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Sharp BM, Leng S, Huang J, Jones C, Chen H. Inbred rat heredity and sex affect oral oxycodone self-administration and augmented intake in long sessions: correlations with anxiety and novelty-seeking. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.11.26.568753. [PMID: 38076806 PMCID: PMC10705287 DOI: 10.1101/2023.11.26.568753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Oxycodone abuse begins with prescription oral oxycodone, yet vulnerability factors determining abuse are largely undefined. We evaluated genetic vulnerability in a rat model of oral oxycodone self-administration (SA): increasing oxycodone concentration/session (0.025-0.1mg/ml; 1,4,16-h) followed by extinction and reinstatement. Active licks and oxycodone intake were greater in females than males during 4-h and 16-h sessions (p< 0.001). Each sex increased intake during 16-h vs 4-h sessions (p<2e-16), but a subset of strains dramatically augmented intake at 16-h (p=0.0005). Heritability (h 2) of active licks/4-h at increasing oxycodone dose ranged from 0.30-0.53. Under a progressive ratio schedule, breakpoints were strain-dependent (p<2e-16). Cued reinstatement was greater in females (p<0.001). Naive rats were assessed by elevated plus maze (EPM), open field (OF) and novel object interaction (NOI). We correlated these behaviors with 28 parameters of oxycodone SA. Anxiety-defining EPM traits were most associated with SA in both sexes, whereas more OF and NOI traits were SA-associated in males. Sex and heredity are major determinants of motivation to take and seek oxycodone; intake augments dramatically during extended access in specific strains; and pleiotropic genes affect anxiety and multiple SA parameters.
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Affiliation(s)
- Burt M Sharp
- Department of Genetics, Genomics and Informatics, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee 38163
| | - Shuangying Leng
- Department of Genetics, Genomics and Informatics, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee 38163
| | - Jun Huang
- Department of Pharmacology, Addiction Science and Toxicology, University of Tennessee Health Science Center, Memphis, Tennessee 38163
| | - Caroline Jones
- Department of Genetics, Genomics and Informatics, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee 38163
| | - Hao Chen
- Department of Pharmacology, Addiction Science and Toxicology, University of Tennessee Health Science Center, Memphis, Tennessee 38163
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Bourgeault-Gagnon Y, Abdel Khalik H, Patel M, Simunovic N, Ayeni OR. Risk factors for prolonged opioid consumption following hip arthroscopy: A secondary analysis of the Femoroacetabular Impingement RandomiSed controlled Trial and embedded cohort study. Knee Surg Sports Traumatol Arthrosc 2024. [PMID: 38713876 DOI: 10.1002/ksa.12204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/16/2024] [Accepted: 04/09/2024] [Indexed: 05/09/2024]
Abstract
PURPOSE The purpose of the study was to identify prognostic risk factors for prolonged opioid use at 2 and 6 weeks after hip arthroscopy using data from the Femoroacetabular Impingement RandomiSed controlled Trial and its external validation cohort study. METHODS Opioids were prescribed for postoperative pain management at the surgeon's discretion, with a majority being prescribed a combination of oxycodone and paracetamol (5/325 mg). Prolonged opioid use was defined as the ongoing use of any dosage of opioids reported at either 2 or 6 weeks after surgery to treat femoroacetabular impingement, as recorded in the patient's study medication log. Multivariable logistic regressions were performed to evaluate patient and surgical characteristics, such as preoperative opioid use, type of surgical procedure and intraoperative cartilage state that may be associated with prolonged opioid use at either 2 and 6 weeks postoperatively. RESULTS A total of 265 and 231 patients were included for analysis at 2 and 6 weeks postoperatively, respectively. The median age of participants was 35 years (interquartile range [IQR]: 27-42) and 33% were female. At 2 weeks postoperatively, female sex (odds ratio [OR]: 2.56; 95% confidence interval: [CI] 1.34-4.98, p = 0.005), higher body mass index (BMI) (OR: 1.10; 95% CI: 1.02-1.18, p = 0.009), active tobacco use (OR: 4.06; 95% CI: 1.90-8.97, p < 0.001), preoperative opioid use (OR: 10.1; 95% CI: 3.25-39.1, p < 0.001) and an Outerbridge classification of ≥3 (OR: 2.33; 95% CI: 1.25-4.43, p = 0.009) were significantly associated with prolonged opioid use. At 6 weeks postoperatively, only preoperative opioid use was significantly associated with prolonged opioid consumption (OR: 10.6; 95% CI: 3.60-32.6, p < 0.001). CONCLUSION Preoperative opioid use was significantly associated with continued opioid use at 2 and 6 weeks postoperatively. Specific patient factors including female sex, higher BMI, active tobacco use and more severe cartilage damage should be considered in developing targeted strategies to limit opioid use after surgery. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Yoan Bourgeault-Gagnon
- Department of Surgery, Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Hassaan Abdel Khalik
- Department of Surgery, Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Mansi Patel
- Department of Surgery, Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Nicole Simunovic
- Department of Surgery, Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Olufemi R Ayeni
- Department of Surgery, Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada
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Krishnapura SR, McNeer E, Dupont WD, Patrick SW. County-Level Atrazine Use and Gastroschisis. JAMA Netw Open 2024; 7:e2410056. [PMID: 38709530 DOI: 10.1001/jamanetworkopen.2024.10056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2024] Open
Abstract
Importance The incidence of gastroschisis, a birth defect involving the herniation of the small bowel through the abdominal wall, has increased in the US since the 1960s. The pesticide atrazine is a hypothesized cause of gastroschisis; however, examination of the association between atrazine and gastroschisis has been limited. Objective To evaluate national trends in gastroschisis incidence, maternal and infant characteristics associated with gastroschisis, and whether county-level atrazine use is associated with gastroschisis. Design, Setting, and Participants This retrospective, repeated cross-sectional study examined birth certificate data of all live births in the US and data on atrazine use from the US Geological Survey from January 1, 2009, through December 31, 2019. The data analysis was performed between August 5, 2021, and May 26, 2023. Exposures County-level atrazine use. Main Outcomes and Measures The primary outcome was gastroschisis incidence. Covariates included maternal age, race and ethnicity, body mass index (measured by weight in kilograms divided by height in meters squared), parity, insurance type, Chlamydia infection during pregnancy, smoking, and rurality. Mixed-effects logistic regression models (year fixed effects and county random effects) were constructed using different county-level atrazine exposure variables (1-, 5-, and 10-year means). Results Between 2009 and 2019, 39 282 566 live births were identified, with 10 527 infant diagnoses of gastroschisis. Infants with gastroschisis were more likely to have mothers who identified as non-Hispanic White (61% vs 54%; P < .001), had a lower body mass index (median [IQR], 23.4 [20.8-27.2] vs 25.4 [22.0-30.8]; P < .001), were more likely to be nulliparous (median [IQR], 0 [0-1] vs 1 [0-2]; P < .001), and were more commonly covered by Medicaid (63% vs 43%; P < .001). During the study period, the rate (per 1000 live births) of gastroschisis decreased from 0.31 (95% CI, 0.29-0.33) to 0.22 (95% CI, 0.21-0.24). The median (IQR) county-level atrazine use estimates were higher among infants with gastroschisis (1 year, 1389 [IQR, 198-10 162] vs 1023 [IQR, 167-6960] kg; 5 years, 1425 [IQR, 273-9895] vs 1057 [IQR, 199-6926] kg; 10 years, 1508 [IQR, 286-10 271] vs 1113 [IQR, 200-6650] kg; P < .001). In adjusted models, higher county levels of atrazine (each 100 000-kg increase) were associated with a higher incidence of gastroschisis (1 year: adjusted odds ratio [AOR], 1.12 [95% CI, 1.01-1.24]; 5 years: AOR, 1.15 [95% CI, 1.02-1.30]; 10 years: AOR, 1.21 [95% CI, 1.07-1.38]). Conclusions and Relevance In this cross-sectional study, higher county levels of atrazine were associated with infant diagnoses of gastroschisis. While atrazine is the second-most used herbicide in the US, numerous countries around the world have banned it out of concern for adverse effects on human health. These findings suggest that exploring alternatives to atrazine in the US may be warranted.
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Affiliation(s)
- Sunaya R Krishnapura
- Vanderbilt University School of Medicine, Nashville, Tennessee
- Vanderbilt Center for Child Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Elizabeth McNeer
- Vanderbilt Center for Child Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - William D Dupont
- Vanderbilt Center for Child Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Stephen W Patrick
- Vanderbilt Center for Child Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee
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Alamaw ED, Casey KM, Tien K, Franco BD, Gorman G, Cotton RM, Nagamine C, Jampachaisri K, Sharp P, Pacharinsak C, Huss MK. Carprofen Attenuates Postoperative Mechanical and Thermal Hypersensitivity after Plantar Incision in Immunodeficient NSG Mice. Comp Med 2024; 74:105-114. [PMID: 38553034 PMCID: PMC11078281 DOI: 10.30802/aalas-cm-23-000058] [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: 09/06/2023] [Revised: 10/28/2023] [Accepted: 02/27/2024] [Indexed: 05/12/2024]
Abstract
Immunodeficient NSG mice are reported to be less responsive to buprenorphine analgesia. Here, we used NSG mice to compare the efficacy of the commonly used dose of carprofen (5 mg/kg) with 5 and 10 times that dose (25 and 50 mg/kg) for attenuating postoperative mechanical and thermal hypersensitivity following an incisional pain model. Male and female NSG mice (n = 45) were randomly assigned to one of 4 groups and received daily subcutaneous injections for 3 d: saline (5 mL/kg), 5 mg/kg carprofen (Carp5), 25 mg/kg carprofen (Carp25), and 50 mg/kg carprofen (Carp50). Mechanical and thermal hypersensitivity were assessed 24 h before and at 4, 24, and 48 h after surgery. Plasma carprofen concentrations were measured in a separate group of mice (n = 56) on days 0 (at 2, 4, 12, and 23 h), 1, and 2 after the first, second, and third doses, respectively. Toxicity was assessed through daily fecal occult blood testing (n = 27) as well as gross and histopathologic evaluation (n = 15). Our results indicated that the saline group showed both mechanical and thermal hypersensitivity throughout the study. Carp5 did not attenuate mechanical or thermal hypersensitivity at any time point. Carp25 attenuated mechanical and thermal (except for the 4-h time point) hypersensitivity. Carp50 attenuated only thermal hypersensitivity at 24 h. Fecal occult blood was detected in 1 of 8 Carp25-treated mice at 48 and 72 h. Histopathologic abnormalities (gastric ulceration, ulcerative enteritis, and renal lesions) were observed in some Carp50-treated mice. Plasma carprofen concentrations were dose and time dependent. Our results indicate that Carp25 attenuated postoperative mechanical and thermal hypersensitivity more effectively than Carp5 or Carp50 in NSG mice with incisional pain. Therefore, we recommend providing carprofen at 25 mg/kg SID for incisional pain procedures using immunodeficient NSG mouse.
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Affiliation(s)
- Eden D Alamaw
- Department of Comparative Medicine, Stanford University, Stanford, California;,
| | - Kerriann M Casey
- Department of Comparative Medicine, Stanford University, Stanford, California
| | - Krystal Tien
- Department of Comparative Medicine, Stanford University, Stanford, California
| | - Benjamin D Franco
- Department of Comparative Medicine, Stanford University, Stanford, California
| | - Gregory Gorman
- Department of Pharmaceutical, Social and Administrative Sciences, Samford University, Birmingham, Alabama
| | - Renee M Cotton
- Department of Comparative Medicine, Stanford University, Stanford, California
| | - Claude Nagamine
- Department of Comparative Medicine, Stanford University, Stanford, California
| | | | | | | | - Monika K Huss
- Department of Comparative Medicine, Stanford University, Stanford, California
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Shu H, Liu S, Crawford J, Tao F. A female-specific role for trigeminal dynorphin in orofacial pain comorbidity. Pain 2023; 164:2801-2811. [PMID: 37463238 PMCID: PMC10790138 DOI: 10.1097/j.pain.0000000000002980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/01/2023] [Indexed: 07/20/2023]
Abstract
ABSTRACT Migraine is commonly reported in patients with temporomandibular disorders (TMDs), but little is known about the mechanisms underlying the comorbid condition. Here, we prepared a mouse model to investigate this comorbidity, in which masseter muscle tendon ligation (MMTL) was performed to induce a myogenic TMD, and the pre-existing TMD enabled a subthreshold dose of nitroglycerin (NTG) to produce migraine-like pain in mice. RNA sequencing followed by real-time quantitative polymerase chain reaction confirmation showed that MMTL plus NTG treatment increased prodynorphin ( Pdyn ) mRNA expression in the spinal trigeminal nucleus caudalis (Sp5C) of female mice but not in male mice. Chemogenetic inhibition of Pdyn -expressing neurons or microinjection of antidynorphin antiserum in the Sp5C alleviated MMTL-induced masseter hypersensitivity and diminished the MMTL-enabled migraine-like pain in female mice but not in male mice. Moreover, chemogenetic activation of Pdyn -expressing neurons or microinjection of dynorphin A (1-17) peptide in the Sp5C enabled a subthreshold dose of NTG to induce migraine-like pain in female mice but not in male mice. Taken together, our results suggest that trigeminal dynorphin has a female-specific role in the modulation of comorbid TMDs and migraine.
