1
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Lowell JA, Dikici E, Joshi PM, Landgraf R, Lemmon VP, Daunert S, Izenwasser S, Daftarian P. Vaccination against cocaine using a modifiable dendrimer nanoparticle platform. Vaccine 2020; 38:7989-7997. [PMID: 33158592 DOI: 10.1016/j.vaccine.2020.10.041] [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: 06/08/2020] [Revised: 09/29/2020] [Accepted: 10/12/2020] [Indexed: 10/23/2022]
Abstract
Pharmacological therapies for the treatment of cocaine addiction have had disappointing efficacy, and the lack of recent developments in the clinical care of cocaine-addicted patients indicates a need for novel treatment strategies. Recent studies have shown that vaccination against cocaine to elicit production of antibodies that reduce concentrations of free drug in the blood is a promising method to protect against the effects of cocaine and reduce rates of relapse. However, the poorly immunogenic nature of cocaine remains a major hurdle to active immunization. Therefore, we hypothesized that strategies to increase targeted exposure of cocaine to the immune system may produce a more effective vaccine. To specifically direct an immune response against cocaine, in the present study we have conjugated a cocaine analog to a dendrimer-based nanoparticle carrier with MHC II-binding moieties that previously has been shown to activate antigen-presenting cells necessary for antibody production. This strategy produced a rapid, prolonged, and high affinity anti-cocaine antibody response without the need for an adjuvant. Surprisingly, additional evaluation using multiple adjuvant formulations in two strains of inbred mice found adjuvants were either functionally redundant or deleterious in the vaccination against cocaine using this platform. The use of conditioned place preference in rats after administration of this vaccine provided proof of concept for the ability of this vaccine to diminish cocaine reward. Together these data demonstrate the intrinsic efficacy of an immune-targeting dendrimer-based cocaine vaccine, with a vast potential for design of future vaccines against other poorly immunogenic antigens by substitution of the conjugated cargo.
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Affiliation(s)
- Jeffrey A Lowell
- Miami Project to Cure Paralysis, University of Miami, 1095 NW 14th Terrace, Miami, FL 33136, United States
| | - Emre Dikici
- Department of Biochemistry and Molecular Biology, University of Miami, 1011 NW 15th Street, Miami, FL 33136, United States; Dr. JT Macdonald Foundation Biomedical Nanotechnology Institute, University of Miami, Life Science and Technology Park, 1951 Northwest 7th Avenue, Miami, FL 33136, United States
| | - Pratibha M Joshi
- Department of Biochemistry and Molecular Biology, University of Miami, 1011 NW 15th Street, Miami, FL 33136, United States; Dr. JT Macdonald Foundation Biomedical Nanotechnology Institute, University of Miami, Life Science and Technology Park, 1951 Northwest 7th Avenue, Miami, FL 33136, United States
| | - Ralf Landgraf
- Department of Biochemistry and Molecular Biology, University of Miami, 1011 NW 15th Street, Miami, FL 33136, United States
| | - Vance P Lemmon
- Miami Project to Cure Paralysis, University of Miami, 1095 NW 14th Terrace, Miami, FL 33136, United States; Department of Neurological Surgery, University of Miami, 1095 NW 14th Terrace, Miami, FL 33136, United States
| | - Sylvia Daunert
- Department of Biochemistry and Molecular Biology, University of Miami, 1011 NW 15th Street, Miami, FL 33136, United States; Dr. JT Macdonald Foundation Biomedical Nanotechnology Institute, University of Miami, Life Science and Technology Park, 1951 Northwest 7th Avenue, Miami, FL 33136, United States; Miami Clinical and Translational Science Institute, University of Miami, Clinical Research Building, 1120 NW 14th St., Miami, FL 33136, United States
| | - Sari Izenwasser
- Department of Psychiatry and Behavioral Sciences, University of Miami, 1600 NW 10(th) Avenue, Miami, FL 33136, United States.
| | - Pirouz Daftarian
- Department of Biochemistry and Molecular Biology, University of Miami, 1011 NW 15th Street, Miami, FL 33136, United States; Dr. JT Macdonald Foundation Biomedical Nanotechnology Institute, University of Miami, Life Science and Technology Park, 1951 Northwest 7th Avenue, Miami, FL 33136, United States.
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Brar R, Grant C, DeBeck K, Milloy MJ, Fairbairn N, Wood E, Kerr T, Hayashi K. Changes in drug use behaviors coinciding with the emergence of illicit fentanyl among people who use drugs in Vancouver, Canada. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2020; 46:625-631. [PMID: 32689810 DOI: 10.1080/00952990.2020.1771721] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background: With the emergence of illicitly-manufactured fentanyl, drug overdose deaths have risen in unprecedented numbers. In this context, there is an urgent need to characterize potential changes in drug use behaviors among people who use drugs (PWUD). Objective: To examine changes in drug use behaviors following the emergence of illicit fentanyl among people who use drugs (PWUD). Methods: Data for this cross-sectional analysis was derived from three prospective cohorts of PWUD between December 2016 and May 2017 in Vancouver, Canada. Multivariable logistic regression was used to determine factors associated with self-reported behavior changes (binary variable "yes" or "no") following the emergence of illicit fentanyl. Results: Among 999 participants [363 (36.3%) females], 388 (38.8%) reported some behavior change. The remaining 611 (61.2%) reported no change in behavior; 240 (39.3%) of these individuals had recently been exposed to fentanyl. In multivariable analyses, factors independently associated with behavior change included recent non-fatal overdose (Adjusted Odds Ratio [AOR] = 2.28), active injection drug use (AOR = 1.96), being on opioid agonist therapy (AOR = 1.80), and urine drug screen positive for fentanyl (AOR = 1.45), (all p < .05). Conclusion: The majority of PWUD in our sample did not change their drug use behavior despite a high prevalence of fentanyl exposure, indicating a need for targeted behavior change messaging and overdose prevention efforts such as naloxone and addiction treatment for this sub-population of PWUD. Further, the high fentanyl exposure observed in our sample suggests a need to address upstream structural factors shaping the overdose risk in addition to individual behavioral change.
