Cortese S, Parellada M. Systematic Review and Meta-analysis: Efficacy of Pharmacological Interventions for Irritability and Emotional Dysregulation in Autism Spectrum Disorder and Predictors of Response. J Am Acad Child Adolesc Psychiatry 2023; 62:151-168. [PMID: 35470032 DOI: 10.1016/j.jaac.2022.03.033] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 02/13/2022] [Accepted: 04/14/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Emotional dysregulation and irritability are common in individuals with autism spectrum disorder (ASD). We conducted the first meta-analysis assessing the efficacy of a broad range of pharmacological interventions for emotional dysregulation and irritability in ASD and predictors of response. METHOD Following a preregistered protocol (PROSPERO: CRD42021235779), we systematically searched multiple databases until January 1, 2021. We included placebo-controlled randomized controlled trials (RCTs) and evaluated the efficacy of pharmacological interventions and predictors of response for emotional dysregulation and irritability. We assessed heterogeneity using Q statistics and publication bias. We conducted subanalyses and meta-regressions to identify predictors of response. The primary effect size was the standardized mean difference. Quality of studies was assessed using the Cochrane Risk of Bias Tool (RoB2). RESULTS A total of 2,856 individuals with ASD in 45 studies were included, among which 26.7% of RCTs had a high risk of bias. Compared to placebo, antipsychotics (standardized mean difference = 1.028, 95% CI = 0.824-1.232) and medications used to treat attention-deficit/hyperactivity disorder (ADHD) (0.471, 0.061-0.881) were significantly better than placebo in improving emotional dysregulation and irritability, whereas evidence of efficacy was not found for other drug classes (p > .05). Within individual medications, evidence of efficacy was found for aripiprazole (1.179, 0.838-1.520) and risperidone (1.074, 0.818-1.331). Increased rates of comorbid epilepsy (β = -0.049, p = .026) were associated with a lower efficacy. CONCLUSION Some pharmacological interventions (particularly risperidone and aripiprazole) have proved efficacy for short-term treatment of emotional dysregulation and irritability in ASD and should be considered within a multimodal treatment plan, taking into account also the tolerability profile and families' preferences.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom; Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - Carolina Pastor Jordá
- University of Pittsburgh Medical Center, Pittsburgh, the Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania, and Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Julio Vaquerizo-Serrano
- Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - Carmen Moreno
- Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain
| | | | - Celso Arango
- Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain
| | - Patricia Hernández
- Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain
| | | | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom; University of Pavia, Italy, and OASIS service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Paramala Santosh
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - Samuele Cortese
- Centre for Innovation in Mental Health, Academic Unit of Psychology, Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, United Kingdom, the New York University Child Study Center, New York, Solent NHS Trust, and the Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, United Kingdom
| | - Mara Parellada
- Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain.
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Baska F, Bozó É, Patócs T. Vasopressin receptor antagonists: a patent summary (2018-2022). Expert Opin Ther Pat 2023; 33:385-395. [PMID: 37226495 DOI: 10.1080/13543776.2023.2218546] [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: 03/28/2023] [Accepted: 05/23/2023] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Arginine-vasopressin hormone (AVP) is a key regulator in many essential physiological processes. The effect of AVP is mediated through three receptors within the body, these are the G protein-coupled vasopressin receptors, namely V1a, V1b (also called V3), and V2. Numerous studies investigated the role of these receptors in certain pathological conditions; therefore, stimulation or inhibition of these receptors may be a treatment option in these diseases. AREAS COVERED In this manuscript, the authors summarize recent patent activity (2018-2022) associated with vasopressin receptor antagonists (selective V1a or V2, and dual-acting V1a/V2), focusing mostly on chemical structures, their modifications, and potential clinical applications. Patent search was carried out using SciFinder, Espacenet, Patentscope, Cortellis Competitive Intelligence, and Derwent Innovation databases. EXPERT OPINION In recent years, vasopressin receptor antagonists have been in the spotlight of drug discovery, especially V1a selective molecules. Publishing balovaptan as a possible treatment for autism spectrum disorder (ASD), greatly increased the interest in CNS-acting vasopressin antagonists. In addition, peripherally active selective V2 and dual-acting V1a/V2 antagonists have also been developed. Although clinical trials were unsuccessful in many cases, there is still potential in the research of vasopressin receptor antagonists as shown by several currently ongoing clinical trials.
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Affiliation(s)
- Ferenc Baska
- Chemistry Division, Gedeon Richter Plc, Budapest 10, Hungary
| | - Éva Bozó
- Chemistry Division, Gedeon Richter Plc, Budapest 10, Hungary
| | - Tamás Patócs
- IP Department, Gedeon Richter Plc, Budapest, Hungary
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10
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Hollander E, Jacob S, Jou R, McNamara N, Sikich L, Tobe R, Smith J, Sanders K, Squassante L, Murtagh L, Gleissl T, Wandel C, Veenstra-VanderWeele J. Balovaptan vs Placebo for Social Communication in Childhood Autism Spectrum Disorder: A Randomized Clinical Trial. JAMA Psychiatry 2022; 79:760-769. [PMID: 35793101 PMCID: PMC9260643 DOI: 10.1001/jamapsychiatry.2022.1717] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Importance There are no approved medications for the core symptoms of autism spectrum disorder (ASD), socialization and communication difficulties. Objective To evaluate the efficacy and safety of balovaptan, an oral selective vasopressin 1a receptor antagonist, compared with placebo in children and adolescents with ASD. Design, Setting, and Participants The aV1ation study was a randomized, double-blind, 24-week, parallel-group, placebo-controlled phase 2 trial. Between November 22, 2016, and September 3, 2019, individuals were screened and randomly assigned to treatment groups. The primary efficacy analysis population comprised participants taking age-adjusted balovaptan equivalent to a 10-mg adult dose and participants from the concurrently randomized placebo group. This multicenter trial took place across 41 sites in the US. Participants were aged 5 to 17 years with diagnosed ASD and an IQ of 70 or greater. Data were analyzed from April 8 to November 16, 2020. Interventions Participants were randomly assigned to daily 4-mg or 10-mg adult-equivalent balovaptan or placebo, until the 4-mg group was discontinued. Main Outcomes and Measures The primary end point was change from baseline on the Vineland-II two-domain composite (2DC; socialization and communication domains) score at week 24. Results Between November 2016 and September 2019, a total of 599 individuals were screened and 339 participants were randomly assigned to receive 4-mg balovaptan adult-equivalent dose (91 [26.8%]), 10-mg balovaptan adult-equivalent dose (126 [37.2%]), or placebo (122 [36.0%]). Primary analysis included 86 participants assigned to receive 10-mg balovaptan adult-equivalent dose and 81 assigned to receive placebo (mean [SD] age, 12.1 [3.4] years; 139 male participants [83.2%]). No statistically significant differences were observed between the balovaptan and placebo groups in change from baseline on the Vineland-II 2DC score at week 24 (difference in adjusted least-squares mean, -0.16; 90% CI, -2.56 to 2.23; P = .91). No improvements for balovaptan vs placebo were observed at week 24 for any secondary end points. Balovaptan was well tolerated with no emerging safety concerns. Similar proportions of participants reported adverse events (balovaptan, 66 of 86 [76.7%] vs placebo, 61 of 81 [75.3%]) and serious adverse events (balovaptan, 1 of 86 [1.2%] vs placebo, 4 of 81 [4.9%]). Conclusions and Relevance In this randomized clinical trial, balovaptan did not demonstrate efficacy in improvement of socialization and communication in this population with pediatric ASD. Balovaptan was well tolerated in children 5 years or older. Further development of robust, sensitive, and objective outcome measures may help to improve future studies in the assessment of therapies targeting communication and socialization in pediatric ASD. Trial Registration ClinicalTrials.gov Identifier: NCT02901431.
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Affiliation(s)
- Eric Hollander
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York, New York
| | - Suma Jacob
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis
| | - Roger Jou
- Child Study Center, Yale School of Medicine, New Haven, Connecticut
| | - Nora McNamara
- Department of Psychiatry, University Hospitals, Cleveland, Ohio
| | - Linmarie Sikich
- Department of Psychiatry and Behavioral Sciences, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
| | - Russell Tobe
- Nathan Kline Institute for Psychiatric Research, Orangeburg, New York
| | - Janice Smith
- F. Hoffmann-La Roche Ltd, Welwyn Garden City, United Kingdom
| | - Kevin Sanders
- F. Hoffmann-La Roche Ltd, Genentech, South San Francisco, California
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11
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Yang YD, Yang BB, Li L. A nonneglectable stereochemical factor in drug development: Atropisomerism. Chirality 2022; 34:1355-1370. [PMID: 35904531 DOI: 10.1002/chir.23497] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/09/2022] [Accepted: 07/11/2022] [Indexed: 11/07/2022]
Abstract
Chirality is one of the key factors affecting the medicinal efficacy of compounds. In addition to central chirality, sterically hindered chiral axes commonly appear in drugs and the resulting chirality is known as atropisomerism. With developments in medicinal chemistry, atropisomerism has attracted increasing attention. This review discusses the classification, biological activity, pharmacokinetics, toxicity and side effects of atropisomers, and can serve as a reference in the research and development of potential chiral drugs.
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Affiliation(s)
- Ya-Dong Yang
- Beijing Key Laboratory of Active Substances Discovery and Druggability Evaluation, Institute of Materia Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Bei-Bei Yang
- Beijing Key Laboratory of Active Substances Discovery and Druggability Evaluation, Institute of Materia Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Li Li
- Beijing Key Laboratory of Active Substances Discovery and Druggability Evaluation, Institute of Materia Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
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12
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Jacob S, Anagnostou E, Hollander E, Jou R, McNamara N, Sikich L, Tobe R, Murphy D, McCracken J, Ashford E, Chatham C, Clinch S, Smith J, Sanders K, Murtagh L, Noeldeke J, Veenstra-VanderWeele J. Large multicenter randomized trials in autism: key insights gained from the balovaptan clinical development program. Mol Autism 2022; 13:25. [PMID: 35690870 PMCID: PMC9188723 DOI: 10.1186/s13229-022-00505-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/31/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a common and heterogeneous neurodevelopmental condition that is characterized by the core symptoms of social communication difficulties and restricted and repetitive behaviors. At present, there is an unmet medical need for therapies to ameliorate these core symptoms in order to improve quality of life of autistic individuals. However, several challenges are currently faced by the ASD community relating to the development of pharmacotherapies, namely in the conduct of clinical trials. Balovaptan is a V1a receptor antagonist that has been investigated to improve social communication difficulties in individuals with ASD. In this viewpoint, we draw upon our recent first-hand experiences of the balovaptan clinical development program to describe current challenges of ASD trials. DISCUSSION POINTS The balovaptan trials were conducted in a wide age range of individuals with ASD with the added complexities associated with international trials. When summarizing all three randomized trials of balovaptan, a placebo response was observed across several outcome measures. Placebo response was predicted by greater baseline symptom severity, online recruitment of participants, and less experienced or non-academic trial sites. We also highlight challenges relating to selection of outcome measures in ASD, the impact of baseline characteristics, and the role of expectation bias in influencing trial results. CONCLUSION Taken together, the balovaptan clinical development program has advanced our understanding of the key challenges facing ASD treatment research. The insights gained can be used to inform and improve the design of future clinical trials with the collective aim of developing efficacious therapies to support individuals with ASD.