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Affiliation(s)
- Hui Shu
- Department of Biomedical Sciences, Texas A&M University
School of Dentistry, Dallas, Texas, USA
| | - Sufang Liu
- Department of Biomedical Sciences, Texas A&M University
School of Dentistry, Dallas, Texas, USA
| | - Joshua Crawford
- Department of Biomedical Sciences, Texas A&M University
School of Dentistry, Dallas, Texas, USA
| | - Feng Tao
- Department of Biomedical Sciences, Texas A&M University
School of Dentistry, Dallas, Texas, USA
- Center for Craniofacial Research and Diagnosis, Texas
A&M University School of Dentistry, Dallas, Texas, USA
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Hámor PU, Hartmann MC, Garcia A, Liu D, Pleil KE. Morphine-context associative memory and locomotor sensitization in mice are modulated by sex and context in a dose-dependent manner. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.03.565492. [PMID: 37961152 PMCID: PMC10635120 DOI: 10.1101/2023.11.03.565492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Sex differences in opioid use, development of opioid used disorder, and relapse behaviors indicate potential variations in opioid effects between men and women. The locomotor and interoceptive effects of opioids play essential roles in opioid addiction, and uncovering the neural mechanisms underlying these effects remain crucial for developing effective treatments. In this study, we examined the dose-dependent effects of morphine on locomotor sensitization and the strength and stability of morphine-context associations in the conditioned place preference (CPP) paradigm in male and female mice, as well as the relationships between these measures. We observed that while CPP is similar between sexes, the locomotor effects of repeated morphine administration and withdrawal differentially contributed to the strength and stability of morphine-context associations. Specifically, females exhibited higher morphine-induced hyperlocomotion than males regardless of the context in which morphine was experienced. Greater locomotor sensitization to morphine in females than males emerged in a dose-dependent manner only when there was sufficient context information for CPP to be established. Additionally, the relationships between the locomotor effects of morphine and the strength and stability of CPP were different in males and females. In females, positive acute and sensitizing locomotor effects of morphine were correlated with a higher CPP score, while the opposite direction of this relationship was found in males. These results suggest that different aspects of the subjective experience of morphine intoxication and withdrawal are important for morphine abuse-related behaviors and highlight the importance of sex-specific responses in the context of opioid addiction.
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Affiliation(s)
- Peter U. Hámor
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY 10065
| | - Matthew C. Hartmann
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY 10065
| | - Aaron Garcia
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY 10065
| | - Dezhi Liu
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY 10065
| | - Kristen E. Pleil
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY 10065
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Carter JS, Costa CC, Kearns AM, Reichel CM. Inhibition of Estradiol Signaling in the Basolateral Amygdala Impairs Extinction Memory Recall for Heroin-Conditioned Cues in a Sex-Specific Manner. Neuroendocrinology 2023; 114:207-222. [PMID: 37848008 PMCID: PMC10922099 DOI: 10.1159/000534647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 10/10/2023] [Indexed: 10/19/2023]
Abstract
INTRODUCTION Relapse is a major treatment barrier for opioid use disorder. Environmental cues become associated with the rewarding effects of opioids and can precipitate relapse, even after numerous unreinforced cue presentations, due to deficits in extinction memory recall (EMR). Estradiol (E2) modulates EMR of fear-related cues, but it is unknown whether E2 impacts EMR of reward cues and what brain region(s) are responsible for E2s effects. Here, we hypothesize that inhibition of E2 signaling in the basolateral amygdala (BLA) will impair EMR of a heroin-associated cue in both male and female rats. METHODS We pharmacologically manipulated E2 signaling to characterize the role of E2 in the BLA on heroin-cue EMR. Following heroin self-administration, during which a light/tone cue was co-presented with each heroin infusion, rats underwent cued extinction to extinguish the conditioned association between the light/tone and heroin. During extinction, E2 signaling in the BLA was blocked by an aromatase inhibitor or specific estrogen receptor (ER) antagonists. The next day, subjects underwent a cued test to assess heroin-cue EMR. RESULTS In both experiments, females took more heroin than males (mg/kg) and had higher operant responding during cued extinction. Inhibition of E2 synthesis in the BLA impaired heroin-cue EMR in both sexes. Notably, E2s actions are mediated by different ER mechanisms, ERα in males but ERβ in females. CONCLUSIONS This study is the first to demonstrate a behavioral role for centrally-produced E2 in the BLA and that E2 also impacts EMR of reward-associated stimuli in both sexes.
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Affiliation(s)
- Jordan S. Carter
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, United States
| | - Caitlyn C. Costa
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, United States
| | - Angela M. Kearns
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, United States
| | - Carmela M. Reichel
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, United States
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Knauss ZT, Hearn CJ, Hendryx NC, Aboalrob FS, Mueller-Figueroa Y, Damron DS, Lewis SJ, Mueller D. Fentanyl-induced reward seeking is sex and dose dependent and is prevented by D-cysteine ethylester. Front Pharmacol 2023; 14:1241578. [PMID: 37795030 PMCID: PMC10546209 DOI: 10.3389/fphar.2023.1241578] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 09/06/2023] [Indexed: 10/06/2023] Open
Abstract
Introduction: Despite their inclination to induce tolerance, addictive states, and respiratory depression, synthetic opioids are among the most effective clinically administered drugs to treat severe acute/chronic pain and induce surgical anesthesia. Current medical interventions for opioid-induced respiratory depression (OIRD), wooden chest syndrome, and opioid use disorder (OUD) show limited efficacy and are marked by low success in the face of highly potent synthetic opioids such as fentanyl. D-Cysteine ethylester (D-CYSee) prevents OIRD and post-treatment withdrawal in male/female rats and mice with minimal effect on analgesic status. However, the potential aversive or rewarding effects of D-CYSee have yet to be fully characterized and its efficacy could be compromised by interactions with opioid-reward pathology. Methods: Using a model of fentanyl-induced conditioned place preference (CPP), this study evaluated 1) the dose and sex dependent effects of fentanyl to induce rewarding states, and 2) the extent to which D-CYSee alters affective state and the acquisition of fentanyl-induced seeking behaviors. Results: Fentanyl reward-related effects were found to be dose and sex dependent. Male rats exhibited a range-bound dose response centered at 5 µg/kg. Female rats exhibited a CPP only at 50 µg/kg. This dose was effective in 25% of females with the remaining 75% showing no significant CPP at any dose. Pretreatment with 100 mg/kg, but not 10 mg/kg, D-CYSee prevented acquisition of fentanyl seeking in males while both doses were effective at preventing acquisition in females. Discussion: These findings suggest that D-CYSee is an effective co-treatment with prescribed opioids to reduce the development of OUD.
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Affiliation(s)
- Zackery T. Knauss
- Department of Biological Sciences, Kent State University, Kent, OH, United States
| | - Caden J. Hearn
- Department of Biological Sciences, Kent State University, Kent, OH, United States
| | - Nathan C. Hendryx
- Department of Biological Sciences, Kent State University, Kent, OH, United States
| | - Fanan S. Aboalrob
- Department of Biological Sciences, Kent State University, Kent, OH, United States
| | | | - Derek S. Damron
- Department of Biological Sciences, Kent State University, Kent, OH, United States
| | - Stephen J. Lewis
- Department of Pediatrics, Division of Pulmonology, Allergy, and Immunology, Case Western Reserve University, Cleveland, OH, United States
| | - Devin Mueller
- Department of Biological Sciences, Kent State University, Kent, OH, United States
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Rivera-Garcia MT, Rose RM, Wilson-Poe AR. High-CBD Cannabis Vapor Attenuates Opioid Reward and Partially Modulates Nociception in Female Rats. ADDICTION NEUROSCIENCE 2023; 5:100050. [PMID: 36937502 PMCID: PMC10019487 DOI: 10.1016/j.addicn.2022.100050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Chronic pain patients report analgesic effects when using cannabidiol (CBD), a phytocannabinoid found in whole-plant cannabis extract (WPE). Several studies suggest that cannabis-derived products may serve as an analgesic adjunct or alternative to opioids, and importantly, CBD may also attenuate the abuse potential of opioids. Vaping is a popular route of administration among people who use cannabis, however both the therapeutic and hazardous effects of vaping are poorly characterized. Despite the fact that chronic pain is more prevalent in women, the ability of inhaled high-CBD WPE to relieve pain and reduce opioid reward has not been studied in females. Here, we present a comprehensive analysis of high-CBD WPE vapor inhalation in female rats. We found that WPE was modestly efficacious in reversing neuropathy-induced cold allodynia in rats with spared nerve injury (SNI). Chronic exposure to WPE did not affect lung cytoarchitecture or estrous cycle, and it did not induce cognitive impairment, social withdrawal or anxiolytic effects. WPE inhalation prevented morphine-induced conditioned place preference and reinstatement. Similarly, WPE exposure reduced fentanyl self-administration in rats with and without neuropathic pain. We also found that WPE vapor lacks of reinforcing effects compared to the standard excipient used in most vapor administration research. Combined, these results suggest that although high-CBD vapor has modest analgesic effects, it has a robust safety profile, no abuse potential, and it significantly reduces opioid reward in females. Clinical studies examining high-CBD WPE as an adjunct treatment during opioid use disorder are highly warranted.
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Affiliation(s)
- Maria T Rivera-Garcia
- RS Dow Neurobiology Laboratories, Legacy Research Institute, Portland, OR, United States
| | - Rizelle Mae Rose
- RS Dow Neurobiology Laboratories, Legacy Research Institute, Portland, OR, United States
| | - Adrianne R Wilson-Poe
- RS Dow Neurobiology Laboratories, Legacy Research Institute, Portland, OR, United States
- Integrative Physiology and Neuroscience, Washington State University
- Corresponding author. Adrianne R Wilson-Poe, Ph.D., 1225 NE 2nd Ave, suite 249, Portland, OR 97232, USA. Tel. (503) 413-1754, (A.R. Wilson-Poe)
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10
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Simmons SC, Grecco GG, Atwood BK, Nugent FS. Effects of prenatal opioid exposure on synaptic adaptations and behaviors across development. Neuropharmacology 2023; 222:109312. [PMID: 36334764 PMCID: PMC10314127 DOI: 10.1016/j.neuropharm.2022.109312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022]
Abstract
In this review, we focus on prenatal opioid exposure (POE) given the significant concern for the mental health outcomes of children with parents affected by opioid use disorder (OUD) in the view of the current opioid crisis. We highlight some of the less explored interactions between developmental age and sex on synaptic plasticity and associated behavioral outcomes in preclinical POE research. We begin with an overview of the rich literature on hippocampal related behaviors and plasticity across POE exposure paradigms. We then discuss recent work on reward circuit dysregulation following POE. Additional risk factors such as early life stress (ELS) could further influence synaptic and behavioral outcomes of POE. Therefore, we include an overview on the use of preclinical ELS models where ELS exposure during key critical developmental periods confers considerable vulnerability to addiction and stress psychopathology. Here, we hope to highlight the similarity between POE and ELS on development and maintenance of opioid-induced plasticity and altered opioid-related behaviors where similar enduring plasticity in reward circuits may occur. We conclude the review with some of the limitations that should be considered in future investigations. This article is part of the Special Issue on 'Opioid-induced addiction'.
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Affiliation(s)
- Sarah C Simmons
- Department of Pharmacology and Molecular Therapeutics, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Greg G Grecco
- Department of Pharmacology & Toxicology, Indiana University School of Medicine, Indianapolis, IN, USA; Medical Scientist Training Program, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Brady K Atwood
- Department of Pharmacology & Toxicology, Indiana University School of Medicine, Indianapolis, IN, USA; Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Fereshteh S Nugent
- Department of Pharmacology and Molecular Therapeutics, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
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Ray MH, Williams BR, Kuppe MK, Bryant CD, Logan RW. A Glitch in the Matrix: The Role of Extracellular Matrix Remodeling in Opioid Use Disorder. Front Integr Neurosci 2022; 16:899637. [PMID: 35757099 PMCID: PMC9218427 DOI: 10.3389/fnint.2022.899637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/20/2022] [Indexed: 12/02/2022] Open
Abstract
Opioid use disorder (OUD) and deaths from drug overdoses have reached unprecedented levels. Given the enormous impact of the opioid crisis on public health, a more thorough, in-depth understanding of the consequences of opioids on the brain is required to develop novel interventions and pharmacological therapeutics. In the brain, the effects of opioids are far reaching, from genes to cells, synapses, circuits, and ultimately behavior. Accumulating evidence implicates a primary role for the extracellular matrix (ECM) in opioid-induced plasticity of synapses and circuits, and the development of dependence and addiction to opioids. As a network of proteins and polysaccharides, including cell adhesion molecules, proteases, and perineuronal nets, the ECM is intimately involved in both the formation and structural support of synapses. In the human brain, recent findings support an association between altered ECM signaling and OUD, particularly within the cortical and striatal circuits involved in cognition, reward, and craving. Furthermore, the ECM signaling proteins, including matrix metalloproteinases and proteoglycans, are directly involved in opioid seeking, craving, and relapse behaviors in rodent opioid models. Both the impact of opioids on the ECM and the role of ECM signaling proteins in opioid use disorder, may, in part, depend on biological sex. Here, we highlight the current evidence supporting sex-specific roles for ECM signaling proteins in the brain and their associations with OUD. We emphasize knowledge gaps and future directions to further investigate the potential of the ECM as a therapeutic target for the treatment of OUD.
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Affiliation(s)
- Madelyn H Ray
- Laboratory of Sleep, Rhythms, and Addiction, Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, United States.,Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, United States
| | - Benjamin R Williams
- Laboratory of Sleep, Rhythms, and Addiction, Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, United States
| | - Madeline K Kuppe
- Laboratory of Sleep, Rhythms, and Addiction, Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, United States.,Center for Systems Neuroscience, Boston University, Boston, MA, United States
| | - Camron D Bryant
- Center for Systems Neuroscience, Boston University, Boston, MA, United States.,Laboratory of Addiction Genetics, Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, United States.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States
| | - Ryan W Logan
- Laboratory of Sleep, Rhythms, and Addiction, Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, United States.,Center for Systems Neuroscience, Boston University, Boston, MA, United States.,Genome Science Institute, Boston University School of Medicine, Boston, MA, United States
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12
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Romanescu M, Buda V, Lombrea A, Andor M, Ledeti I, Suciu M, Danciu C, Dehelean CA, Dehelean L. Sex-Related Differences in Pharmacological Response to CNS Drugs: A Narrative Review. J Pers Med 2022; 12:jpm12060907. [PMID: 35743692 PMCID: PMC9224918 DOI: 10.3390/jpm12060907] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/23/2022] [Accepted: 05/26/2022] [Indexed: 02/07/2023] Open
Abstract
In the last decades, both animal and human studies have neglected female subjects with the aim of evading a theorized intricacy of feminine hormonal status. However, clinical experience proves that pharmacological response may vary between the two sexes since pathophysiological dissimilarities between men and women significantly influence the pharmacokinetics and pharmacodynamics of drugs. Sex-related differences in central nervous system (CNS) medication are particularly challenging to assess due to the complexity of disease manifestation, drugs’ intricate mechanisms of action, and lack of trustworthy means of evaluating the clinical response to medication. Although many studies showed contrary results, it appears to be a general tendency towards a certain sex-related difference in each pharmacological class. Broadly, opioids seem to produce better analgesia in women especially when they are administered for a prolonged period of time. On the other hand, respiratory and gastrointestinal adverse drug reactions (ADRs) following morphine therapy are more prevalent among female patients. Regarding antidepressants, studies suggest that males might respond better to tricyclic antidepressants (TCAs), whereas females prefer selective serotonin reuptake inhibitors (SSRI), probably due to their tolerance to particular ADRs. In general, studies missed spotting any significant sex-related differences in the therapeutic effect of antiepileptic drugs (AED), but ADRs have sex variations in conjunction with sex hormones’ metabolism. On the subject of antipsychotic therapy, women appear to have a superior response to this pharmacological class, although there are also studies claiming the opposite. However, it seems that reported sex-related differences regarding ADRs are steadier: women are more at risk of developing various side effects, such as metabolic dysfunctions, cardiovascular disorders, and hyperprolactinemia. Taking all of the above into account, it seems that response to CNS drugs might be occasionally influenced by sex as a biological variable. Nonetheless, although for each pharmacological class, studies generally converge to a certain pattern, opposite outcomes are standing in the way of a clear consensus. Hence, the fact that so many studies are yielding conflicting results emphasizes once again the need to address sex-related differences in pharmacological response to drugs.
