1
|
Azargoonjahromi A. The role of epigenetics in anxiety disorders. Mol Biol Rep 2023; 50:9625-9636. [PMID: 37804465 DOI: 10.1007/s11033-023-08787-6] [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: 06/22/2023] [Accepted: 08/30/2023] [Indexed: 10/09/2023]
Abstract
Anxiety disorders (ADs) are extremely common psychiatric conditions that frequently co-occur with other physical and mental disorders. The pathophysiology of ADs is multifaceted and involves intricate connections among biological elements, environmental stimuli, and psychological mechanisms. Recent discoveries have highlighted the significance of epigenetics in bridging the gap between multiple risk factors that contribute to ADs and expanding our understanding of the pathomechanisms underlying ADs. Epigenetics is the study of how changes in the environment and behavior can have an impact on gene function. Indeed, researchers have found that epigenetic mechanisms can affect how genes are activated or inactivated, as well as whether they are expressed. Such mechanisms may also affect how ADs form and are protected. That is, the bulk of pharmacological trials evaluating epigenetic treatments for the treatment of ADs have used histone deacetylase inhibitors (HDACi), yielding promising outcomes in both preclinical and clinical studies. This review will provide an outline of how epigenetic pathways can be used to treat ADs or lessen their risk. It will also present the findings from preclinical and clinical trials that are currently available on the use of epigenetic drugs to treat ADs.
Collapse
|
2
|
Ma M, Quan H, Chen S, Fu X, Zang L, Dong L. The Anxiolytic Effect of Polysaccharides from Stellariae Radix through Monoamine Neurotransmitters, HPA Axis, and ECS/ERK/CREB/BDNF Signaling Pathway in Stress-induced Male Rats. Brain Res Bull 2023; 203:110768. [PMID: 37739234 DOI: 10.1016/j.brainresbull.2023.110768] [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: 06/19/2023] [Revised: 09/05/2023] [Accepted: 09/20/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND Stellaria dichotoma L. var. lanceolata Bge. is renowned for its efficacy in "clearing deficiency heat" and represents a significant traditional Chinese medicine (TCM) resource. Modern pharmacology has demonstrated the anti-anxiety effects of Stellaria dichotoma L. var. lanceolata Bge. polysaccharides (SDPs). SDPs are one of the active constituents of Stellaria dichotoma L. var. lanceolata Bge. This study presents the first extraction of SDPs and investigates their potential molecular mechanisms and anxiolytic effects that are not previously reported. METHODS First, SDPs were obtained by water extraction and alcohol precipitation and analyzed for their monosaccharide composition by high performance liquid chromatography (HPLC). Male SD rats were subjected to a two-week indeterminate empty bottle stress procedure and a three-day acute restraint stress procedure, during which diazepam (DZP) (1 mg/kg) and SDPs (50, 100 and 200 mg/kg, intragastrically) were administered. A number of behavioral tests, including the elevated plus maze test (EPM), the open field test (OFT) and the light/dark box test (LDB), were used to assess the anti-anxiety potential of SDPs. Serum levels of Corticosterone (CORT) and Adrenocorticotropic hormone (ACTH), as well as the levels of Dopamine (DA) and serotonin (5-HT) found in the hippocampus and frontal cortex, were quantified using commercially available enzyme-linked immunosorbent assay (ELISA) kits. In addition, protein levels of key proteins cAMP-response element binding protein (CREB), phospho-CREB (p-CREB), brain-derived neurotrophic factor (BDNF), ERK½, p-ERK½, and GAPDH expression in rat hippocampus were measured by Western blot analysis, and modulation of the endocannabinoid system was assessed by immunohistochemistry. RESULTS Following administration of SDPs (50, 100, 200 mg/kg) and diazepam 1 mg/kg, anxiolytic activity was exhibited through an increase in the percentage of arm opening times and arm opening time of rats in the elevated plus maze. Additionally, there was an increase in the number of times and time spent in the open field center, percentage of time spent in the open box, and shuttle times in the LDB. Furthermore, tissue levels of DA and 5-HT were increased in the hippocampus and frontal cortex of rats after treatment with SDPs. In addition, SDPs significantly decreased serum levels of CORT and ACTH in rats. SDPs also effectively regulated the phosphorylation of the extracellular regulated protein kinases (ERK) and CREB-BDNF pathway in the hippocampus. Moreover, the expression levels of CB1 and CB2 proteins were heightened due to SDPs treatment in rats. CONCLUSIONS The study verified that SDPs alleviate anxiety in the EBS and ARS. The neuroregulatory behavior is accomplished by regulating the Monoamine neurotransmitter, HPA axis, and ECB-ERK-CREB-BDNF signaling pathway.
Collapse
Affiliation(s)
- Miao Ma
- School of Pharmacy, Ningxia Medical University, Yinchuan 750004, China
| | - Hongfeng Quan
- School of Pharmacy, Ningxia Medical University, Yinchuan 750004, China
| | - Shujuan Chen
- School of Pharmacy, Ningxia Medical University, Yinchuan 750004, China
| | - Xueyan Fu
- School of Pharmacy, Ningxia Medical University, Yinchuan 750004, China; Ningxia Collaborative Innovation Center of Regional Characteristic Traditional Chinese Medicine, Yinchuan 750004, China; Key Laboratory of Hui Ethnic Medicine Modernization, Ministry of Education (Ningxia Medical University), Yinchuan 750004, China
| | - Lingling Zang
- Hainan Health Vocational College, Haikou 813099, China
| | - Lin Dong
- School of Pharmacy, Ningxia Medical University, Yinchuan 750004, China; Ningxia Collaborative Innovation Center of Regional Characteristic Traditional Chinese Medicine, Yinchuan 750004, China; Key Laboratory of Hui Ethnic Medicine Modernization, Ministry of Education (Ningxia Medical University), Yinchuan 750004, China.
| |
Collapse
|
3
|
Serum BDNF levels are involved in the diagnosis and treatment response in patients with PD. J Affect Disord 2023; 327:31-37. [PMID: 36739005 DOI: 10.1016/j.jad.2023.01.107] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/14/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND The study aimed to explore whether brain-derived neurotrophic factor (BDNF) could be predictive for the diagnosis of panic disorder (PD) and to explore the association between serum BDNF levels and the treatment response to escitalopram in PD patients. METHODS Ninety PD patients and 99 healthy controls (HCs) were finally recruited. PD patients were treated only by escitalopram for 8 weeks. All patients were administered the Short-Form Health Survey-36 (SF-36), Hamilton Anxiety Rating Scale (HAMA-14), and State-Trait Anxiety Inventory (STAI) to assess life quality, anxiety symptoms and trait, respectively. Neuropsychological tests were assessed at baseline in all participants. Besides, peripheral venous blood was drawn from all participants for BDNF serum levels detection both at baseline and after 8 weeks of treatment. RESULTS In PD patients, the baseline serum BDNF levels were lower than HCs. The area under the ROC curve (AUC) of baseline serum BDNF levels predicting PD from HCs was 0.947 (94.9 % for sensitivity, 77.8 % for specificity). The baseline serum BDNF levels (beta = 0.276, p = 0.007), the current duration (beta = -0.301, p = 0.004), and trait anxiety (TAI) (beta = 0.201, p = 0.045) were predictors for reduction rates of HAMA-14 after 8 weeks' escitalopram treatment. LIMITATIONS A long-term observation and high homogeneity of sample may make the results more convincing. CONCLUSION This preliminary finding highlighted the value of serum BDNF levels for the diagnosis of PD. In addition, the higher baseline serum BDNF levels may predict the better escitalopram treatment response in PD patients.
Collapse
|
4
|
Garcia-Argibay M, Du Rietz E, Hartman CA, Lichtenstein P, Chang Z, Fava C, Cortese S, Larsson H. Cardiovascular risk factors in attention-deficit/hyperactivity disorder: A family design study of Swedish conscripts. Int J Methods Psychiatr Res 2022; 31:e1930. [PMID: 35765813 PMCID: PMC9720218 DOI: 10.1002/mpr.1930] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/24/2022] [Accepted: 06/21/2022] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE (1) investigate the associations of attention-deficit/hyperactivity disorder (ADHD) with systolic and diastolic blood pressure, resting heart rate, pulse pressure (PP), physical fitness, and BMI; (2) explore whether cardiovascular risk factors and ADHD share genetic and environmental influences; (3) assess if pharmacological treatment for ADHD influences these associations. METHODS We identified 395,978 individuals born between 1973 and 1991 who had military conscription examinations at a mean age of 18.3 years (SD = 0.57) and their full-siblings within the same cohort (N = 208,060) by linking population-based registers in Sweden. RESULTS Significantly increased risk of ADHD was observed in individuals with low systolic blood pressure (SBP) and PP, low physical fitness, and in those who had overweight or obesity after adjustments (adjusted Odds Ratio [OR] ranging from 1.10 to 1.45). Full siblings of individuals with low SBP, low physical fitness, and obesity were more likely to receive an ADHD diagnosis compared to full siblings without those risk factors (OR ranging from 1.17 to 1.31). Additionally, analyses showed robust associations between ADHD and low SBP, low physical fitness, and obesity, even in ADHD medication-naïve individuals. CONCLUSIONS Individuals with several cardiovascular risk factors are more often diagnosed with ADHD, regardless of psychiatric comorbidity. These association are not explained by ADHD pharmacotherapy, rather, they are in part due to shared familial risk factors.