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Affiliation(s)
- Suma Jacob
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA.
| | - Evdokia Anagnostou
- Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, Toronto, ON, Canada
| | - Eric Hollander
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York, NY, USA
| | - Roger Jou
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Nora McNamara
- Department of Psychiatry, University Hospitals, Cleveland, OH, USA
| | - Linmarie Sikich
- Department of Psychiatry and Behavioral Sciences, Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
| | - Russell Tobe
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | | | - James McCracken
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | | | | | | | - Janice Smith
- F. Hoffmann-La Roche Ltd, Welwyn Garden City, UK
| | - Kevin Sanders
- F. Hoffmann-La Roche Ltd, Genentech, South San Francisco, CA, USA
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13
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Shic F, Naples AJ, Barney EC, Chang SA, Li B, McAllister T, Kim M, Dommer KJ, Hasselmo S, Atyabi A, Wang Q, Helleman G, Levin AR, Seow H, Bernier R, Charwaska K, Dawson G, Dziura J, Faja S, Jeste SS, Johnson SP, Murias M, Nelson CA, Sabatos-DeVito M, Senturk D, Sugar CA, Webb SJ, McPartland JC. The autism biomarkers consortium for clinical trials: evaluation of a battery of candidate eye-tracking biomarkers for use in autism clinical trials. Mol Autism 2022; 13:15. [PMID: 35313957 PMCID: PMC10124777 DOI: 10.1186/s13229-021-00482-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 12/20/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Eye tracking (ET) is a powerful methodology for studying attentional processes through quantification of eye movements. The precision, usability, and cost-effectiveness of ET render it a promising platform for developing biomarkers for use in clinical trials for autism spectrum disorder (ASD). METHODS The autism biomarkers consortium for clinical trials conducted a multisite, observational study of 6-11-year-old children with ASD (n = 280) and typical development (TD, n = 119). The ET battery included: Activity Monitoring, Social Interactive, Static Social Scenes, Biological Motion Preference, and Pupillary Light Reflex tasks. A priori, gaze to faces in Activity Monitoring, Social Interactive, and Static Social Scenes tasks were aggregated into an Oculomotor Index of Gaze to Human Faces (OMI) as the primary outcome measure. This work reports on fundamental biomarker properties (data acquisition rates, construct validity, six-week stability, group discrimination, and clinical relationships) derived from these assays that serve as a base for subsequent development of clinical trial biomarker applications. RESULTS All tasks exhibited excellent acquisition rates, met expectations for construct validity, had moderate or high six-week stabilities, and highlighted subsets of the ASD group with distinct biomarker performance. Within ASD, higher OMI was associated with increased memory for faces, decreased autism symptom severity, and higher verbal IQ and pragmatic communication skills. LIMITATIONS No specific interventions were administered in this study, limiting information about how ET biomarkers track or predict outcomes in response to treatment. This study did not consider co-occurrence of psychiatric conditions nor specificity in comparison with non-ASD special populations, therefore limiting our understanding of the applicability of outcomes to specific clinical contexts-of-use. Research-grade protocols and equipment were used; further studies are needed to explore deployment in less standardized contexts. CONCLUSIONS All ET tasks met expectations regarding biomarker properties, with strongest performance for tasks associated with attention to human faces and weakest performance associated with biological motion preference. Based on these data, the OMI has been accepted to the FDA's Biomarker Qualification program, providing a path for advancing efforts to develop biomarkers for use in clinical trials.
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Affiliation(s)
- Frederick Shic
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA, 98101, USA.
- Department of General Pediatrics, University of Washington School of Medicine, Seattle, WA, USA.
| | - Adam J Naples
- Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA
| | - Erin C Barney
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA, 98101, USA
- Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA
| | - Shou An Chang
- Department of Psychology, Yale University, 2 Hillhouse Ave, New Haven, CT, 06520, USA
| | - Beibin Li
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA, 98101, USA
- Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, WA, USA
| | - Takumi McAllister
- Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA
| | - Minah Kim
- Department of Psychology, University of Virginia, 102 Gilmer Hall, P.O. Box 400400, Charlottesville, VA, 22904, USA
| | - Kelsey J Dommer
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA, 98101, USA
| | - Simone Hasselmo
- Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA
| | - Adham Atyabi
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA, 98101, USA
- Department of General Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
- Department of Computer Science, University of Colorado - Colorado Springs, Colorado Springs, CO, USA
| | - Quan Wang
- Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA
| | - Gerhard Helleman
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - April R Levin
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Helen Seow
- Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA
| | - Raphael Bernier
- Department of Psychiatry and Behavioral Science, University of Washington School of Medicine, Seattle, WA, USA
| | - Katarzyna Charwaska
- Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA
| | - Geraldine Dawson
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, USA
| | - James Dziura
- Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Susan Faja
- Harvard Medical School, Boston, MA, USA
- Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Shafali Spurling Jeste
- Division of Neurology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Scott P Johnson
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Michael Murias
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Charles A Nelson
- Harvard Medical School, Boston, MA, USA
- Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
- Graduate School of Education, Harvard University, Boston, MA, USA
| | | | - Damla Senturk
- Department of Biostatistics, University of California Los Angeles, Los Angeles, CA, USA
| | - Catherine A Sugar
- Department of Biostatistics, University of California Los Angeles, Los Angeles, CA, USA
- Division of Neurology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Sara J Webb
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA, 98101, USA
- Department of Psychiatry and Behavioral Science, University of Washington School of Medicine, Seattle, WA, USA
| | - James C McPartland
- Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA.
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Jacob S, Veenstra-VanderWeele J, Murphy D, McCracken J, Smith J, Sanders K, Meyenberg C, Wiese T, Deol-Bhullar G, Wandel C, Ashford E, Anagnostou E. Efficacy and safety of balovaptan for socialisation and communication difficulties in autistic adults in North America and Europe: a phase 3, randomised, placebo-controlled trial. Lancet Psychiatry 2022; 9:199-210. [PMID: 35151410 DOI: 10.1016/s2215-0366(21)00429-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/17/2021] [Accepted: 10/14/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND There are no approved pharmacological therapies to support treatment of the core communication and socialisation difficulties associated with autism spectrum disorder in adults. We aimed to assess the efficacy, safety, and pharmacokinetics of balovaptan, a vasopressin 1a receptor antagonist, versus placebo in autistic adults. METHODS V1aduct was a phase 3, randomised, placebo-controlled, double-blind trial, conducted at 46 sites across six countries (the USA, the UK, France, Italy, Spain, and Canada). Eligible participants were aged 18 years or older with an intelligence quotient (IQ) of 70 or higher, and met the criteria for moderate-to-severe autism spectrum disorder (DSM-5 and Autism Diagnostic Observation Schedule). Participants were randomly allocated (1:1), with an independent interactive voice or web-based response system, to receive balovaptan (10 mg) or placebo daily for 24 weeks. Randomisation was stratified by an individual's baseline Vineland-II two-domain composite (2DC) score (<60 or ≥60), sex, region (North America or rest of world), and age (<25 years or ≥25 years). Participants, study site personnel, and the sponsor were masked to treatment assignment. The primary endpoint was change from baseline in Vineland-II 2DC score (the mean composite score across the Vineland-II socialisation and communication domains) at week 24. The primary analysis was done with ANCOVA in the intention-to-treat population. The V1aduct study was terminated for futility after around 50% of participants completed the week 24 visit. This trial is registered with ClinicalTrials.gov (NCT03504917). FINDINGS Between Aug 8, 2018, and July 1, 2020, 540 people were screened for eligibility, of whom 322 were allocated to receive balovaptan (164 [51%]) or placebo (158 [49%]). One participant from the balovaptan group was not treated before trial termination and was excluded from the analysis. 60 participants in the balovaptan group and 55 in the placebo group discontinued treatment before week 24. The sample consisted of 64 (20%) women and 257 (80%) men, with 260 (81%) participants from North America and 61 (19%) from Europe. At baseline, mean age was 27·6 years (SD 9·7) and mean IQ score was 104·8 (18·1). Two (1%) participants were American Indian or Alaska Native, eight (2%) were Asian, 15 (5%) were Black or African American, 283 (88%) were White, four (1%) were of multiple races, and nine (3%) were of unknown race. Mean baseline Vineland-II 2DC scores were 67·2 (SD 15·3) in the balovaptan group and 66·2 (17·7) in the placebo group. The interim futility analysis showed no improvement for balovaptan versus placebo in terms of Vineland-II 2DC score at week 24 compared with baseline, with a least-squares mean change of 2·91 (SE 1·52) in the balovaptan group (n=79) and 4·75 (1·60) in the placebo group (n=71; estimated treatment difference -1·84 [95% CI -5·15 to 1·48]). In the final analysis, mean change from baseline in Vineland-II 2DC score at week 24 was 4·56 (SD 10·85) in the balovaptan group (n=111) and 6·83 (12·18) in the placebo group (n=99). Balovaptan was well tolerated, with similar proportions of participants with at least one adverse event in the balovaptan group (98 [60%] of 163) and placebo group (104 [66%] of 158). The most common adverse events were nasopharyngitis (14 [9%] in the balovaptan group and 19 [12%] in the placebo group), diarrhoea (11 [7%] and 14 [9%]), upper respiratory tract infection (ten [6%] and nine [6%]), insomnia (five [3%] and eight [5%]), oropharyngeal pain (five [3%] and eight [5%]), and dizziness (two [1%] and ten [6%]). Serious adverse events were reported for two (1%) participants in the balovaptan group (one each of suicidal ideation and schizoaffective disorder), and five (3%) participants in the placebo group (one each of suicidal ideation, panic disorder, limb abscess, urosepsis, colitis [in the same participant with urosepsis], and death by suicide). No treatment-related deaths occurred. INTERPRETATION Balovaptan did not improve social communication in autistic adults. This study provides insights into challenges facing autism spectrum disorder trials, including the considerable placebo response and the selection of appropriate outcome measures. FUNDING F Hoffmann-La Roche.
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Affiliation(s)
- Suma Jacob
- Child and Adolescent Psychiatry, University of Minnesota, Minneapolis, MN, USA.
| | | | | | - James McCracken
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | | | - Kevin Sanders
- F Hoffmann-La Roche, Genentech, South San Francisco, CA, USA
| | | | | | | | | | | | - Evdokia Anagnostou
- Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, Toronto, ON, Canada
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Le C, Finger E. Pharmacotherapy for Neuropsychiatric Symptoms in Frontotemporal Dementia. CNS Drugs 2021; 35:1081-1096. [PMID: 34426949 DOI: 10.1007/s40263-021-00854-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2021] [Indexed: 10/20/2022]
Abstract
Despite significant progress in the understanding of the frontotemporal dementias (FTDs), there remains no disease-modifying treatment for these conditions, and limited effective symptomatic treatment. Behavioural variant frontotemporal dementia (bvFTD) is the most common FTD syndrome, and is characterized by severe impairments in behaviour, personality and cognition. Neuropsychiatric symptoms are common features of bvFTD but are present in the other FTD syndromes. Current treatment strategies therefore focus on ameliorating the neuropsychiatric features. Here we review the rationale for current treatments related to each of the main neuropsychiatric symptoms forming the diagnostic criteria for bvFTD relevant to all FTD subtypes, and two additional symptoms not currently part of the diagnostic criteria: lack of insight and psychosis. Given the paucity of effective treatments for these symptoms, we highlight how contributing mechanisms delineated in cognitive neuroscience may inform future approaches to clinical trials and more precise symptomatic treatments for FTDs.
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Affiliation(s)
- Christine Le
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.
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16
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Henneberry E, Lamy M, Dominick KC, Erickson CA. Decades of Progress in the Psychopharmacology of Autism Spectrum Disorder. J Autism Dev Disord 2021; 51:4370-4394. [PMID: 34491511 DOI: 10.1007/s10803-021-05237-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2021] [Indexed: 12/14/2022]
Abstract
Recent decades have been marked by a wave drug treatment research in autism spectrum disorder (ASD). This work has resulted in improved ability to treat commonly occurring behavioral challenges associated with ASD including most prominently irritability marked by aggression, self-injurious behavior, and severe tantrums. While treatment of interfering behavior has progressed in our field, there remain several areas of unmet medical need including most prominently a lack of any approved drug therapies for the core, defining symptoms of autism. We outline the progress to date in the field of autism drug treatment while taking a future look forward into how decades of work can inform better future steps in this field.
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Affiliation(s)
- Erin Henneberry
- Division of Child and Adolescent Psychiatry, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 4002, Cincinnati, OH, 45229, USA
| | - Martine Lamy
- Division of Child and Adolescent Psychiatry, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 4002, Cincinnati, OH, 45229, USA.,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati School of Medicine, Cincinnati, USA
| | - Kelli C Dominick
- Division of Child and Adolescent Psychiatry, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 4002, Cincinnati, OH, 45229, USA.,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati School of Medicine, Cincinnati, USA
| | - Craig A Erickson
- Division of Child and Adolescent Psychiatry, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 4002, Cincinnati, OH, 45229, USA. .,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati School of Medicine, Cincinnati, USA.