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Affiliation(s)
- Mirabela Romanescu
- Faculty of Pharmacy, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (M.R.); (A.L.); (I.L.); (M.S.); (C.D.); (C.A.D.)
| | - Valentina Buda
- Faculty of Pharmacy, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (M.R.); (A.L.); (I.L.); (M.S.); (C.D.); (C.A.D.)
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
- Correspondence: ; Tel.: +40-755-100-408
| | - Adelina Lombrea
- Faculty of Pharmacy, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (M.R.); (A.L.); (I.L.); (M.S.); (C.D.); (C.A.D.)
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
| | - Minodora Andor
- Faculty of Medicine, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (M.A.); (L.D.)
| | - Ionut Ledeti
- Faculty of Pharmacy, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (M.R.); (A.L.); (I.L.); (M.S.); (C.D.); (C.A.D.)
- Advanced Instrumental Screening Center, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
| | - Maria Suciu
- Faculty of Pharmacy, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (M.R.); (A.L.); (I.L.); (M.S.); (C.D.); (C.A.D.)
| | - Corina Danciu
- Faculty of Pharmacy, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (M.R.); (A.L.); (I.L.); (M.S.); (C.D.); (C.A.D.)
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
| | - Cristina Adriana Dehelean
- Faculty of Pharmacy, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (M.R.); (A.L.); (I.L.); (M.S.); (C.D.); (C.A.D.)
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
| | - Liana Dehelean
- Faculty of Medicine, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania; (M.A.); (L.D.)
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13
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Franco D, Wulff AB, Lobo MK, Fox ME. Chronic Physical and Vicarious Psychosocial Stress Alter Fentanyl Consumption and Nucleus Accumbens Rho GTPases in Male and Female C57BL/6 Mice. Front Behav Neurosci 2022; 16:821080. [PMID: 35221946 PMCID: PMC8867005 DOI: 10.3389/fnbeh.2022.821080] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/20/2022] [Indexed: 12/16/2022] Open
Abstract
Chronic stress can increase the risk of developing a substance use disorder in vulnerable individuals. Numerous models have been developed to probe the underlying neurobiological mechanisms, however, most prior work has been restricted to male rodents, conducted only in rats, or introduces physical injury that can complicate opioid studies. Here we sought to establish how chronic psychosocial stress influences fentanyl consumption in male and female C57BL/6 mice. We used chronic social defeat stress (CSDS), or the modified vicarious chronic witness defeat stress (CWDS), and used social interaction to stratify mice as stress-susceptible or resilient. We then subjected mice to a 15 days fentanyl drinking paradigm in the home cage that consisted of alternating forced and choice periods with increasing fentanyl concentrations. Male mice susceptible to either CWDS or CSDS consumed more fentanyl relative to unstressed mice. CWDS-susceptible female mice did not differ from unstressed mice during the forced periods, but showed increased preference for fentanyl over time. We also found decreased expression of nucleus accumbens Rho GTPases in male, but not female mice following stress and fentanyl drinking. We also compare fentanyl drinking behavior in mice that had free access to plain water throughout. Our results indicate that stress-sensitized fentanyl consumption is dependent on both sex and behavioral outcomes to stress.
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Affiliation(s)
- Daniela Franco
- Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Andreas B. Wulff
- Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Mary Kay Lobo
- Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Megan E. Fox
- Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, MD, United States,Department of Anesthesiology and Perioperative Medicine, Penn State College of Medicine, Hershey, PA, United States,*Correspondence: Megan E. Fox,
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14
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Berthold EC, Kamble SH, Raju KS, Kuntz MA, Senetra AS, Mottinelli M, León F, Restrepo LF, Patel A, Ho NP, Hiranita T, Sharma A, McMahon LR, McCurdy CR. The Lack of Contribution of 7-Hydroxymitragynine to the Antinociceptive Effects of Mitragynine in Mice: A Pharmacokinetic and Pharmacodynamic Study. Drug Metab Dispos 2022; 50:158-167. [PMID: 34759012 PMCID: PMC8969138 DOI: 10.1124/dmd.121.000640] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/05/2021] [Indexed: 02/03/2023] Open
Abstract
Kratom (Mitragyna speciosa), a Southeast Asian tree, has been used for centuries in pain relief and mitigation of opium withdrawal symptoms. Mitragynine (MTG), the major kratom alkaloid, is being investigated for its potential to provide analgesia without the deleterious effects associated with typical opioids. Concerns have been raised regarding the active metabolite of MTG, 7-hydroxymitragynine (7HMG), which has higher affinity and efficacy at µ-opioid receptors than MTG. Here we investigated the hotplate antinociception, pharmacokinetics, and tissue distribution of MTG and 7HMG at equianalgesic oral doses in male and female C57BL/6 mice to determine the extent to which 7HMG metabolized from MTG accounts for the antinociceptive effects of MTG and investigate any sex differences. The mechanism of action was examined by performing studies with the opioid receptor antagonist naltrexone. A population pharmacokinetic/pharmacodynamic model was developed to predict the behavioral effects after administration of various doses of MTG and 7HMG. When administered alone, 7HMG was 2.8-fold more potent than MTG to produce antinociception. At equivalent effective doses of MTG and 7HMG, there was a marked difference in the maximum brain concentration of 7HMG achieved, i.e., 11-fold lower as a metabolite of MTG. The brain concentration of 7HMG observed 4 hours post administration, producing an analgesic effect <10%, was still 1.5-fold higher than the maximum concentration of 7HMG as a metabolite of MTG. These results provide strong evidence that 7HMG has a negligible role in the antinociceptive effects of MTG in mice. SIGNIFICANCE STATEMENT: Mitragynine (MTG) is being investigated for its potential to aid in pain relief, opioid withdrawal syndrome, and opioid use disorder. The active metabolite of MTG, 7-hydroxymitragynine (7HMG), has been shown to have abuse potential and has been implicated in the opioid-like analgesic effect after MTG administration. The results of this study suggest a lack of involvement of 7HMG in the antinociceptive effects of MTG in mice.
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Affiliation(s)
- Erin C Berthold
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Shyam H Kamble
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Kanumuri S Raju
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Michelle A Kuntz
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Alexandria S Senetra
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Marco Mottinelli
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Francisco León
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Luis F Restrepo
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Avi Patel
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Nicholas P Ho
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Takato Hiranita
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Abhisheak Sharma
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Lance R McMahon
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
| | - Christopher R McCurdy
- Department of Pharmaceutics, College of Pharmacy, (E.C.B., S.H.K., K.S.R., M.A.K., A.S.S., A.S., C.R.M.), Translational Drug Development Core, Clinical and Translational Science Institute (S.H.K., K.S.R., A.S., C.R.M.), Department of Medicinal Chemistry, College of Pharmacy (M.M., F.L., C.R.M.), and Department of Pharmacodynamics, College of Pharmacy, USA (L.F.R., A.P., N.P.H., T.H., L.R.M.) University of Florida, Gainesville, Florida
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15
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What Obstetrician–Gynecologists Should Know About Substance Use Disorders in the Perinatal Period. Obstet Gynecol 2022; 139:317-337. [DOI: 10.1097/aog.0000000000004657] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 10/01/2021] [Indexed: 11/26/2022]
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16
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Calarco CA, Fox ME, Van Terheyden S, Turner MD, Alipio JB, Chandra R, Lobo MK. Mitochondria-Related Nuclear Gene Expression in the Nucleus Accumbens and Blood Mitochondrial Copy Number After Developmental Fentanyl Exposure in Adolescent Male and Female C57BL/6 Mice. Front Psychiatry 2021; 12:737389. [PMID: 34867530 PMCID: PMC8637046 DOI: 10.3389/fpsyt.2021.737389] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/06/2021] [Indexed: 12/21/2022] Open
Abstract
The potency of the synthetic opioid fentanyl and its increased clinical availability has led to the rapid escalation of use in the general population, increased recreational exposure, and subsequently opioid-related overdoses. The wide-spread use of fentanyl has, consequently, increased the incidence of in utero exposure to the drug, but the long-term effects of this type of developmental exposure are not yet understood. Opioid use has also been linked to reduced mitochondrial copy number in blood in clinical populations, but the link between this peripheral biomarker and genetic or functional changes in reward-related brain circuitry is still unclear. Additionally, mitochondrial-related gene expression in reward-related brain regions has not been examined in the context of fentanyl exposure, despite the growing literature demonstrating drugs of abuse impact mitochondrial function, which subsequently impacts neuronal signaling. The current study uses exposure to fentanyl via dam access to fentanyl drinking water during gestation and lactation as a model for developmental drug exposure. This perinatal drug-exposure is sufficient to impact mitochondrial copy number in circulating blood leukocytes, as well as mitochondrial-related gene expression in the nucleus accumbens (NAc), a reward-related brain structure, in a sex-dependent manner in adolescent offspring. Specific NAc gene expression is correlated with both blood mitochondrial copy number and with anxiety related behaviors dependent on developmental exposure to fentanyl and sex. These data indicate that developmental fentanyl exposure impacts mitochondrial function in both the brain and body in ways that can impact neuronal signaling and may prime the brain for altered reward-related behavior in adolescence and later into adulthood.
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Affiliation(s)
| | | | | | | | | | | | - Mary Kay Lobo
- Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, MD, United States
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17
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Sharp BM, Fan X, Redei EE, Mulligan MK, Chen H. Sex and heredity are determinants of drug intake in a novel model of rat oral oxycodone self-administration. GENES, BRAIN, AND BEHAVIOR 2021; 20:e12770. [PMID: 34459088 PMCID: PMC8815756 DOI: 10.1111/gbb.12770] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 11/26/2022]
Abstract
The steady rise in prescription opioids such as oxycodone has led to a virulent epidemic of widespread abuse and deaths in the United States; approximately 80% of affected individuals initiate the habitual use of oxycodone by using prescription oral oxycodone. Given the importance of drug pharmacokinetics in determining abuse potential, we designed an oral operant oxycodone self-administration (SA) procedure in rats to model drug intake by most human users/abusers of oxycodone. Key aspects of the model include limited initial drug intake followed by increasing drug concentrations during extended 4-h sessions on alternating days. Sex and genetic predisposition are major determinants of human opiate abuse. Therefore, we studied females in seven inbred strains (WLI, WMI, LEW, DSS, F344, BN and SHR) and both sexes in three of these strains. All strains increased intake across serially increasing doses (0.025-0.2 mg/ml; p < 0.001): the range of intakes at the final concentration of oxycodone was 0.72 ± 0.17-4.84 ± 1.42 mg/kg (mean ± SEM) - a 6.7-fold difference across strains. In LEW, WLI and WMI strains, oxycodone intake increased significantly across all sessions in both sexes. However, in LEW and WMI male rats but not WLI, daily oxycodone intake was significantly lower across all 4-h sessions than females (p < 0.005). The estimated heritability in oxycodone intake was in the range of 0.21-0.41. In summary, our novel operant oral oxycodone SA model captures the strong abuse potential of oral oxycodone and shows dose, sex and strain-specific drug intake that is significantly dependent on heredity.
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Affiliation(s)
- Burt M Sharp
- Department of Genetics, Genomics and Informatics, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Xinyu Fan
- Department of Pharmacology, Addiction Science and Toxicology, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Eva E Redei
- Department of Psychiatry and Behavioral Sciences, and Physiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Megan K Mulligan
- Department of Genetics, Genomics and Informatics, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Hao Chen
- Department of Pharmacology, Addiction Science and Toxicology, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
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18
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Sex and Estrous Cycle Differences in Analgesia and Brain Oxycodone Levels. Mol Neurobiol 2021; 58:6540-6551. [PMID: 34581987 DOI: 10.1007/s12035-021-02560-1] [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: 06/09/2021] [Accepted: 09/10/2021] [Indexed: 12/29/2022]
Abstract
Sex differences in opioid analgesia occur in rodents and humans, and could be due to differences in drug and metabolite levels. Thus, we investigated the sex and cycle differences in analgesia (nociception) from oxycodone in rats and related these to sex and cycle differences in brain and plasma oxycodone and metabolite levels. Since numerous opioids are CYP2D enzyme substrates and variation in CYP2D alters opioid drug levels and response, we also initiated studies to see if the sex and cycle differences observed might be due to differences in brain CYP2D activity. Across oxycodone doses, females in diestrus had higher analgesia (using tail flick latency) compared to males and females in estrus; we also demonstrated a direct effect of estrous cycle on analgesia within females. Consistent with the analgesia, females in diestrus had highest brain oxycodone levels (assessed using microdialysis) compared to males and females in estrus. Analgesia correlated with brain oxycodone, but not brain oxymorphone or noroxycodone levels, or plasma drug or metabolite levels. Propranolol (a CYP2D mechanism-based inhibitor), versus vehicle pre-treatments, increased brain oxycodone, and decreased brain oxymorphone/oxycodone drug level ratios (an in vivo CYP2D activity phenotype in the brain) in males and females in estrus, but not in females in diestrus. Brain oxymorphone/oxycodone inversely correlated with analgesia. Together, both sex and estrous cycle impact oxycodone analgesia and brain oxycodone levels, likely through regulation of brain CYP2D oxycodone metabolism. As CYP2D6 is expressed in human brain, perhaps similar sex and cycle influences also occur in humans.