Collapse
Affiliation(s)
- Miguel Garcia-Argibay
- School of Medical Science, Örebro University, Örebro, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ebba Du Rietz
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Catharina A Hartman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Zheng Chang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Cristiano Fava
- Department of Medicine, University of Verona, Verona, Italy.,Department of Clinical Science, University of Lund, Malmö, Sweden
| | - Samuele Cortese
- School of Psychology, University of Southampton, Southampton, UK.,Faculty of Medicine, Clinical and Experimental Science (CNS and Psychiatry), University of Southampton, Southampton, Hampshire, UK.,Solent NHS Trust, Southampton, UK.,Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, New York, USA.,School of Medicine, Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
| | - Henrik Larsson
- School of Medical Science, Örebro University, Örebro, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
5
|
Zou J, Shang W, Yang L, Liu T, Wang L, Li X, Zhao J, Rao X, Gao J, Fan X. Microglia activation in the mPFC mediates anxiety-like behaviors caused by Staphylococcus aureus strain USA300. Brain Behav 2022; 12:e2715. [PMID: 35977050 PMCID: PMC9480961 DOI: 10.1002/brb3.2715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/19/2022] [Accepted: 07/07/2022] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Staphylococcus aureus (S. aureus) is considered as one of the major causative agents of serious hospital- and community-acquired infections. Recent studies have reported that S. aureus infection induced neuroinflammation and was linked with some mental disorders. To evaluate the effects of S. aureus infection on abnormal behaviors, we conducted the present study. METHODS A S. aureus USA300-infected mouse model was established using bacterial suspension injection into tail vein. A series of behavioral tests were performed after USA300 infection. The expression of cytokines was detected in serum and mPFC. The number and some morphological parameters of microglia were also evaluated by immunofluorescence staining. RESULTS Anxiety-like behaviors, instead of locomotor activity impairment or depression-like behaviors, were observed in mice infected with S. aureus USA300 compared with control. S. aureus USA300 infection caused overexpression of IL-6, TNF-α, and IL-1β in serum, resulted in microglial over-activation and excessive release of proinflammatory cytokines in the mPFC. In addition, overexpression of TLR2 accompanied by increased GLS1 and p-STAT3 was observed in the mPFC of mice infected with S. aureus USA300. CONCLUSION This study provides evidence that S. aureus USA300 infection can lead to neuroinflammation in the mPFC of mice, which may contribute to the development of anxiety.
Collapse
Affiliation(s)
- Jiao Zou
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, China
| | - Weilong Shang
- Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University (Army Medical University), Key Laboratory of Microbial Engineering under the Educational Committee in Chongqing, Chongqing, China
| | - Ling Yang
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, China
| | - Tianyao Liu
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, China
| | - Lian Wang
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, China
| | - Xin Li
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, China
| | - Jinghui Zhao
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, China
| | - Xiancai Rao
- Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University (Army Medical University), Key Laboratory of Microbial Engineering under the Educational Committee in Chongqing, Chongqing, China
| | - Junwei Gao
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, China
| | - Xiaotang Fan
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, China
| |
Collapse
|
6
|
Li X, Zhong H, Wang Z, Xiao R, Antonson P, Liu T, Wu C, Zou J, Wang L, Nalvarte I, Xu H, Warner M, Gustafsson JA, Fan X. Loss of liver X receptor β in astrocytes leads to anxiety-like behaviors via regulating synaptic transmission in the medial prefrontal cortex in mice. Mol Psychiatry 2021; 26:6380-6393. [PMID: 33963286 DOI: 10.1038/s41380-021-01139-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 04/08/2021] [Accepted: 04/19/2021] [Indexed: 02/03/2023]
Abstract
Astrocytes are integral components of synaptic transmission, and their dysfunction leads to neuropsychiatric disorders such as anxiety and depression. Liver X receptor β (LXRβ) is expressed in astrocytes, and LXRβ global knockout mice shows impaired synaptic formation. In order to define the role of LXRβ in astrocytes, we used a conditional Cre-loxP system to specifically remove LXRβ from astrocytes. We found that this deletion caused anxiety-like but not depressive-like behaviors in adult male mice. This behavioral phenotype could be completely reproduced by selective deletion of LXRβ in astrocytes in the medial prefrontal cortex (mPFC). Pyramidal neurons in layer V of mPFC are involved in mood behaviors. We found that there was an increased spontaneous excitatory synaptic transmission in layer V pyramidal neurons of the mPFC of these mice. This was concurrent with increased dendritic complexity, despite normal appearance and number of dendritic spines. In addition, gene ontology analysis of RNA sequencing revealed that deletion of astrocytic LXRβ led to the enrichment of the process of synaptic transmission in mPFC. Finally, we also confirmed that renormalized excitatory synaptic transmission in layer V pyramidal neurons alleviated the anxiety in mice with astrocytic LXRβ deletion in mPFC. Together, our findings reveal that astrocytic LXRβ in mPFC is critical in the regulation of synaptic transmission, and this provides a potential new target for treatment of anxiety-like behavior.
Collapse
Affiliation(s)
- Xin Li
- Department of Developmental Neuropsychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, PR China
| | - Hongyu Zhong
- Department of Developmental Neuropsychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, PR China
| | - Zhongke Wang
- Department of Developmental Neuropsychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, PR China
| | - Rui Xiao
- Department of Developmental Neuropsychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, PR China
| | - Per Antonson
- Department of Biosciences and Nutrition, Karolinska Institute, Huddinge, Sweden
| | - Tianyao Liu
- Department of Developmental Neuropsychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, PR China
| | - Chuan Wu
- Department of Developmental Neuropsychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, PR China
| | - Jiao Zou
- Department of Developmental Neuropsychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, PR China
| | - Lian Wang
- Department of Developmental Neuropsychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, PR China
| | - Ivan Nalvarte
- Department of Biosciences and Nutrition, Karolinska Institute, Huddinge, Sweden
| | - Haiwei Xu
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, PR China
| | - Margaret Warner
- Center for Nuclear Receptors and Cell Signaling, Department of Biology and Biochemistry, University of Houston, Houston, TX, USA
| | - Jan-Ake Gustafsson
- Department of Biosciences and Nutrition, Karolinska Institute, Huddinge, Sweden. .,Center for Nuclear Receptors and Cell Signaling, Department of Biology and Biochemistry, University of Houston, Houston, TX, USA.
| | - Xiaotang Fan
- Department of Developmental Neuropsychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, PR China.
| |
Collapse
|
7
|
Baldi E, Costa A, Rani B, Passani MB, Blandina P, Romano A, Provensi G. Oxytocin and Fear Memory Extinction: Possible Implications for the Therapy of Fear Disorders? Int J Mol Sci 2021; 22:10000. [PMID: 34576161 PMCID: PMC8467761 DOI: 10.3390/ijms221810000] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/07/2021] [Accepted: 09/10/2021] [Indexed: 02/07/2023] Open
Abstract
Several psychiatric conditions such as phobias, generalized anxiety, and post-traumatic stress disorder (PTSD) are characterized by pathological fear and anxiety. The main therapeutic approach used in the management of these disorders is exposure-based therapy, which is conceptually based upon fear extinction with the formation of a new safe memory association, allowing the reduction in behavioral conditioned fear responses. Nevertheless, this approach is only partially resolutive, since many patients have difficulty following the demanding and long process, and relapses are frequently observed over time. One strategy to improve the efficacy of the cognitive therapy is the combination with pharmacological agents. Therefore, the identification of compounds able to strengthen the formation and persistence of the inhibitory associations is a key goal. Recently, growing interest has been aroused by the neuropeptide oxytocin (OXT), which has been shown to have anxiolytic effects. Furthermore, OXT receptors and binding sites have been found in the critical brain structures involved in fear extinction. In this review, the recent literature addressing the complex effects of OXT on fear extinction at preclinical and clinical levels is discussed. These studies suggest that the OXT roles in fear behavior are due to its local effects in several brain regions, most notably, distinct amygdaloid regions.
Collapse
Affiliation(s)
- Elisabetta Baldi
- Section of Physiological Sciences, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy;
| | - Alessia Costa
- Section of Clinical Pharmacology and Oncology, Department of Health Sciences (DSS), University of Florence, 50139 Florence, Italy; (A.C.); (B.R.); (M.B.P.)
| | - Barbara Rani
- Section of Clinical Pharmacology and Oncology, Department of Health Sciences (DSS), University of Florence, 50139 Florence, Italy; (A.C.); (B.R.); (M.B.P.)
| | - Maria Beatrice Passani
- Section of Clinical Pharmacology and Oncology, Department of Health Sciences (DSS), University of Florence, 50139 Florence, Italy; (A.C.); (B.R.); (M.B.P.)
| | - Patrizio Blandina
- Section of Pharmacology of Toxicology, Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, 50139 Florence, Italy;
| | - Adele Romano
- Department of Physiology and Pharmacology ‘V. Erspamer’, Sapienza University of Rome, 00185 Rome, Italy;
| | - Gustavo Provensi
- Section of Pharmacology of Toxicology, Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, 50139 Florence, Italy;
| |
Collapse
|
8
|
Jancke D, Herlitze S, Kringelbach ML, Deco G. Bridging the gap between single receptor type activity and whole-brain dynamics. FEBS J 2021; 289:2067-2084. [PMID: 33797854 DOI: 10.1111/febs.15855] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/15/2021] [Accepted: 03/31/2021] [Indexed: 02/05/2023]
Abstract
What is the effect of activating a single modulatory neuronal receptor type on entire brain network dynamics? Can such effect be isolated at all? These are important questions because characterizing elementary neuronal processes that influence network activity across the given anatomical backbone is fundamental to guide theories of brain function. Here, we introduce the concept of the cortical 'receptome' taking into account the distribution and densities of expression of different modulatory receptor types across the brain's anatomical connectivity matrix. By modelling whole-brain dynamics in silico, we suggest a bidirectional coupling between modulatory neurotransmission and neuronal connectivity hardware exemplified by the impact of single serotonergic (5-HT) receptor types on cortical dynamics. As experimental support of this concept, we show how optogenetic tools enable specific activation of a single 5-HT receptor type across the cortex as well as in vivo measurement of its distinct effects on cortical processing. Altogether, we demonstrate how the structural neuronal connectivity backbone and its modulation by a single neurotransmitter system allow access to a rich repertoire of different brain states that are fundamental for flexible behaviour. We further propose that irregular receptor expression patterns-genetically predisposed or acquired during a lifetime-may predispose for neuropsychiatric disorders like addiction, depression and anxiety along with distinct changes in brain state. Our long-term vision is that such diseases could be treated through rationally targeted therapeutic interventions of high specificity to eventually recover natural transitions of brain states.