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17
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Derks M, Lennon-Chrimes S, Guenther A, Squassante L, Wandel C, Szczesny P, Paehler A, Kletzl H. Bioavailability and pharmacokinetic profile of balovaptan, a selective, brain-penetrant vasopressin 1a receptor antagonist, in healthy volunteers. Expert Opin Investig Drugs 2021; 30:893-901. [PMID: 34176392 DOI: 10.1080/13543784.2021.1948009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Balovaptan is a potent, selective vasopressin 1a receptor antagonist. The early-phase pharmacokinetics (PK) of balovaptan are reported. RESEARCH DESIGN AND METHODS Two Phase 1 studies (overall N = 93) assessed single- and multiple-dose balovaptan PK in healthy adults. One (N = 16) assessed absolute oral bioavailability (10 mg or 50 mg) vs a [13C]-balovaptan microdose. The other (N = 77) explored single- (0.5-76 mg) and multiple-dose (14 days; 12-52 mg/day) - randomized 6:2 balovaptan:placebo per dose - PK, dose proportionality, and the effect of food on single-dose (32 mg) Cmax and AUCinf. RESULTS Absolute balovaptan bioavailability was high (103-116%). Steady-state (Day 14) balovaptan PK was approximately dose proportional with a half-life of 45-47 hours, but single-dose Cmax increased more than dose proportionally and half-life was inversely dose-proportional - a discordance partially attributable to a dose-and-time-dependent volume of distribution. Accumulation (Day 1-Day 14) was inversely dose-proportional (~3.5 [12 mg] to ~1.8 [52 mg]). There was no relevant effect of a high-fat meal on single-dose balovaptan exposure. There were no safety signals: 2/93 subjects discontinued for adverse events. CONCLUSIONS Balovaptan was well tolerated at single (≤76 mg) and multiple (≤52 mg/day) doses, with a PK profile supportive of once-daily administration without food restrictions. TRIAL REGISTRATION ClinicalTrials.gov NCT03764449; NCT01418963.
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Affiliation(s)
- Michael Derks
- Roche Pharma Research & Early Development, Roche Innovation Center Welwyn, Roche Products Ltd, Welwyn Garden City, UK
| | - Sian Lennon-Chrimes
- Roche Pharma Research & Early Development, Roche Innovation Center Welwyn, Roche Products Ltd, Welwyn Garden City, UK
| | - Andreas Guenther
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche AG, Basel, Switzerland
| | - Lisa Squassante
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche AG, Basel, Switzerland
| | - Christoph Wandel
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche AG, Basel, Switzerland
| | - Piotr Szczesny
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche AG, Basel, Switzerland
| | - Axel Paehler
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche AG, Basel, Switzerland
| | - Heidemarie Kletzl
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche AG, Basel, Switzerland
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18
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Szeleczky Z, Szakács Z, Bozó É, Baska F, Vukics K, Lévai S, Temesvári K, Vass E, Béni Z, Krámos B, Magdó I, Szántay C, Kóti J, Domány-Kovács K, Greiner I, Bata I. Synthesis and Characterization of New V 1A Antagonist Compounds: The Separation of Four Atropisomeric Stereoisomers. J Med Chem 2021; 64:10445-10468. [PMID: 34255509 DOI: 10.1021/acs.jmedchem.1c00863] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
A new class of selective vasopressin receptor 1A (V1A) antagonists was identified, where "methyl-scan" was performed around the benzene ring of the 5-hydroxy-triazolobenzazepine core. This led to the synthesis of two 10-methyl derivatives, each possessing a chiral axis and a stereogenic center. The four atropisomeric stereoisomers (involving two enantiomer pairs and atropisomeric diastereomers) could be successfully isolated and spectroscopically characterized. According to the in vitro pharmacological profiles of the compounds, the human V1A receptor has a strong preference toward the isomers having an aR axial chirality, the most active isomer being the aR,5S isomer. Furthermore, the structure-activity relationships obtained for the isomers and for the newly synthesized analogues could be tentatively explained by an in silico study.
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Affiliation(s)
- Zsolt Szeleczky
- Gedeon Richter Plc., 19-21 Gyömrői út, Budapest 1103, Hungary
| | - Zoltán Szakács
- Gedeon Richter Plc., 19-21 Gyömrői út, Budapest 1103, Hungary
| | - Éva Bozó
- Gedeon Richter Plc., 19-21 Gyömrői út, Budapest 1103, Hungary
| | - Ferenc Baska
- Gedeon Richter Plc., 19-21 Gyömrői út, Budapest 1103, Hungary
| | | | - Sándor Lévai
- Gedeon Richter Plc., 19-21 Gyömrői út, Budapest 1103, Hungary
| | | | - Elemér Vass
- Institute of Chemistry, Eötvös Loránd University, Pázmány Péter sétány 1/A, Budapest H-1117, Hungary
| | - Zoltán Béni
- Gedeon Richter Plc., 19-21 Gyömrői út, Budapest 1103, Hungary
| | - Balázs Krámos
- Gedeon Richter Plc., 19-21 Gyömrői út, Budapest 1103, Hungary
| | - Ildikó Magdó
- Gedeon Richter Plc., 19-21 Gyömrői út, Budapest 1103, Hungary
| | - Csaba Szántay
- Gedeon Richter Plc., 19-21 Gyömrői út, Budapest 1103, Hungary
| | - János Kóti
- Gedeon Richter Plc., 19-21 Gyömrői út, Budapest 1103, Hungary
| | | | - István Greiner
- Gedeon Richter Plc., 19-21 Gyömrői út, Budapest 1103, Hungary
| | - Imre Bata
- Gedeon Richter Plc., 19-21 Gyömrői út, Budapest 1103, Hungary
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19
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A white paper on a neurodevelopmental framework for drug discovery in autism and other neurodevelopmental disorders. Eur Neuropsychopharmacol 2021; 48:49-88. [PMID: 33781629 DOI: 10.1016/j.euroneuro.2021.02.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/08/2021] [Accepted: 02/15/2021] [Indexed: 12/20/2022]
Abstract
In the last decade there has been a revolution in terms of genetic findings in neurodevelopmental disorders (NDDs), with many discoveries critical for understanding their aetiology and pathophysiology. Clinical trials in single-gene disorders such as fragile X syndrome highlight the challenges of investigating new drug targets in NDDs. Incorporating a developmental perspective into the process of drug development for NDDs could help to overcome some of the current difficulties in identifying and testing new treatments. This paper provides a summary of the proceedings of the 'New Frontiers Meeting' on neurodevelopmental disorders organised by the European College of Neuropsychopharmacology in conjunction with the Innovative Medicines Initiative-sponsored AIMS-2-TRIALS consortium. It brought together experts in developmental genetics, autism, NDDs, and clinical trials from academia and industry, regulators, patient and family associations, and other stakeholders. The meeting sought to provide a platform for focused communication on scientific insights, challenges, and methodologies that might be applicable to the development of CNS treatments from a neurodevelopmental perspective. Multidisciplinary translational consortia to develop basic and clinical research in parallel could be pivotal to advance knowledge in the field. Although implementation of clinical trials for NDDs in paediatric populations is widely acknowledged as essential, safety concerns should guide each aspect of their design. Industry and academia should join forces to improve knowledge of the biology of brain development, identify the optimal timing of interventions, and translate these findings into new drugs, allowing for the needs of users and families, with support from regulatory agencies.
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20
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Exploring Social Biomarkers in High-Functioning Adults with Autism and Asperger's Versus Healthy Controls: A Cross-Sectional Analysis. J Autism Dev Disord 2021; 50:4412-4430. [PMID: 32279223 PMCID: PMC7677266 DOI: 10.1007/s10803-020-04493-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Biomarkers for autism spectrum disorder (ASD) are lacking but would facilitate drug development for the core deficits of the disorder. We evaluated markers proposed for characterization of differences in social communication and interaction in adults with ASD versus healthy controls (HC) for utility as biomarkers. Data pooled from an observational study and baseline data from a placebo-controlled study were analyzed. Between-group differences were observed in eye-tracking tasks for activity monitoring, biomotion, human activity preference, composite score (p = 0.0001-0.037) and pupillometry (various tasks, p = 0.017-0.05). Impaired olfaction was more common in the ASD sample versus HC (p = 0.018). Our preliminary results suggest the potential use for stratification and response sub-analyses outcome-prediction of specific eye-tracking tasks, pupillometry and olfaction tests in ASD trials.
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21
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Derks MGM, Wandel C, Young A, Bolt SK, Meyenberg C. Open-Label Assessment of the Effects of Itraconazole and Rifampicin on Balovaptan Pharmacokinetics in Healthy Volunteers. Adv Ther 2020; 37:4720-4729. [PMID: 32935287 DOI: 10.1007/s12325-020-01491-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 08/28/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Balovaptan, an investigational vasopressin 1a receptor antagonist that has been evaluated for improvement of social communication and interaction, is primarily metabolized by cytochrome P450 3A4 (CYP3A4). METHODS Two single-center, non-randomized, two-period, phase 1 studies assessed the effect of the strong CYP3A4 inhibitor itraconazole (study NCT03579719) or the strong CYP3A4 inducer rifampicin (study NCT03586726) at steady state on the pharmacokinetics (PK) of steady-state balovaptan in healthy volunteers. Participants received balovaptan (5 or 10 mg/day) alone for 10 days, or in combination with itraconazole (200 mg/day) for 15 days, or rifampicin (600 mg/day) for 10 days, following balovaptan washout and itraconazole/rifampicin pre-dosing. Geometric mean ratios (GMRs) and 90% confidence intervals (90% CIs) for the area under the concentration-time curve over the dosing interval (AUC) and maximum plasma concentration (Cmax) of balovaptan dosed with vs. without itraconazole/rifampicin were estimated from a mixed effects model. RESULTS Both studies comprised 15-16 healthy male and female volunteers. Itraconazole 200 mg/day elevated steady-state exposure to 5 mg/day balovaptan approximately 4.5-5.5-fold (Day 15 GMR [90% CI], 4.46 [4.06-4.90] for Cmax and 5.57 [5.00-6.21] for AUC) and extended the time to steady state from ~ 5 days to ~ 13-14 days. Rifampicin 600 mg/day resulted in ~ 90% reductions in both the Cmax (Day 10 GMR [90% CI], 0.14 [0.12-0.15]) and AUC (0.07 [0.06-0.07]) of balovaptan 10 mg/day. Time to balovaptan steady state could not be determined with rifampicin. There were no clinically significant safety findings in either study. CONCLUSIONS Strong modulators of CYP3A4 activity will significantly alter the PK of balovaptan, with the effect of CYP3A4 induction greater than that of inhibition. Caution should be taken when concomitantly dosing balovaptan with moderate or strong CYP3A4 inducers or strong CYP3A4 inhibitors. TRIAL REGISTRATION NUMBER NCT03579719; NCT03586726.
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22
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Recent Advances in the Pharmacological Management of Behavioral Disturbances Associated with Autism Spectrum Disorder in Children and Adolescents. Paediatr Drugs 2020; 22:473-483. [PMID: 32686015 DOI: 10.1007/s40272-020-00408-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Autism spectrum disorder (ASD) is a heterogeneous neuropsychiatric condition affecting an estimated one in 36 children. Youth with ASD may have severe behavioral disturbances including irritability, aggression, and hyperactivity. Currently, there are only two medications (risperidone and aripiprazole) approved by the US Food and Drug Administration (FDA) for the treatment of irritability associated with ASD. Pharmacologic treatments are commonly used to target ASD-associated symptoms including irritability, mood lability, anxiety, and hyperactivity. However, evidence for the efficacy of many commonly used treatments is limited by the lack of large placebo-controlled trials of these medications in this population. Research into the pathophysiology of ASD has led to new targets for pharmacologic therapy including the neuroimmune system, the endocannabinoid system, and the glutamatergic neurotransmitter system. The goal of this review is to provide an overview of the current evidence base for commonly used treatments, as well as emerging treatment options for common behavioral disturbances seen in youth with ASD.
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23
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Grzadzinski R, Janvier D, Kim SH. Recent Developments in Treatment Outcome Measures for Young Children With Autism Spectrum Disorder (ASD). Semin Pediatr Neurol 2020; 34:100806. [PMID: 32446440 PMCID: PMC7248125 DOI: 10.1016/j.spen.2020.100806] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Significant advancements have been made in early intervention programs for children with Autism spectrum disorder (ASD). However, measuring treatment response for children with ASD is difficult due to the heterogeneity of changes in symptoms, which can be subtle, especially over a short period of time. Here we outline the challenge of evaluating treatment response with currently available measures as well as newly developed or refined measures that may be useful in clinical trials for young children with ASD. Continued development of treatment outcome measures will help the field identify and compare efficacious interventions and tailor treatments for children with ASD.
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Affiliation(s)
- Rebecca Grzadzinski
- University of North Carolina, Carolina Institute for Developmental Disabilities, Chapel Hill, NC.
| | - Denisse Janvier
- Center for Autism and the Developing Brain, Weill Cornell Medical College, New York-Presbyterian Hospital, White Plains, NY
| | - So Hyun Kim
- Center for Autism and the Developing Brain, Weill Cornell Medical College, New York-Presbyterian Hospital, White Plains, NY
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24
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Neurobiology of sensory processing in autism spectrum disorder. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2020; 173:161-181. [PMID: 32711809 DOI: 10.1016/bs.pmbts.2020.04.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Altered sensory processing and perception has been one of the characteristics of autism spectrum disorder (ASD). In this chapter, we review the neural underpinnings of sensory abnormalities of ASD by examining the literature on clinical, behavioral and neurobiological evidence that underlies the main patterns of sensory integration function and dysfunction. Furthermore, neural differences in anatomy, function and connectivity of different regions underlying sensory processing are also discussed. We conclude that sensory integration intervention is built on the premise of neuroplasticity to improve function and behavior for individuals with ASD.