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Affiliation(s)
- R Brar
- British Columbia Centre for Substance Use , Vancouver, BC, CANADA.,Department of Medicine, University of British Columbia , Vancouver, BC, CANADA
| | - C Grant
- British Columbia Centre for Substance Use , Vancouver, BC, CANADA
| | - K DeBeck
- British Columbia Centre for Substance Use , Vancouver, BC, CANADA.,School of Public Policy, Simon Fraser University , Vancouver, BC, CANADA
| | - M-J Milloy
- British Columbia Centre for Substance Use , Vancouver, BC, CANADA.,Department of Medicine, University of British Columbia , Vancouver, BC, CANADA
| | - N Fairbairn
- British Columbia Centre for Substance Use , Vancouver, BC, CANADA.,Department of Medicine, University of British Columbia , Vancouver, BC, CANADA
| | - E Wood
- British Columbia Centre for Substance Use , Vancouver, BC, CANADA.,Department of Medicine, University of British Columbia , Vancouver, BC, CANADA
| | - T Kerr
- British Columbia Centre for Substance Use , Vancouver, BC, CANADA.,Department of Medicine, University of British Columbia , Vancouver, BC, CANADA
| | - Kanna Hayashi
- British Columbia Centre for Substance Use , Vancouver, BC, CANADA.,Faculty of Health Sciences, Simon Fraser University , Burnaby, BC, Canada
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3
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Mimiaga MJ, Closson EF, Pantalone DW, Safren SA, Mitty JA. Applying behavioral activation to sustain and enhance the effects of contingency management for reducing stimulant use among individuals with HIV infection. PSYCHOL HEALTH MED 2018; 24:374-381. [PMID: 30211620 DOI: 10.1080/13548506.2018.1515492] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
There is a high prevalence of stimulant use among HIV-infected individuals, which is associated with suboptimal antiretroviral therapy (ART) adherence, HIV treatment interruptions, detectable HIV viral load, and transmission of HIV via increased sexual risk behavior. Contingency management (CM) is an initially effective treatment for stimulant use. However, the effects of CM are not sustained after the active intervention has ended. One potential contributor to the intractability of existing treatments may be a lack of attention to replacement activities or the role of depressed mood. Behavioral activation (BA) is an evidence-based approach for depression that involves identifying and participating in pleasurable, goal-directed activities. As a potential approach to address the CM rebound effect - informed by our formative qualitative research with the participant population - we conducted an open pilot trial of an intervention combining CM-BA for HIV-infected individuals with stimulant use disorder. Participants completed weekly BA therapy sessions (10-16 sessions) and thrice-weekly toxicology screenings (12 weeks); contingencies were rewarded for negative toxicology tests to support reengagement into positive life activities. Major assessments were conducted at baseline, 3-, and 6-months. Toxicology screening was repeated prior to the 6-month assessment. Eleven participants with stimulant use disorder enrolled; 7 initiated treatment and completed the full intervention. The mean age was 46 (SD = 5.03) and 14% identified as a racial/ethnic minority. Of the completers, the mean change score in self-reported stimulant use within the past 30 days (within-person change; reduction in self-reported stimulant use) was 4.14 days at 3 months and 5.0 days at 6 months [Cohen's d = 0.89]. The mean change score in weekly toxicology screens (reduction in positive toxicology screens) was .71 at 3 months and 1 at 6 months [Cohen's d = 1.05]. Exit interviews indicated that the integrated intervention was well received and acceptable. This study provides preliminary evidence that a combined CM-BA intervention for this population was feasible (100% retention at 6-months), acceptable (100% of intervention sessions attended; participants rated the intervention 'acceptable' or 'very acceptable'), and may be an option to augment the potency and sustained impact of CM for this population. Future pilot testing using a randomized controlled design is warranted.
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Affiliation(s)
- Matthew J Mimiaga
- a Departments of Behavioral and Social Sciences, Epidemiology, and Psychiatry and Human Behavior , Brown University , Providence , RI , USA.,b The Fenway Institute, Fenway Health , Boston , MA , USA
| | - Elizabeth F Closson
- b The Fenway Institute, Fenway Health , Boston , MA , USA.,c Department of Public Health, Environments and Society , London School of Hygiene and Tropical Medicine , London , UK
| | - David W Pantalone
- b The Fenway Institute, Fenway Health , Boston , MA , USA.,d Department of Psychology , University of Massachusetts Boston , Boston , MA , USA
| | - Steven A Safren
- b The Fenway Institute, Fenway Health , Boston , MA , USA.,e Department of Psychology , University of Miami , Coral Gables , FL , USA
| | - Jennifer A Mitty
- b The Fenway Institute, Fenway Health , Boston , MA , USA.,f Department of Medicine , Brown University , Providence , RI , USA
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4
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Kimishima A, Olson ME, Janda KD. Investigations into the efficacy of multi-component cocaine vaccines. Bioorg Med Chem Lett 2018; 28:2779-2783. [PMID: 29317163 DOI: 10.1016/j.bmcl.2017.12.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 12/18/2017] [Accepted: 12/19/2017] [Indexed: 12/15/2022]
Abstract
Although cocaine addiction remains a serious health and societal problem in the United States, no FDA-approved treatment has been developed. Vaccines offer an exciting strategy for the treatment of cocaine addiction; however, vaccine formulations need to be optimized to improve efficacy. Herein, we examine the effectiveness of a tricomponent cocaine vaccine, defined as having its hapten (GNE) and adjuvant (cytosine-guanine oligodeoxynucleotide 1826, CpG ODN 1826) covalently linked via the immunogenic protein ovalbumin (OVA). The tricomponent vaccine (GNE-OVA-CpG 1826) and a vaccine of analogous, individual components (GNE-OVA+CpG ODN 1826) were found to similarly induce highly specific anticocaine antibody production in mice and block cocaine's stimulant effects in hyperlocomotor testing.
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Affiliation(s)
- Atsushi Kimishima
- Department of Chemistry, Department of Immunology and Microbial Science, The Skaggs Institute for Chemical Biology and the Worm Institute of Research and Medicine, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, United States
| | - Margaret E Olson
- Department of Chemistry, Department of Immunology and Microbial Science, The Skaggs Institute for Chemical Biology and the Worm Institute of Research and Medicine, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, United States
| | - Kim D Janda
- Department of Chemistry, Department of Immunology and Microbial Science, The Skaggs Institute for Chemical Biology and the Worm Institute of Research and Medicine, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, United States.
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5
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Kimishima A, Olson ME, Natori Y, Janda KD. Efficient Syntheses of Cocaine Vaccines and Their in Vivo Evaluation. ACS Med Chem Lett 2018; 9:411-416. [PMID: 29795751 PMCID: PMC5949726 DOI: 10.1021/acsmedchemlett.8b00051] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 04/16/2018] [Indexed: 01/03/2023] Open
Abstract
![]()
Though cocaine abuse
and addiction continue to have serious implications
for health and society, no FDA-approved interventions have been developed.
Anticocaine conjugate vaccines offer an attractive opportunity for
addiction treatment; however, vaccines have thus far failed in clinical
trials. As a result, anticocaine vaccines must be further optimized
to achieve clinical translation. Herein, we report a study on the
relationship between vaccine efficacy and hapten stability toward
hydrolysis. Two haptens developed by our laboratory, GND and GNE,
were conjugated to tetanus toxoid (TT) and formulated with alum and
cytosine-guanine oligodeoxynucleotide 1826 (CpG ODN 1826) adjuvants,
the optimal formulation in anticocaine vaccine design. GND, a diamide,
is more hydrolytically stable than GNE, a monoamide, toward butyrylcholinesterases.
Ultimately, both vaccines induced antibodies with high affinity for
cocaine. In hyperlocomotion testing, GND-TT and GNE-TT vaccinated
mice exhibited a robust blockade of cocaine’s stimulatory effects
at all tested doses. Overall, antibodies raised against both haptens
were highly effective in protecting mice from cocaine-induced psychostimulation.