Collapse
Affiliation(s)
- Dirk Jancke
- Optical Imaging Group, Institut für Neuroinformatik, Ruhr University Bochum, Germany.,International Graduate School of Neuroscience (IGSN), Ruhr University Bochum, Germany
| | - Stefan Herlitze
- Department of General Zoology and Neurobiology, Ruhr University, Bochum, Germany
| | - Morten L Kringelbach
- Department of Psychiatry, University of Oxford, UK.,Center for Music in the Brain, Department of Clinical Medicine, Aarhus University, Denmark.,Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,Centre for Eudaimonia and Human Flourishing, University of Oxford, UK
| | - Gustavo Deco
- Center for Brain and Cognition, Computational Neuroscience Group, Universitat Pompeu Fabra, Barcelona, Spain.,Institució Catalana de la Recerca i Estudis Avançats, Barcelona, Spain.,Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,School of Psychological Sciences, Monash University, Clayton, Melbourne, Australia
| |
Collapse
|
9
|
Yang J, Li S, Lv H, Wang W, Zhang J, Chu L, Zhang Y. CREB1 and BDNF gene polymorphisms are associated with early treatment response to escitalopram in panic disorder. J Affect Disord 2021; 278:536-541. [PMID: 33017682 DOI: 10.1016/j.jad.2020.09.076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 08/08/2020] [Accepted: 09/21/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Increasing evidence shows that the alternations under escitalopram treatment for Panic disorder (PD) patients are related to the cAMP response element-binding protein (CREB) and brain-derived neurotrophic factor (BDNF). We aimed to explore the single nucleotide polymorphisms (SNPs) of genes BDNF and CREB1 in the treatment response to escitalopram on PD. METHODS There were 80 PD patients with DSM-5 diagnosis and 78 healthy controls. All PD patients have received escitalopram treatment for consecutive 8 weeks. The Chinese version of Panic Disorder Severity Scale (PDSS-CV) and the Hamilton Anxiety Scale (HAMA-14) were used to evaluate the severity of panic and anxious symptoms for PD patients at baseline, week-2, week-4, and week-8, respectively. Four SNPs (rs11904814, rs6740584, rs2253206, and rs2551941) in CREB1 gene and rs6265 in BDNF gene were genotyped using matrix-assisted laser desorption time-of-flight mass spectrometry (MALDI-TOF MS). Quantitative and binary genetic associations between SNPs and escitalopram treatment response were performed. RESULTS The comparisons of three genotypes in CREB1 SNPs rs11904814 and rs2551941 among the PDSS-CV responders showed significant differences at the end of week-2 (both p<0.05). The results remained significant after Bonferroni corrections. For candidate genes in our present study, the gene CREB1 SNP rs11904814 (p=0.007) was significantly associated with changes of PDSS-CV scores under escitalopram treatment for 12 weeks in PD patients. And the result was still significant after adjusting age and gender. CONCLUSIONS The findings provide preliminary evidence supporting the potential role of BDNF and CREB1 on a rapid response after escitalopram intervention in PD patients.
Collapse
Affiliation(s)
- Junfeng Yang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Shen Li
- Department of Psychiatry, College of Basic Medical Sciences, Tianjin Medical University, Tianjin 300070, China; Mental Health Institute, Tianjin Anding Hospital, Tianjin 300222, China
| | - Hao Lv
- Mental Health Institute, Tianjin Anding Hospital, Tianjin 300222, China
| | - Wenchen Wang
- Mental Health Institute, Tianjin Anding Hospital, Tianjin 300222, China
| | - Jian Zhang
- Mental Health Institute, Tianjin Anding Hospital, Tianjin 300222, China
| | - Lijun Chu
- Mental Health Institute, Tianjin Anding Hospital, Tianjin 300222, China
| | - Yong Zhang
- Mental Health Institute, Tianjin Anding Hospital, Tianjin 300222, China.
| |
Collapse
|
10
|
Vismara M, Girone N, Cirnigliaro G, Fasciana F, Vanzetto S, Ferrara L, Priori A, D’Addario C, Viganò C, Dell’Osso B. Peripheral Biomarkers in DSM-5 Anxiety Disorders: An Updated Overview. Brain Sci 2020; 10:E564. [PMID: 32824625 PMCID: PMC7464377 DOI: 10.3390/brainsci10080564] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/06/2020] [Accepted: 08/13/2020] [Indexed: 12/12/2022] Open
Abstract
Anxiety disorders are prevalent and highly disabling mental disorders. In recent years, intensive efforts focused on the search for potential neuroimaging, genetic, and peripheral biomarkers in order to better understand the pathophysiology of these disorders, support their diagnosis, and characterize the treatment response. Of note, peripheral blood biomarkers, as surrogates for the central nervous system, represent a promising instrument to characterize psychiatric disorders, although their role has not been extensively applied to clinical practice. In this report, the state of the art on peripheral biomarkers of DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) Anxiety Disorders is presented, in order to examine their role in the pathogenesis of these conditions and their potential application for diagnosis and treatment. Available data on the cerebrospinal fluid and blood-based biomarkers related to neurotransmitters, neuropeptides, the hypothalamic-pituitary-adrenal axis, neurotrophic factors, and the inflammation and immune system are reviewed. Despite the wide scientific literature and the promising results in the field, only a few of the proposed peripheral biomarkers have been defined as a specific diagnostic instrument or have been identified as a guide in the treatment response to DSM-5 Anxiety Disorders. Therefore, further investigations are needed to provide new biological insights into the pathogenesis of anxiety disorders, to help in their diagnosis, and to tailor a treatment.
Collapse
Affiliation(s)
- Matteo Vismara
- Department of Mental Health, Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (N.G.); (G.C.); (F.F.); (S.V.); (L.F.); (C.V.); (B.D.)
| | - Nicolaja Girone
- Department of Mental Health, Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (N.G.); (G.C.); (F.F.); (S.V.); (L.F.); (C.V.); (B.D.)
| | - Giovanna Cirnigliaro
- Department of Mental Health, Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (N.G.); (G.C.); (F.F.); (S.V.); (L.F.); (C.V.); (B.D.)
| | - Federica Fasciana
- Department of Mental Health, Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (N.G.); (G.C.); (F.F.); (S.V.); (L.F.); (C.V.); (B.D.)
| | - Simone Vanzetto
- Department of Mental Health, Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (N.G.); (G.C.); (F.F.); (S.V.); (L.F.); (C.V.); (B.D.)
| | - Luca Ferrara
- Department of Mental Health, Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (N.G.); (G.C.); (F.F.); (S.V.); (L.F.); (C.V.); (B.D.)
| | - Alberto Priori
- Department of Health Sciences, Aldo Ravelli Center for Neurotechnology and Brain Therapeutic, University of Milan, 20142 Milan, Italy;
| | - Claudio D’Addario
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, 64100 Teramo, Italy;
- Department of Clinical Neuroscience, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Caterina Viganò
- Department of Mental Health, Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (N.G.); (G.C.); (F.F.); (S.V.); (L.F.); (C.V.); (B.D.)
| | - Bernardo Dell’Osso
- Department of Mental Health, Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, 20157 Milan, Italy; (N.G.); (G.C.); (F.F.); (S.V.); (L.F.); (C.V.); (B.D.)
- Department of Health Sciences, Aldo Ravelli Center for Neurotechnology and Brain Therapeutic, University of Milan, 20142 Milan, Italy;
- Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford University, Stanford, CA 94305, USA
- “Centro per lo studio dei meccanismi molecolari alla base delle patologie neuro-psico-geriatriche”, University of Milan, 20100 Milan, Italy
| |
Collapse
|
11
|
Kokras N, Dioli C, Paravatou R, Sotiropoulos MG, Delis F, Antoniou K, Calogeropoulou T, Charalampopoulos I, Gravanis A, Dalla C. Psychoactive properties of BNN27, a novel neurosteroid derivate, in male and female rats. Psychopharmacology (Berl) 2020; 237:2435-2449. [PMID: 32506234 DOI: 10.1007/s00213-020-05545-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 04/30/2020] [Indexed: 12/18/2022]
Abstract
RATIONALE Νeurosteroids, like dehydroepiandrosterone (DHEA), play an important role in neurodegeneration and neural protection, but they are metabolized in androgens, estrogens, or other active metabolites. A newly developed synthetic DHEA analog, BNN27 ((20R)-3β,21-dihydroxy-17R,20-epoxy-5-pregnene), exerts neurotrophic and neuroprotective actions without estrogenic or androgenic effects. OBJECTIVES This study aimed to investigate potential anxiolytic or antidepressant properties of BNN27. METHODS Male and female adult Wistar rats were treated with BNN27 (10, 30, or 90 mg/kg, i.p.) and subjected to behavioral tests measuring locomotion, exploration, and "depressive-like" behavior (open field, light/dark box, hole-board, and forced swim tests). The hippocampus and prefrontal cortex were collected for glutamate and GABA measurements, and trunk blood was collected for gonadal hormone analysis. RESULTS Acute high-dose BNN27 reduced locomotion and exploratory behavior in both sexes. Intermediate acute doses (30 mg/kg) of BNN27 reduced exploration and testosterone levels only in males, and enhanced progesterone levels in both sexes. Notably, with the present design, BNN27 had neither anxiolytic nor antidepressant effects and did not affect estrogen levels. Interestingly, acute administration of a low BNN27 dose (10 mg/kg) increased glutamate turnover, GABA, and glutamine levels in the hippocampus. The same dose also enhanced glutamate levels in the prefrontal cortex of males only. Sex differences were apparent in the basal levels of behavioral, hormonal, and neurochemical parameters, as expected. CONCLUSIONS BNN27 affects locomotion, progesterone, and testosterone levels, as well as the glutamatergic and GABAergic systems of the hippocampus and prefrontal cortex in a sex-dependent way.