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25
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Abstract
PURPOSE OF REVIEW Research on the pathophysiology of syndromic autism spectrum disorder (ASD) has contributed to the uncovering of mechanisms in nonsyndromic ASD. The current review aims to compare recent progress in therapeutics development for ASD with those for fragile X syndrome (FXS), the most frequent monogenic form of ASD. RECENT FINDINGS Although candidates such as oxytocin, vasopressin, and cannabinoids are being tested as novel therapeutics, it remains difficult to focus on a specific molecular target of drug development for ASD core symptoms. As the pathophysiology of FXS has been well described as having a causal gene, fragile X mental retardation-1, development of therapeutic agents for FXS is focused on specific molecular targets, such as metabotropic glutamate receptor 5 and GABAB receptor. SUMMARY There is a large unmet medical need in ASD, a heterogeneous and clinically defined behavioral syndrome, owing to its high prevalence in the general population, lifelong cognitive and behavioral deficits, and no established treatment of ASD core symptoms, such as deficits in social communication and restrictive repetitive behaviors. The molecular pathogenesis of nonsyndromic ASD is largely undefined. Lessons from initial attempts at targeted treatment development in FXS, and new designs resulting from these lessons, will inform trials in nonsyndromic ASD for development of therapeutics for its core symptoms.
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26
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Yoon SH, Choi J, Lee WJ, Do JT. Genetic and Epigenetic Etiology Underlying Autism Spectrum Disorder. J Clin Med 2020; 9:E966. [PMID: 32244359 PMCID: PMC7230567 DOI: 10.3390/jcm9040966] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/28/2020] [Accepted: 03/28/2020] [Indexed: 12/19/2022] Open
Abstract
Autism spectrum disorder (ASD) is a pervasive neurodevelopmental disorder characterized by difficulties in social interaction, language development delays, repeated body movements, and markedly deteriorated activities and interests. Environmental factors, such as viral infection, parental age, and zinc deficiency, can be plausible contributors to ASD susceptibility. As ASD is highly heritable, genetic risk factors involved in neurodevelopment, neural communication, and social interaction provide important clues in explaining the etiology of ASD. Accumulated evidence also shows an important role of epigenetic factors, such as DNA methylation, histone modification, and noncoding RNA, in ASD etiology. In this review, we compiled the research published to date and described the genetic and epigenetic epidemiology together with environmental risk factors underlying the etiology of the different phenotypes of ASD.
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Affiliation(s)
| | | | | | - Jeong Tae Do
- Department of Stem Cell and Regenerative Biotechnology, KU Institute of Technology, Konkuk University, Seoul 05029, Korea; (S.H.Y.); (J.C.); (W.J.L.)
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27
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Webb SJ, Shic F, Murias M, Sugar CA, Naples AJ, Barney E, Borland H, Hellemann G, Johnson S, Kim M, Levin AR, Sabatos-DeVito M, Santhosh M, Senturk D, Dziura J, Bernier RA, Chawarska K, Dawson G, Faja S, Jeste S, McPartland J. Biomarker Acquisition and Quality Control for Multi-Site Studies: The Autism Biomarkers Consortium for Clinical Trials. Front Integr Neurosci 2020; 13:71. [PMID: 32116579 PMCID: PMC7020808 DOI: 10.3389/fnint.2019.00071] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 11/28/2019] [Indexed: 12/31/2022] Open
Abstract
The objective of the Autism Biomarkers Consortium for Clinical Trials (ABC-CT) is to evaluate a set of lab-based behavioral video tracking (VT), electroencephalography (EEG), and eye tracking (ET) measures for use in clinical trials with children with autism spectrum disorder (ASD). Within the larger organizational structure of the ABC-CT, the Data Acquisition and Analytic Core (DAAC) oversees the standardization of VT, EEG, and ET data acquisition, data processing, and data analysis. This includes designing and documenting data acquisition and analytic protocols and manuals; facilitating site training in acquisition; data acquisition quality control (QC); derivation and validation of dependent variables (DVs); and analytic deliverables including preparation of data for submission to the National Database for Autism Research (NDAR). To oversee consistent application of scientific standards and methodological rigor for data acquisition, processing, and analytics, we developed standard operating procedures that reflect the logistical needs of multi-site research, and the need for well-articulated, transparent processes that can be implemented in future clinical trials. This report details the methodology of the ABC-CT related to acquisition and QC in our Feasibility and Main Study phases. Based on our acquisition metrics from a preplanned interim analysis, we report high levels of acquisition success utilizing VT, EEG, and ET experiments in a relatively large sample of children with ASD and typical development (TD), with data acquired across multiple sites and use of a manualized training and acquisition protocol.
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Affiliation(s)
- Sara Jane Webb
- Center on Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, United States
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States
| | - Frederick Shic
- Center on Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, United States
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United States
| | - Michael Murias
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, United States
| | - Catherine A. Sugar
- Department of Biostatistics, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Statistics, University of California, Los Angeles, Los Angeles, CA, United States
| | - Adam J. Naples
- Yale Child Study Center, Yale University, New Haven, CT, United States
| | - Erin Barney
- Center on Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, United States
| | - Heather Borland
- Center on Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, United States
| | - Gerhard Hellemann
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Scott Johnson
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Minah Kim
- Center on Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, United States
| | - April R. Levin
- Department of Neurology, Boston Children’s Hospital, Boston, MA, United States
- Harvard Medical School, Harvard University, Boston, MA, United States
| | - Maura Sabatos-DeVito
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, United States
| | - Megha Santhosh
- Center on Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, United States
| | - Damla Senturk
- Department of Biostatistics, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Statistics, University of California, Los Angeles, Los Angeles, CA, United States
| | - James Dziura
- Yale Child Study Center, Yale University, New Haven, CT, United States
| | - Raphael A. Bernier
- Center on Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, United States
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States
- Center on Human Development and Disability, University of Washington, Seattle, WA, United States
| | | | - Geraldine Dawson
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, United States
| | - Susan Faja
- Harvard Medical School, Harvard University, Boston, MA, United States
- Department of Pediatrics, Boston Children’s Hospital, Boston, MA, United States
| | - Shafali Jeste
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, United States
| | - James McPartland
- Yale Child Study Center, Yale University, New Haven, CT, United States
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28
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Schnider P, Bissantz C, Bruns A, Dolente C, Goetschi E, Jakob-Roetne R, Künnecke B, Mueggler T, Muster W, Parrott N, Pinard E, Ratni H, Risterucci C, Rogers-Evans M, von Kienlin M, Grundschober C. Discovery of Balovaptan, a Vasopressin 1a Receptor Antagonist for the Treatment of Autism Spectrum Disorder. J Med Chem 2020; 63:1511-1525. [PMID: 31951127 DOI: 10.1021/acs.jmedchem.9b01478] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We recently reported the discovery of a potent, selective, and brain-penetrant V1a receptor antagonist, which was not suitable for full development. Nevertheless, this compound was found to improve surrogates of social behavior in adults with autism spectrum disorder in an exploratory proof-of-mechanism study. Here we describe scaffold hopping that gave rise to triazolobenzodiazepines with improved pharmacokinetic properties. The key to balancing potency and selectivity while minimizing P-gp mediated efflux was fine-tuning of hydrogen bond acceptor basicity. Ascertaining a V1a antagonist specific brain activity pattern by pharmacological magnetic resonance imaging in the rat played a seminal role in guiding optimization efforts, culminating in the discovery of balovaptan (RG7314, RO5285119) 1. In a 12-week clinical phase 2 study in adults with autism spectrum disorder balovaptan demonstrated improvements in Vineland-II Adaptive Behavior Scales, a secondary end point comprising communication, socialization, and daily living skills. Balovaptan entered phase 3 clinical development in August 2018.
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Affiliation(s)
- Patrick Schnider
- Pharmaceutical Research and Early Development, Roche Innovation Center Basel , F. Hoffmann-La Roche Ltd. , Grenzacherstrasse 124 , 4070 Basel , Switzerland
| | - Caterina Bissantz
- Pharmaceutical Research and Early Development, Roche Innovation Center Basel , F. Hoffmann-La Roche Ltd. , Grenzacherstrasse 124 , 4070 Basel , Switzerland
| | - Andreas Bruns
- Pharmaceutical Research and Early Development, Roche Innovation Center Basel , F. Hoffmann-La Roche Ltd. , Grenzacherstrasse 124 , 4070 Basel , Switzerland
| | - Cosimo Dolente
- Pharmaceutical Research and Early Development, Roche Innovation Center Basel , F. Hoffmann-La Roche Ltd. , Grenzacherstrasse 124 , 4070 Basel , Switzerland
| | - Erwin Goetschi
- Pharmaceutical Research and Early Development, Roche Innovation Center Basel , F. Hoffmann-La Roche Ltd. , Grenzacherstrasse 124 , 4070 Basel , Switzerland
| | - Roland Jakob-Roetne
- Pharmaceutical Research and Early Development, Roche Innovation Center Basel , F. Hoffmann-La Roche Ltd. , Grenzacherstrasse 124 , 4070 Basel , Switzerland
| | - Basil Künnecke
- Pharmaceutical Research and Early Development, Roche Innovation Center Basel , F. Hoffmann-La Roche Ltd. , Grenzacherstrasse 124 , 4070 Basel , Switzerland
| | - Thomas Mueggler
- Pharmaceutical Research and Early Development, Roche Innovation Center Basel , F. Hoffmann-La Roche Ltd. , Grenzacherstrasse 124 , 4070 Basel , Switzerland
| | - Wolfgang Muster
- Pharmaceutical Research and Early Development, Roche Innovation Center Basel , F. Hoffmann-La Roche Ltd. , Grenzacherstrasse 124 , 4070 Basel , Switzerland
| | - Neil Parrott
- Pharmaceutical Research and Early Development, Roche Innovation Center Basel , F. Hoffmann-La Roche Ltd. , Grenzacherstrasse 124 , 4070 Basel , Switzerland
| | - Emmanuel Pinard
- Pharmaceutical Research and Early Development, Roche Innovation Center Basel , F. Hoffmann-La Roche Ltd. , Grenzacherstrasse 124 , 4070 Basel , Switzerland
| | - Hasane Ratni
- Pharmaceutical Research and Early Development, Roche Innovation Center Basel , F. Hoffmann-La Roche Ltd. , Grenzacherstrasse 124 , 4070 Basel , Switzerland
| | - Céline Risterucci
- Pharmaceutical Research and Early Development, Roche Innovation Center Basel , F. Hoffmann-La Roche Ltd. , Grenzacherstrasse 124 , 4070 Basel , Switzerland
| | - Mark Rogers-Evans
- Pharmaceutical Research and Early Development, Roche Innovation Center Basel , F. Hoffmann-La Roche Ltd. , Grenzacherstrasse 124 , 4070 Basel , Switzerland
| | - Markus von Kienlin
- Pharmaceutical Research and Early Development, Roche Innovation Center Basel , F. Hoffmann-La Roche Ltd. , Grenzacherstrasse 124 , 4070 Basel , Switzerland
| | - Christophe Grundschober
- Pharmaceutical Research and Early Development, Roche Innovation Center Basel , F. Hoffmann-La Roche Ltd. , Grenzacherstrasse 124 , 4070 Basel , Switzerland
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Hong MP, Erickson CA. Investigational drugs in early-stage clinical trials for autism spectrum disorder. Expert Opin Investig Drugs 2019; 28:709-718. [PMID: 31352835 DOI: 10.1080/13543784.2019.1649656] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction: Pharmacologic interventions in Autism Spectrum Disorder (ASD) have historically focused on symptom-based approaches. However, a treatment for the core social deficits has remained unidentified. While a definitive theory for the cause of ASD is not yet known, recent advances in our understanding of ASD pathophysiology have opened the door for research on new pharmaceutical methods to target core symptomology. Areas covered: Herein, we review the novel pharmacologic therapies undergoing early-stage clinical trials for the treatment of the social symptoms associated with ASD. Specifically, these strategies center on altering neurologic excitatory and inhibitory imbalance, neuropeptide abnormalities, immunologic dysfunction, and biochemical deficiencies in ASD. Expert opinion: Utilizing the growing field of knowledge regarding the pathological mechanisms and altered neurobiology of individuals with ASD has led to the development of many innovative pharmaceutical interventions. Clinical trials for neurobiologic and immunologic targets show promise in impacting the social behavior and processing deficits in ASD but need evaluation in larger clinical trials and continued biomarker development to more effectively and consistently assess pharmacologic effects. Additionally, evaluating patient-specific drug responsivity and integrating behavioral intervention in conjunction with pharmacologic treatment is crucial to developing a successful approach to ASD treatment.