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Affiliation(s)
- Atsushi Kimishima
- Department of Chemistry, Department of Immunology and Microbial Science, The Skaggs Institute for Chemical Biology, and WIRM Institute for Research and Medicine, The Scripps Research Institute, La Jolla, California 92037, United States
| | - Margaret E. Olson
- Department of Chemistry, Department of Immunology and Microbial Science, The Skaggs Institute for Chemical Biology, and WIRM Institute for Research and Medicine, The Scripps Research Institute, La Jolla, California 92037, United States
| | - Yoshihiro Natori
- Department of Chemistry, Department of Immunology and Microbial Science, The Skaggs Institute for Chemical Biology, and WIRM Institute for Research and Medicine, The Scripps Research Institute, La Jolla, California 92037, United States
| | - Kim D. Janda
- Department of Chemistry, Department of Immunology and Microbial Science, The Skaggs Institute for Chemical Biology, and WIRM Institute for Research and Medicine, The Scripps Research Institute, La Jolla, California 92037, United States
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6
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Schenberg EE, de Castro Comis MA, Alexandre JFM, Tófoli LF, Chaves BDR, da Silveira DX. A phenomenological analysis of the subjective experience elicited by ibogaine in the context of a drug dependence treatment. JOURNAL OF PSYCHEDELIC STUDIES 2017. [DOI: 10.1556/2054.01.2017.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
| | | | | | - Luís Fernando Tófoli
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil
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7
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Schenberg EE, de Castro Comis MA, Alexandre JFM, Chaves BDR, Tófoli LF, da Silveira DX. Treating drug dependence with the aid of ibogaine: A qualitative study. JOURNAL OF PSYCHEDELIC STUDIES 2017. [DOI: 10.1556/2054.01.2016.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
| | | | | | - Bruno Daniel Rasmussen Chaves
- Instituto Plantando Consciência, São Paulo, Brazil
- Hospital e Maternidade Maria Perpétua Piedade Gonçalves, Santa Cruz do Rio Pardo, Brazil
| | - Luís Fernando Tófoli
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil
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8
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Strickland JC, Bolin BL, Romanelli MR, Rush CR, Stoops WW. Effects of acute buspirone administration on inhibitory control and sexual discounting in cocaine users. Hum Psychopharmacol 2017; 32. [PMID: 28120485 DOI: 10.1002/hup.2567] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 10/12/2016] [Accepted: 11/25/2016] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Cocaine users display deficits in inhibitory control and make impulsive choices that may increase risky behavior. Buspirone is an anxiolytic that activates dopaminergic and serotonergic systems and improves impulsive choice (i.e., reduces sexual risk-taking intent) in cocaine users when administered chronically. We evaluated the effects of acutely administered buspirone on inhibitory control and impulsive choice. METHODS Eleven subjects with a recent history of cocaine use completed this within-subject, placebo-controlled study. Subjects performed two cued go/no-go and a sexual risk delay-discounting task following oral administration of buspirone (10 and 30 mg), triazolam (0.375 mg; positive control), and placebo (negative control). Physiological and psychomotor performance and subject-rated data were also collected. RESULTS Buspirone failed to change inhibitory control or impulsive choice; however, slower reaction times were observed at the highest dose tested. Buspirone did not produce subject-rated drug effects but dose-dependently decreased diastolic blood pressure. Triazolam impaired psychomotor performance and increased ratings of positive subject-rated effects (e.g., Like Drug). CONCLUSIONS These findings indicate that acutely administered buspirone has little impact on behavioral measures of inhibitory control and impulsive sexual decision-making. Considering previous findings with chronic dosing, these findings highlight that the behavioral effects of buspirone differ as a function of dosing conditions.
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Affiliation(s)
| | - B Levi Bolin
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
| | | | - Craig R Rush
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA.,Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, Kentucky, USA.,Department of Psychiatry, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - William W Stoops
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA.,Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, Kentucky, USA.,Department of Psychiatry, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
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9
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Mahmud A, Gallant S, Sedki F, D'Cunha T, Shalev U. Effects of an acute cannabidiol treatment on cocaine self-administration and cue-induced cocaine seeking in male rats. J Psychopharmacol 2017; 31:96-104. [PMID: 27624146 DOI: 10.1177/0269881116667706] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cannabidiol is a non-psychoactive compound that is the second most abundant component of cannabis. It has been shown to have a potential therapeutic value for a wide range of disorders, including anxiety, psychosis, and depression. Recently, it was suggested that cannabidiol might be a potential treatment for heroin craving and relapse. Here we investigated the effects of an acute treatment with cannabidiol on cocaine self-administration and cue-induced cocaine seeking in rats. Rats were trained to press a lever to self-administer cocaine (0.5 mg/kg/infusion), first under a fixed interval 20 s (FI-20 s) and then under a progressive ratio (PR) schedule of reinforcement. Cocaine self-administration under a PR schedule of reinforcement was not attenuated by cannabidiol injections (5.0 mg/kg and 10.0 mg/kg; i.p.) when tested 30 min and 24 h after treatment. Cannabidiol treatment (5.0 mg/kg or 10.0 mg/kg) also did not attenuate cue-induced cocaine seeking in rats after a withdrawal period of 14 days. In contrast, treatment with cannabidiol (10.0 mg/kg; i.p.) resulted in a statistically significant anxiolytic effect in the elevated plus-maze. Our findings suggest that, under the conditions described here, an acute cannabidiol treatment has a minimal effect on a rat model of cocaine intake and relapse.
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Affiliation(s)
- Ashraf Mahmud
- Department of Psychology, CSBN/GRNC, Concordia University, Montreal, Canada
| | - Stephanie Gallant
- Department of Psychology, CSBN/GRNC, Concordia University, Montreal, Canada
| | - Firas Sedki
- Department of Psychology, CSBN/GRNC, Concordia University, Montreal, Canada
| | - Tracey D'Cunha
- Department of Psychology, CSBN/GRNC, Concordia University, Montreal, Canada
| | - Uri Shalev
- Department of Psychology, CSBN/GRNC, Concordia University, Montreal, Canada
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10
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Ruzza C, Calò G, Di Maro S, Pacifico S, Trapella C, Salvadori S, Preti D, Guerrini R. Neuropeptide S receptor ligands: a patent review (2005-2016). Expert Opin Ther Pat 2016; 27:347-362. [PMID: 27788040 DOI: 10.1080/13543776.2017.1254195] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Neuropeptide S (NPS) is a 20-residue peptide and endogenous ligand of the NPS receptor (NPSR). This receptor was a formerly orphan GPCR whose activation increases calcium and cyclic adenosine monophosphate levels. The NPS/NPSR system is expressed in several brain regions where it controls important biological functions including locomotor activity, arousal and sleep, anxiety, food intake, memory, pain, and drug addiction. Areas covered: This review furnishes an updated overview of the patent literature covering NPSR ligands since 2005, when the first example of an NPSR antagonist was disclosed. Expert opinion: Several potent NPSR antagonists are available as valuable pharmacological tools despite showing suboptimal pharmacokinetic properties in vivo. The optimization of these ligands is needed to speed up their potential clinical advancement as pharmaceuticals to treat drug addiction. In order to support the design of novel NPSR antagonists, we performed a ligand-based conformational analysis recognizing some structural requirements for NPSR antagonism. The identification of small-molecule NPSR agonists now represents an unmet challenge to be addressed. These molecules will allow investigation of the beneficial effects of selective NPSR activation in a large panel of psychiatric disorders and to foresee their therapeutic potential as anxiolytics, nootropics, and analgesics.