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Lum JS, Bird KM, Wilkie J, Millard SJ, Pallimulla S, Newell KA, Wright IM. Prenatal methadone exposure impairs adolescent cognition and GABAergic neurodevelopment in a novel rat model of maternal methadone treatment. Prog Neuropsychopharmacol Biol Psychiatry 2021; 110:110281. [PMID: 33571606 DOI: 10.1016/j.pnpbp.2021.110281] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 01/21/2021] [Accepted: 02/05/2021] [Indexed: 10/22/2022]
Abstract
Methadone maintenance treatment (MMT) is the most common treatment for opioid-dependent pregnant women worldwide. Despite its widespread use, MMT is associated with a variety of adverse neurodevelopmental outcomes in exposed offspring, particularly cognitive impairments. The neurobiological abnormalities underlying these cognitive impairments are, however, poorly understood. This is, in part, due to a lack of animal models that represents the standard of care that methadone is administered in the clinic, with inconsistencies in the timing, doses and durations of treatment. Here we describe the characterisation of a clinically relevant rat model of MMT in which the long-term behavioural and neurobiological effects of prenatal methadone exposure can be assessed in adolescent offspring. Female Sprague-Dawley rats were treated orally with an ascending methadone dosage schedule (5, 10, 15, 20, 25 and 30 mg/kg/day), self-administered in drinking water prior to conception, throughout gestation and lactation. Pregnancy success, maternal gestational weight gain, litter survival and size were not significantly altered in methadone-exposed animals. Methadone-exposed offspring body and brain weights were significantly lower at birth. Novel object recognition tests performed at adolescence revealed methadone-exposed offspring had impaired recognition memory. Furthermore, the rewarded T-maze alternation task demonstrated that methadone-exposed female, but not male, offspring also exhibit working memory and learning deficits. Immunoblots of the adolescent prefrontal cortex and hippocampus showed methadone-exposed offspring displayed reduced levels of mature BDNF, in addition to the GABAergic proteins, GAD67 and parvalbumin, in a sex- and brain region-specific fashion. This rat model closely emulates the clinical scenario in which methadone is administered to opioid-dependent pregnant woman and provides evidence MMT can cause cognitive impairments in adolescent offspring that may be underlined by perturbed neurodevelopment of the GABAergic system.
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Affiliation(s)
- Jeremy S Lum
- Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia; School of Medicine, University of Wollongong University of Wollongong, Wollongong, NSW 2522, Australia; Molecular Horizons, University of Wollongong, Wollongong, NSW 2522, Australia.
| | - Katrina M Bird
- Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia; School of Medicine, University of Wollongong University of Wollongong, Wollongong, NSW 2522, Australia; Molecular Horizons, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Jennifer Wilkie
- Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia; School of Medicine, University of Wollongong University of Wollongong, Wollongong, NSW 2522, Australia
| | - Samuel J Millard
- Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia; School of Medicine, University of Wollongong University of Wollongong, Wollongong, NSW 2522, Australia
| | - Sachie Pallimulla
- Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia; School of Medicine, University of Wollongong University of Wollongong, Wollongong, NSW 2522, Australia
| | - Kelly A Newell
- Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia; School of Medicine, University of Wollongong University of Wollongong, Wollongong, NSW 2522, Australia; Molecular Horizons, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Ian M Wright
- Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia; School of Medicine, University of Wollongong University of Wollongong, Wollongong, NSW 2522, Australia; University of Queensland Centre for Clinical Research, University of Queensland, Herston, QLD 4029, Australia; College of Medicine and Dentistry, James Cook University, Cairns, QLD 4870, Australia
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20
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Muchhala KH, Jacob JC, Dewey WL, Akbarali HI. Role of β-arrestin-2 in short- and long-term opioid tolerance in the dorsal root ganglia. Eur J Pharmacol 2021; 899:174007. [PMID: 33705801 PMCID: PMC8058323 DOI: 10.1016/j.ejphar.2021.174007] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 02/25/2021] [Accepted: 02/28/2021] [Indexed: 11/26/2022]
Abstract
G-protein-biased agonists with reduced β-arrestin-2 activation are being investigated as safer alternatives to clinically-used opioids. β-arrestin-2 has been implicated in the mechanism of opioid-induced antinociceptive tolerance. Opioid-induced analgesic tolerance is classically considered as centrally-mediated, but recent reports implicate nociceptive dorsal root ganglia neurons as critical mediators in this process. Here, we investigated the role of β-arrestin-2 in the mechanism of opioid tolerance in dorsal root ganglia nociceptive neurons using β-arrestin-2 knockout mice and the G-protein-biased μ-opioid receptor agonist, TRV130. Whole-cell current-clamp electrophysiology experiments revealed that 15-18-h overnight exposure to 10 μM morphine in vitro induced acute tolerance in β-arrestin-2 wild-type but not knockout neurons. Furthermore, in wild-type neurons circumventing β-arrestin-2 activation by overnight treatment with 200 nM TRV130 attenuated tolerance. Similarly, acute morphine tolerance in vivo in β-arrestin-2 knockout mice was prevented in the warm-water tail-withdrawal assay. Treatment with 30 mg/kg TRV130 s.c. also inhibited acute antinociceptive tolerance in vivo in wild-type mice. Alternately, in β-arrestin-2 knockout neurons tolerance induced by 7-day in vivo exposure to 50 mg morphine pellet was conserved. Likewise, β-arrestin-2 deletion did not mitigate in vivo antinociceptive tolerance induced by 7-day exposure to 25 mg or 50 mg morphine pellet in both female or male mice, respectively. Consequently, these results indicated that β-arrestin-2 mediates acute but not chronic opioid tolerance in dorsal root ganglia neurons and to antinociception in vivo. This suggests that opioid-induced antinociceptive tolerance may develop even in the absence of β-arrestin-2 activation, and thus significantly affect the clinical utility of biased agonists.
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MESH Headings
- Analgesics, Opioid/pharmacology
- Animals
- Behavior, Animal/drug effects
- Cells, Cultured
- Disease Models, Animal
- Drug Tolerance
- Female
- Ganglia, Spinal/drug effects
- Ganglia, Spinal/metabolism
- Ganglia, Spinal/physiopathology
- Male
- Mice, Knockout
- Morphine/pharmacology
- Neurons/drug effects
- Neurons/metabolism
- Nociceptive Pain/genetics
- Nociceptive Pain/metabolism
- Nociceptive Pain/physiopathology
- Nociceptive Pain/prevention & control
- Pain Threshold/drug effects
- Receptors, Opioid, mu/agonists
- Receptors, Opioid, mu/metabolism
- Spiro Compounds/pharmacology
- Thiophenes/pharmacology
- Time Factors
- beta-Arrestin 2/deficiency
- beta-Arrestin 2/genetics
- beta-Arrestin 2/metabolism
- Mice
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Affiliation(s)
- Karan H Muchhala
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, 1112 East Clay St, Richmond, VA, 23298, USA
| | - Joanna C Jacob
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, 1112 East Clay St, Richmond, VA, 23298, USA
| | - William L Dewey
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, 1112 East Clay St, Richmond, VA, 23298, USA
| | - Hamid I Akbarali
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, 1112 East Clay St, Richmond, VA, 23298, USA.
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21
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Liu SX, Gades MS, Swain Y, Ramakrishnan A, Harris AC, Tran PV, Gewirtz JC. Repeated morphine exposure activates synaptogenesis and other neuroplasticity-related gene networks in the dorsomedial prefrontal cortex of male and female rats. Drug Alcohol Depend 2021; 221:108598. [PMID: 33626484 PMCID: PMC8026706 DOI: 10.1016/j.drugalcdep.2021.108598] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 01/27/2021] [Accepted: 01/27/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Opioid abuse is a chronic disorder likely involving stable neuroplastic modifications. While a number of molecules contributing to these changes have been identified, the broader spectrum of genes and gene networks that are affected by repeated opioid administration remain understudied. METHODS We employed Next-Generation RNA-sequencing (RNA-seq) followed by quantitative chromatin immunoprecipitation to investigate changes in gene expression and their regulation in adult male and female rats' dorsomedial prefrontal cortex (dmPFC) after a regimen of daily injection of morphine (5.0 mg/kg; 10 days). Ingenuity Pathway Analysis (IPA) was used to analyze affected molecular pathways, gene networks, and associated regulatory factors. A complementary behavioral study evaluated the effects of the same morphine injection regimen on locomotor activity, pain sensitivity, and somatic withdrawal signs. RESULTS Behaviorally, repeated morphine injection induced locomotor hyperactivity and hyperalgesia in both sexes. 90 % of differentially expressed genes (DEGs) in morphine-treated rats were upregulated in both males and females, with a 35 % overlap between sexes. A substantial number of DEGs play roles in synaptic signaling and neuroplasticity. Chromatin immunoprecipitation revealed enrichment of H3 acetylation, a transcriptionally activating chromatin mark. Although broadly similar, some differences were revealed in the gene ontology networks enriched in females and males. CONCLUSIONS Our results cohere with findings from previous studies based on a priori gene selection. Our results also reveal novel genes and molecular pathways that are upregulated by repeated morphine exposure, with some common to males and females and others that are sex-specific.
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Affiliation(s)
| | - Mari S. Gades
- Department of Psychology, University of Minnesota, MN 55455
| | - Yayi Swain
- Department of Psychology, University of Minnesota, MN 55455,Hennepin Healthcare Research Institute, 914 S 8th St, Minneapolis, MN 55404
| | | | - Andrew C. Harris
- Department of Psychology, University of Minnesota, MN 55455,Department of Medicine, University of Minnesota, MN 55455,Hennepin Healthcare Research Institute, 914 S 8th St, Minneapolis, MN 55404
| | - Phu V. Tran
- Department of Pediatrics, University of Minnesota, MN 55455
| | - Jonathan C. Gewirtz
- Department of Psychology, University of Minnesota, MN 55455,Corresponding author: Jonathan Gewirtz Department of Psychology University of Minnesota Elliott Hall 75 East River Road Minneapolis, MN 55455
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22
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Gao L, Roy Robertson J, Bird SM. Scotland's 2009-2015 methadone-prescription cohort: Quintiles for daily dose of prescribed methadone and risk of methadone-specific death. Br J Clin Pharmacol 2021; 87:652-673. [PMID: 32530053 PMCID: PMC7612180 DOI: 10.1111/bcp.14432] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 04/16/2020] [Accepted: 04/22/2020] [Indexed: 12/18/2022] Open
Abstract
AIMS As methadone clients age, their drug-related death (DRD) risks increase, more than doubling at 45+ years for methadone-specific DRDs. METHODS Using Community Health Index (CHI) numbers, mortality to 31 December 2015 was ascertained for 36 347 methadone-prescription clients in Scotland during 2009-2015. Cohort entry, quantity of prescribed methadone and daily dose (actual or recovered by effective, simple rules) were defined by clients' first CHI-identified methadone prescription after 30 June 2009 and used in proportional hazards analysis. As custodian of death records, National Records of Scotland identified non-DRDs from DRDs. Methadone-specific DRD means methadone was implicated but neither heroin nor buprenorphine. RESULTS The cohort's 192 928 person-years included 1857 non-DRDs and 1323 DRDs (42%), 546 of which were methadone specific. Actual/recovered daily dose was available for 26 533 (73%) clients who experienced 420 methadone-specific DRDs. Top quintile for daily dose at first CHI-identified methadone prescription was >90 mg. Age 45+ years at cohort-entry (hazard ratio vs 25-34 years: 3.1, 95% confidence interval: 2.4-4.2), top quintile for baseline daily dose of prescribed methadone (vs 50-70 mg: 1.9, 1.1-3.1) and being female (1.3, 1.0-1.6) significantly increased clients' risk of methadone-specific DRD. CONCLUSION Extra care is needed when methadone daily dose exceeds 90 mg. Females' higher risk for methadone-specific DRD is new and needs validation. Further analyses of prescribed daily dose linked to mortality for large cohorts of methadone clients are needed internationally, together with greater pharmacodynamic and pharmacokinetic understanding of methadone by age and sex. Balancing age-related risks is challenging for prescribers who manage chronic opiate dependency against additional uncertainty about the nature, strength and pharmacological characteristics of drugs from illegal markets.
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Affiliation(s)
- Lu Gao
- MRC Biostatistics Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | | | - Sheila M. Bird
- MRC Biostatistics Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- University of Edinburgh Centre for Medical Informatics, Edinburgh, UK
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23
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Liu J, Seaman R, Johnson B, Wu R, Vu J, Tian J, Zhang Y, Li JX. Activation of trace amine-associated receptor 1 selectively attenuates the reinforcing effects of morphine. Br J Pharmacol 2021; 178:933-945. [PMID: 33247948 DOI: 10.1111/bph.15335] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 11/10/2020] [Accepted: 11/24/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND PURPOSE Trace amine-associated TA1 receptors play critical roles in regulating dopamine transmission. Previous studies showed that pharmacologically or genetically manipulating the activity of TA1 receptors modulates addiction-like behaviours associated with psychostimulants. However, little is known about whether TA1 receptor modulation would regulate the behavioural effects of opioids. EXPERIMENTAL APPROACH Effects of the selective TA1 receptor partial agonist RO5263397 on the addiction-related and antinociceptive effects of morphine were systematically assessed in male rats and mice. KEY RESULTS RO5263397 attenuated the expression of morphine-induced behavioural sensitization in wildtype but not TA1 receptor knockout mice. RO5263397 shifted the dose-effect curve of morphine self-administration downward and reduced the breakpoint in a progressive ratio schedule of reinforcement but did not affect food self-administration in rats. RO5263397 decreased the cue- and drug-induced reinstatement of morphine-seeking behaviour in rats. RO5263397 alone did not trigger reinstatement of morphine-seeking behaviour or change locomotor activity in rats with a history of morphine self-administration. However, RO5263397 did not affect the expression of morphine-induced conditioned place preference in mice or rats. RO5263397 did not affect naltrexone-precipitated jumping behaviour or naltrexone-induced conditioned place aversion in morphine-dependent mice. Furthermore, RO5263397 did not affect the analgesic effects of morphine in an acute nociception model in mice and a chronic pain model in rats. CONCLUSION AND IMPLICATIONS These results indicated that TA1 receptor activation selectively attenuated the reinforcing, but not withdrawal or antinociceptive effects of morphine, suggesting that selective TA1 receptor agonists might be useful to combat opioid addiction, while sparing the analgesic effects.