Collapse
Affiliation(s)
- Nikolaos Kokras
- Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527, Athens, Greece.,First Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Chrysoula Dioli
- Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527, Athens, Greece
| | - Rafaella Paravatou
- Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527, Athens, Greece
| | - Marinos G Sotiropoulos
- Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527, Athens, Greece.,Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Hale ΒΤΜ 9002AA, 60 Fenwood Road, Boston, MA, 02115, USA
| | - Foteini Delis
- Department of Pharmacology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110, Ioannina, Greece
| | - Katerina Antoniou
- Department of Pharmacology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110, Ioannina, Greece
| | - Theodora Calogeropoulou
- Institute of Chemical Biology, National Hellenic Research Foundation, 48 Vassileos Constantinou Ave, 11635, Athens, Greece
| | - Ioannis Charalampopoulos
- Department of Pharmacology, School of Medicine, University of Crete, 71110, Heraklion, Greece.,Institute of Molecular Biology and Biotechnology, Foundation of Research and Technology Hellas (FORTH), Heraklion, Greece
| | - Achille Gravanis
- Department of Pharmacology, School of Medicine, University of Crete, 71110, Heraklion, Greece.,Institute of Molecular Biology and Biotechnology, Foundation of Research and Technology Hellas (FORTH), Heraklion, Greece
| | - Christina Dalla
- Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527, Athens, Greece.
| |
Collapse
|
12
|
Chatoui H, Abbaoui A, El Hiba O, Draoui A, Gamrani H. Neurobehavioral and neurophysiological effects of prolonged osmotic stress in rats: A focus on anxiety state and pain perception. J Chem Neuroanat 2020; 106:101789. [DOI: 10.1016/j.jchemneu.2020.101789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 03/28/2020] [Accepted: 03/28/2020] [Indexed: 10/24/2022]
|
13
|
Zhu LJ, Shi HJ, Chang L, Zhang CC, Si M, Li N, Zhu DY. nNOS-CAPON blockers produce anxiolytic effects by promoting synaptogenesis in chronic stress-induced animal models of anxiety. Br J Pharmacol 2020; 177:3674-3690. [PMID: 32343840 DOI: 10.1111/bph.15084] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 03/16/2020] [Accepted: 04/17/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND AND PURPOSE Anxiety disorder is a common mental health disorder. However, there are few safe and fast-acting anxiolytic drugs available that can treat anxiety disorder. We previously demonstrated that the interaction of neuronal NOS (nNOS) with its carboxy-terminal PDZ ligand (CAPON) is involved in regulating anxiety-related behaviours. Here, we further investigated the anxiolytic effects of nNOS-CAPON disruptors in chronic stress-induced anxiety in animals. EXPERIMENTAL APPROACH Mice were intravenously treated with nNOS-CAPON disruptors, ZLc-002 or Tat-CAPON12C, at the last week of chronic mild stress (CMS) exposure. We also infused corticosterone (CORT) into the hippocampus of mice to model anxiety behaviours and also delivered ZLc-002 or Tat-CAPON12C on the last week of chronic CORT treatment via pre-implanted cannula. Anxiety-related behaviours were examined using elevated plus maze, open field, novelty-suppressed feeding and light-dark (LD) tests. The level of nNOS-CAPON interaction was determined by co-immunoprecipitation (CO-IP) and proximity ligation assay (PLA). The neural mechanisms underlying the behavioural effects of nNOS-CAPON uncoupling in anxiety animal models were assessed by western blot, immunofluorescence and Golgi-Cox staining. KEY RESULTS ZLc-002 and Tat-CAPON12C reversed CMS- or CORT-induced anxiety-related behaviours. ZLc-002 and Tat-CAPON12C increased synaptogenesis along with improved dendritic remodelling in CMS mice or CORT-treated cultured neurons. Meanwhile, blocking nNOS-CAPON interaction significantly activated the cAMP response element-binding protein (CREB)-brain-derived neurotrophic factor (BDNF) pathway, which is associated with synaptic plasticity. CONCLUSION AND IMPLICATIONS Collectively, these results provide evidence for the anxiolytic effects of nNOS-CAPON uncouplers and their underlying mechanisms in anxiety disorders.
Collapse
Affiliation(s)
- Li-Juan Zhu
- Key Laboratory of Developmental Genes and Human Diseases, MOE, Department of Histology and Embryology, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Hu-Jiang Shi
- Key Laboratory of Developmental Genes and Human Diseases, MOE, Department of Histology and Embryology, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Lei Chang
- Department of Pharmacology, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Cheng Cheng Zhang
- Key Laboratory of Developmental Genes and Human Diseases, MOE, Department of Histology and Embryology, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Meng Si
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Na Li
- Key Laboratory of Developmental Genes and Human Diseases, MOE, Department of Histology and Embryology, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Dong-Ya Zhu
- Department of Pharmacology, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, China
| |
Collapse
|
14
|
Common and dissociable effects of oxytocin and lorazepam on the neurocircuitry of fear. Proc Natl Acad Sci U S A 2020; 117:11781-11787. [PMID: 32385158 DOI: 10.1073/pnas.1920147117] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Benzodiazepines (BZDs) represent the gold standard of anxiolytic pharmacotherapy; however, their clinical benefit is limited by side effects and addictive potential. Consequently, there is an urgent need to develop novel and safe anxiolytics. The peptide hormone oxytocin (OXT) exhibits anxiolytic-like properties in animals and humans, but whether OXT and BZDs share similar effects on the neural circuitry of fear is unclear. Therefore, the rationale of this ultra-high-field functional MRI (fMRI) study was to test OXT against the clinical comparator lorazepam (LZP) with regard to their neuromodulatory effects on local and network responses to fear-related stimuli. One hundred twenty-eight healthy male participants volunteered in this randomized double-blind, placebo-controlled, between-group study. Before scanning using an emotional face-matching paradigm, participants were randomly administered a single dose of OXT (24 IU), LZP (1 mg), or placebo. On the behavioral level, LZP, but not OXT, caused mild sedation, as evidenced by a 19% increase in reaction times. On the neural level, both OXT and LZP inhibited responses to fearful faces vs. neutral faces within the centromedial amygdala (cmA). In contrast, they had different effects on intra-amygdalar connectivity; OXT strengthened the coupling between the cmA and basolateral amygdala, whereas LZP increased the interplay between the cmA and superficial amygdala. Furthermore, OXT, but not LZP, enhanced the coupling between the cmA and the precuneus and dorsomedial prefrontal cortex. These data implicate inhibition of the cmA as a common denominator of anxiolytic action, with only OXT inducing large-scale connectivity changes of potential therapeutic relevance.
Collapse
|
15
|
Zhu LJ, Chang L, Shi HJ, Li N. Systemic administration of ZLc-002 exerts anxiolytic-like effects by dissociation of nNOS from CAPON in adult mice. Biochem Biophys Res Commun 2020; 523:299-306. [PMID: 31864709 DOI: 10.1016/j.bbrc.2019.12.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 12/06/2019] [Indexed: 11/15/2022]
Abstract
Anxiety is recognized as primary clinical phenotype of psychiatric disorders. However, many patients with anxiety have not yet received effective treatment. Our previous study demonstrated that hippocampal nNOS-CAPON interaction is implicated in anxiety-related behaviors, and blocking nNOS-CAPON interaction in the hippocampus produces anxiolytic-like effects. Here, ZLc-002, a small molecule inhibitor of nNOS-CAPON coupling, was evaluated for anxiolytic-like properties after systemic administered using anxiety behavioral tests, including open-field (OF), elevated plus maze (EPM), novelty-suppressed feeding (NSF) and light-dark (LD) tests. We reported that ZLc-002 when administered intraperitoneally at the dose of 40 or 80 mg/kg/d for 14 days produces anxiolytic-like effects. Furthermore, the similar effects of ZLc-002 were observed when administered intravenously at the dose of 10, 20 or 40 mg/kg/d for 7 days. More importantly, the mice dosing with 80 mg/kg/d ZLc-002 intraperitoneally or 40 mg/kg/d ZLc-002 intravenously for 3 days exerted significant behavioral effects. However, intragastric administration with ZLc-002 was devoid of effect on anxiety behaviors, even at high doses. Furthermore, intraperitoneal or intravenous treatment of ZLc-002 significantly disrupted the interaction between nNOS and CAPON in the hippocampus of adult mice, and there was a significant anxiolytic-like effect of ZLc-002 at day 3 after intrahippocampal microinjection. Our results verified that systemic administration of putative small molecule inhibitor of nNOS-CAPON can be used for the treatment of anxiety disorders.
Collapse
Affiliation(s)
- Li-Juan Zhu
- Key Laboratory of Developmental Genes and Human Diseases, MOE, Department of Histology and Embryology, School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, PR China.
| | - Lei Chang
- Department of Pharmacology, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, 211166, PR China
| | - Hu-Jiang Shi
- Key Laboratory of Developmental Genes and Human Diseases, MOE, Department of Histology and Embryology, School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, PR China
| | - Na Li
- Key Laboratory of Developmental Genes and Human Diseases, MOE, Department of Histology and Embryology, School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, PR China
| |
Collapse
|
16
|
Abstract
MicroRNAs as critical regulators of gene expression important for functions including neuronal development, synapse formation, and synaptic plasticity have been linked with the regulation of neurobiological systems that underlie anxiety processing in the brain. In this chapter, we give an update on associative evidence linking regulation of microRNAs with anxiety- and trauma-related disorders. Moving beyond correlative research, functional studies have emerged recently that explore causal relationships between microRNA expression and anxiety-like behavior. It has been demonstrated that experimental up- or downregulation of the candidate microRNAs in important nodes of the anxiety neurocircuitry can indeed modulate anxiety-related behavior in animal models. Improved methodologies for assessing microRNA-mediated modulation have aided such functional studies, revealing a number of anxiety-regulating microRNAs including miR-15a, miR-17-92, miR-34, miR-101, miR-124, miR-135, and miR-155. Important functional target genes of these identified microRNAs are associated with specific neurotransmitter/neuromodulator signaling, neurotrophin (e.g., BDNF) expression and other aspects of synaptic plasticity, as well as with stress-regulatory/hypothalamic-pituitary-axis function. Furthermore, microRNAs have been revealed that are regulated in distinct brain regions following various anxiety-attenuating strategies. These include pharmacological treatments such as antidepressants and other drugs, as well as non-pharmacological interventions such as fear extinction/exposure therapy or positive stimuli such as exposure to environmental enrichment. These are first indications for a role for microRNAs in the mechanism of action of anxiolytic treatments. As research continues, there is much hope that a deeper understanding of the microRNA-mediated mechanisms underlying anxiety-related disorders could open up possibilities for future novel biomarker and treatment strategies.
Collapse
|
17
|
Translational Studies in the Complex Role of Neurotransmitter Systems in Anxiety and Anxiety Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:121-140. [PMID: 32002926 DOI: 10.1007/978-981-32-9705-0_8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Discovery of innovative anxiolytics is severely hampering. Existing anxiolytics are developed decades ago and are still the therapeutics of choice. Moreover, lack of new drug targets forecasts a severe jeopardy in the future treatment of the huge population of CNS-diseased patients. We simply lack the knowledge on what is wrong in brains of anxious people (normal and diseased). Translational research, based on interacting clinical and preclinical research, is extremely urgent. In this endeavor, genetic and genomic approaches are part of the spectrum of contributing factors. We focus on three druggable targets: serotonin transporter, 5-HT1A, and GABAA receptors. It is still uncertain whether and how these targets are involved in normal and diseased anxiety processes. For serotonergic anxiolytics, the slow onset of action points to indirect effects leading to plasticity changes in brain systems leading to reduced anxiety. For GABAA benzodiazepine drugs, acute anxiolytic effects are found indicating primary mechanisms directly influencing anxiety processes. Close translational collaboration between fundamental academic and discovery research will lead to badly needed breakthroughs in the search for new anxiolytics.