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Affiliation(s)
- Michael P Hong
- a Division of Psychiatry, Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA.,b College of Medicine, University of Cincinnati , Cincinnati , Oh , USA
| | - Craig A Erickson
- a Division of Psychiatry, Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA.,b College of Medicine, University of Cincinnati , Cincinnati , Oh , USA
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30
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Aulinas A, Plessow F, Asanza E, Silva L, Marengi DA, Fan W, Abedi P, Verbalis J, Tritos NA, Nachtigall L, Faje AT, Miller KK, Lawson EA. Low Plasma Oxytocin Levels and Increased Psychopathology in Hypopituitary Men With Diabetes Insipidus. J Clin Endocrinol Metab 2019; 104:3181-3191. [PMID: 30882859 PMCID: PMC6570634 DOI: 10.1210/jc.2018-02608] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 03/12/2019] [Indexed: 11/19/2022]
Abstract
CONTEXT Oxytocin (OT) and vasopressin share anatomical pathways of synthesis and secretion, and patients with central diabetes insipidus (CDI) presumably are at risk for OT deficiency. However, an OT-deficient state in hypopituitary patients has not been established. OBJECTIVES We hypothesized that men with CDI compared to patients with similar anterior pituitary deficiencies (APD) but no CDI and healthy controls (HC) of similar age and body mass index, would have lower plasma OT levels, associated with increased psychopathology. DESIGN Cross-sectional. SETTING Clinical research center. PARTICIPANTS Sixty-two men (20 CDI, 20 APD, 22 HC), age 18 to 60 years. INTERVENTIONS Frequent sampling of blood every 5 minutes for OT over 1 hour and validated questionnaires to assess psychopathology. MAIN OUTCOMES Pooled plasma OT levels; depressive, anxiety, and alexithymia symptoms; and quality of life. RESULTS The mean 1-hour pool of fasting OT levels was lower in CDI compared with APD and HC (P = 0.02 and P = 0.009, respectively), with no differences between APD and HC (P = 0.78). Symptoms of depression, anxiety, and alexithymia were more pronounced in CDI than in HC (P = 0.001, P = 0.004, and P = 0.02, respectively). Although CDI and APD reported worse physical health compared with HC (P = 0.001 and P = 0.005) with no differences between APD and CDI, only CDI reported worse mental health compared with HC (P = 0.009). CONCLUSIONS We have demonstrated low plasma OT levels and increased psychopathology in hypopituitary men with CDI, suggestive of a possible OT-deficient state. Larger studies of both sexes are required to confirm these findings and clinically characterize hypopituitary patients with OT deficiency.
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Affiliation(s)
- Anna Aulinas
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Franziska Plessow
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Elisa Asanza
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Lisseth Silva
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Dean A Marengi
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - WuQiang Fan
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Parisa Abedi
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Joseph Verbalis
- Division of Endocrinology and Metabolism, Georgetown University Medical Center, Washington, DC
| | - Nicholas A Tritos
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Lisa Nachtigall
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Alexander T Faje
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Karen K Miller
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Elizabeth A Lawson
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Correspondence and Reprint Requests: Elizabeth A. Lawson, MD, MMSc, Neuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts 02114. E-mail:
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31
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Steinman MQ, Duque-Wilckens N, Trainor BC. Complementary Neural Circuits for Divergent Effects of Oxytocin: Social Approach Versus Social Anxiety. Biol Psychiatry 2019; 85:792-801. [PMID: 30503164 PMCID: PMC6709863 DOI: 10.1016/j.biopsych.2018.10.008] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 10/12/2018] [Accepted: 10/16/2018] [Indexed: 01/04/2023]
Abstract
Oxytocin (OT) is widely known for promoting social interactions, but there is growing appreciation that it can sometimes induce avoidance of social contexts. The social salience hypothesis posed an innovative solution to these apparently opposing actions by proposing that OT enhances the salience of both positive and negative social interactions. The mesolimbic dopamine system was put forth as a likely system to evaluate social salience owing to its well-described role in motivation. Evidence from several sources supports the premise that OT acting within the nucleus accumbens and ventral tegmental area facilitates social reward and approach behavior. However, in aversive social contexts, additional pathways play critical roles in mediating the effects of OT. Recent data indicate that OT acts in the bed nucleus of the stria terminalis to induce avoidance of potentially dangerous social contexts. Here, we review evidence for neural circuits mediating the effects of OT in appetitive and aversive social contexts. Specifically, we propose that distinct but potentially overlapping circuits mediate OT-dependent social approach or social avoidance. We conclude that a broader and more inclusive consideration of neural circuits of social approach and avoidance is needed as the field continues to evaluate the potential of OT-based therapeutics.
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Affiliation(s)
- Michael Q Steinman
- Department of Neuroscience, The Scripps Research Institute, La Jolla, California
| | - Natalia Duque-Wilckens
- Department of Large Animal Clinical Sciences and Department of Physiology/Neuroscience, Michigan State University, East Lansing, Michigan
| | - Brian C Trainor
- Department of Psychology, University of California, Davis, Davis, California.
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32
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Bolognani F, del Valle Rubido M, Squassante L, Wandel C, Derks M, Murtagh L, Sevigny J, Khwaja O, Umbricht D, Fontoura P. A phase 2 clinical trial of a vasopressin V1a receptor antagonist shows improved adaptive behaviors in men with autism spectrum disorder. Sci Transl Med 2019; 11:scitranslmed.aat7838. [DOI: 10.1126/scitranslmed.aat7838] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 11/30/2018] [Indexed: 12/16/2022]
Abstract
There are no approved pharmacological therapies to address the core symptoms of autism spectrum disorder (ASD), namely, persistent deficits in social communication and social interaction and the presence of restricted, repetitive patterns of behaviors, interests, or activities. The neuropeptide vasopressin has been implicated in the regulation of social behaviors, and its modulation has emerged as a therapeutic target for ASD. The phase 2 VANILLA clinical trial reported here evaluated balovaptan, an orally administered selective vasopressin V1a receptor antagonist, in 223 men with ASD and intelligence quotient ≥70. The drug was administered daily for 12 weeks and was compared with placebo. Participants were randomized to placebo (n = 75) or one of three balovaptan dose arms (1.5 mg, n = 32; 4 mg, n = 77; 10 mg, n = 39). Balovaptan treatment was not associated with a change from baseline compared with placebo at 12 weeks in the primary efficacy endpoint (Social Responsiveness Scale, 2nd Edition). However, dose-dependent and clinically meaningful improvements on the Vineland-II Adaptive Behavior Scales composite score were observed for participants treated with balovaptan 4 or 10 mg compared with placebo. This was driven principally by improvements in the Vineland-II socialization and communication scores. Balovaptan was well tolerated across all doses, and no drug-related safety concerns were identified. These results support further study of balovaptan as a potential treatment for the socialization and communication deficits in ASD.
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33
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Bradshaw J, Shic F, Holden AN, Horowitz EJ, Barrett AC, German TC, Vernon TW. The Use of Eye Tracking as a Biomarker of Treatment Outcome in a Pilot Randomized Clinical Trial for Young Children with Autism. Autism Res 2019; 12:779-793. [PMID: 30891960 DOI: 10.1002/aur.2093] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 02/07/2019] [Accepted: 02/22/2019] [Indexed: 11/06/2022]
Abstract
There is a pressing need for objective, quantifiable outcome measures in intervention trials for children with autism spectrum disorder (ASD). The current study investigated the use of eye tracking as a biomarker of treatment response in the context of a pilot randomized clinical trial of treatment for young children with ASD. Participants included 28 children with ASD, aged 18-48 months, who were randomized to one of two conditions: Pivotal Response Intervention for Social Motivation (PRISM) or community treatment as usual (TAU). Eye-tracking and behavioral assessment of developmental functioning were administered at Time 1 (prior to randomization) and at Time 2 (after 6 months of intervention). Two well-established eye-tracking paradigms were used to measure social attention: social preference and face scanning. As a context for understanding relationships between social attention and developmental ability, we first examined how scanning patterns at Time 1 were associated with concurrent developmental functioning and compared to those of 23 age-matched typically developing (TD) children. Changes in scanning patterns from Time 1 to Time 2 were then compared between PRISM and TAU groups and associated with behavioral change over time. Results showed that the social preference paradigm differentiated children with ASD from TD children. In addition, attention during face scanning was associated with language and adaptive communication skills at Time 1 and change in language skills from Time 1 to Time 2. These findings highlight the importance of examining targeted biomarkers that measure unique aspects of child functioning and that are well-matched to proposed mechanisms of change. Autism Research 2019, 12: 779-793. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Biomarkers have the potential to provide important information about how and why early interventions effect positive change for young children with ASD. The current study suggests that eye-tracking measures of social attention can be used to track change in specific areas of development, such as language, and points to the need for targeted eye-tracking paradigms designed to measure specific behavioral changes. Such biomarkers could inform the development of optimal, individualized, and adaptive interventions for young children with ASD.
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Affiliation(s)
- Jessica Bradshaw
- Department of Psychology, University of South Carolina, Columbia, South Carolina
| | - Frederick Shic
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington.,Department of Pediatrics, University of Washington, Seattle, Washington
| | - Anahita N Holden
- Department of Counseling, Clinical, and School Psychology, University of California Santa Barbara, Santa Barbara, California
| | - Erin J Horowitz
- Department of Psychological and Brain Sciences, University of California Santa Barbara, Santa Barbara, California
| | - Amy C Barrett
- Department of Counseling, Clinical, and School Psychology, University of California Santa Barbara, Santa Barbara, California
| | - Tamsin C German
- Department of Psychological and Brain Sciences, University of California Santa Barbara, Santa Barbara, California
| | - Ty W Vernon
- Department of Counseling, Clinical, and School Psychology, University of California Santa Barbara, Santa Barbara, California
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34
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Ness SL, Bangerter A, Manyakov NV, Lewin D, Boice M, Skalkin A, Jagannatha S, Chatterjee M, Dawson G, Goodwin MS, Hendren R, Leventhal B, Shic F, Frazier JA, Janvier Y, King BH, Miller JS, Smith CJ, Tobe RH, Pandina G. An Observational Study With the Janssen Autism Knowledge Engine (JAKE ®) in Individuals With Autism Spectrum Disorder. Front Neurosci 2019; 13:111. [PMID: 30872988 PMCID: PMC6402449 DOI: 10.3389/fnins.2019.00111] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 01/30/2019] [Indexed: 11/13/2022] Open
Abstract
Objective: The Janssen Autism Knowledge Engine (JAKE®) is a clinical research outcomes assessment system developed to more sensitively measure treatment outcomes and identify subpopulations in autism spectrum disorder (ASD). Here we describe JAKE and present results from its digital phenotyping (My JAKE) and biosensor (JAKE Sense) components. Methods: An observational, non-interventional, prospective study of JAKE in children and adults with ASD was conducted at nine sites in the United States. Feedback on JAKE usability was obtained from caregivers. JAKE Sense included electroencephalography, eye tracking, electrocardiography, electrodermal activity, facial affect analysis, and actigraphy. Caregivers of individuals with ASD reported behaviors using My JAKE. Results from My JAKE and JAKE Sense were compared to traditional ASD symptom measures. Results: Individuals with ASD (N = 144) and a cohort of typically developing (TD) individuals (N = 41) participated in JAKE Sense. Most caregivers reported that overall use and utility of My JAKE was "easy" (69%, 74/108) or "very easy" (74%, 80/108). My JAKE could detect differences in ASD symptoms as measured by traditional methods. The majority of biosensors included in JAKE Sense captured sizable amounts of quality data (i.e., 93-100% of eye tracker, facial affect analysis, and electrocardiogram data was of good quality), demonstrated differences between TD and ASD individuals, and correlated with ASD symptom scales. No significant safety events were reported. Conclusions: My JAKE was viewed as easy or very easy to use by caregivers participating in research outside of a clinical study. My JAKE sensitively measured a broad range of ASD symptoms. JAKE Sense biosensors were well-tolerated. JAKE functioned well when used at clinical sites previously inexperienced with some of the technologies. Lessons from the study will optimize JAKE for use in clinical trials to assess ASD interventions. Additionally, because biosensors were able to detect features differentiating TD and ASD individuals, and also were correlated with standardized symptom scales, these measures could be explored as potential biomarkers for ASD and as endpoints in future clinical studies. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT02668991 identifier: NCT02668991.