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Affiliation(s)
- Jianfeng Liu
- Department of Pharmacology and Toxicology, University at Buffalo, Buffalo, New York, USA
| | - Robert Seaman
- Department of Pharmacology and Toxicology, University at Buffalo, Buffalo, New York, USA
| | - Bernard Johnson
- Department of Pharmacology and Toxicology, University at Buffalo, Buffalo, New York, USA
| | - Ruyan Wu
- Department of Pharmacology and Toxicology, University at Buffalo, Buffalo, New York, USA
| | - Jimmy Vu
- Department of Pharmacology and Toxicology, University at Buffalo, Buffalo, New York, USA
| | - Jingwei Tian
- School of Pharmacy, Yantai University, Yantai, China
| | - Yanan Zhang
- Research Triangle Institute, Research Triangle Park, North Carolina, USA
| | - Jun-Xu Li
- Department of Pharmacology and Toxicology, University at Buffalo, Buffalo, New York, USA
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24
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Mallet C, Boudieu L, Lamoine S, Coudert C, Jacquot Y, Eschalier A. The Antitumor Peptide ERα17p Exerts Anti-Hyperalgesic and Anti-Inflammatory Actions Through GPER in Mice. Front Endocrinol (Lausanne) 2021; 12:578250. [PMID: 33815268 PMCID: PMC8011567 DOI: 10.3389/fendo.2021.578250] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 02/08/2021] [Indexed: 12/12/2022] Open
Abstract
Persistent inflammation and persistent pain are major medical, social and economic burdens. As such, related pharmacotherapy needs to be continuously improved. The peptide ERα17p, which originates from a part of the hinge region/AF2 domain of the human estrogen receptor α (ERα), exerts anti-proliferative effects in breast cancer cells through a mechanism involving the hepta-transmembrane G protein-coupled estrogen receptor (GPER). It is able to decrease the size of xenografted human breast tumors, in mice. As GPER has been reported to participate in pain and inflammation, we were interested in exploring the potential of ERα17p in this respect. We observed that the peptide promoted anti-hyperalgesic effects from 2.5 mg/kg in a chronic mice model of paw inflammation induced by the pro-inflammatory complete Freund's adjuvant (CFA). This action was abrogated by the specific GPER antagonist G-15, leading to the conclusion that a GPER-dependent mechanism was involved. A systemic administration of a Cy5-labeled version of the peptide allowed its detection in both, the spinal cord and brain. However, ERα17p-induced anti-hyperalgesia was detected at the supraspinal level, exclusively. In the second part of the study, we have assessed the anti-inflammatory action of ERα17p in mice using a carrageenan-evoked hind-paw inflammation model. A systemic administration of ERα17p at a dose of 2.5 mg/kg was responsible for reduced paw swelling. Overall, our work strongly suggests that GPER inverse agonists, including ERα17p, could be used to control hyperalgesia and inflammation.
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Affiliation(s)
- Christophe Mallet
- Université Clermont Auvergne, INSERM, NEURO-DOL Basics & Clinical Pharmacology of Pain, Clermont-Ferrand, France
- ANALGESIA Institute, Faculty of Medicine, Clermont-Ferrand, France
- *Correspondence: Christophe Mallet,
| | - Ludivine Boudieu
- Université Clermont Auvergne, INSERM, NEURO-DOL Basics & Clinical Pharmacology of Pain, Clermont-Ferrand, France
- ANALGESIA Institute, Faculty of Medicine, Clermont-Ferrand, France
| | - Sylvain Lamoine
- Université Clermont Auvergne, INSERM, NEURO-DOL Basics & Clinical Pharmacology of Pain, Clermont-Ferrand, France
- ANALGESIA Institute, Faculty of Medicine, Clermont-Ferrand, France
| | - Catherine Coudert
- Université Clermont Auvergne, INSERM, NEURO-DOL Basics & Clinical Pharmacology of Pain, Clermont-Ferrand, France
- ANALGESIA Institute, Faculty of Medicine, Clermont-Ferrand, France
| | - Yves Jacquot
- Université de Paris, Faculté de Pharmacie de Paris, CiTCoM, CNRS UMR 8038, INSERM U1268, Paris, France
| | - Alain Eschalier
- Université Clermont Auvergne, INSERM, NEURO-DOL Basics & Clinical Pharmacology of Pain, Clermont-Ferrand, France
- ANALGESIA Institute, Faculty of Medicine, Clermont-Ferrand, France
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25
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Cortez I, Rodgers SP, Kosten TA, Leasure JL. Sex and Age Effects on Neurobehavioral Toxicity Induced by Binge Alcohol. Brain Plast 2020; 6:5-25. [PMID: 33680843 PMCID: PMC7902983 DOI: 10.3233/bpl-190094] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Historically, most alcohol neurotoxicity studies were conducted in young adult males and focused on chronic intake. There has been a shift towards studying the effects of alcohol on the adolescent brain, due to alcohol consumption during this formative period disrupting the brain's developmental trajectory. Because the most typical pattern of adolescent alcohol intake is heavy episodic (binge) drinking, there has also been a shift towards the study of binge alcohol-induced neurobehavioral toxicity. It has thus become apparent that binge alcohol damages the adolescent brain and there is increasing attention to sex-dependent effects. Significant knowledge gaps remain in our understanding of the effects of binge alcohol on the female brain, however. Moreover, it is unsettling that population-level studies indicate that the prevalence of binge drinking is increasing among American women, particularly those in older age groups. Although study of adolescents has made it apparent that binge alcohol disrupts ongoing brain maturational processes, we know almost nothing about how it impacts the aging brain, as studies of its effects on the aged brain are relatively scarce, and the study of sex-dependent effects is just beginning. Given the rapidly increasing population of older Americans, it is crucial that studies address age-dependent effects of binge alcohol, and given the increase in binge drinking in older women who are at higher risk for cognitive decline relative to men, studies must encompass both sexes. Because adolescence and older age are both characterized by age-typical brain changes, and because binge drinking is the most common pattern of alcohol intake in both age groups, the knowledge that we have amassed on binge alcohol effects on the adolescent brain can inform our study of its effects on the aging brain. In this review, we therefore cover the current state of knowledge of sex and age-dependent effects of binge alcohol, as well as statistical and methodological considerations for studies aimed at addressing them.
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Affiliation(s)
- Ibdanelo Cortez
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | | | - J. Leigh Leasure
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Biology & Biochemistry, University of Houston, Houston, TX, USA
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26
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Bossert JM, Kiyatkin E, Korah H, Hoots JK, Afzal A, Perekopskiy D, Thomas S, Fredriksson I, Blough BE, Negus SS, Epstein DH, Shaham Y. In a Rat Model of Opioid Maintenance, the G Protein-Biased Mu Opioid Receptor Agonist TRV130 Decreases Relapse to Oxycodone Seeking and Taking and Prevents Oxycodone-Induced Brain Hypoxia. Biol Psychiatry 2020; 88:935-944. [PMID: 32305216 PMCID: PMC7483192 DOI: 10.1016/j.biopsych.2020.02.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 02/13/2020] [Accepted: 02/13/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Maintenance treatment with opioid agonists (buprenorphine, methadone) is effective for opioid addiction but does not eliminate opioid use in all patients. We modeled maintenance treatment in rats that self-administered the prescription opioid oxycodone. The maintenance medication was either buprenorphine or the G protein-biased mu opioid receptor agonist TRV130. We then tested prevention of oxycodone seeking and taking during abstinence using a modified context-induced reinstatement procedure, a rat relapse model. METHODS We trained rats to self-administer oxycodone (6 hours/day, 14 days) in context A; infusions were paired with discrete tone-light cues. We then implanted osmotic pumps containing buprenorphine or TRV130 (0, 3, 6, or 9 mg/kg/day) and performed 3 consecutive tests: lever pressing reinforced by oxycodone-associated discrete cues in nondrug context B (extinction responding), context-induced reinstatement of oxycodone seeking in context A, and reacquisition of oxycodone self-administration in context A. We also tested whether TRV130 maintenance would protect against acute oxycodone-induced decreases in nucleus accumbens oxygen levels. RESULTS In male rats, buprenorphine and TRV130 decreased extinction responding and reacquisition of oxycodone self-administration but had a weaker (nonsignificant) effect on context-induced reinstatement. In female rats, buprenorphine decreased responding in all 3 tests, while TRV130 decreased only extinction responding. In both sexes, TRV130 prevented acute brain hypoxia induced by moderate doses of oxycodone. CONCLUSIONS TRV130 decreased oxycodone seeking and taking during abstinence in a partly sex-specific manner and prevented acute oxycodone-induced brain hypoxia. We propose that G protein-biased mu opioid receptor agonists, currently in development as analgesics, should be considered as relapse prevention maintenance treatment for opioid addiction.
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Affiliation(s)
- Jennifer M. Bossert
- Behavioral Neuroscience Branch, IRP/NIDA/NIH, Baltimore, MD, U.S.A.,Correspondence: Jennifer M. Bossert ()
| | - Eugene Kiyatkin
- Behavioral Neuroscience Branch, IRP/NIDA/NIH, Baltimore, MD, U.S.A
| | - Hannah Korah
- Behavioral Neuroscience Branch, IRP/NIDA/NIH, Baltimore, MD, U.S.A
| | | | - Anum Afzal
- Behavioral Neuroscience Branch, IRP/NIDA/NIH, Baltimore, MD, U.S.A
| | | | - Shruthi Thomas
- Behavioral Neuroscience Branch, IRP/NIDA/NIH, Baltimore, MD, U.S.A
| | - Ida Fredriksson
- Behavioral Neuroscience Branch, IRP/NIDA/NIH, Baltimore, MD, U.S.A
| | - Bruce E. Blough
- Center for Drug Discovery, Research Triangle Institute, Research Triangle Park, NC, U.S.A
| | - S. Stevens Negus
- Dept. of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, U.S.A
| | - David H. Epstein
- Clinical Pharmacology and Therapeutics Research Branch, IRP/NIDA/NIH, Baltimore, MD, U.S.A
| | - Yavin Shaham
- Behavioral Neuroscience Branch, IRP/NIDA/NIH, Baltimore, MD, U.S.A
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27
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Phillips AG, McGovern DJ, Lee S, Ro K, Huynh DT, Elvig SK, Fegan KN, Root DH. Oral prescription opioid-seeking behavior in male and female mice. Addict Biol 2020; 25:e12828. [PMID: 31489746 DOI: 10.1111/adb.12828] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 08/15/2019] [Accepted: 08/16/2019] [Indexed: 01/23/2023]
Abstract
A significant portion of prescription opioid users self-administer orally rather than intravenously. Animal models of opioid addiction have demonstrated that intravenous cues are sufficient to cause drug seeking. However, intravenous models may not characterize oral users, and the preference to self-administer orally appears to be partially influenced by the user's sex. Our objectives were to determine whether oral opioid-associated cues are sufficient for relapse and whether sex differences exist in relapse susceptibility. Mice orally self-administered escalating doses of oxycodone under postprandial (prefed) or non-postprandial (no prefeeding) conditions. Both sexes demonstrated cue-induced reinstatement following abstinence. In separate mice, we found that oral oxycodone cues were sufficient to reinstate extinguished oral oxycodone-seeking behavior following abstinence without prior postprandial or water self-administration training. During self-administration, we incidentally found that female mice earned significantly more mg/kg oxycodone than male mice. Follow-up studies indicated sex differences in psychomotor stimulation and plasma oxycodone/oxymorphone following oral oxycodone administration. In addition, gonadal studies were performed in which we found divergent responses where ovariectomy-enhanced and orchiectomy-suppressed oral self-administration. While the suppressive effects of orchiectomy were identified across doses and postprandial conditions, the enhancing effects of ovariectomy were selective to non-postprandial conditions. These studies establish that (a) oral drug cues are sufficient to cause reinstatement that is independent of prandial conditions and water-seeking behavior, (b) earned oral oxycodone is larger in female mice compared with male mice potentially through differences in psychomotor stimulation and drug metabolism, and (c) gonadectomy produces divergent effects on oral oxycodone self-administration between sexes.