Collapse
|
18
|
Metzger M, Souza R, Lima LB, Bueno D, Gonçalves L, Sego C, Donato J, Shammah-Lagnado SJ. Habenular connections with the dopaminergic and serotonergic system and their role in stress-related psychiatric disorders. Eur J Neurosci 2019; 53:65-88. [PMID: 31833616 DOI: 10.1111/ejn.14647] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/28/2019] [Accepted: 12/09/2019] [Indexed: 12/19/2022]
Abstract
The habenula (Hb) is a phylogenetically old epithalamic structure differentiated into two nuclear complexes, the medial (MHb) and lateral habenula (LHb). After decades of search for a great unifying function, interest in the Hb resurged when it was demonstrated that LHb plays a major role in the encoding of aversive stimuli ranging from noxious stimuli to the loss of predicted rewards. Consistent with a role as an anti-reward center, aberrant LHb activity has now been identified as a key factor in the pathogenesis of major depressive disorder. Moreover, both MHb and LHb emerged as new players in the reward circuitry by primarily mediating the aversive properties of distinct drugs of abuse. Anatomically, the Hb serves as a bridge that links basal forebrain structures with monoaminergic nuclei in the mid- and hindbrain. So far, research on Hb has focused on the role of the LHb in regulating midbrain dopamine release. However, LHb/MHb are also interconnected with the dorsal (DR) and median (MnR) raphe nucleus. Hence, it is conceivable that some of the habenular functions are at least partly mediated by the complex network that links MHb/LHb with pontomesencephalic monoaminergic nuclei. Here, we summarize research about the topography and transmitter phenotype of the reciprocal connections between the LHb and ventral tegmental area-nigra complex, as well as those between the LHb and DR/MnR. Indirect MHb outputs via interpeduncular nucleus to state-setting neuromodulatory networks will also be commented. Finally, we discuss the role of specific LHb-VTA and LHb/MHb-raphe circuits in anxiety and depression.
Collapse
Affiliation(s)
- Martin Metzger
- Department of Physiology & Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Rudieri Souza
- Department of Physiology & Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Leandro B Lima
- Department of Physiology & Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Debora Bueno
- Department of Physiology & Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Luciano Gonçalves
- Department of Human Anatomy, Federal University of the Triângulo Mineiro, Uberaba, Brazil
| | - Chemutai Sego
- Department of Physiology & Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Jose Donato
- Department of Physiology & Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Sara J Shammah-Lagnado
- Department of Physiology & Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
19
|
Abstract
Currently all aspects of Parkinson’s disease (PD) treatment are less than ideal and would benefit from new interventions. We focus on problems associated with brain neurotransmitters amenable to more specific subreceptor and temporal manipulation. In addition, we consider potentially treatable CNS non-PD co-pathologies or co-morbidities that may exacerbate progression of various aspects of PD.
Collapse
Affiliation(s)
- John G Nutt
- Department of Neurology, Oregon Health & Sciences University, Portland, OR, USA.,Director Emeritus of the OHSU Parkinson Center and Movement Disorders Program, Oregon Health & Sciences University, Portland, OR, USA
| | - Nicolaas I Bohnen
- Radiology, University of Michigan, Ann Arbor, MI, USA.,Neurology, University of Michigan, Ann Arbor, MI, USA.,Neurology Service and GRECC, Veterans Administration Ann Arbor Healthcare System, Ann Arbor, MI, USA.,Morris K. Udall Center of Excellence for Parkinson's Disease Research, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
20
|
Sartori SB, Singewald N. Novel pharmacological targets in drug development for the treatment of anxiety and anxiety-related disorders. Pharmacol Ther 2019; 204:107402. [PMID: 31470029 DOI: 10.1016/j.pharmthera.2019.107402] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 08/19/2019] [Indexed: 12/24/2022]
Abstract
Current medication for anxiety disorders is suboptimal in terms of efficiency and tolerability, highlighting the need for improved drug treatments. In this review an overview of drugs being studied in different phases of clinical trials for their potential in the treatment of fear-, anxiety- and trauma-related disorders is presented. One strategy followed in drug development is refining and improving compounds interacting with existing anxiolytic drug targets, such as serotonergic and prototypical GABAergic benzodiazepines. A more innovative approach involves the search for compounds with novel mechanisms of anxiolytic action using the growing knowledge base concerning the relevant neurocircuitries and neurobiological mechanisms underlying pathological fear and anxiety. The target systems evaluated in clinical trials include glutamate, endocannabinoid and neuropeptide systems, as well as ion channels and targets derived from phytochemicals. Examples of promising novel candidates currently in clinical development for generalised anxiety disorder, social anxiety disorder, panic disorder, obsessive compulsive disorder or post-traumatic stress disorder include ketamine, riluzole, xenon with one common pharmacological action of modulation of glutamatergic neurotransmission, as well as the neurosteroid aloradine. Finally, compounds such as D-cycloserine, MDMA, L-DOPA and cannabinoids have shown efficacy in enhancing fear-extinction learning in humans. They are thus investigated in clinical trials as an augmentative strategy for speeding up and enhancing the long-term effectiveness of exposure-based psychotherapy, which could render chronic anxiolytic drug treatment dispensable for many patients. These efforts are indicative of a rekindled interest and renewed optimism in the anxiety drug discovery field, after decades of relative stagnation.
Collapse
Affiliation(s)
- Simone B Sartori
- Institute of Pharmacy, Department of Pharmacology and Toxicology, Center for Molecular Biosciences Innsbruck (CMBI), Leopold Franzens University Innsbruck, Innsbruck, Austria
| | - Nicolas Singewald
- Institute of Pharmacy, Department of Pharmacology and Toxicology, Center for Molecular Biosciences Innsbruck (CMBI), Leopold Franzens University Innsbruck, Innsbruck, Austria.
| |
Collapse
|
21
|
Fontana BD, Franscescon F, Rosemberg DB, Norton WH, Kalueff AV, Parker MO. Zebrafish models for attention deficit hyperactivity disorder (ADHD). Neurosci Biobehav Rev 2019; 100:9-18. [DOI: 10.1016/j.neubiorev.2019.02.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 02/15/2019] [Accepted: 02/15/2019] [Indexed: 01/23/2023]
|
22
|
Ratner MH, Kumaresan V, Farb DH. Neurosteroid Actions in Memory and Neurologic/Neuropsychiatric Disorders. Front Endocrinol (Lausanne) 2019; 10:169. [PMID: 31024441 PMCID: PMC6465949 DOI: 10.3389/fendo.2019.00169] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 02/28/2019] [Indexed: 12/24/2022] Open
Abstract
Memory dysfunction is a symptomatic feature of many neurologic and neuropsychiatric disorders; however, the basic underlying mechanisms of memory and altered states of circuitry function associated with disorders of memory remain a vast unexplored territory. The initial discovery of endogenous neurosteroids triggered a quest to elucidate their role as neuromodulators in normal and diseased brain function. In this review, based on the perspective of our own research, the advances leading to the discovery of positive and negative neurosteroid allosteric modulators of GABA type-A (GABAA), NMDA, and non-NMDA type glutamate receptors are brought together in a historical and conceptual framework. We extend the analysis toward a state-of-the art view of how neurosteroid modulation of neural circuitry function may affect memory and memory deficits. By aggregating the results from multiple laboratories using both animal models for disease and human clinical research on neuropsychiatric and age-related neurodegenerative disorders, elements of a circuitry level view begins to emerge. Lastly, the effects of both endogenously active and exogenously administered neurosteroids on neural networks across the life span of women and men point to a possible underlying pharmacological connectome by which these neuromodulators might act to modulate memory across diverse altered states of mind.
Collapse
|
23
|
Flores Á, Fullana MÀ, Soriano-Mas C, Andero R. Lost in translation: how to upgrade fear memory research. Mol Psychiatry 2018; 23:2122-2132. [PMID: 29298989 DOI: 10.1038/s41380-017-0006-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 10/30/2017] [Accepted: 11/03/2017] [Indexed: 12/24/2022]
Abstract
We address some of the current limitations of translational research in fear memory and suggest alternatives that might help to overcome them. Appropriate fear responses are adaptive, but disruption of healthy fear memory circuits can lead to anxiety and fear-based disorders. Stress is one of the main environmental factors that can disrupt memory circuits and constitutes as a key factor in the etiopathology of these psychiatric conditions. Current therapies for anxiety and fear-based disorders have limited success rate, revealing a clear need for an improved understanding of their neurobiological basis. Although animal models are excellent for dissecting fear memory circuits and have driven tremendous advances in the field, translation of these findings into the clinic has been limited so far. Animal models of stress-induced pathological fear combined with powerful cutting-edge techniques would help to improve the translational value of preclinical studies. We also encourage combining animal and human research, including psychiatric patients in order to find new pharmacological targets with real therapeutic potential that will improve the extrapolation of the findings. Finally, we highlight novel neuroimaging approaches that improve our understanding of anxiety and fear-based disorders.