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Affiliation(s)
- Chiara Ruzza
- a Department of Medical Sciences, Section of Pharmacology, School of Medicine and National Institute of Neuroscience , University of Ferrara , Ferrara , Italy
| | - Girolamo Calò
- a Department of Medical Sciences, Section of Pharmacology, School of Medicine and National Institute of Neuroscience , University of Ferrara , Ferrara , Italy
| | | | - Salvatore Pacifico
- c Department of Chemical and Pharmaceutical Sciences , University of Ferrara , Ferrara , Italy
| | - Claudio Trapella
- c Department of Chemical and Pharmaceutical Sciences , University of Ferrara , Ferrara , Italy
| | - Severo Salvadori
- c Department of Chemical and Pharmaceutical Sciences , University of Ferrara , Ferrara , Italy
| | - Delia Preti
- c Department of Chemical and Pharmaceutical Sciences , University of Ferrara , Ferrara , Italy
| | - Remo Guerrini
- c Department of Chemical and Pharmaceutical Sciences , University of Ferrara , Ferrara , Italy
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Kimishima A, Wenthur CJ, Eubanks LM, Sato S, Janda KD. Cocaine Vaccine Development: Evaluation of Carrier and Adjuvant Combinations That Activate Multiple Toll-Like Receptors. Mol Pharm 2016; 13:3884-3890. [PMID: 27717287 PMCID: PMC6381837 DOI: 10.1021/acs.molpharmaceut.6b00682] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Although cocaine abuse and addiction continue to cause serious health and societal problems, an FDA-approved medication to treat cocaine addiction has yet to be developed. Employing a pharmacokinetic strategy, an anticocaine vaccine provides an attractive avenue to address these issues; however, current vaccines have shown varying degrees of efficacy, indicating that further formulation is necessary. As a means to improve vaccine efficacy, we examined the effects of varying anticocaine vaccine formulations by combining a Toll-like receptor 9 (TLR9) agonist with a TLR5 agonist in the presence of alum. The TLR9 agonist used was cytosine-guanine oligodeoxynucleotide 1826 (CpG 1826), while the TLR5 agonist was flagellin (FliC). Formulations with the TLR9 agonist elicited superior anticocaine antibody titers and blockade of hyperlocomotor effects compared to vaccines without CpG 1826. This improvement was seen regardless of whether the TLR5 agonist, FliC, or the nonadjuvanting Tetanus Toxoid (TT) was used as the carrier protein. Additional insights into the value of FliC as a carrier versus adjuvant was also investigated by generating two unique formats of the protein, wild-type and mutated flagellin (mFliC). While the mFliC conjugate retained its ability to stimulate mTLR5, it yielded reduced cocaine sequestration and functional blockade relative to FliC and TT. Overall, this work indicates that activation of TLR9 can improve the function of cocaine vaccines in the presence of TLR5 activation by FliC, with any potential additive effects limited by the inefficiency of FliC as a carrier protein as compared to TT.
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Affiliation(s)
- Atsushi Kimishima
- Departments of Chemistry and Immunology, The Skaggs Institute for Chemical Biology, WIRM Institute for Research and Medicine The Scripps Research Institute, La Jolla, CA, 92037
| | - Cody J Wenthur
- Departments of Chemistry and Immunology, The Skaggs Institute for Chemical Biology, WIRM Institute for Research and Medicine The Scripps Research Institute, La Jolla, CA, 92037
| | - Lisa M Eubanks
- Departments of Chemistry and Immunology, The Skaggs Institute for Chemical Biology, WIRM Institute for Research and Medicine The Scripps Research Institute, La Jolla, CA, 92037
| | - Shun Sato
- Departments of Chemistry and Immunology, The Skaggs Institute for Chemical Biology, WIRM Institute for Research and Medicine The Scripps Research Institute, La Jolla, CA, 92037
| | - Kim D Janda
- Departments of Chemistry and Immunology, The Skaggs Institute for Chemical Biology, WIRM Institute for Research and Medicine The Scripps Research Institute, La Jolla, CA, 92037
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12
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Karila L, Leroy C, Dubol M, Trichard C, Mabondo A, Marill C, Dubois A, Bordas N, Martinot JL, Reynaud M, Artiges E. Dopamine Transporter Correlates and Occupancy by Modafinil in Cocaine-Dependent Patients: A Controlled Study With High-Resolution PET and [(11)C]-PE2I. Neuropsychopharmacology 2016; 41:2294-302. [PMID: 26892922 PMCID: PMC4946060 DOI: 10.1038/npp.2016.28] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 02/03/2016] [Accepted: 02/07/2016] [Indexed: 11/09/2022]
Abstract
Modafinil is a candidate compound for the treatment of cocaine addiction that binds to the dopamine transporter (DAT) in healthy humans, as observed by positron emission tomography (PET). This mechanism, analogous to that of cocaine, might mediate a putative therapeutic effect of modafinil on cocaine dependence, though the binding of modafinil to DAT has never been assessed in cocaine-dependent patients. We aimed at quantifying the DAT availability during a controlled treatment by modafinil, and its clinical and psychometric correlates in cocaine-dependent patients at the onset of abstinence initiation. Twenty-nine cocaine-dependent male patients were enrolled in a 3-month trial for cocaine abstinence. Modafinil was used in a randomized double-blind placebo-controlled design and was administered as follows: 400 mg/day for 26 days, then 300 mg/day for 30 days, and 200 mg/day for 31 days. Participants were examined twice during a 17-day hospitalization for their DAT availability using PET and [(11)C]-PE2I and for assessments of craving, depressive symptoms, working memory, and decision-making. Cocaine abstinence was further assessed during a 10-week outpatient follow-up period. Baseline [(11)C]-PE2I-binding potential covaried with risk taking and craving index in striatal and extrastriatal regions. A 65.6% decrease of binding potential was detected in patients receiving modafinil for 2 weeks, whereas placebo induced no significant change. During hospitalization, an equivalent improvement in clinical outcomes was observed in both treatment groups, and during the outpatient follow-up there were more therapeutic failures in the modafinil-treated group. Therefore, these results do not support the usefulness of modafinil to treat cocaine addiction.