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Affiliation(s)
- Alysabeth G. Phillips
- Department of Psychology and Neuroscience University of Colorado Boulder Colorado USA
| | - Dillon J. McGovern
- Department of Psychology and Neuroscience University of Colorado Boulder Colorado USA
| | - Soo Lee
- Department of Psychology and Neuroscience University of Colorado Boulder Colorado USA
| | - Kyu Ro
- Department of Psychology and Neuroscience University of Colorado Boulder Colorado USA
| | - David T. Huynh
- Department of Psychology and Neuroscience University of Colorado Boulder Colorado USA
| | - Sophie K. Elvig
- Department of Psychology and Neuroscience University of Colorado Boulder Colorado USA
| | - Katelynn N. Fegan
- Department of Psychology and Neuroscience University of Colorado Boulder Colorado USA
| | - David H. Root
- Department of Psychology and Neuroscience University of Colorado Boulder Colorado USA
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Islam A, Rahman MA, Brenner MB, Moore A, Kellmyer A, Buechler HM, DiGiorgio F, Verchio VR, McCracken L, Sumi M, Hartley R, Lizza JR, Moura-Letts G, Fischer BD, Keck TM. Abuse Liability, Anti-Nociceptive, and Discriminative Stimulus Properties of IBNtxA. ACS Pharmacol Transl Sci 2020; 3:907-920. [DOI: 10.1021/acsptsci.0c00066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Bradford D. Fischer
- Cooper Medical School of Rowan University, 401 Broadway, Camden, New Jersey 08103, United States
| | - Thomas M. Keck
- Cooper Medical School of Rowan University, 401 Broadway, Camden, New Jersey 08103, United States
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29
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Fattore L, Marti M, Mostallino R, Castelli MP. Sex and Gender Differences in the Effects of Novel Psychoactive Substances. Brain Sci 2020; 10:brainsci10090606. [PMID: 32899299 PMCID: PMC7564810 DOI: 10.3390/brainsci10090606] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/28/2020] [Accepted: 08/31/2020] [Indexed: 12/12/2022] Open
Abstract
Sex and gender deeply affect the subjective effects and pharmaco-toxicological responses to drugs. Men are more likely than women to use almost all types of illicit drugs and to present to emergency departments for serious or fatal intoxications. However, women are just as likely as men to develop substance use disorders, and may be more susceptible to craving and relapse. Clinical and preclinical studies have shown important differences between males and females after administration of “classic” drugs of abuse (e.g., Δ9-tetrahydrocannabinol (THC), morphine, cocaine). This scenario has become enormously complicated in the last decade with the overbearing appearance of the new psychoactive substances (NPS) that have emerged as alternatives to regulated drugs. To date, more than 900 NPS have been identified, and can be catalogued in different pharmacological categories including synthetic cannabinoids, synthetic stimulants (cathinones and amphetamine-like), hallucinogenic phenethylamines, synthetic opioids (fentanyls and non-fentanyls), new benzodiazepines and dissociative anesthetics (i.e., methoxetamine and phencyclidine-derivatives). This work collects the little knowledge reached so far on the effects of NPS in male and female animal and human subjects, highlighting how much sex and gender differences in the effects of NPS has yet to be studied and understood.
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Affiliation(s)
- Liana Fattore
- Institute of Neuroscience-Cagliari, National Research Council (CNR), Cittadella Universitaria, 09042 Monserrato, Cagliari, Italy
- Correspondence:
| | - Matteo Marti
- Department of Morphology, Surgery and Experimental Medicine, Section of Legal Medicine and LTTA Center, University of Ferrara, 44121 Ferrara, Italy;
- Department of Anti-Drug Policies, Collaborative Center for the Italian National Early Warning System, Presidency of the Council of Ministers, 00187 Rome, Italy
| | - Rafaela Mostallino
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cittadella Universitaria, 09042 Monserrato, Cagliari, Italy; (R.M.); (M.P.C.)
| | - Maria Paola Castelli
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cittadella Universitaria, 09042 Monserrato, Cagliari, Italy; (R.M.); (M.P.C.)
- National Institute of Neuroscience (INN), University of Cagliari, 09124 Cagliari, Italy
- Center of Excellence “Neurobiology of Addiction”, University of Cagliari, 09124 Cagliari, Italy
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30
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Lopresti NM, Esguerra M, Mermelstein PG. Sex Differences in Animal Models of Opioid Reward. CURRENT SEXUAL HEALTH REPORTS 2020; 12:186-194. [PMID: 33574737 PMCID: PMC7872138 DOI: 10.1007/s11930-020-00266-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW This review aims to discuss sex differences observed in preclinical rodent models of opioid reward. RECENT FINDINGS Utilizing a variety of methodological approaches and drug regimens, no clear consensus has emerged regarding the effects of opiates between males and females. This is quite dissimilar to work examining psychostimulants, where female animals reliably exhibit stronger behavioral responses. SUMMARY With opioid research quickly expanding to determine the neural underpinnings of opioid addiction, further research is essential to determine the conditions wherein sex differences may occur and how they may relate to the human condition.
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Affiliation(s)
| | - Manuel Esguerra
- University of Minnesota, Twin Cities, Department of Neuroscience
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31
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Fundamental sex differences in morphine withdrawal-induced neuronal plasticity. Pain 2020; 161:2022-2034. [PMID: 32345917 DOI: 10.1097/j.pain.0000000000001901] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 04/21/2020] [Indexed: 12/25/2022]
Abstract
ABSTRACT Withdrawal from systemic opioids can induce long-term potentiation (LTP) at spinal C-fibre synapses ("opioid-withdrawal-LTP"). This is considered to be a cellular mechanism underlying opioid withdrawal-induced hyperalgesia, which is a major symptom of the opioid withdrawal syndrome. Opioids can activate glial cells leading to the release of proinflammatory mediators. These may influence synaptic plasticity and could thus contribute to opioid-withdrawal-LTP. Here, we report a sexual dimorphism in the mechanisms of morphine-withdrawal-LTP in adult rats. We recorded C-fibre-evoked field potentials in the spinal cord dorsal horn from deeply anaesthetised male and female rats. In both sexes, we induced a robust LTP through withdrawal from systemic morphine infusion (8 mg·kg-1 bolus, followed by a 1-hour infusion at a rate of 14 mg·kg-1·h-1). This paradigm also induced mechanical hypersensitivity of similar magnitude in both sexes. In male rats, systemic but not spinal application of (-)naloxone blocked the induction of morphine-withdrawal-LTP, suggesting the involvement of descending pronociceptive pathways. Furthermore, we showed that in male rats, the induction of morphine-withdrawal-LTP required the activation of spinal astrocytes and the release of the proinflammatory cytokines tumour necrosis factor and interleukin-1. In striking contrast, in female rats, the induction of morphine-withdrawal-LTP was independent of spinal glial cells. Instead, blocking µ-opioid receptors in the spinal cord was sufficient to prevent a facilitation of synaptic strength. Our study revealed fundamental sex differences in the mechanisms underlying morphine-withdrawal-LTP at C-fibre synapses: supraspinal and gliogenic mechanisms in males and a spinal, glial cell-independent mechanism in females.
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32
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Houser C, Huynh D, Jasarevic A, Do MT, Young M, Villeneuve PJ. Do statutory holidays impact the number of opioid-related hospitalizations among Canadian adults? Findings from a national case-crossover study. Canadian Journal of Public Health 2020; 112:38-48. [PMID: 32767270 DOI: 10.17269/s41997-020-00384-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 07/07/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE In Canada, emergency department visits, hospitalizations, and deaths due to opioid use have risen substantially in recent years. While these events have exhibited seasonal and day of week patterns, there have been no attempts to investigate the extent to which statutory holidays influence these patterns, particularly opioid-related hospitalizations. METHODS We applied a time-stratified case-crossover study design to investigate whether statutory holidays were predictive of opioid-related hospitalizations using the Canadian Discharge Abstract Database (excluding Quebec) for fiscal years 2011/2012 to 2016/2017. This design controls for day of week effects. We restricted analyses to opioid hospitalizations (ICD-10 codes: F11.x, T40.0-T40.4, and T40.6) among individuals 15 years and older. Conditional logistic regression models were fit to estimate the odds of opioid-related hospitalization on holidays relative to non-holidays. We examined these patterns across different holiday types, namely social gathering holidays (e.g., Canada Day) and family holidays (e.g., Christmas). Stratified analyses were done to identify whether these associations varied by age group and sex. RESULTS We identified a total of 59,965 opioid-related hospitalizations. Overall, we found a 12% reduced odds in opioid hospitalizations on holidays (odds ratio [OR] = 0.88, 95% CI 0.83, 0.93) relative to non-holidays. Similar reductions were observed for both family (OR = 0.86, 95% CI 0.79, 0.93) and social gathering holidays (OR = 0.90, 95% CI 0.84, 0.96). No substantive differences were noted by age group or sex. CONCLUSIONS Our findings support the hypothesis that opioid-related hospitalizations occur less frequently on statutory holidays. This knowledge may help inform healthcare resources and health promotion activities to reduce the impacts of opioid use.
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Affiliation(s)
- Chantal Houser
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
| | - David Huynh
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
| | - Amir Jasarevic
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
| | - Minh T Do
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
| | - Matthew Young
- Canadian Centre on Substance Use and Addiction, Ottawa, Ontario, Canada.,Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | - Paul J Villeneuve
- School of Mathematics and Statistics, Carleton University, Herzberg Building, Room 5413, 1125 Colonel By Dr., Ottawa, ON, K1S 5B6, Canada.
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33
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Kokane SS, Perrotti LI. Sex Differences and the Role of Estradiol in Mesolimbic Reward Circuits and Vulnerability to Cocaine and Opiate Addiction. Front Behav Neurosci 2020; 14:74. [PMID: 32508605 PMCID: PMC7251038 DOI: 10.3389/fnbeh.2020.00074] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 04/22/2020] [Indexed: 12/15/2022] Open
Abstract
Although both men and women become addicted to drugs of abuse, women transition to addiction faster, experience greater difficulties remaining abstinent, and relapse more often than men. In both humans and rodents, hormonal cycles are associated with females' faster progression to addiction. Higher concentrations and fluctuating levels of ovarian hormones in females modulate the mesolimbic reward system and influence reward-directed behavior. For example, in female rodents, estradiol (E2) influences dopamine activity within the mesolimbic reward system such that drug-directed behaviors that are normally rewarding and reinforcing become enhanced when circulating levels of E2 are high. Therefore, neuroendocrine interactions, in part, explain sex differences in behaviors motivated by drug reward. Here, we review sex differences in the physiology and function of the mesolimbic reward system in order to explore the notion that sex differences in response to drugs of abuse, specifically cocaine and opiates, are the result of molecular neuroadaptations that differentially develop depending upon the hormonal state of the animal. We also reconsider the notion that ovarian hormones, specifically estrogen/estradiol, sensitize target neurons thereby increasing responsivity when under the influence of either cocaine or opiates or in response to exposure to drug-associated cues. These adaptations may ultimately serve to guide the motivational behaviors that underlie the factors that cause women to be more vulnerable to cocaine and opiate addiction than men.
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Affiliation(s)
- Saurabh S Kokane
- Department of Psychology, University of Texas at Arlington, Arlington, TX, United States
| | - Linda I Perrotti
- Department of Psychology, University of Texas at Arlington, Arlington, TX, United States
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34
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Luster BR, Cogan ES, Schmidt KT, Pati D, Pina MM, Dange K, McElligott ZA. Inhibitory transmission in the bed nucleus of the stria terminalis in male and female mice following morphine withdrawal. Addict Biol 2020; 25:e12748. [PMID: 30963693 DOI: 10.1111/adb.12748] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 02/13/2019] [Accepted: 02/22/2019] [Indexed: 01/15/2023]
Abstract
The United States is experiencing an opioid crisis imposing enormous fiscal and societal costs and driving the staggering overdose death rate. While prescription opioid analgesics are essential for treating acute pain, cessation of use in individuals with a physical dependence induces an aversive withdrawal syndrome that promotes continued drug use to alleviate/avoid these symptoms. Additionally, repeated bouts of withdrawal often lead to an increased propensity for relapse. Understanding the neurobiology underlying withdrawal is essential for providing novel treatment options to alleviate physiological and affective components accompanying the cessation of opiate use. Here, we administered morphine and precipitated withdrawal with naloxone to investigate behavioral and cellular responses in C57BL/6J male and female mice. Following 3 days of administration, both male and female mice demonstrated sensitized withdrawal symptoms. Since the bed nucleus of the stria terminalis (BNST) plays a role in mediating withdrawal-associated behaviors, we examined plastic changes in inhibitory synaptic transmission within this structure 24 hours following the final precipitated withdrawal. In male mice, morphine withdrawal increased spontaneous GABAergic signaling compared with controls. In contrast, morphine withdrawal decreased spontaneous GABAergic signaling in female mice. Intriguingly, these opposing GABAergic effects were contingent upon activity-dependent dynamics within the ex vivo slice. Our findings suggest that male and female mice exhibit some divergent cellular responses in the BNST following morphine withdrawal, and alterations in BNST inhibitory signaling may contribute to the expression of behaviors following opioid withdrawal.
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Affiliation(s)
- Brennon R. Luster
- Bowles Center for Alcohol StudiesUNC Chapel Hill School of Medicine Chapel Hill NC USA
- Department of PsychiatryUNC Chapel Hill School of Medicine Chapel Hill NC USA
| | - Elizabeth S. Cogan
- Bowles Center for Alcohol StudiesUNC Chapel Hill School of Medicine Chapel Hill NC USA
| | - Karl T. Schmidt
- Bowles Center for Alcohol StudiesUNC Chapel Hill School of Medicine Chapel Hill NC USA
| | - Dipanwita Pati
- Bowles Center for Alcohol StudiesUNC Chapel Hill School of Medicine Chapel Hill NC USA
- Department of PharmacologyUNC Chapel Hill School of Medicine Chapel Hill NC USA
| | - Melanie M. Pina
- Bowles Center for Alcohol StudiesUNC Chapel Hill School of Medicine Chapel Hill NC USA
- Department of PharmacologyUNC Chapel Hill School of Medicine Chapel Hill NC USA
| | - Kedar Dange
- Bowles Center for Alcohol StudiesUNC Chapel Hill School of Medicine Chapel Hill NC USA
| | - Zoé A. McElligott
- Bowles Center for Alcohol StudiesUNC Chapel Hill School of Medicine Chapel Hill NC USA
- Department of PsychiatryUNC Chapel Hill School of Medicine Chapel Hill NC USA
- Department of PharmacologyUNC Chapel Hill School of Medicine Chapel Hill NC USA
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35
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Ross JA, Van Bockstaele EJ. The role of catecholamines in modulating responses to stress: Sex-specific patterns, implications, and therapeutic potential for post-traumatic stress disorder and opiate withdrawal. Eur J Neurosci 2020; 52:2429-2465. [PMID: 32125035 DOI: 10.1111/ejn.14714] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 01/15/2020] [Accepted: 02/20/2020] [Indexed: 12/22/2022]
Abstract
Emotional arousal is one of several factors that determine the strength of a memory and how efficiently it may be retrieved. The systems at play are multifaceted; on one hand, the dopaminergic mesocorticolimbic system evaluates the rewarding or reinforcing potential of a stimulus, while on the other, the noradrenergic stress response system evaluates the risk of threat, commanding attention, and engaging emotional and physical behavioral responses. Sex-specific patterns in the anatomy and function of the arousal system suggest that sexually divergent therapeutic approaches may be advantageous for neurological disorders involving arousal, learning, and memory. From the lens of the triple network model of psychopathology, we argue that post-traumatic stress disorder and opiate substance use disorder arise from maladaptive learning responses that are perpetuated by hyperarousal of the salience network. We present evidence that catecholamine-modulated learning and stress-responsive circuitry exerts substantial influence over the salience network and its dysfunction in stress-related psychiatric disorders, and between the sexes. We discuss the therapeutic potential of targeting the endogenous cannabinoid system; a ubiquitous neuromodulator that influences learning, memory, and responsivity to stress by influencing catecholamine, excitatory, and inhibitory synaptic transmission. Relevant preclinical data in male and female rodents are integrated with clinical data in men and women in an effort to understand how ideal treatment modalities between the sexes may be different.