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Affiliation(s)
- Seth L. Ness
- Neuroscience Therapeutic Area, Janssen Research & Development, Titusville, FL, United States
| | - Abigail Bangerter
- Neuroscience Therapeutic Area, Janssen Research & Development, Titusville, FL, United States
| | - Nikolay V. Manyakov
- Computational Biology, Discovery Sciences, Janssen Research & Development, Beerse, Belgium
| | - David Lewin
- Statistically Speaking Consulting, LLC, Chicago, IL, United States
| | - Matthew Boice
- Neuroscience Therapeutic Area, Janssen Research & Development, Titusville, FL, United States
| | - Andrew Skalkin
- Informatics, Janssen Research & Development, Spring House, PA, United States
| | - Shyla Jagannatha
- Statistical Decision Sciences, Janssen Research & Development, Titusville, NJ, United States
| | - Meenakshi Chatterjee
- Computational Biology, Discovery Sciences, Janssen Research & Development, Spring House, PA, United States
| | - Geraldine Dawson
- Departments of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC, United States
| | - Matthew S. Goodwin
- Department of Health Sciences, Northeastern University, Boston, MA, United States
| | - Robert Hendren
- Department of Psychiatry, School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Bennett Leventhal
- Department of Psychiatry, School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Frederick Shic
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, United States
- Department of Pediatrics, University of Washington, Seattle, WA, United States
| | - Jean A. Frazier
- Eunice Kennedy Shriver Center and Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, United States
| | - Yvette Janvier
- Department of Developmental-Behavioral Pediatrics, Children's Specialized Hospital, Toms River, NJ, United States
| | - Bryan H. King
- Department of Psychiatry, School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Judith S. Miller
- Center for Autism Research, Perelman School of Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States
| | | | - Russell H. Tobe
- Department of Outpatient Research, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States
| | - Gahan Pandina
- Neuroscience Therapeutic Area, Janssen Research & Development, Pennington, NJ, United States
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35
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Drozd HP, Karathanasis SF, Molosh AI, Lukkes JL, Clapp DW, Shekhar A. From bedside to bench and back: Translating ASD models. PROGRESS IN BRAIN RESEARCH 2018; 241:113-158. [PMID: 30447753 DOI: 10.1016/bs.pbr.2018.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Autism spectrum disorders (ASD) represent a heterogeneous group of disorders defined by deficits in social interaction/communication and restricted interests, behaviors, or activities. Models of ASD, developed based on clinical data and observations, are used in basic science, the "bench," to better understand the pathophysiology of ASD and provide therapeutic options for patients in the clinic, the "bedside." Translational medicine creates a bridge between the bench and bedside that allows for clinical and basic science discoveries to challenge one another to improve the opportunities to bring novel therapies to patients. From the clinical side, biomarker work is expanding our understanding of possible mechanisms of ASD through measures of behavior, genetics, imaging modalities, and serum markers. These biomarkers could help to subclassify patients with ASD in order to better target treatments to a more homogeneous groups of patients most likely to respond to a candidate therapy. In turn, basic science has been responding to developments in clinical evaluation by improving bench models to mechanistically and phenotypically recapitulate the ASD phenotypes observed in clinic. While genetic models are identifying novel therapeutics targets at the bench, the clinical efforts are making progress by defining better outcome measures that are most representative of meaningful patient responses. In this review, we discuss some of these challenges in translational research in ASD and strategies for the bench and bedside to bridge the gap to achieve better benefits to patients.
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Affiliation(s)
- Hayley P Drozd
- Program in Medical Neurobiology, Stark Neurosciences Institute, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Sotirios F Karathanasis
- Program in Medical Neurobiology, Stark Neurosciences Institute, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Andrei I Molosh
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Jodi L Lukkes
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - D Wade Clapp
- Department of Pediatrics, Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, United States; Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Anantha Shekhar
- Program in Medical Neurobiology, Stark Neurosciences Institute, Indiana University School of Medicine, Indianapolis, IN, United States; Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States; Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN, United States; Indiana Clinical and Translation Sciences Institute, Indiana University School of Medicine, Indianapolis, IN, United States.
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36
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Del Valle Rubido M, McCracken JT, Hollander E, Shic F, Noeldeke J, Boak L, Khwaja O, Sadikhov S, Fontoura P, Umbricht D. In Search of Biomarkers for Autism Spectrum Disorder. Autism Res 2018; 11:1567-1579. [PMID: 30324656 PMCID: PMC6282609 DOI: 10.1002/aur.2026] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 07/27/2018] [Accepted: 08/28/2018] [Indexed: 12/14/2022]
Abstract
Autism Spectrum Disorder (ASD) lacks validated measures of core social functions across development stages suitable for clinical trials. We assessed the concurrent validity between ASD clinical measures and putative biomarkers of core deficits, and their feasibility of implementation in human studies. Datasets from two adult ASD studies were combined (observational study [n = 19] and interventional study baseline data [n = 19]). Potential biomarkers included eye‐tracking, olfaction, and auditory and visual emotion recognition assessed via the Affective Speech Recognition test (ASR) and Reading‐the‐Mind‐in‐the‐Eyes Test (RMET). Current functioning was assessed with intelligence quotient (IQ), adaptive skill testing, and behavioral ratings. Autism severity was determined by the Autism Diagnostic Observation Scale‐2 and Social Communication Interaction Test (SCIT). Exploratory measures showed varying significant associations across ASD severity, adaptive skills, and behavior. Eye tracking endpoints showed little relationship to adaptive ability but correlated with severity and behavior. ASR scores significantly correlated with most adaptive behavior domains, as well as severity. Olfaction predicted visual and auditory emotion recognition. SCIT scores related moderately to multiple severity domains, and was the only measure not related with IQ. RMET accuracy was less related to ASD features. Eye tracking, SCIT, and ASR showed high test–retest reliability. We documented associations of proximal biomarkers of social functioning with multiple ASD dimensions. With the exception of SCIT, most correlations were modest, limiting utility as proxy measures of social communication. Feasibility and reliability were high for eye‐tracking, ASR, and SCIT. Overall, several novel experimental paradigms showed potential as social biomarkers or surrogate markers in ASD. Autism Research 2018, 11: 1567–1579. © 2018 The Authors. Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc. Lay Summary More accurate measurements of treatment effects are needed to help the development of new drug treatments for autism spectrum disorders (ASD). This study evaluates the relationship between assessments designed to measure behaviors associated with social communication and cognition in ASD with clinical and diagnostic assessments of symptom severity as well as their implementation. The assessments including eye‐tracking, auditory and visual social stimuli recognition, and olfaction identification showed potential for use in the evaluation of treatments for social difficulties in ASD.
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Affiliation(s)
- Marta Del Valle Rubido
- Roche Innovation Center Basel, Roche Pharmaceutical Research and Early Development NORD, Basel, Switzerland
| | - James T McCracken
- Psychiatry and Behavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Eric Hollander
- Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York
| | - Frederick Shic
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington.,Department of Pediatrics, University of Washington, Seattle, Washington
| | - Jana Noeldeke
- Roche Innovation Center Basel, Roche Pharmaceutical Research and Early Development NORD, Basel, Switzerland
| | - Lauren Boak
- Roche Product Development Neuroscience, Basel, Switzerland
| | - Omar Khwaja
- Roche Innovation Center Basel, Roche Pharmaceutical Research and Early Development NORD, Basel, Switzerland
| | - Shamil Sadikhov
- Roche Innovation Center Basel, Roche Pharmaceutical Research and Early Development NORD, Basel, Switzerland
| | - Paulo Fontoura
- Roche Product Development Neuroscience, Basel, Switzerland
| | - Daniel Umbricht
- Roche Innovation Center Basel, Roche Pharmaceutical Research and Early Development NORD, Basel, Switzerland
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Pujol CN, Pellissier LP, Clément C, Becker JAJ, Le Merrer J. Back-translating behavioral intervention for autism spectrum disorders to mice with blunted reward restores social abilities. Transl Psychiatry 2018; 8:197. [PMID: 30242222 PMCID: PMC6155047 DOI: 10.1038/s41398-018-0247-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 07/31/2018] [Accepted: 08/05/2018] [Indexed: 12/12/2022] Open
Abstract
The mu opioid receptor (MOR) plays a critical role in modulating social behavior in humans and animals. Accordingly, MOR null mice display severe alterations in their social repertoire as well as multiple other behavioral deficits, recapitulating core and secondary symptoms of autism spectrum disorder (ASD). Such behavioral profile suggests that MOR dysfunction, and beyond this, altered reward processes may contribute to ASD etiopathology. Interestingly, the only treatments that proved efficacy in relieving core symptoms of ASD, early behavioral intervention programs, rely principally on positive reinforcement to ameliorate behavior. The neurobiological underpinnings of their beneficial effects, however, remain poorly understood. Here we back-translated applied behavior analysis (ABA)-based behavioral interventions to mice lacking the MOR (Oprm1-/-), as a model of autism with blunted reward processing. By associating a positive reinforcement, palatable food reward, to daily encounter with a wild-type congener, we were able to rescue durably social interaction and preference in Oprm1-/- mice. Along with behavioral improvements, the expression of marker genes of neuronal activity and plasticity as well as genes of the oxytocin/vasopressin system were remarkably normalized in the reward/social circuitry. Our study provides further evidence for a critical involvement of reward processes in driving social behavior and opens new perspectives regarding therapeutic intervention in ASD.
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Affiliation(s)
- Camille N. Pujol
- 0000 0001 2157 9291grid.11843.3fMédecine Translationelle et Neurogénétique, Institut de Génétique et de Biologie Moléculaire et Cellulaire, Inserm U-964, CNRS UMR-7104, Université de Strasbourg, Illkirch, France ,0000 0004 0383 2080grid.461890.2Present Address: Département de Neurosciences, Institut de Génomique fonctionnelle, Inserm U-661, CNRS UMR 5203, 34094 Montpellier, France
| | - Lucie P. Pellissier
- 0000 0001 2182 6141grid.12366.30Physiologie de la Reproduction et des Comportements, INRA UMR-0085, CNRS UMR-7247, IFCE, Université de Tours, Inserm, Nouzilly, France ,0000 0004 0383 2080grid.461890.2Present Address: Département de Neurosciences, Institut de Génomique fonctionnelle, Inserm U-661, CNRS UMR 5203, 34094 Montpellier, France
| | - Céline Clément
- 0000 0001 2157 9291grid.11843.3fLaboratoire Interuniversitaire en Sciences de l’Education et de la Communication, EA 2310, Université de Strasbourg, Strasbourg, France
| | - Jérôme A. J. Becker
- 0000 0001 2157 9291grid.11843.3fMédecine Translationelle et Neurogénétique, Institut de Génétique et de Biologie Moléculaire et Cellulaire, Inserm U-964, CNRS UMR-7104, Université de Strasbourg, Illkirch, France ,0000 0001 2182 6141grid.12366.30Physiologie de la Reproduction et des Comportements, INRA UMR-0085, CNRS UMR-7247, IFCE, Université de Tours, Inserm, Nouzilly, France ,0000 0004 0383 2080grid.461890.2Present Address: Département de Neurosciences, Institut de Génomique fonctionnelle, Inserm U-661, CNRS UMR 5203, 34094 Montpellier, France
| | - Julie Le Merrer
- Médecine Translationelle et Neurogénétique, Institut de Génétique et de Biologie Moléculaire et Cellulaire, Inserm U-964, CNRS UMR-7104, Université de Strasbourg, Illkirch, France. .,Physiologie de la Reproduction et des Comportements, INRA UMR-0085, CNRS UMR-7247, IFCE, Université de Tours, Inserm, Nouzilly, France.