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Affiliation(s)
- Laurent Karila
- INSERM U.1000 Research Unit ‘Neuroimaging and Psychiatry', Paris Sud University, Paris Descartes University, Paris, Orsay, France,AP-HP, Addiction Research and Treatment Center, Paul Brousse Hospital, Villejuif, France,AP-HP, Addiction Research and Treatment Centre, Paul Brousse Hospital, 12 Avenue Paul Vaillant Couturier, Villejuif, 94800, France, Tel: +33 1 45 59 65 13, E-mail:
| | - Claire Leroy
- INSERM U.1000 Research Unit ‘Neuroimaging and Psychiatry', Paris Sud University, Paris Descartes University, Paris, Orsay, France,CEA, DSV, I2BM, Service Hospitalier Frédéric Joliot, Orsay, France,Laboratoire Imagerie Moléculaire In Vivo (IMIV), CEA, Inserm, Paris Sud University, CNRS, Université Paris Saclay, CEA-SHFJ, Orsay, France
| | - Manon Dubol
- INSERM U.1000 Research Unit ‘Neuroimaging and Psychiatry', Paris Sud University, Paris Descartes University, Paris, Orsay, France
| | - Christian Trichard
- INSERM U.1000 Research Unit ‘Neuroimaging and Psychiatry', Paris Sud University, Paris Descartes University, Paris, Orsay, France,Psychiatry Department, Orsay Hospital, Orsay, France
| | - Audrey Mabondo
- INSERM U.1000 Research Unit ‘Neuroimaging and Psychiatry', Paris Sud University, Paris Descartes University, Paris, Orsay, France
| | - Catherine Marill
- AP-HP, Addiction Research and Treatment Center, Paul Brousse Hospital, Villejuif, France
| | - Albertine Dubois
- Laboratoire Imagerie et Modélisation en Neurobiologie et Cancérologie, UMR 8165 CNRS-Université Paris 7-Université Paris 11, Orsay, France
| | - Nadège Bordas
- INSERM U.1000 Research Unit ‘Neuroimaging and Psychiatry', Paris Sud University, Paris Descartes University, Paris, Orsay, France
| | - Jean-Luc Martinot
- INSERM U.1000 Research Unit ‘Neuroimaging and Psychiatry', Paris Sud University, Paris Descartes University, Paris, Orsay, France
| | - Michel Reynaud
- AP-HP, Addiction Research and Treatment Center, Paul Brousse Hospital, Villejuif, France
| | - Eric Artiges
- INSERM U.1000 Research Unit ‘Neuroimaging and Psychiatry', Paris Sud University, Paris Descartes University, Paris, Orsay, France,Psychiatry Department, Orsay Hospital, Orsay, France
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13
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Salazar-Juárez A, Barbosa-Méndez S, Jurado N, Hernández-Miramontes R, Leff P, Antón B. Mirtazapine prevents induction and expression of cocaine-induced behavioral sensitization in rats. Prog Neuropsychopharmacol Biol Psychiatry 2016; 68:15-24. [PMID: 26922897 DOI: 10.1016/j.pnpbp.2016.02.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 02/03/2016] [Accepted: 02/23/2016] [Indexed: 01/07/2023]
Abstract
Cocaine abuse is a major health problem worldwide. Treatment based on both 5-HT2A/C and 5-HT3 receptor antagonists attenuate not only the effects of cocaine abuse but also the incentive/motivational effect related to cocaine-paired cues. Mirtazapine, an antagonist of postsynaptic α2-adrenergic, 5-HT2A/C and 5HT3 receptors and inverse agonist of the 5-HT2C receptor, has been shown to effectively modify, at the preclinical and clinical levels, various behavioral alterations induced by drugs abuse. Therefore, it is important to assess whether chronic dosing of mirtazapine alters locomotor effects of cocaine as well as induction and expression of cocaine sensitization. Our results reveal that a daily mirtazapine regimen administered for 30days effectively induces a significant attenuation of cocaine-dependent locomotor activity and as well as the induction and expression of behavioral sensitization. These results suggest that mirtazapine may be used as a potentially effective therapy to attenuate induction and expression of cocaine-induced locomotor sensitization.
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Affiliation(s)
- Alberto Salazar-Juárez
- Subdirección de investigaciones Clínicas, Laboratorio de Neurobiología Molecular y Neuroquímica de las Adicciones, Instituto Nacional de Psiquiatría, México DF 14370, Mexico
| | - Susana Barbosa-Méndez
- Subdirección de investigaciones Clínicas, Laboratorio de Neurobiología Molecular y Neuroquímica de las Adicciones, Instituto Nacional de Psiquiatría, México DF 14370, Mexico
| | - Noe Jurado
- Subdirección de investigaciones Clínicas, Laboratorio de Neurobiología Molecular y Neuroquímica de las Adicciones, Instituto Nacional de Psiquiatría, México DF 14370, Mexico
| | - Ricardo Hernández-Miramontes
- Subdirección de investigaciones Clínicas, Laboratorio de Neurobiología Molecular y Neuroquímica de las Adicciones, Instituto Nacional de Psiquiatría, México DF 14370, Mexico
| | - Philippe Leff
- Subdirección de investigaciones Clínicas, Laboratorio de Neurobiología Molecular y Neuroquímica de las Adicciones, Instituto Nacional de Psiquiatría, México DF 14370, Mexico
| | - Benito Antón
- Subdirección de investigaciones Clínicas, Laboratorio de Neurobiología Molecular y Neuroquímica de las Adicciones, Instituto Nacional de Psiquiatría, México DF 14370, Mexico.
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14
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Shen S, Jiang X, Li J, Straubinger RM, Suarez M, Tu C, Duan X, Thompson AC, Qu J. Large-Scale, Ion-Current-Based Proteomic Investigation of the Rat Striatal Proteome in a Model of Short- and Long-Term Cocaine Withdrawal. J Proteome Res 2016; 15:1702-16. [PMID: 27018876 DOI: 10.1021/acs.jproteome.6b00137] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Given the tremendous detriments of cocaine dependence, effective diagnosis and patient stratification are critical for successful intervention yet difficult to achieve due to the largely unknown molecular mechanisms involved. To obtain new insights into cocaine dependence and withdrawal, we employed a reproducible, reliable, and large-scale proteomics approach to investigate the striatal proteomes of rats (n = 40, 10 per group) subjected to chronic cocaine exposure, followed by either short- (WD1) or long- (WD22) term withdrawal. By implementing a surfactant-aided precipitation/on-pellet digestion procedure, a reproducible and sensitive nanoLC-Orbitrap MS analysis, and an optimized ion-current-based MS1 quantification pipeline, >2000 nonredundant proteins were quantified confidently without missing data in any replicate. Although cocaine was cleared from the body, 129/37 altered proteins were observed in WD1/WD22 that are implicated in several biological processes related closely to drug-induced neuroplasticity. Although many of these changes recapitulate the findings from independent studies reported over the last two decades, some novel insights were obtained and further validated by immunoassays. For example, significantly elevated striatal protein kinase C activity persisted over the 22 day cocaine withdrawal. Cofilin-1 activity was up-regulated in WD1 and down-regulated in WD22. These discoveries suggest potentially distinct structural plasticity after short- and long-term cocaine withdrawal. In addition, this study provides compelling evidence that blood vessel narrowing, a long-known effect of cocaine use, occurred after long-term but not short-term withdrawal. In summary, this work developed a well-optimized paradigm for ion-current-based quantitative proteomics in brain tissues and obtained novel insights into molecular alterations in the striatum following cocaine exposure and withdrawal.