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Affiliation(s)
- Jennifer A Ross
- Department of Pharmacology and Physiology, College of Medicine, Drexel University, Philadelphia, PA, USA
| | - Elisabeth J Van Bockstaele
- Department of Pharmacology and Physiology, College of Medicine, Drexel University, Philadelphia, PA, USA
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36
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Bravo IM, Luster BR, Flanigan ME, Perez PJ, Cogan ES, Schmidt KT, McElligott ZA. Divergent behavioral responses in protracted opioid withdrawal in male and female C57BL/6J mice. Eur J Neurosci 2020; 51:742-754. [PMID: 31544297 PMCID: PMC7069788 DOI: 10.1111/ejn.14580] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/28/2019] [Accepted: 09/04/2019] [Indexed: 01/24/2023]
Abstract
Persons suffering from opioid use disorder (OUD) experience long-lasting dysphoric symptoms well into extended periods of withdrawal. This protracted withdrawal syndrome is notably characterized by heightened anxiety and hyperkatifeia. Here, we investigated if an exacerbated withdrawal model of acute morphine dependence results in lasting behavioral adaptation 6 weeks into forced abstinence in C57BL/6J mice. We found that our exacerbated morphine withdrawal paradigm produced distinct alterations in behavior in elevated plus maze (EPM), open field, and social interaction tests in male and female mice. Following protracted withdrawal male mice showed enhanced exploration of the open arms of the EPM, reduced latency to enter the corner of the OF, and a social interaction deficit. In contrast, female mice showed enhanced thigmotaxis in the OF. In both sexes, protracted withdrawal enhanced locomotor behavior in response to subsequent morphine challenge, albeit at different doses. These findings will be relevant for future investigation examining the neural mechanisms underlying these behaviors and will aid in uncovering physiological sex differences in response to opioid withdrawal.
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Affiliation(s)
- Isabel M. Bravo
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Brennon R. Luster
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Meghan E. Flanigan
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Patric J. Perez
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Post-baccalaureate Research Education Program, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Elizabeth S. Cogan
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Karl T. Schmidt
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Zoe A. McElligott
- Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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37
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Abstract
Opioid use disorder (OUD) is a chronic relapsing disorder that, whilst initially driven by activation of brain reward neurocircuits, increasingly engages anti-reward neurocircuits that drive adverse emotional states and relapse. However, successful recovery is possible with appropriate treatment, although with a persisting propensity to relapse. The individual and public health burdens of OUD are immense; 26.8 million people were estimated to be living with OUD globally in 2016, with >100,000 opioid overdose deaths annually, including >47,000 in the USA in 2017. Well-conducted trials have demonstrated that long-term opioid agonist therapy with methadone and buprenorphine have great efficacy for OUD treatment and can save lives. New forms of the opioid receptor antagonist naltrexone are also being studied. Some frequently used approaches have less scientifically robust evidence but are nevertheless considered important, including community preventive strategies, harm reduction interventions to reduce adverse sequelae from ongoing use and mutual aid groups. Other commonly used approaches, such as detoxification alone, lack scientific evidence. Delivery of effective prevention and treatment responses is often complicated by coexisting comorbidities and inadequate support, as well as by conflicting public and political opinions. Science has a crucial role to play in informing public attitudes and developing fuller evidence to understand OUD and its associated harms, as well as in obtaining the evidence today that will improve the prevention and treatment interventions of tomorrow.
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38
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Koob GF. Neurobiology of Opioid Addiction: Opponent Process, Hyperkatifeia, and Negative Reinforcement. Biol Psychiatry 2020; 87:44-53. [PMID: 31400808 DOI: 10.1016/j.biopsych.2019.05.023] [Citation(s) in RCA: 233] [Impact Index Per Article: 58.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 05/29/2019] [Accepted: 05/29/2019] [Indexed: 01/29/2023]
Abstract
Opioids are powerful drugs that usurp and overpower the reward function of endogenous opioids and engage dramatic tolerance and withdrawal via molecular and neurocircuitry neuroadaptations within the same reward system. However, they also engage the brain systems for stress and pain (somatic and emotional) while producing hyperalgesia and hyperkatifeia, which drive pronounced drug-seeking behavior via processes of negative reinforcement. Hyperkatifeia (derived from the Greek "katifeia" for dejection or negative emotional state) is defined as an increase in intensity of the constellation of negative emotional or motivational signs and symptoms of withdrawal from drugs of abuse. In animal models, repeated extended access to drugs or opioids results in negative emotion-like states, reflected by the elevation of reward thresholds, lower pain thresholds, anxiety-like behavior, and dysphoric-like responses. Such negative emotional states that drive negative reinforcement are hypothesized to derive from the within-system dysregulation of key neurochemical circuits that mediate incentive-salience and/or reward systems (dopamine, opioid peptides) in the ventral striatum and from the between-system recruitment of brain stress systems (corticotropin-releasing factor, dynorphin, norepinephrine, hypocretin, vasopressin, glucocorticoids, and neuroimmune factors) in the extended amygdala. Hyperkatifeia can extend into protracted abstinence and interact with learning processes in the form of conditioned withdrawal to facilitate relapse to compulsive-like drug seeking. Compelling evidence indicates that plasticity in the brain pain emotional systems is triggered by acute excessive drug intake and becomes sensitized during the development of compulsive drug taking with repeated withdrawal. It then persists into protracted abstinence and contributes to the development and persistence of compulsive opioid-seeking behavior.
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Affiliation(s)
- George F Koob
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland; National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland.
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39
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Gholami M, Saboory E, Ahmadi AA, Asouri M, Nasirikenari M, Rostamnezhad M. Long-time effects of prenatal morphine, tramadol, methadone, and buprenorphine exposure on seizure and anxiety in immature rats. Int J Neurosci 2019; 130:898-905. [PMID: 31877061 DOI: 10.1080/00207454.2019.1709841] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Purpose: This study aimed to investigate seizures and anxiety-like behaviors in immature rats prenatally exposed to opiate drugs.Materials and methods: Pregnant rats were randomly divided into five groups: saline, morphine, tramadol, methadone, and buprenorphine. Administrations were performed intraperitoneally once a day for the last seven days of pregnancy. Neonatal rats were subdivided into ten groups, split according to sex. Anxiety-like behavior was tested on postnatal day (PD) 19. On PD 20, seizure was induced by PTZ injection.Results: Morphine in male rats had an increased time to onset (p < 0.005), whereas there was a decreased number of tonic-clonic seizures in females (p < 0.05). Tramadol had an increased duration of tonic-clonic seizures compared to morphine and methadone in males (p < 0.005). Moreover, tramadol decreased open arm time and locomotor activity in males more than in females (p < 0.05). Methadone decreased open arm time in males (p < 0.05). Furthermore, buprenorphine and tramadol decreased open arm entrance in male rats (p < 0.05).Conclusions: It was demonstrated that prenatal tramadol significantly increases both the duration of seizures and anxiety-like behaviors in immature male rats, whereas morphine decreases both of them. The effects of tramadol on seizure and anxiety-like behavior may be due to the comorbid occurrence of the symptoms of these two disorders.
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Affiliation(s)
- Morteza Gholami
- North Research Center, Pasteur Institute of Iran, Amol, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular -Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ehsan Saboory
- Zanjan Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Ali Asghar Ahmadi
- North Research Center, Pasteur Institute of Iran, Amol, Iran.,Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mohsen Asouri
- North Research Center, Pasteur Institute of Iran, Amol, Iran
| | | | - Mostafa Rostamnezhad
- Faculty of Pharmacy, Department of Pharmaceutics, Tehran University of Medical Sciences, Tehran, Iran
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40
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Dunn KE, Barrett FS, Brands B, Marsh DC, Bigelow GE. Individual differences in human opioid abuse potential as observed in a human laboratory study. Drug Alcohol Depend 2019; 205:107688. [PMID: 31710994 PMCID: PMC7219469 DOI: 10.1016/j.drugalcdep.2019.107688] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 10/16/2019] [Accepted: 10/18/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Opioids have high abuse potential and pose a major public health concern. Yet, a large percentage of individuals exposed to opioids do not develop problematic use. Individual differences in opioid abuse potential are not well understood. METHODS This within-subject (N = 16), double-blind, double-dummy, human laboratory study evaluated individual differences in response to dose (placebo, low, medium, high) following administration of heroin and hydromorphone through intravenous and subcutaneous routes, in opioid-experienced but non physically-dependent participants. Outcomes were self-reported visual analog scale (VAS) ratings (High, Liking, Drug Effect, Good Effect, Rush), pupil diameter change from baseline, and crossover point on the Drug vs. Money questionnaire. The degree to which results were consistent across measures within an individual was assessed using a mixed-effects model from which an intraclass correlation coefficient measure of between and within-subject variance was derived. RESULTS The mixed effects model fit was significant (p < 0.0001) and revealed that 85.5% of the explainable variance was due to between-subject effects, suggesting the responses within an individual were highly consistent. Visual inspection reveals a myriad response pattern across participants, with some demonstrating classic dose-effect responses and others not differentiating any active doses from placebo. CONCLUSIONS Data suggest the abuse potential of opioids is significantly different between individuals but that the experience within an individual is highly consistent. Research to prospectively characterize and evaluate mechanisms underlying these differences is warranted and may provide a foundation to help identify persons at heightened risk of transitioning from opioid exposure to misuse and/or opioid use disorder.
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Affiliation(s)
- Kelly E Dunn
- Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, United States.
| | - Frederick S Barrett
- Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, United States
| | - Bruna Brands
- Health Canada, Canada; Centre for Addiction and Mental Health, Canada; University of Toronto, Canada
| | | | - George E Bigelow
- Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, United States
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Nasser SA, Afify EA. Sex differences in pain and opioid mediated antinociception: Modulatory role of gonadal hormones. Life Sci 2019; 237:116926. [PMID: 31614148 DOI: 10.1016/j.lfs.2019.116926] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 09/18/2019] [Accepted: 09/30/2019] [Indexed: 12/14/2022]
Abstract
Sex-related differences in pain and opioids has been the focus of many researches. It is demonstrated that women experience greater clinical pain, lower pain threshold and tolerance, more sensitivity and distress to experimentally induced pain compared to men. Sex differences in response to opioid treatment revealed inconsistent results. However, the etiology of these disparities is not fully elucidated. It is, therefore, conceivable now that this literature merits to be revisited comprehensively. Possible multifaceted factors seem to be associated. These include neuroanatomical, hormonal, neuroimmunological, psychological, social and cultural aspects and comorbidities. This review aims at providing an overview of the substantial literature documenting the sex differences in pain and analgesic response to opioids from animal and human studies within the context of the modulatory effects of the aforementioned factors. A detailed and critical discussion of the cellular and molecular signaling pathways underlying the modulatory actions of gonadal hormones in the sexual dimorphism in pain processing and opioid analgesia is extensively presented. It is indicated that sexual dimorphic activation of certain brain regions contributes to differential pain sensitivity between females and males. Plausible crosstalk between sex hormones and neuroimmunological signaling pertinent to toll-like and purinergic receptors is uncovered as causal cues underlying sexually dimorphic pain and opioid analgesia. Conceivably, a thorough understanding of these factors may aid in sex-related advancement in pain therapeutic management.
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Affiliation(s)
- Suzanne A Nasser
- Department of Pharmacology and Therapeutics, Faculty of Pharmacy, Beirut Arab University, Beirut, Lebanon
| | - Elham A Afify
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt.
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Rao AG, Chan PH, Prentice HA, Paxton EW, Funahashi TT, Maletis GB. Risk Factors for Opioid Use After Anterior Cruciate Ligament Reconstruction. Am J Sports Med 2019; 47:2130-2137. [PMID: 31303011 DOI: 10.1177/0363546519854754] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The misuse of opioid medications has contributed to a significant national crisis affecting public health as well as patient morbidity and medical costs. After orthopaedic surgical procedures, patients may require prescription (Rx) opioid medication, which can fuel the opioid epidemic. Opioid Rx usage after anterior cruciate ligament reconstruction (ACLR) is not well characterized. PURPOSE To determine baseline utilization of Rx opioids in patients undergoing ACLR and examine demographic, patient, and surgical factors associated with greater and prolonged postoperative opioid utilization. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS Primary elective ACLRs were identified using Kaiser Permanente's ACLR registry (2005-2015). We studied the association of perioperative risk factors on the number of dispensed opioid Rx in the early (0-90 days) and late (91-360 days) postoperative recovery periods using logistic regression. RESULTS Of 21,202 ACLRs, 25.5% used at least 1 opioid Rx in the 1-year preoperative period; 17.7% and 2.7% used ≥2 opioid Rx in the early and late recovery periods, respectively. Risk factors associated with greater opioid Rx in both the early and the late periods included the following: ≥2 preoperative opioid Rx, age ≥20 years, American Society of Anesthesiologists classification ≥3, other activity at the time of injury, chondroplasty, chronic pulmonary disease, and substance abuse. Risk factors associated with opioid Rx use during the early period only included the following: other race, acute injury, meniscal injury repair, multiligament injury, and dementia/psychosis. Risk factors associated with greater opioid Rx during the late period only included the following: 1 preoperative opioid Rx, female sex, body mass index ≥25 kg/m2, motor vehicle accident as the mechanism of injury, and hypertension. CONCLUSION A quarter of ACLR patients had at least 1 opioid Rx before the procedure, but usage dropped to 2.7% toward the end of the postoperative year. We identified several perioperative risk factors for greater and prolonged opioid usage after ACLR.