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Frantz MC, Pellissier LP, Pflimlin E, Loison S, Gandía J, Marsol C, Durroux T, Mouillac B, Becker JAJ, Le Merrer J, Valencia C, Villa P, Bonnet D, Hibert M. LIT-001, the First Nonpeptide Oxytocin Receptor Agonist that Improves Social Interaction in a Mouse Model of Autism. J Med Chem 2018; 61:8670-8692. [DOI: 10.1021/acs.jmedchem.8b00697] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Marie-Céline Frantz
- Laboratoire d’Innovation Thérapeutique, Faculté de Pharmacie, UMR7200 CNRS/Université de Strasbourg, 74 Route du Rhin, F-67412 Illkirch, France
| | - Lucie P. Pellissier
- Physiologie de la Reproduction et des Comportements, INRA UMR-0085, CNRS UMR-7247, IFCE, Inserm, Université François Rabelais de Tours, F-37380 Nouzilly, France
| | - Elsa Pflimlin
- Laboratoire d’Innovation Thérapeutique, Faculté de Pharmacie, UMR7200 CNRS/Université de Strasbourg, 74 Route du Rhin, F-67412 Illkirch, France
| | - Stéphanie Loison
- Laboratoire d’Innovation Thérapeutique, Faculté de Pharmacie, UMR7200 CNRS/Université de Strasbourg, 74 Route du Rhin, F-67412 Illkirch, France
| | - Jorge Gandía
- Physiologie de la Reproduction et des Comportements, INRA UMR-0085, CNRS UMR-7247, IFCE, Inserm, Université François Rabelais de Tours, F-37380 Nouzilly, France
| | - Claire Marsol
- Laboratoire d’Innovation Thérapeutique, Faculté de Pharmacie, UMR7200 CNRS/Université de Strasbourg, 74 Route du Rhin, F-67412 Illkirch, France
- LabEx MEDALIS, Université de Strasbourg, F-67000 Strasbourg, France
- PCBIS Plateforme de Chimie Biologique Intégrative de Strasbourg, UMS3286, CNRS/Université de Strasbourg, F-67000 Strasbourg, France
| | - Thierry Durroux
- Institut de Génomique Fonctionnelle, CNRS UMR5203, INSERM U661, Université de Montpellier (IFR3), 141 Rue de la Cardonille, F-34094 Montpellier Cedex 5, France
| | - Bernard Mouillac
- Institut de Génomique Fonctionnelle, CNRS UMR5203, INSERM U661, Université de Montpellier (IFR3), 141 Rue de la Cardonille, F-34094 Montpellier Cedex 5, France
| | - Jérôme A. J. Becker
- Physiologie de la Reproduction et des Comportements, INRA UMR-0085, CNRS UMR-7247, IFCE, Inserm, Université François Rabelais de Tours, F-37380 Nouzilly, France
| | - Julie Le Merrer
- Physiologie de la Reproduction et des Comportements, INRA UMR-0085, CNRS UMR-7247, IFCE, Inserm, Université François Rabelais de Tours, F-37380 Nouzilly, France
| | - Christel Valencia
- LabEx MEDALIS, Université de Strasbourg, F-67000 Strasbourg, France
- PCBIS Plateforme de Chimie Biologique Intégrative de Strasbourg, UMS3286, CNRS/Université de Strasbourg, F-67000 Strasbourg, France
| | - Pascal Villa
- LabEx MEDALIS, Université de Strasbourg, F-67000 Strasbourg, France
- PCBIS Plateforme de Chimie Biologique Intégrative de Strasbourg, UMS3286, CNRS/Université de Strasbourg, F-67000 Strasbourg, France
| | - Dominique Bonnet
- Laboratoire d’Innovation Thérapeutique, Faculté de Pharmacie, UMR7200 CNRS/Université de Strasbourg, 74 Route du Rhin, F-67412 Illkirch, France
- LabEx MEDALIS, Université de Strasbourg, F-67000 Strasbourg, France
| | - Marcel Hibert
- Laboratoire d’Innovation Thérapeutique, Faculté de Pharmacie, UMR7200 CNRS/Université de Strasbourg, 74 Route du Rhin, F-67412 Illkirch, France
- LabEx MEDALIS, Université de Strasbourg, F-67000 Strasbourg, France
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Sadino JM, Donaldson ZR. Prairie Voles as a Model for Understanding the Genetic and Epigenetic Regulation of Attachment Behaviors. ACS Chem Neurosci 2018. [PMID: 29513516 DOI: 10.1021/acschemneuro.7b00475] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Over a lifetime, humans build relationships with family, friends, and partners that are critically important for our mental and physical health. Unlike commonly used laboratory mice and rats, Microtine rodents provide a unique model to study the neurobiology underlying pair bonding and the selective attachments that form between adults. Comparisons between monogamous prairie voles and the closely related but nonmonogamous meadow and montane voles have revealed that brain-region-specific neuropeptide receptor patterning modulates social behavior between and within species. In particular, diversity in vasopressin 1a receptor (V1aR) distribution has been linked to individual and species differences in monogamy-related behaviors such as partner preference, mate guarding, and space use. Given the importance of differential receptor expression for regulating social behavior, a critical question has emerged: What are the genetic and epigenetic mechanisms that underlie brain-region-specific receptor patterns? This review will summarize what is known about how the vasopressin (AVP)-V1aR axis regulates social behaviors via signaling in discrete brain regions. From this work, we propose that brain-region-specific regulatory mechanisms facilitate robust evolvability of V1aR expression to generate diverse sociobehavioral traits. Translationally, we provide a perspective on how these studies have contributed to our understanding of human social behaviors and how brain-region-specific regulatory mechanisms might be harnessed for targeted therapies to treat social deficits in psychiatric disorders such as depression, complicated grief, and autism spectrum disorder.
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Affiliation(s)
- Julie M. Sadino
- Department of Molecular, Cellular, and Developmental Biology, University of Colorado Boulder, Boulder, Colorado 80309, United States
| | - Zoe R. Donaldson
- Department of Molecular, Cellular, and Developmental Biology, University of Colorado Boulder, Boulder, Colorado 80309, United States
- Department of Psychology & Neuroscience, University of Colorado Boulder, Boulder, Colorado 80309, United States
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Imaging neuropeptide effects on human brain function. Cell Tissue Res 2018; 375:279-286. [PMID: 30069597 DOI: 10.1007/s00441-018-2899-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 07/20/2018] [Indexed: 10/28/2022]
Abstract
The discovery of prosocial effects of oxytocin (OT) opened new directions for studying neuropeptide effects on the human brain. However, despite obvious effects of OT on neural responses as reported in numerous studies, other peptides have received less attention. Therefore, we will only briefly summarize evidence of OT effects on human functional magnetic resonance imaging (fMRI) and primarily focus on OT's sister neuropeptide arginine-vasopressin by presenting our own coordinated-based activation likelihood estimation meta-analysis. In addition, we will recapitulate rather limited data on few other neuropeptides, including pharmacological and genetic fMRI studies. Finally, we will review experiments with external neuropeptide administration to patients afflicted with mental disorders, such as autism or schizophrenia. In conclusion, despite remaining uncertainty regarding the penetrance of exogenous neuropeptides through the blood-brain barrier, it is evident that neuropeptides simultaneously influence the activity of limbic and cortical areas, indicating that these systems have a good potential for therapeutic drug development. Hence, this calls for further systematic studies of a wide spectrum of known and less known neuropeptides to understand their normal function in the brain and, subsequently, to tackle their potential contribution for pathophysiological mechanisms of mental disorders.
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Frye RE. Social Skills Deficits in Autism Spectrum Disorder: Potential Biological Origins and Progress in Developing Therapeutic Agents. CNS Drugs 2018; 32:713-734. [PMID: 30105528 PMCID: PMC6105175 DOI: 10.1007/s40263-018-0556-y] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Autism spectrum disorder is defined by two core symptoms: a deficit in social communication and the presence of repetitive behaviors and/or restricted interests. Currently, there is no US Food and Drug Administration-approved drug for these core symptoms. This article reviews the biological origins of the social function deficit associated with autism spectrum disorder and the drug therapies with the potential to treat this deficit. A review of the history of autism demonstrates that a deficit in social interaction has been the defining feature of the concept of autism from its conception. Abnormalities identified in early social skill development and an overview of the pathophysiology abnormalities associated with autism spectrum disorder are discussed as are the abnormalities in brain circuits associated with the social function deficit. Previous and ongoing clinical trials examining agents that have the potential to improve social deficits associated with autism spectrum disorder are discussed in detail. This discussion reveals that agents such as oxytocin and propranolol are particularly promising and undergoing active investigation, while other agents such as vasopressin agonists and antagonists are being activity investigated but have limited published evidence at this time. In addition, agents such as bumetanide and manipulation of the enteric microbiome using microbiota transfer therapy appear to have promising effects on core autism spectrum disorder symptoms including social function. Other pertinent issues associated with developing treatments in autism spectrum disorder, such as disease heterogeneity, high placebo response rates, trial design, and the most appropriate way of assessing effects on social skills (outcome measures), are also discussed.
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Affiliation(s)
- Richard E Frye
- Division of Neurodevelopmental Disorders, Department of Neurology, Barrow Neurological Institute, Phoenix Children's Hospital, 1919 E Thomas St, Phoenix, AZ, 85016, USA.
- Department of Child Health, University of Arizona College of Medicine - Phoenix, Phoenix, AZ, 85004, USA.
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Abstract
Autism Spectrum Disorder (ASD) refers to a group of neurodevelopmental disorders including autism, Asperger's syndrome (AS) and pervasive developmental disorder-not otherwise specified (PDD-NOS). The new diagnostic criteria of ASD focuses on two core domains: social communication impairment and restricted interests/repetitive behaviors. The prevalence of ASD has been steadily increasing over the past two decades, with current estimates reaching up to 1 in 36 children. Hereditary factors, parental history of psychiatric disorders, pre-term births, and fetal exposure to psychotropic drugs or insecticides have all been linked to higher risk of ASD. Several scales such as the Childhood Autism Rating Scale (CARS), The Autism Spectrum Disorder-Observation for Children (ASD-OC), The Developmental, Dimensional, and Diagnostic Interview (3di), are available to aid in better assessing the behaviors and symptoms associated with ASD. Nearly 75% of ASD patients suffer from comorbid psychiatric illnesses or conditions, which may include attention-deficit hyperactivity disorder (ADHD), anxiety, bipolar disorder, depression, Tourette syndrome, and others. Both pharmacological and non-pharmacological interventions are available for ASD. Pharmacological treatments include psychostimulants, atypical antipsychotics, antidepressants, and alpha-2 adrenergic receptor agonists. These medications provide partial symptomatic relief of core symptoms of ASD or manage the symptoms of comorbid conditions. Non-pharmacological interventions, which show promising evidence in improving social interaction and verbal communication of ASD patients, include music therapy, cognitive behavioral therapy and social behavioral therapy. Hormonal therapies with oxytocyin or vasopressin receptor antagonists have also shown some promise in improving core ASD symptoms. The use of vitamins, herbal remedies and nutritional supplements in conjunction with pharmacological and behavioral treatment appear to have some effect in symptomatic improvement in ASD, though additional studies are needed to confirm these benefits. Developing novel disease-modifying therapies may prove to be the ultimate intervention for sustained improvement of symptoms in ASD.
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Affiliation(s)
- Samata R Sharma
- Department of Psychiatry, Harvard Medical School, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Kutvolgyi Clinical Centre, Semmelweis University, Kutvolgyi ut 4, 1125 Budapest, Hungary
| | - Frank I Tarazi
- Department of Psychiatry and Neuroscience Program, , Harvard Medical School, McLean Hospital, Belmont, MA 02478, USA.
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Chatham CH, Taylor KI, Charman T, Liogier D'ardhuy X, Eule E, Fedele A, Hardan AY, Loth E, Murtagh L, Del Valle Rubido M, San Jose Caceres A, Sevigny J, Sikich L, Snyder L, Tillmann JE, Ventola PE, Walton-Bowen KL, Wang PP, Willgoss T, Bolognani F. Adaptive behavior in autism: Minimal clinically important differences on the Vineland-II. Autism Res 2018; 11:270-283. [PMID: 28941213 PMCID: PMC5997920 DOI: 10.1002/aur.1874] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 08/09/2017] [Accepted: 08/16/2017] [Indexed: 12/28/2022]
Abstract
Autism Spectrum Disorder (ASD) is associated with persistent impairments in adaptive abilities across multiple domains. These social, personal, and communicative impairments become increasingly pronounced with development, and are present regardless of IQ. The Vineland Adaptive Behavior Scales, Second Edition (Vineland-II) is the most commonly used instrument for quantifying these impairments, but minimal clinically important differences (MCIDs) on Vineland-II scores have not been rigorously established in ASD. We pooled data from several consortia/registries (EU-AIMS LEAP study, ABIDE-I, ABIDE-II, INFOR, Simons Simplex Collection and Autism Treatment Network [ATN]) and clinical investigations and trials (Stanford, Yale, Roche) resulting in a data set of over 9,000 individuals with ASD. Two approaches were used to estimate MCIDs: distribution-based methods and anchor-based methods. Distribution-based MCID [d-MCID] estimates included the standard error of the measurement, as well as one-fifth and one-half of the covariate-adjusted standard deviation (both cross-sectionally and longitudinally). Anchor-based MCID [a-MCID] estimates include the slope of linear regression of clinician ratings of severity on the Vineland-II score, the slope of linear regression of clinician ratings of longitudinal improvement category on Vineland-II change, the Vineland-II change score maximally differentiating clinical impressions of minimal versus no improvement, and equipercentile equating. Across strata, the Vineland-II Adaptive Behavior Composite standardized score MCID estimates range from 2.01 to 3.2 for distribution-based methods, and from 2.42 to 3.75 for sample-size-weighted anchor-based methods. Lower Vineland-II standardized score MCID estimates were observed for younger and more cognitively impaired populations. These MCID estimates enable users of Vineland-II to assess both the statistical and clinical significance of any observed change. Autism Res 2018, 11: 270-283. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY The Vineland Adaptive Behavior Scales (2nd edition; Vineland-II) is the most widely used scale for assessing day-to-day "adaptive" skills. Yet, it is unknown how much Vineland-II scores must change for those changes to be regarded as clinically significant. We pooled data from over 9,000 individuals with ASD to show that changes of 2-3.75 points on the Vineland-II Composite score represent the "minimal clinically-important difference." These estimates will help evaluate the benefits of potential new treatments for ASD.