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Affiliation(s)
- Shichen Shen
- New York State Center of Excellence in Bioinformatics & Life Sciences , Buffalo, New York 14203, United States.,Department of Biochemistry, School of Medicine and Biomedical Sciences, SUNY at Buffalo , Buffalo, New York 14214, United States
| | - Xiaosheng Jiang
- Department of Pharmaceutical Sciences, SUNY at Buffalo , Buffalo, New York 14214, United States.,New York State Center of Excellence in Bioinformatics & Life Sciences , Buffalo, New York 14203, United States
| | - Jun Li
- Department of Pharmaceutical Sciences, SUNY at Buffalo , Buffalo, New York 14214, United States.,New York State Center of Excellence in Bioinformatics & Life Sciences , Buffalo, New York 14203, United States
| | - Robert M Straubinger
- Department of Pharmaceutical Sciences, SUNY at Buffalo , Buffalo, New York 14214, United States
| | - Mauricio Suarez
- Department of Psychology, SUNY at Buffalo , Buffalo, New York 14260, United States.,Research Institute on Addictions, SUNY at Buffalo , Buffalo, New York 14203, United States
| | - Chengjian Tu
- New York State Center of Excellence in Bioinformatics & Life Sciences , Buffalo, New York 14203, United States.,Department of Biochemistry, School of Medicine and Biomedical Sciences, SUNY at Buffalo , Buffalo, New York 14214, United States
| | - Xiaotao Duan
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology , Beijing 100850, China
| | - Alexis C Thompson
- Department of Psychology, SUNY at Buffalo , Buffalo, New York 14260, United States.,Research Institute on Addictions, SUNY at Buffalo , Buffalo, New York 14203, United States
| | - Jun Qu
- Department of Pharmaceutical Sciences, SUNY at Buffalo , Buffalo, New York 14214, United States.,New York State Center of Excellence in Bioinformatics & Life Sciences , Buffalo, New York 14203, United States
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15
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Selective activation of the trace amine-associated receptor 1 decreases cocaine's reinforcing efficacy and prevents cocaine-induced changes in brain reward thresholds. Prog Neuropsychopharmacol Biol Psychiatry 2015; 63:70-5. [PMID: 26048337 DOI: 10.1016/j.pnpbp.2015.05.014] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 05/26/2015] [Accepted: 05/26/2015] [Indexed: 01/09/2023]
Abstract
The newly discovered trace amine-associated receptor 1 (TAAR1) has emerged as a promising target for medication development in stimulant addiction due to its ability to regulate dopamine (DA) function and modulate stimulants' effects. Recent findings indicate that TAAR1 activation blocks some of the abuse-related physiological and behavioral effects of cocaine. However, findings from existing self-administration studies are inconclusive due to the very limited range of cocaine unit doses tested. Here, in order to shed light on the influence of TAAR1 on cocaine's reward and reinforcement, we studied the effects of partial and full activation of TAAR1on (1) the dose-response curve for cocaine self-administration and (2) cocaine-induced changes in intracranial self-stimulation (ICSS). In the first experiment, we examined the effects of the selective full and partial TAAR1 agonists, RO5256390 and RO5203648, on self-administration of five unit-injection doses of cocaine (0.03, 0.1, 0.2, 0.45, and 1mg/kg/infusion). Both agonists induced dose-dependent downward shifts in the cocaine dose-response curve, indicating that both partial and full TAAR1 activation decrease cocaine, reinforcing efficacy. In the second experiment, RO5256390 and the partial agonist, RO5263397, dose-dependently prevented cocaine-induced lowering of ICSS thresholds. Taken together, these data demonstrated that TAAR1 stimulation effectively suppresses the rewarding and reinforcing effects of cocaine in self-administration and ICSS models, supporting the candidacy of TAAR1 as a drug discovery target for cocaine addiction.
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16
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Fischer B, Kuganesan S, Gallassi A, Malcher-Lopes R, van den Brink W, Wood E. Addressing the stimulant treatment gap: A call to investigate the therapeutic benefits potential of cannabinoids for crack-cocaine use. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 26:1177-82. [DOI: 10.1016/j.drugpo.2015.09.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 09/08/2015] [Accepted: 09/15/2015] [Indexed: 01/14/2023]
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17
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Czoty PW. Effects of chronic binge-like ethanol consumption on cocaine self-administration in rhesus monkeys. Drug Alcohol Depend 2015; 153:278-85. [PMID: 26048636 PMCID: PMC4509795 DOI: 10.1016/j.drugalcdep.2015.05.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 05/01/2015] [Accepted: 05/04/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND Most cocaine abusers also abuse alcohol, but little is known about interactions that promote co-abuse. These experiments in rhesus monkeys determined the effects of >8 weeks of ethanol (EtOH) consumption on cocaine self-administration (n=6), effects of dopamine (DA) receptor antagonists on cocaine reinforcement (n=3-4 per drug) and the ability of the D2-like DA receptor agonist quinpirole to elicit yawning (n=3). METHODS Monkeys self-administered cocaine (0.0-1.0mg/kg/injection, i.v.) under a 300-s fixed-interval schedule and the above-listed variables were measured before EtOH exposure. Next, monkeys consumed a sweetened, 4% EtOH solution in the home cage under binge-like conditions: 1h, 5 days/week with daily intake equaling 2.0g/kg EtOH. After approximately 8 weeks, measures were re-determined, then EtOH drinking was discontinued. Finally, acute effects of EtOH on cocaine self-administration were determined by infusing EtOH (0.0-1.0g/kg. i.v.) prior to cocaine self-administration sessions (n=4). RESULTS In five of six monkeys, EtOH drinking increased self-administration of low cocaine doses but did not alter reinforcing effects of higher doses. Self-administration returned to baseline after EtOH access was terminated (n=3). Effects of DA receptor antagonists on cocaine self-administration were not consistently altered after EtOH consumption, but the ability of quinpirole to induce yawning was enhanced in two of three monkeys. Acute EtOH infusions only decreased self-administration of lower cocaine doses. CONCLUSIONS Taken together, the data suggest that long-term EtOH exposure can increase sensitivity to cocaine, possibly by increasing D3 receptor sensitivity. Data do not support a role for acute pharmacological interactions in promoting cocaine/EtOH co-abuse.