Collapse
Affiliation(s)
- África Flores
- Institut de Neurociènces, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Miquel À Fullana
- FIDMAG Germanes Hospitalàries-CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain.,Department of Psychiatry, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Hospitalet de Llobregat, Spain.,CIBERSAM-G17, Barcelona, Spain.,Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Raül Andero
- Institut de Neurociènces, Universitat Autònoma de Barcelona, Bellaterra, Spain. .,CIBERSAM, Corporació Sanitaria Parc Taulí, Sabadell, Spain. .,Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona, Bellaterra, Spain.
| |
Collapse
|
24
|
Babaev O, Piletti Chatain C, Krueger-Burg D. Inhibition in the amygdala anxiety circuitry. Exp Mol Med 2018; 50:1-16. [PMID: 29628509 PMCID: PMC5938054 DOI: 10.1038/s12276-018-0063-8] [Citation(s) in RCA: 175] [Impact Index Per Article: 29.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 01/25/2018] [Indexed: 01/09/2023] Open
Abstract
Inhibitory neurotransmission plays a key role in anxiety disorders, as evidenced by the anxiolytic effect of the benzodiazepine class of γ-aminobutyric acid (GABA) receptor agonists and the recent discovery of anxiety-associated variants in the molecular components of inhibitory synapses. Accordingly, substantial interest has focused on understanding how inhibitory neurons and synapses contribute to the circuitry underlying adaptive and pathological anxiety behaviors. A key element of the anxiety circuitry is the amygdala, which integrates information from cortical and thalamic sensory inputs to generate fear and anxiety-related behavioral outputs. Information processing within the amygdala is heavily dependent on inhibitory control, although the specific mechanisms by which amygdala GABAergic neurons and synapses regulate anxiety-related behaviors are only beginning to be uncovered. Here, we summarize the current state of knowledge and highlight open questions regarding the role of inhibition in the amygdala anxiety circuitry. We discuss the inhibitory neuron subtypes that contribute to the processing of anxiety information in the basolateral and central amygdala, as well as the molecular determinants, such as GABA receptors and synapse organizer proteins, that shape inhibitory synaptic transmission within the anxiety circuitry. Finally, we conclude with an overview of current and future approaches for converting this knowledge into successful treatment strategies for anxiety disorders.
Collapse
Affiliation(s)
- Olga Babaev
- Department of Molecular Neurobiology, Max Planck Institute of Experimental Medicine, Hermann-Rein-Str. 3, 37075, Göttingen, Germany
| | - Carolina Piletti Chatain
- Department of Molecular Neurobiology, Max Planck Institute of Experimental Medicine, Hermann-Rein-Str. 3, 37075, Göttingen, Germany
| | - Dilja Krueger-Burg
- Department of Molecular Neurobiology, Max Planck Institute of Experimental Medicine, Hermann-Rein-Str. 3, 37075, Göttingen, Germany.
| |
Collapse
|
25
|
Faraone SV. The pharmacology of amphetamine and methylphenidate: Relevance to the neurobiology of attention-deficit/hyperactivity disorder and other psychiatric comorbidities. Neurosci Biobehav Rev 2018; 87:255-270. [PMID: 29428394 DOI: 10.1016/j.neubiorev.2018.02.001] [Citation(s) in RCA: 305] [Impact Index Per Article: 50.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 01/25/2018] [Accepted: 02/05/2018] [Indexed: 12/20/2022]
Abstract
Psychostimulants, including amphetamines and methylphenidate, are first-line pharmacotherapies for individuals with attention-deficit/hyperactivity disorder (ADHD). This review aims to educate physicians regarding differences in pharmacology and mechanisms of action between amphetamine and methylphenidate, thus enhancing physician understanding of psychostimulants and their use in managing individuals with ADHD who may have comorbid psychiatric conditions. A systematic literature review of PubMed was conducted in April 2017, focusing on cellular- and brain system-level effects of amphetamine and methylphenidate. The primary pharmacologic effect of both amphetamine and methylphenidate is to increase central dopamine and norepinephrine activity, which impacts executive and attentional function. Amphetamine actions include dopamine and norepinephrine transporter inhibition, vesicular monoamine transporter 2 (VMAT-2) inhibition, and monoamine oxidase activity inhibition. Methylphenidate actions include dopamine and norepinephrine transporter inhibition, agonist activity at the serotonin type 1A receptor, and redistribution of the VMAT-2. There is also evidence for interactions with glutamate and opioid systems. Clinical implications of these actions in individuals with ADHD with comorbid depression, anxiety, substance use disorder, and sleep disturbances are discussed.
Collapse
Affiliation(s)
- Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, State University of New York (SUNY) Upstate Medical University, Syracuse, NY, United States; K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Bergen, Norway.
| |
Collapse
|
26
|
Murphy CP, Singewald N. Potential of microRNAs as novel targets in the alleviation of pathological fear. GENES BRAIN AND BEHAVIOR 2017; 17:e12427. [DOI: 10.1111/gbb.12427] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/20/2017] [Accepted: 10/05/2017] [Indexed: 12/16/2022]
Affiliation(s)
- C. P. Murphy
- Department of Pharmacology and Toxicology, Institute of Pharmacy, Center for Molecular Biosciences Innsbruck; University of Innsbruck; Innsbruck Austria
| | - N. Singewald
- Department of Pharmacology and Toxicology, Institute of Pharmacy, Center for Molecular Biosciences Innsbruck; University of Innsbruck; Innsbruck Austria
| |
Collapse
|
27
|
Hernández-López L, García-Granados DM, Chavira-Ramírez R, Mondragón-Ceballos R. Testosterone, the progesterone/estradiol ratio, and female ratings of masculine facial fluctuating asymmetry for a long-term relationship. Physiol Behav 2017; 175:66-71. [DOI: 10.1016/j.physbeh.2017.03.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 03/06/2017] [Accepted: 03/23/2017] [Indexed: 12/29/2022]
|
28
|
The lateral habenula and the serotonergic system. Pharmacol Biochem Behav 2017; 162:22-28. [PMID: 28528079 DOI: 10.1016/j.pbb.2017.05.007] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 04/10/2017] [Accepted: 05/16/2017] [Indexed: 12/15/2022]
Abstract
The habenula (Hb) is an epithalamic structure differentiated into two nuclear complexes, medial (MHb) and lateral habenula (LHb). After decades of relative neglect, interest in the Hb resurged when it was demonstrated that LHb neurons play a key role in encoding disappointments and expectation of punishments. Consistent with such a role, the LHb has been implicated in a broad array of functions and pathologic conditions, notably in mechanisms of stress and pain, as well as in the pathophysiology of mood disorders. So far, the vast majority of research involving the LHb has focused on its role in regulating midbrain dopamine release. However, the LHb is also robustly interconnected in a reciprocal manner with a set of rostral serotonin (5-HT) nuclei. Thus, there is increasing evidence that the LHb is amply linked to the dorsal (DR) and median raphe nucleus (MnR) by a complex network of parallel topographically organized direct and indirect pathways. Here, we summarize research about the interconnections of the LHb with different subregions of the DR and MnR, as well as findings about 5-HT-dependent modulation of LHb neurons. Finally, we discuss the contribution of distinct LHb-raphe loops to stress and stress-related psychiatric disorders including anxiety and depression.
Collapse
|
29
|
Molas S, DeGroot SR, Zhao-Shea R, Tapper AR. Anxiety and Nicotine Dependence: Emerging Role of the Habenulo-Interpeduncular Axis. Trends Pharmacol Sci 2017; 38:169-180. [PMID: 27890353 PMCID: PMC5258775 DOI: 10.1016/j.tips.2016.11.001] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 10/31/2016] [Accepted: 11/01/2016] [Indexed: 11/24/2022]
Abstract
While innovative modern neuroscience approaches have aided in discerning brain circuitry underlying negative emotional behaviors including fear and anxiety responses, how these circuits are recruited in normal and pathological conditions remains poorly understood. Recently, genetic tools that selectively manipulate single neuronal populations have uncovered an understudied circuit, the medial habenula (mHb)-interpeduncular (IPN) axis, that modulates basal negative emotional responses. Interestingly, the mHb-IPN pathway also represents an essential circuit that signals heightened anxiety induced by nicotine withdrawal. Insights into how this circuit interconnects with regions more classically associated with anxiety, and how chronic nicotine exposure induces neuroadaptations resulting in an anxiogenic state, may thereby provide novel strategies and molecular targets for therapies that facilitate smoking cessation, as well as for anxiety relief.
Collapse
Affiliation(s)
- Susanna Molas
- Brudnick Neuropsychiatric Research Institute, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Steven R DeGroot
- Brudnick Neuropsychiatric Research Institute, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA; Graduate Program in Neuroscience, University of Massachusetts Medical School, Worcester, MA, USA
| | - Rubing Zhao-Shea
- Brudnick Neuropsychiatric Research Institute, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Andrew R Tapper
- Brudnick Neuropsychiatric Research Institute, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA.
| |
Collapse
|
30
|
Jucaite A, Cselényi Z, Lappalainen J, McCarthy DJ, Lee CM, Nyberg S, Varnäs K, Stenkrona P, Halldin C, Cross A, Farde L. GABA A receptor occupancy by subtype selective GABA Aα2,3 modulators: PET studies in humans. Psychopharmacology (Berl) 2017; 234:707-716. [PMID: 28013354 PMCID: PMC5263201 DOI: 10.1007/s00213-016-4506-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 12/08/2016] [Indexed: 01/04/2023]
Abstract
RATIONALE Sedation, dependence, and abuse liability limit the use of non-selective γ-aminobutyric acid (GABAA) receptor positive modulators for the treatment of anxiety. AZD7325 and AZD6280 are novel, subtype-selective GABAAα2,3 receptor positive modulators with limited sedative effects. OBJECTIVES The current study aimed to confirm target engagement at GABAA receptors by AZD7325 and AZD6280 in humans and to determine the relationship between exposure, GABAA receptor occupancy, and tolerability. METHOD Two PET studies, using high-resolution research tomography (HRRT) and the radioligand [11C]flumazenil, were performed in 12 subjects at baseline and after administration of single oral doses of AZD7325 (0.2 to 30 mg) and AZD6280 (5 to 40 mg). PET images were analyzed using a simplified reference tissue model, and regional binding potentials (BPND) were obtained. The relationship between plasma concentration of AZD7325 or AZD6280 and GABAA receptor occupancy was described by hyperbolic function, and K i,plasma (plasma concentration required for 50% receptor occupancy) was estimated. Assessments of safety and tolerability included recording of adverse events, vital signs, electrocardiogram, and laboratory tests. RESULTS The [11C]flumazenil binding was reduced in a dose-dependent, saturable manner by both agents. Maximum receptor occupancy could be reached for both compounds without causing sedation or cognitive impairment. The K i,plasma estimates for AZD7325 and AZD6280 were 15 and 440 nmol/l, respectively. CONCLUSION High GABAA receptor occupancy by AZD7325 and AZD6280 could be reached without clear sedative effects.