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Affiliation(s)
- C H Chatham
- F. Hoffmann La Roche, Innovation Center Basel, Hoffmann La Roche, Basel, 4070, Switzerland
| | - K I Taylor
- F. Hoffmann La Roche, Innovation Center Basel, Hoffmann La Roche, Basel, 4070, Switzerland
| | - T Charman
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, Camberwell, London, SE5 8AF, UK
| | - X Liogier D'ardhuy
- F. Hoffmann La Roche, Innovation Center Basel, Hoffmann La Roche, Basel, 4070, Switzerland
| | - E Eule
- F. Hoffmann La Roche, Innovation Center Basel, Hoffmann La Roche, Basel, 4070, Switzerland
| | - A Fedele
- Autism Speaks, New York, New York, 10016
| | - A Y Hardan
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, 94305-5717
| | - E Loth
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, Camberwell, London, SE5 8AF, UK
| | - L Murtagh
- F. Hoffmann La Roche, Innovation Center Basel, Hoffmann La Roche, Basel, 4070, Switzerland
| | - M Del Valle Rubido
- F. Hoffmann La Roche, Innovation Center Basel, Hoffmann La Roche, Basel, 4070, Switzerland
| | - A San Jose Caceres
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, Camberwell, London, SE5 8AF, UK
| | - J Sevigny
- F. Hoffmann La Roche, Innovation Center Basel, Hoffmann La Roche, Basel, 4070, Switzerland
| | - L Sikich
- Duke Center for Autism and Brain Development, Pavilion East at Lakeview, Durham, North Carolina, 27705
| | - L Snyder
- Simons Foundation, New York, New York, 10010
| | - J E Tillmann
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, Camberwell, London, SE5 8AF, UK
| | - P E Ventola
- Yale Child Study Center, New Haven, CT, 06520
| | | | - P P Wang
- Simons Foundation, New York, New York, 10010
| | - T Willgoss
- F. Hoffmann La Roche, Innovation Center Basel, Hoffmann La Roche, Basel, 4070, Switzerland
| | - F Bolognani
- F. Hoffmann La Roche, Innovation Center Basel, Hoffmann La Roche, Basel, 4070, Switzerland
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Lacivita E, Perrone R, Margari L, Leopoldo M. Targets for Drug Therapy for Autism Spectrum Disorder: Challenges and Future Directions. J Med Chem 2017; 60:9114-9141. [PMID: 29039668 DOI: 10.1021/acs.jmedchem.7b00965] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by persistent deficits in social communication and interaction and restricted, repetitive patterns of behavior, interests, and activities. Various factors are involved in the etiopathogenesis of ASD, including genetic factors, environmental toxins and stressors, impaired immune responses, mitochondrial dysfunction, and neuroinflammation. The heterogeneity in the phenotype among ASD patients and the complex etiology of the condition have long impeded the advancement of the development of pharmacological therapies. In the recent years, the integration of findings from mouse models to human genetics resulted in considerable progress toward the understanding of ASD pathophysiology. Currently, strategies to treat core symptoms of ASD are directed to correct synaptic dysfunctions, abnormalities in central oxytocin, vasopressin, and serotonin neurotransmission, and neuroinflammation. Here, we present a survey of the studies that have suggested molecular targets for drug development for ASD and the state-of-the-art of medicinal chemistry efforts in related areas.
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Affiliation(s)
- Enza Lacivita
- Dipartimento di Farmacia-Scienze del Farmaco, Università degli Studi di Bari Aldo Moro , via Orabona 4, 70125, Bari, Italy
| | - Roberto Perrone
- Dipartimento di Farmacia-Scienze del Farmaco, Università degli Studi di Bari Aldo Moro , via Orabona 4, 70125, Bari, Italy
| | - Lucia Margari
- Dipartimento di Scienze Mediche di Base, Neuroscienze e Organi di Senso, Unità di Neuropsichiatria Infantile, Università degli Studi di Bari Aldo Moro , Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Marcello Leopoldo
- Dipartimento di Farmacia-Scienze del Farmaco, Università degli Studi di Bari Aldo Moro , via Orabona 4, 70125, Bari, Italy
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Naik R, Valentine H, Hall A, Mathews WB, Harris JC, Carter CS, Dannals RF, Wong DF, Horti AG. Development of a radioligand for imaging V 1a vasopressin receptors with PET. Eur J Med Chem 2017; 139:644-656. [PMID: 28843869 DOI: 10.1016/j.ejmech.2017.08.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 08/15/2017] [Accepted: 08/16/2017] [Indexed: 10/19/2022]
Abstract
A series of vasopressin receptor V1a ligands have been synthesized for positron emission tomography (PET) imaging. The lead compound (1S,5R)-1 ((4-(1H-indol-3-yl)-3-methoxyphenyl) ((1S,5R)-1,3,3-trimethyl-6-azabicyclo[3.2.1]octan-6-yl)methanone) and its F-ethyl analog 6c exhibited the best combination of high binding affinity and optimal lipophilicity within the series. (1S,5R)-1 was radiolabeled with 11C for PET studies. [11CH3](1S,5R)-1 readily entered the mouse (4.7% ID/g tissue) and prairie vole brains (∼2% ID/g tissue) and specifically (30-34%) labeled V1a receptor. The common animal anesthetic Propofol significantly blocked the brain uptake of [11CH3](1S,5R)-1 in the mouse brain, whereas anesthetics Ketamine and Saffan increased the uptake variability. Future PET imaging studies with V1a radiotracers in non-human primates should be performed in awake animals or using anesthetics that do not affect the V1a receptor.
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Affiliation(s)
- Ravi Naik
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore 21287, USA
| | - Heather Valentine
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore 21287, USA
| | - Andrew Hall
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore 21287, USA
| | - William B Mathews
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore 21287, USA
| | - James C Harris
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore 21287, USA
| | - C Sue Carter
- The Kinsey Institute, Indiana University, Bloomington, IN 47405, USA
| | - Robert F Dannals
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore 21287, USA
| | - Dean F Wong
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore 21287, USA
| | - Andrew G Horti
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore 21287, USA.
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Probst D, Heitz M, Poirier M, Gan BH, Delalande C, Reymond JL. Frontiers in Medicinal Chemistry 2017 in Bern, Switzerland. ChemMedChem 2017; 12:1645-1651. [PMID: 28941184 DOI: 10.1002/cmdc.201700306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Indexed: 11/06/2022]
Abstract
Sharing capital ideas: The 2017 Frontiers in Medicinal Chemistry (FiMC) conference, organized jointly by the German Chemical Society, the German Pharmaceutical Society, and the Swiss Chemical Society, was held at the Department of Chemistry and Biochemistry of the University of Bern in February 2017. Herein we summarize the many conference highlights, and look forward to the next FiMC meeting, to be held in Jena (Germany) in March 2018.
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Affiliation(s)
- Daniel Probst
- Universität Bern, Departement für Chemie und Biochemie, Freiestrasse 3, Bern, 3012, Switzerland
| | - Marc Heitz
- Universität Bern, Departement für Chemie und Biochemie, Freiestrasse 3, Bern, 3012, Switzerland
| | - Marion Poirier
- Universität Bern, Departement für Chemie und Biochemie, Freiestrasse 3, Bern, 3012, Switzerland
| | - Bee Ha Gan
- Universität Bern, Departement für Chemie und Biochemie, Freiestrasse 3, Bern, 3012, Switzerland
| | - Clémence Delalande
- Universität Bern, Departement für Chemie und Biochemie, Freiestrasse 3, Bern, 3012, Switzerland
| | - Jean-Louis Reymond
- Universität Bern, Departement für Chemie und Biochemie, Freiestrasse 3, Bern, 3012, Switzerland
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Cerebellar anatomical alterations and attention to eyes in autism. Sci Rep 2017; 7:12008. [PMID: 28931838 PMCID: PMC5607223 DOI: 10.1038/s41598-017-11883-w] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 08/29/2017] [Indexed: 01/01/2023] Open
Abstract
The cerebellum is implicated in social cognition and is likely to be involved in the pathophysiology of autism spectrum disorder (ASD). The goal of our study was to explore cerebellar morphology in adults with ASD and its relationship to eye contact, as measured by fixation time allocated on the eye region using an eye-tracking device. Two-hundred ninety-four subjects with ASD and controls were included in our study and underwent a structural magnetic resonance imaging scan. Global segmentation and cortical parcellation of the cerebellum were performed. A sub-sample of 59 subjects underwent an eye tracking protocol in order to measure the fixation time allocated to the eye region. We did not observe any difference in global cerebellar volumes between ASD patients and controls; however, regional analyses found a decrease of the volume of the right anterior cerebellum in subjects with ASD compared to controls. There were significant correlations between fixation time on eyes and the volumes of the vermis and Crus I. Our results suggest that cerebellar morphology may be related to eye avoidance and reduced social attention. Eye tracking may be a promising neuro-anatomically based stratifying biomarker of ASD.
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Terranova JI, Ferris CF, Albers HE. Sex Differences in the Regulation of Offensive Aggression and Dominance by Arginine-Vasopressin. Front Endocrinol (Lausanne) 2017; 8:308. [PMID: 29184535 PMCID: PMC5694440 DOI: 10.3389/fendo.2017.00308] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 10/23/2017] [Indexed: 02/01/2023] Open
Abstract
Arginine-vasopressin (AVP) plays a critical role in the regulation of offensive aggression and social status in mammals. AVP is found in an extensive neural network in the brain. Here, we discuss the role of AVP in the regulation of aggression in the limbic system with an emphasis on the critical role of hypothalamic AVP in the control of aggression. In males, activation of AVP V1a receptors (V1aRs) in the hypothalamus stimulates offensive aggression, while in females activation of V1aRs inhibits aggression. Serotonin (5-HT) also acts within the hypothalamus to modulate the effects of AVP on aggression in a sex-dependent manner. Activation of 5-HT1a receptors (5-HT1aRs) inhibits aggression in males and stimulates aggression in females. There are also striking sex differences in the mechanisms underlying the acquisition of dominance. In males, the acquisition of dominance is associated with the activation of AVP-containing neurons in the hypothalamus. By contrast, in females, the acquisition of dominance is associated with the activation of 5-HT-containing neurons in the dorsal raphe. AVP and 5-HT also play critical roles in the regulation of a form of social communication that is important for the maintenance of dominance relationships. In both male and female hamsters, AVP acts via V1aRs in the hypothalamus, as well as in other limbic structures, to communicate social status through the stimulation of a form of scent marking called flank marking. 5-HT acts on 5-HT1aRs as well as other 5-HT receptors within the hypothalamus to inhibit flank marking induced by AVP in both males and females. Interestingly, while AVP and 5-HT influence the expression of aggression in opposite ways in males and females, there are no sex differences in the effects of AVP and 5-HT on the expression of social communication. Given the profound sex differences in the incidence of many psychiatric disorders and the increasing evidence for a relationship between aggressiveness/dominance and the susceptibility to these disorders, understanding the neural regulation of aggression and social status will have significant import for translational studies.
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Affiliation(s)
- Joseph I. Terranova
- Center for Behavioral Neuroscience, Neuroscience Institute, Georgia State University, Atlanta, GA, United States
| | - Craig F. Ferris
- Department of Psychology, Center for Translational NeuroImaging, Northeastern University, Boston, MA, United States
| | - H. Elliott Albers
- Center for Behavioral Neuroscience, Neuroscience Institute, Georgia State University, Atlanta, GA, United States
- *Correspondence: H. Elliott Albers,
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