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Affiliation(s)
- Paul W. Czoty
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC 27157-1083
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18
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Riley ED, Shumway M, Knight KR, Guzman D, Cohen J, Weiser SD. Risk factors for stimulant use among homeless and unstably housed adult women. Drug Alcohol Depend 2015; 153:173-9. [PMID: 26070454 PMCID: PMC4510017 DOI: 10.1016/j.drugalcdep.2015.05.023] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 05/11/2015] [Accepted: 05/16/2015] [Indexed: 01/14/2023]
Abstract
BACKGROUND One of the most common causes of death among homeless and unstably housed women is acute intoxication where cocaine is present. While correlates of stimulant use have been determined in prior research, few studies have assessed risk factors of use specifically in this high-risk population. METHODS We sampled biological women with a history of housing instability from community-based venues to participate in a cohort study. Baseline and 6-month follow-up data were used to determine the relative risk of stimulant use (crack cocaine, powder cocaine or methamphetamine) among individuals who did not use at baseline. RESULTS Among 260 study participants, the median age was 47 years, 70% were women of color; 47% reported having unmet subsistence needs and 53% reported abstinence from stimulants at baseline. In analyses adjusting for baseline sociodemographics and drug treatment, the risk of using stimulants within 6 months was significantly higher among women who reported recent sexual violence (Adjusted Relative Risk [ARR]=4.31; 95% CI:1.97-9.45), sleeping in a shelter or public place (ARR=2.75; 95% CI:1.15-6.57), and using unprescribed opioid analgesics (ARR=2.54; 95% CI:1.01-6.38). CONCLUSION We found that almost half of homeless and unstably housed women used stimulants at baseline and 14% of those who did not use began within 6 months. Addressing homelessness and sexual violence is critical to reduce stimulant use among impoverished women.
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Affiliation(s)
- Elise D Riley
- School of Medicine, Department of Medicine, University of California, San Francisco, CA, USA.
| | - Martha Shumway
- School of Medicine, Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Kelly R Knight
- School of Medicine, Department of Anthropology, History and Social Medicine, University of California, San Francisco, CA, USA
| | - David Guzman
- School of Medicine, Department of General Internal Medicine, University of California, San Francisco, CA, USA
| | - Jennifer Cohen
- School of Medicine, Department of Clinical Pharmacy, University of California, San Francisco, CA, USA
| | - Sheri D Weiser
- School of Medicine, Department of Medicine, University of California, San Francisco, CA, USA
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19
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Minozzi S, Cinquini M, Amato L, Davoli M, Farrell MF, Pani PP, Vecchi S. Anticonvulsants for cocaine dependence. Cochrane Database Syst Rev 2015; 2015:CD006754. [PMID: 25882271 PMCID: PMC8812341 DOI: 10.1002/14651858.cd006754.pub4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Cocaine dependence is a major public health problem that is characterised by recidivism and a host of medical and psychosocial complications. Although effective pharmacotherapy is available for alcohol and heroin dependence, none is currently available for cocaine dependence, despite two decades of clinical trials primarily involving antidepressant, anticonvulsivant and dopaminergic medications. Extensive consideration has been given to optimal pharmacological approaches to the treatment of individuals with cocaine dependence, and both dopamine antagonists and agonists have been considered. Anticonvulsants have been candidates for use in the treatment of addiction based on the hypothesis that seizure kindling-like mechanisms contribute to addiction. OBJECTIVES To evaluate the efficacy and safety of anticonvulsants for individuals with cocaine dependence. SEARCH METHODS We searched the Cochrane Drugs and Alcohol Group Trials Register (June 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (2014, Issue 6), MEDLINE (1966 to June 2014), EMBASE (1988 to June 2014), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to June 2014), Web of Science (1991 to June 2014) and the reference lists of eligible articles. SELECTION CRITERIA All randomised controlled trials and controlled clinical trials that focus on the use of anticonvulsant medications to treat individuals with cocaine dependence. DATA COLLECTION AND ANALYSIS We used the standard methodological procedures expected by The Cochrane Collaboration. MAIN RESULTS We included a total of 20 studies with 2068 participants. We studied the anticonvulsant drugs carbamazepine, gabapentin, lamotrigine, phenytoin, tiagabine, topiramate and vigabatrin. All studies compared anticonvulsants versus placebo. Only one study had one arm by which the anticonvulsant was compared with the antidepressant desipramine. Upon comparison of anticonvulsant versus placebo, we found no significant differences for any of the efficacy and safety measures. Dropouts: risk ratio (RR) 0.95, 95% confidence interval (CI) 0.86 to 1.05, 17 studies, 20 arms, 1695 participants, moderate quality of evidence. Use of cocaine: RR 0.92, 95% CI 0.84 to 1.02, nine studies, 11 arms, 867 participants, moderate quality of evidence; side effects: RR 1.39, 95% CI 1.01 to 1.90, eight studies, 775 participants; craving: standardised mean difference (SMD) -0.25, 95% CI -0.59 to 0.09, seven studies, eight arms, 428 participants, low quality of evidence. AUTHORS' CONCLUSIONS Although caution is needed when results from a limited number of small clinical trials are assessed, no current evidence supports the clinical use of anticonvulsant medications in the treatment of patients with cocaine dependence. Although the findings of new trials will improve the quality of study results, especially in relation to specific medications, anticonvulsants as a category cannot be considered first-, second- or third-line treatment for cocaine dependence.
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Affiliation(s)
- Silvia Minozzi
- Lazio Regional Health ServiceDepartment of EpidemiologyVia di Santa Costanza, 53RomeItaly00198
| | - Michela Cinquini
- Mario NegriCentro Cochrane Italianovia Giuseppe La Masa 19MILANOItaly20156
| | - Laura Amato
- Lazio Regional Health ServiceDepartment of EpidemiologyVia di Santa Costanza, 53RomeItaly00198
| | - Marina Davoli
- Lazio Regional Health ServiceDepartment of EpidemiologyVia di Santa Costanza, 53RomeItaly00198
| | - Michael F Farrell
- University of New South WalesNational Drug and Alcohol Research Centre36 King StreetRandwickSydneyNSWAustraliaNSW 2025
| | - Pier Paolo Pani
- Health District 8 (ASL 8) CagliariSocial‐Health DivisionVia Logudoro 17CagliariSardiniaItaly09127
| | - Simona Vecchi
- Lazio Regional Health ServiceDepartment of EpidemiologyVia di Santa Costanza, 53RomeItaly00198
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20
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Effectiveness of secondary prevention and treatment interventions for crack-cocaine abuse: a comprehensive narrative overview of English-language studies. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 26:352-63. [PMID: 25662894 DOI: 10.1016/j.drugpo.2015.01.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 12/30/2014] [Accepted: 01/06/2015] [Indexed: 11/18/2022]
Abstract
There are an estimated several million crack-cocaine users globally; use is highest in the Americas. Most crack users are socio-economically marginalized (e.g., homeless), and feature elevated risks for morbidity (e.g., blood-borne viruses), mortality and crime/violence involvement, resulting in extensive burdens. No comprehensive reviews of evidence-based prevention and/or treatment interventions specifically for crack use exist. We conducted a comprehensive narrative overview of English-language studies on the efficacy of secondary prevention and treatment interventions for crack (cocaine) abuse/dependence. Literature searches (1990-2014) using pertinent keywords were conducted in main scientific databases. Titles/abstracts were reviewed for relevance, and full studies were included in the review if involving a primary prevention/treatment intervention study comprising a substantive crack user sample. Intervention outcomes considered included drug use, health risks/status (e.g., HIV or sexual risks) and select social outcome indicators. Targeted (e.g., behavioral/community-based) prevention measures show mixed and short-term effects on crack use/HIV risk outcomes. Material (e.g., safer crack use kit distribution) interventions also document modest efficacy in risk reduction; empirical assessments of environmental (e.g., drug consumption facilities) for crack smokers are not available. Diverse psycho-social treatment (including contingency management) interventions for crack abuse/dependence show some positive but also limited/short-term efficacy, yet likely constitute best currently available treatment options. Ancillary treatments show little effects but are understudied. Despite ample studies, pharmaco-therapeutic/immunotherapy treatment agents have not produced convincing evidence; select agents may hold potential combined with personalized approaches and/or psycho-social strategies. No comprehensively effective 'gold-standard' prevention/treatment interventions for crack abuse exist; concerted research towards improved interventions is urgently needed.