Collapse
Affiliation(s)
- Aurelija Jucaite
- Department of Clinical Neuroscience, AstraZeneca PET Center, Karolinska Institutet, R5:02, SE-17176, Stockholm, Sweden. .,Department of Clinical Neuroscience, PET Centre, Karolinska Institutet, Stockholm, Sweden.
| | - Zsolt Cselényi
- 0000 0004 1937 0626grid.4714.6Department of Clinical Neuroscience, AstraZeneca PET Center, Karolinska Institutet, R5:02, SE-17176 Stockholm, Sweden ,0000 0004 1937 0626grid.4714.6Department of Clinical Neuroscience, PET Centre, Karolinska Institutet, Stockholm, Sweden
| | - Jaakko Lappalainen
- AstraZeneca Neuroscience Innovative Medicines, Cambridge, MA USA ,Marinus Pharmaceuticals, Radnor, PA USA
| | - Dennis J. McCarthy
- 0000 0001 1519 6403grid.418151.8AstraZeneca R&D, Södertälje, Sweden ,Independent Consultant, Newark, DE USA
| | - Chi-Ming Lee
- 0000 0001 1519 6403grid.418151.8AstraZeneca R&D, Södertälje, Sweden ,Ever East Consultants Limited, Hong Kong, People’s Republic of China
| | - Svante Nyberg
- 0000 0001 1519 6403grid.418151.8AstraZeneca R&D, Södertälje, Sweden ,0000 0000 9241 5705grid.24381.3cDepartment of Psychiatry, Karolinska University Hospital (Huddinge), Stockholm, Sweden
| | - Katarina Varnäs
- 0000 0004 1937 0626grid.4714.6Department of Clinical Neuroscience, PET Centre, Karolinska Institutet, Stockholm, Sweden
| | - Per Stenkrona
- 0000 0004 1937 0626grid.4714.6Department of Clinical Neuroscience, PET Centre, Karolinska Institutet, Stockholm, Sweden
| | - Christer Halldin
- 0000 0004 1937 0626grid.4714.6Department of Clinical Neuroscience, PET Centre, Karolinska Institutet, Stockholm, Sweden
| | - Alan Cross
- AstraZeneca Neuroscience Innovative Medicines, Cambridge, MA USA
| | - Lars Farde
- 0000 0004 1937 0626grid.4714.6Department of Clinical Neuroscience, AstraZeneca PET Center, Karolinska Institutet, R5:02, SE-17176 Stockholm, Sweden ,0000 0004 1937 0626grid.4714.6Department of Clinical Neuroscience, PET Centre, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
31
|
Amygdala-Dependent Molecular Mechanisms of the Tac2 Pathway in Fear Learning. Neuropsychopharmacology 2016; 41:2714-22. [PMID: 27238620 PMCID: PMC5026739 DOI: 10.1038/npp.2016.77] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 05/04/2016] [Accepted: 05/08/2016] [Indexed: 02/03/2023]
Abstract
Recently we determined that activation of the tachykinin 2 (Tac2) pathway in the central amygdala (CeA) is necessary and sufficient for the modulation of fear memories. The Tac2 pathway includes the Tac2 gene, which encodes the neuropeptide neurokinin B and its corresponding receptor neurokinin 3 receptor (NK3R). In this study, using Tac2-cre and Tac2-GFP mice, we applied a combination of in vivo (optogenetics) and multiple in vitro techniques to further explore the mechanisms of action within the Tac2 pathway. In transgenic mice that express ChR2 solely in Tac2 neurons, in vivo optogenetic stimulation of CeA Tac2-expressing neurons during fear acquisition enhanced fear memory consolidation and drove action potential firing in vitro. In addition, Tac2-CeA neurons were shown to co-express striatal-enriched protein tyrosine phosphatase, which may have an important role in regulating Nk3R signaling during fear conditioning. These data extend our current understanding for the underlying mechanism(s) for the role of the Tac2 pathway in the regulation of fear memory, which may serve as a new therapeutic target in the treatment of fear-related disorders.
Collapse
|
32
|
Maron E, Nutt D. Biological predictors of pharmacological therapy in anxiety disorders. DIALOGUES IN CLINICAL NEUROSCIENCE 2016. [PMID: 26487811 PMCID: PMC4610615 DOI: 10.31887/dcns.2015.17.3/emaron] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
At least one third of patients with anxiety disorders do not adequately respond to available pharmacological treatment. The reason that some patients with anxiety disorders respond well, but others not, to the same classes of medication is not yet fully understood. It is suggested that several biological factors may influence treatment mechanisms in anxiety and therefore could be identified as possible biomarkers predicting treatment response. In this review, we look at current evidence exploring different types of treatment predictors, including neuroimaging, genetic factors, and blood-related measures, which could open up novel perspectives in clinical management of patients with anxiety disorders.
Collapse
Affiliation(s)
- Eduard Maron
- Department of Psychiatry, North Estonia Medical Centre, Tallinn, Estonia; Department of Psychiatry, University of Tartu, Tartu, Estonia ; Faculty of Medicine, Department of Medicine, Centre for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, London, UK
| | - David Nutt
- Faculty of Medicine, Department of Medicine, Centre for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, London, UK
| |
Collapse
|
33
|
The role of inositol 1,4,5-trisphosphate 3-kinase A in regulating emotional behavior and amygdala function. Sci Rep 2016; 6:23757. [PMID: 27053114 PMCID: PMC4823716 DOI: 10.1038/srep23757] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 03/14/2016] [Indexed: 12/20/2022] Open
Abstract
Inositol 1,4,5-trisphosphate 3-kinase A (IP3K-A) is a molecule enriched in the brain and neurons that regulates intracellular calcium levels via signaling through the inositol trisphosphate receptor. In the present study, we found that IP3K-A expression is highly enriched in the central nucleus of the amygdala (CeA), which plays a pivotal role in the processing and expression of emotional phenotypes in mammals. Genetic abrogation of IP3K-A altered amygdala gene expression, particularly in genes involved in key intracellular signaling pathways and genes mediating fear- and anxiety-related behaviors. In agreement with the changes in amygdala gene expression profiles, IP3K-A knockout (KO) mice displayed more robust responses to aversive stimuli and spent less time in the open arms of the elevated plus maze, indicating high levels of innate fear and anxiety. In addition to behavioral phenotypes, decreased excitatory and inhibitory postsynaptic current and reduced c-Fos immunoreactivity in the CeA of IP3K-A KO mice suggest that IP3K-A has a profound influence on the basal activities of fear- and anxiety-mediating amygdala circuitry. In conclusion, our findings collectively demonstrate that IP3K-A plays an important role in regulating affective states by modulating metabotropic receptor signaling pathways and neural activity in the amygdala.
Collapse
|
34
|
Robitsek J, Ratner MH, Stewart T, Eichenbaum H, Farb DH. Combined administration of levetiracetam and valproic acid attenuates age-related hyperactivity of CA3 place cells, reduces place field area, and increases spatial information content in aged rat hippocampus. Hippocampus 2015; 25:1541-55. [PMID: 25941121 PMCID: PMC4633399 DOI: 10.1002/hipo.22474] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2015] [Indexed: 01/15/2023]
Abstract
Learning and memory deficits associated with age-related mild cognitive impairment have long been attributed to impaired processing within the hippocampus. Hyperactivity within the hippocampal CA3 region that is associated with aging is mediated in part by a loss of functional inhibitory interneurons and thought to underlie impaired performance in spatial memory tasks, including the abnormal tendency in aged animals to pattern complete spatial representations. Here, we asked whether the spatial firing patterns of simultaneously recorded CA3 and CA1 neurons in young and aged rats could be manipulated pharmacologically to selectively reduce CA3 hyperactivity and thus, according to hypothesis, the associated abnormality in spatial representations. We used chronically implanted high-density tetrodes to record the spatial firing properties of CA3 and CA1 units during animal exploration for food in familiar and novel environments. Aged CA3 place cells have higher firing rates, larger place fields, less spatial information content, and respond less to a change from a familiar to a novel environment than young CA3 cells. We also find that the combination of levetiracetam (LEV) + valproic acid (VPA), previously shown to act as a cognitive enhancer in tests of spatial memory, attenuate CA3 place cell firing rates, reduce place field area, and increase spatial information content in aged but not young adult rats. This is consistent with drug enhancing the specificity of neuronal firing with respect to spatial location. Contrary to expectation, however, LEV + VPA reduces place cell discrimination between novel and familiar environments, i.e., spatial correlations increase, independent of age even though drug enhances performance in cognitive tasks. The results demonstrate that spatial information content, or the number of bits of information encoded per action potential, may be the key correlate for enhancement of spatial memory by LEV + VPA.
Collapse
Affiliation(s)
- Jonathan Robitsek
- Laboratory of Molecular Neurobiology, Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, Massachusetts
| | - Marcia H Ratner
- Laboratory of Molecular Neurobiology, Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, Massachusetts
| | - Tara Stewart
- Laboratory of Molecular Neurobiology, Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, Massachusetts
| | - Howard Eichenbaum
- Department of Psychology, Center for Memory and Brain, Boston University, Boston, Massachusetts
| | - David H Farb
- Laboratory of Molecular Neurobiology, Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, Massachusetts
| |
Collapse
|
35
|
Prager EM, Bergstrom HC, Wynn GH, Braga MFM. The basolateral amygdala γ-aminobutyric acidergic system in health and disease. J Neurosci Res 2015; 94:548-67. [PMID: 26586374 DOI: 10.1002/jnr.23690] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 10/01/2015] [Accepted: 10/18/2015] [Indexed: 01/13/2023]
Abstract
The brain comprises an excitatory/inhibitory neuronal network that maintains a finely tuned balance of activity critical for normal functioning. Excitatory activity in the basolateral amygdala (BLA), a brain region that plays a central role in emotion and motivational processing, is tightly regulated by a relatively small population of γ-aminobutyric acid (GABA) inhibitory neurons. Disruption in GABAergic inhibition in the BLA can occur when there is a loss of local GABAergic interneurons, an alteration in GABAA receptor activation, or a dysregulation of mechanisms that modulate BLA GABAergic inhibition. Disruptions in GABAergic control of the BLA emerge during development, in aging populations, or after trauma, ultimately resulting in hyperexcitability. BLA hyperexcitability manifests behaviorally as an increase in anxiety, emotional dysregulation, or development of seizure activity. This Review discusses the anatomy, development, and physiology of the GABAergic system in the BLA and circuits that modulate GABAergic inhibition, including the dopaminergic, serotonergic, noradrenergic, and cholinergic systems. We highlight how alterations in various neurotransmitter receptors, including the acid-sensing ion channel 1a, cannabinoid receptor 1, and glutamate receptor subtypes, expressed on BLA interneurons, modulate GABAergic transmission and how defects of these systems affect inhibitory tonus within the BLA. Finally, we discuss alterations in the BLA GABAergic system in neurodevelopmental (autism/fragile X syndrome) and neurodegenerative (Alzheimer's disease) diseases and after the development of epilepsy, anxiety, and traumatic brain injury. A more complete understanding of the intrinsic excitatory/inhibitory circuit balance of the amygdala and how imbalances in inhibitory control contribute to excessive BLA excitability will guide the development of novel therapeutic approaches in neuropsychiatric diseases.