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Affiliation(s)
- Anita G Rao
- Department of Orthopaedic Surgery, Northwest Permanente Medical Group, Portland, Oregon, USA
| | - Priscilla H Chan
- Surgical Outcomes and Analysis, Kaiser Permanente, San Diego, California, USA
| | - Heather A Prentice
- Surgical Outcomes and Analysis, Kaiser Permanente, San Diego, California, USA
| | - Elizabeth W Paxton
- Surgical Outcomes and Analysis, Kaiser Permanente, San Diego, California, USA
| | - Tadashi T Funahashi
- Department of Orthopaedic Surgery, Southern California Permanente Medical Group, Irvine, California, USA
| | - Gregory B Maletis
- Department of Orthopaedic Surgery, Southern California Permanente Medical Group, Baldwin Park, California, USA
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43
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Summary of the Symposium of Sex and Gender in Physiology and Pharmacology Held at the Royal Swedish Academy of Sciences in Stockholm, October 2018. GENDER AND THE GENOME 2019. [DOI: 10.1177/2470289719838097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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44
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Elliott KR, Jones E. The association between frequency of opioid misuse and opioid use disorder among youth and adults in the United States. Drug Alcohol Depend 2019; 197:73-77. [PMID: 30784951 DOI: 10.1016/j.drugalcdep.2019.01.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Studies have shown the frequency of drug misuse is important in the development of a substance use disorder, but little is known about this relationship in the context of opioid misuse and opioid use disorder and withdrawal symptoms. METHODS Our study included 2694 civilian respondents from the United States 12 years and older who had misused prescription opioids in the past year from the 2014 National Survey on Drug Use and Health. Logistic regression was used to model the association between frequency of prescription opioid misuse and opioid use disorder and withdrawal symptoms, adjusting for age, sex, race/ethnicity, and income level. RESULTS Misusing prescription opioids more frequently was significantly associated with opioid use disorder in a dose-dependent manner (daily misuse: OR = 14.92, 95% confidence interval (CI) 9.29, 23.95; 1-2 days/week: OR = 4.46 95% CI: 2.52, 7.89}; 1-4 times/month: OR = 2.40, 95% CI: 1.37, 4.18) compared to use less than 1 time a month. OR = 2.89, 95% CI 1.90, 4.40, respectively) after controlling for sex, age, race/ethnicity, and income. A dose-dependent relationship was found between frequency of opioid misuse and withdrawal symptoms (daily misuse: OR = 2.89, 95% CI: 1.90, 4.40; 1-2 times/week: OR = 1.91, 95% CI: 1.05, 3.45; and 1-4 times/month: 1.74, 95% CI: 1.90, 4.40) after controlling for all covariates mentioned above. CONCLUSIONS Our results provide evidence that higher frequency of opioid misuse is associated with both opioid use disorder and withdrawal symptoms. Frequency of use should be considered in the development of more effective opioid use disorder prevention strategies.
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Affiliation(s)
- Kathleen R Elliott
- Science Policy Branch, Office of Science Policy and Communications, National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Blvd, Fifth Floor, Rockville, MD 20852, United States.
| | - Emily Jones
- Science Policy Branch, Office of Science Policy and Communications, National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Blvd, Fifth Floor, Rockville, MD 20852, United States; Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave, NW, Washington DC 20052, United States
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Pedrón VT, Varani AP, Bettler B, Balerio GN. GABA B receptors modulate morphine antinociception: Pharmacological and genetic approaches. Pharmacol Biochem Behav 2019; 180:11-21. [PMID: 30851293 DOI: 10.1016/j.pbb.2019.02.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 02/28/2019] [Accepted: 02/28/2019] [Indexed: 10/27/2022]
Abstract
Previous studies in our laboratory showed an interaction between the GABAergic and opioid systems involved in the analgesic effect of baclofen (BAC). Furthermore, it is known that sex differences exist regarding various pharmacological responses of morphine (MOR) and they are related to an increased sensitivity to MOR effects in males. The aims of the present study were to evaluate the possible involvement of the GABAB receptors in the antinociceptive responses induced by MOR (1, 3 and 9 mg/kg, s.c.) administration using both pharmacological (BAC 2 mg/kg, i.p.; and 2-OH-saclofen, SAC 0.3 mg/kg, intra cisterna magna) and genetic approaches (GABAB1 knockout mice; GABAB1 KO) in mice of both sexes. In addition, we explored the alterations in c-Fos expression of different brain areas involved in the antinociceptive effect of MOR using both approaches. The pharmacological approach showed a higher dose-dependent antinociceptive effect of MOR in male mice compared to female mice. BAC and SAC pretreatment potentiated and attenuated the antinociceptive effect of MOR, respectively, in both sexes. The genetic approach revealed a dose-dependent antinociceptive effect of MOR in the wild type mice, but not in the GABAB1 KO mice and no sex differences were observed. Additionally, BAC and SAC pretreatment and the lack of GABAB1 subunit of the GABAB receptor prevented the changes observed in c-Fos expression in the cingulate cortex and nucleus accumbens of male mice. Our results suggest that the GABAB receptors are involved in the MOR antinociceptive effect of both male and female mice.
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Affiliation(s)
- Valeria T Pedrón
- CONICET - Universidad de Buenos Aires, Instituto de Investigaciones Farmacológicas (ININFA), Buenos Aires, Argentina
| | - Andrés P Varani
- CONICET - Universidad de Buenos Aires, Instituto de Investigaciones Farmacológicas (ININFA), Buenos Aires, Argentina
| | - Bernhard Bettler
- Department of Biomedicine, Institute of Physiology, Pharmazentrum, University of Basel, Klingelbergstrasse 50/70, CH-4056 Basel, Switzerland
| | - Graciela N Balerio
- CONICET - Universidad de Buenos Aires, Instituto de Investigaciones Farmacológicas (ININFA), Buenos Aires, Argentina; Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Cátedra de Farmacología, Buenos Aires, Argentina.
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Bedwell JS, Spencer CC, Chirino CA, O’Donnell JP. The Sweet Taste Test: Relationships with Anhedonia Subtypes, Personality Traits, and Menstrual Cycle Phases. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2019. [DOI: 10.1007/s10862-019-09717-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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47
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Moningka H, Lichenstein S, Worhunsky PD, DeVito EE, Scheinost D, Yip SW. Can neuroimaging help combat the opioid epidemic? A systematic review of clinical and pharmacological challenge fMRI studies with recommendations for future research. Neuropsychopharmacology 2019; 44:259-273. [PMID: 30283002 PMCID: PMC6300537 DOI: 10.1038/s41386-018-0232-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 09/11/2018] [Accepted: 09/18/2018] [Indexed: 02/04/2023]
Abstract
The current opioid epidemic is an urgent public health problem, with enormous individual, societal, and healthcare costs. Despite effective, evidence-based treatments, there is significant individual variability in treatment responses and relapse rates are high. In addition, the neurobiology of opioid-use disorder (OUD) and its treatment is not well understood. This review synthesizes published fMRI literature relevant to OUD, with an emphasis on findings related to opioid medications and treatment, and proposes areas for further research. We conducted a systematic literature review of Medline and Psychinfo to identify (i) fMRI studies comparing OUD and control participants; (ii) studies related to medication, treatment, abstinence or withdrawal effects in OUD; and (iii) studies involving manipulation of the opioid system in healthy individuals. Following application of exclusionary criteria (e.g., insufficient sample size), 45 studies were retained comprising data from ~1400 individuals. We found convergent evidence that individuals with OUD display widespread heightened neural activation to heroin cues. This pattern is potentiated by heroin, attenuated by medication-assisted treatments for opioids, predicts treatment response, and is reduced following extended abstinence. Nonetheless, there is a paucity of literature examining neural characteristics of OUD and its treatment. We discuss limitations of extant research and identify critical areas for future neuroimaging studies, including the urgent need for studies examining prescription opioid users, assessing sex differences and utilizing a wider range of clinically relevant task-based fMRI paradigms across different stages of addiction.
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Affiliation(s)
- Hestia Moningka
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Sarah Lichenstein
- Yale School of Medicine, Radiology and Bioimaging Sciences, New Haven, CT, 06510, USA
| | - Patrick D Worhunsky
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Elise E DeVito
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Dustin Scheinost
- Yale School of Medicine, Radiology and Bioimaging Sciences, New Haven, CT, 06510, USA
| | - Sarah W Yip
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA.
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Chang L, Kigar SL, Ho JH, Cuarenta A, Gunderson HC, Baldo BA, Bakshi VP, Auger AP. Early life stress alters opioid receptor mRNA levels within the nucleus accumbens in a sex-dependent manner. Brain Res 2018; 1710:102-108. [PMID: 30594547 DOI: 10.1016/j.brainres.2018.12.040] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 09/10/2018] [Accepted: 12/26/2018] [Indexed: 01/24/2023]
Abstract
Early life stress (ELS) strongly impacts mental health, but little is known about its interaction with biological sex and postnatal development to influence risk and resilience to psychopathologies. A number of psychiatric disorders, such as social anhedonia and drug addiction, involve dysfunctional opioid signaling; moreover, there is evidence for differential central opioid function in males vs. females. The present study examined opioid receptor gene expression in the nucleus accumbens (NAc) and amygdala of male and female rats subjected to a neonatal predator odor exposure (POE) paradigm to model ELS. Brain tissue was collected at two developmental time points: neonatal and juvenile. Results showed that, following the neonatal POE experience, opioid receptor mRNA levels in the NAc were differentially regulated at the neonatal and juvenile time points. POE downregulated neonatal mu- and kappa-opioid receptor mRNA levels in neonatal females, but upregulated mu- and delta-opioid receptor mRNA levels in juvenile females. Intriguingly, POE had no significant effect on NAc opioid receptor mRNA levels in males at either time point, indicating that the impact of POE on opioid system development is sex-dependent. Finally, POE failed to alter amygdalar opioid receptor gene expression in either sex at either time-point. The spatiotemporally- and sex-specific impact of ELS within the developing brain may confer differential risk or resilience for males and females to develop atypical opioid-regulated behaviors associated with conditions such as depression and addiction.
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Affiliation(s)
- Liza Chang
- Department of Psychology, University of Wisconsin-Madison, United States.
| | - Stacey L Kigar
- Molecular and Cellular Pharmacology Training Program, University of Wisconsin-Madison, United States
| | - Jasmine H Ho
- Department of Psychology, University of Wisconsin-Madison, United States
| | - Amelia Cuarenta
- Department of Psychology, University of Wisconsin-Madison, United States
| | - Haley C Gunderson
- Department of Psychology, University of Wisconsin-Madison, United States
| | - Brian A Baldo
- Department of Psychiatry, University of Wisconsin-Madison, United States; Neuroscience Training Program, University of Wisconsin-Madison, United States
| | - Vaishali P Bakshi
- Department of Psychiatry, University of Wisconsin-Madison, United States; Neuroscience Training Program, University of Wisconsin-Madison, United States
| | - Anthony P Auger
- Department of Psychology, University of Wisconsin-Madison, United States; Neuroscience Training Program, University of Wisconsin-Madison, United States.
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Rao AG, Chan PH, Prentice HA, Paxton EW, Navarro RA, Dillon MT, Singh A. Risk factors for postoperative opioid use after elective shoulder arthroplasty. J Shoulder Elbow Surg 2018; 27:1960-1968. [PMID: 29891412 DOI: 10.1016/j.jse.2018.04.018] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/24/2018] [Accepted: 04/27/2018] [Indexed: 02/01/2023]
Abstract
BACKGROUND The opioid epidemic remains a serious issue in the United States with significant impact to the medical and socioeconomic welfare of communities. We sought to determine baseline opioid use in patients undergoing shoulder arthroplasty (SA) and identify patient characteristics, comorbidities, and surgical risk factors associated with postoperative opioid use. METHODS A Shoulder Arthroplasty Registry identified the number of dispensed opioid medication prescriptions (Rxs) in the first postoperative year in patients who underwent elective primary SA from 2008 to 2014. We used Poisson regression to study the effect of preoperative risks factors on number of dispensed opioid Rxs in the first postoperative year, evaluated quarterly (Q1: days 0-90, Q2: days 91-180, Q3: days 181-270, Q4: days 271-360). RESULTS Included were 4243 SAs from 3996 patients, and 75% used opioids in the 1-year preoperative period. The factors associated with increased opioid use in all postoperative quarters (Q4 incident rate ratio [IRR] shown) were age <60 years (IRR, 1.40; 95% confidence interval [CI], 1.29-1.51), preoperative opioid use (1-4 Rxs: IRR, 2.15; 95% CI, 1.85-2.51; ≥5 Rxs: IRR, 9.83; 95% CI , 8.53-11.32), anxiety (IRR, 1.11; 95% CI, 1.03-1.20), opioid dependence (IRR, 1.23; 95% CI, 1.05-1.43), substance abuse (IRR, 1.17; 95% CI, 1.07-1.28), and general chronic pain (IRR, 1.38; 95% CI, 1.28-1.50). CONCLUSION Opioid usage in patients undergoing SA is widespread at 1 year, with three-fourths of patients having been dispensed at least one Rx. These findings emphasize the need for surgeon and patient awareness as well as education in the management of postoperative opioid usage associated with the indicated conditions. Surgeons may consider these risk factors for preoperative risk stratification and targeted deployment of preventative strategies.
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Affiliation(s)
- Anita G Rao
- Department of Orthopaedic Surgery, Northwest Permanente Medical Group, Portland, OR, USA.
| | - Priscilla H Chan
- Surgical Outcomes and Analysis, Kaiser Permanente, San Diego, CA, USA
| | | | | | - Ronald A Navarro
- Department of Orthopaedic Surgery, Southern California Permanente Medical Group, Harbor City, CA, USA
| | - Mark T Dillon
- Department of Orthopaedic Surgery, The Permanente Medical Group, Sacramento, CA, USA
| | - Anshuman Singh
- Department of Orthopaedic Surgery, Southern California Permanente Medical Group, San Diego, CA, USA
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Management Strategies in Opioid Abuse and Sexual Dysfunction: A Review of Opioid-Induced Androgen Deficiency. Sex Med Rev 2018; 6:618-623. [DOI: 10.1016/j.sxmr.2018.04.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 04/18/2018] [Accepted: 04/27/2018] [Indexed: 11/19/2022]
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