Collapse
Affiliation(s)
- Eric M Prager
- Department of Anatomy, Physiology, and Genetics, F. Edward Hébert School of Medicine, Uniformed Services, University of the Health Sciences, Bethesda, Maryland
| | | | - Gary H Wynn
- Center for the Study of Traumatic Stress, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland.,Department of Psychiatry, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland.,Program in Neuroscience, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Maria F M Braga
- Department of Anatomy, Physiology, and Genetics, F. Edward Hébert School of Medicine, Uniformed Services, University of the Health Sciences, Bethesda, Maryland.,Center for the Study of Traumatic Stress, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland.,Department of Psychiatry, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland.,Program in Neuroscience, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| |
Collapse
|
36
|
Davies MN, Verdi S, Burri A, Trzaskowski M, Lee M, Hettema JM, Jansen R, Boomsma DI, Spector TD. Generalised Anxiety Disorder--A Twin Study of Genetic Architecture, Genome-Wide Association and Differential Gene Expression. PLoS One 2015; 10:e0134865. [PMID: 26274327 PMCID: PMC4537268 DOI: 10.1371/journal.pone.0134865] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 07/14/2015] [Indexed: 12/30/2022] Open
Abstract
Generalised Anxiety Disorder (GAD) is a common anxiety-related diagnosis, affecting approximately 5% of the adult population. One characteristic of GAD is a high degree of anxiety sensitivity (AS), a personality trait which describes the fear of arousal-related sensations. Here we present a genome-wide association study of AS using a cohort of 730 MZ and DZ female twins. The GWAS showed a significant association for a variant within the RBFOX1 gene. A heritability analysis of the same cohort also confirmed a significant genetic component with h2 of 0.42. Additionally, a subset of the cohort (25 MZ twins discordant for AS) was studied for evidence of differential expression using RNA-seq data. Significant differential expression of two exons with the ITM2B gene within the discordant MZ subset was observed, a finding that was replicated in an independent cohort. While previous research has shown that anxiety has a high comorbidity with a variety of psychiatric and neurodegenerative disorders, our analysis suggests a novel etiology specific to AS.
Collapse
Affiliation(s)
- Matthew N. Davies
- Twin Research and Genetic Epidemiology, King’s College London, London, United Kingdom
- Translational Oncogenomics Laboratory, Centre for Evolution and Cancer, Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
| | - Serena Verdi
- Twin Research and Genetic Epidemiology, King’s College London, London, United Kingdom
| | - Andrea Burri
- Twin Research and Genetic Epidemiology, King’s College London, London, United Kingdom
| | - Maciej Trzaskowski
- Social Genetic & Developmental Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Minyoung Lee
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, United States of America
| | - John M. Hettema
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Rick Jansen
- Department of Biological Psychology, VU University Amsterdam, Neuroscience Campus, Amsterdam, the Netherlands
| | - Dorret I. Boomsma
- Department of Psychiatry, VU University Medical Center, Neuroscience Campus, Amsterdam, the Netherlands
| | - Tim D. Spector
- Twin Research and Genetic Epidemiology, King’s College London, London, United Kingdom
| |
Collapse
|
37
|
Lin R, Rittenhouse D, Sweeney K, Potluri P, Wallace DC. TSPO, a Mitochondrial Outer Membrane Protein, Controls Ethanol-Related Behaviors in Drosophila. PLoS Genet 2015; 11:e1005366. [PMID: 26241038 PMCID: PMC4524697 DOI: 10.1371/journal.pgen.1005366] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 06/17/2015] [Indexed: 11/25/2022] Open
Abstract
The heavy consumption of ethanol can lead to alcohol use disorders (AUDs) which impact patients, their families, and societies. Yet the genetic and physiological factors that predispose humans to AUDs remain unclear. One hypothesis is that alterations in mitochondrial function modulate neuronal sensitivity to ethanol exposure. Using Drosophila genetics we report that inactivation of the mitochondrial outer membrane translocator protein 18kDa (TSPO), also known as the peripheral benzodiazepine receptor, affects ethanol sedation and tolerance in male flies. Knockdown of dTSPO in adult male neurons results in increased sensitivity to ethanol sedation, and this effect requires the dTSPO depletion-mediated increase in reactive oxygen species (ROS) production and inhibition of caspase activity in fly heads. Systemic loss of dTSPO in male flies blocks the development of tolerance to repeated ethanol exposures, an effect that is not seen when dTSPO is only inactivated in neurons. Female flies are naturally more sensitive to ethanol than males, and female fly heads have strikingly lower levels of dTSPO mRNA than males. Hence, mitochondrial TSPO function plays an important role in ethanol sensitivity and tolerance. Since a large array of benzodiazepine analogues have been developed that interact with the peripheral benzodiazepine receptor, the mitochondrial TSPO might provide an important new target for treating AUDs. Alcohol use disorders (AUDs) affect millions of patients worldwide and result in high social and economic burdens. Although environmental factors are involved, there are clear genetic components to AUDs. Both the acute sedating effect of alcohol exposure and alcohol tolerance contribute to long term risk for alcohol dependence and addiction. Yet the genetic etiology of AUDs remains to be determined. The mitochondria play a central role in ethanol metabolism and are important in many aspects of cellular physiology such as REDOX and ROS regulation, and apoptosis. The mitochondrial outer membrane translocator protein 18 kDa (TSPO) binds the benzodiazepines and perhaps other addictive drugs, and thus may play a role in AUDs. Since Drosophila is a well-established model for ethanol-related behaviors, we have developed systems for manipulating the Drosophila tspo gene and protein. With these systems, we have discovered that neuronal TSPO controls sensitivity to ethanol sedation via ROS and caspase-mediated signaling and that systemic TSPO levels are important in the development of tolerance to repeated ethanol exposure. Given the variety of known TSPO ligands, and the common mechanisms of various abusive substances, our studies suggest that TSPO might be a promising target to combat alcoholism as well as addiction to other drugs.
Collapse
Affiliation(s)
- Ran Lin
- Center for Mitochondrial and Epigenomic Medicine, Children’s Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania, United States of America
| | - Danielle Rittenhouse
- Center for Mitochondrial and Epigenomic Medicine, Children’s Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania, United States of America
| | - Katelyn Sweeney
- Center for Mitochondrial and Epigenomic Medicine, Children’s Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania, United States of America
| | - Prasanth Potluri
- Center for Mitochondrial and Epigenomic Medicine, Children’s Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania, United States of America
| | - Douglas C. Wallace
- Center for Mitochondrial and Epigenomic Medicine, Children’s Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania, United States of America
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- * E-mail:
| |
Collapse
|
38
|
The role of the dynorphin/κ opioid receptor system in anxiety. Acta Pharmacol Sin 2015; 36:783-90. [PMID: 25982631 DOI: 10.1038/aps.2015.32] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 04/02/2015] [Indexed: 01/26/2023] Open
Abstract
Anxiety disorders are the most common and prevalent forms of psychiatric disease, although the biological basis of anxiety is not well understood. The dynorphin/κ opioid receptor system is widely distributed in the central nervous system and has been shown to play a critical role in modulating mood and emotional behaviors. In the present review, we summarize current literature relating to the role played by the dynorphin/κ opioid receptor system in anxiety and κ opioid receptor antagonists as potential therapeutic agents for the treatment of anxiety disorders.
Collapse
|
39
|
Cousijn J. Embracing comorbidity: a way toward understanding the role of motivational and control processes in cannabis use disorders. Front Psychol 2015; 6:677. [PMID: 26074841 PMCID: PMC4444647 DOI: 10.3389/fpsyg.2015.00677] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 05/08/2015] [Indexed: 01/01/2023] Open
Affiliation(s)
- Janna Cousijn
- Departments of Developmental and Experimental Psychology, Utrecht University Utrecht, Netherlands
| |
Collapse
|
40
|
Choi YM, Kim KH. Etifoxine for pain patients with anxiety. Korean J Pain 2015; 28:4-10. [PMID: 25589941 PMCID: PMC4293506 DOI: 10.3344/kjp.2015.28.1.4] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 12/17/2014] [Accepted: 12/18/2014] [Indexed: 02/05/2023] Open
Abstract
Etifoxine (etafenoxine, Stresam®) is a non-benzodiazepine anxiolytic with an anticonvulsant effect. It was developed in the 1960s for anxiety disorders and is currently being studied for its ability to promote peripheral nerve healing and to treat chemotherapy-induced pain. In addition to being mediated by GABAAα2 receptors like benzodiazepines, etifoxine appears to produce anxiolytic effects directly by binding to β2 or β3 subunits of the GABAA receptor complex. It also modulates GABAA receptors indirectly via stimulation of neurosteroid production after etifoxine binds to the 18 kDa translocator protein (TSPO) of the outer mitochondrial membrane in the central and peripheral nervous systems, previously known as the peripheral benzodiazepine receptor (PBR). Therefore, the effects of etifoxine are not completely reversed by the benzodiazepine antagonist flumazenil. Etifoxine is used for various emotional and bodily reactions followed by anxiety. It is contraindicated in situations such as shock, severely impaired liver or kidney function, and severe respiratory failure. The average dosage is 150 mg per day for no more than 12 weeks. The most common adverse effect is drowsiness at the initial stage. It does not usually cause any withdrawal syndromes. In conclusion, etifoxine shows less adverse effects of anterograde amnesia, sedation, impaired psychomotor performance, and withdrawal syndromes than those of benzodiazepines. It potentiates GABAA receptor-function by a direct allosteric effect and by an indirect mechanism involving the activation of TSPO. It seems promising that non-benzodiazepine anxiolytics including etifoxine will replenish shortcomings of benzodiazepines and selective serotonin reuptake inhibitors according to animated studies related to TSPO.
Collapse
Affiliation(s)
- Yun Mi Choi
- Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Korea
| | - Kyung Hoon Kim
- Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Korea
| |
Collapse
|