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Lockner JW, Eubanks LM, Choi JL, Lively JM, Schlosburg JE, Collins KC, Globisch D, Rosenfeld-Gunn RJ, Wilson IA, Janda KD. Flagellin as carrier and adjuvant in cocaine vaccine development. Mol Pharm 2015; 12:653-62. [PMID: 25531528 PMCID: PMC4319694 DOI: 10.1021/mp500520r] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Cocaine abuse is problematic, directly and indirectly impacting the lives of millions, and yet existing therapies are inadequate and usually ineffective. A cocaine vaccine would be a promising alternative therapeutic option, but efficacy is hampered by variable production of anticocaine antibodies. Thus, new tactics and strategies for boosting cocaine vaccine immunogenicity must be explored. Flagellin is a bacterial protein that stimulates the innate immune response via binding to extracellular Toll-like receptor 5 (TLR5) and also via interaction with intracellular NOD-like receptor C4 (NLRC4), leading to production of pro-inflammatory cytokines. Reasoning that flagellin could serve as both carrier and adjuvant, we modified recombinant flagellin protein to display a cocaine hapten termed GNE. The resulting conjugates exhibited dose-dependent stimulation of anti-GNE antibody production. Moreover, when adjuvanted with alum, but not with liposomal MPLA, GNE-FliC was found to be better than our benchmark GNE-KLH. This work represents a new avenue for exploration in the use of hapten-flagellin conjugates to elicit antihapten immune responses.
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Affiliation(s)
- Jonathan W Lockner
- Departments of Chemistry, Integrative Structural and Computational Biology, and Immunology and Microbial Science, The Scripps Research Institute , 10550 North Torrey Pines Road, La Jolla, California 92037, United States
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22
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Brutcher RE, Nader MA. Effects of quetiapine treatment on cocaine self-administration and behavioral indices of sleep in adult rhesus monkeys. Psychopharmacology (Berl) 2015; 232:411-20. [PMID: 25030802 PMCID: PMC4297597 DOI: 10.1007/s00213-014-3672-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 06/27/2014] [Indexed: 10/25/2022]
Abstract
RATIONALE Clinical literature suggests a link between substance abuse and sleep disturbances. Quetiapine, an atypical antipsychotic, has shown efficacy in treating sleep disturbances, with clinical studies showing promise for quetiapine as a treatment for cocaine abuse. OBJECTIVE The goal of this study was to examine the effects of quetiapine on cocaine self-administration and behavioral indices of sleep in monkeys. METHODS Seven adult male rhesus monkeys, fitted with Actical® activity monitors, were trained to respond under a choice paradigm of food (1.0-g pellets) and cocaine (0.003-0.3 mg/kg per injection) presentation. First, monkeys received acute pretreatment (45 min) with quetiapine (25-75 mg, p.o.) prior to choice sessions; three cocaine doses were studied in combination with quetiapine. Next, the effect of chronic (14-16 days) quetiapine treatment (25-250 mg, p.o., BID) was examined in combination with the lowest preferred cocaine dose (≥80 % cocaine choice). Behavioral indices of sleep, based on activity measures obtained during lights-out, were recorded throughout the study. RESULTS Acute quetiapine decreased cocaine choice in four of the seven monkeys. Chronic quetiapine treatment resulted in initial decreases in cocaine choice, but tolerance developed to these effects. Acute doses of quetiapine did not improve sleep efficiency the following night nor did chronic quetiapine. The first night after discontinuing quetiapine treatment resulted in significant decreases in sleep efficiency and increases in nighttime activity. CONCLUSIONS These findings do not offer support for the use of quetiapine as a monotherapy for treatment of cocaine abuse nor as an adjunct therapy to treat sleep disturbances associated with stimulant abuse.
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Affiliation(s)
- Robert E Brutcher
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1083, USA
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Gjini K, Qazi A, Greenwald MK, Sandhu R, Gooding DC, Boutros NN. Relationships of behavioral measures of frontal lobe dysfunction with underlying electrophysiology in cocaine-dependent patients. Am J Addict 2014; 23:265-71. [PMID: 24724884 DOI: 10.1111/j.1521-0391.2014.12095.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 04/29/2013] [Accepted: 06/01/2013] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Despite evidence that frontal lobe functioning is impaired in cocaine-dependent individuals, relationships between behavioral measures of frontal dysfunction and electrophysiological measures of inhibition in cocaine use have not been explored. METHODS Using the Frontal Systems Behavior Scale (FrSBe), frontal dysfunction was assessed in a group of abstinent cocaine-dependent subjects (N = 49) and healthy controls (N = 32). Using transcranial magnetic stimulation (TMS) and evoked potential (EP)-based electrophysiological measures of inhibition, we assessed associations between these measures and FrSBe estimates of frontal dysfunction. RESULTS Patients had significantly higher FrSBe scores for executive dysfunction, disinhibition, and apathy than controls. Lower TMS-based resting motor thresholds (ie, hyperexcitability) were significantly associated with higher executive dysfunction scores in the patients. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE Relationships between FrSBe scores and TMS-based measures highlight neurophysiological aberrations underlying frontal lobe dysfunction in cocaine abusers. TMS and EP measures may be useful probes of the intermediary steps between frontal lobe dysfunction and addictive behavior.
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Affiliation(s)
- Klevest Gjini
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, Michigan
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24
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Stoops WW, Rush CR. Agonist replacement for stimulant dependence: a review of clinical research. Curr Pharm Des 2014; 19:7026-35. [PMID: 23574440 DOI: 10.2174/138161281940131209142843] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 04/04/2013] [Indexed: 11/22/2022]
Abstract
Stimulant use disorders are an unrelenting public health concern worldwide. Agonist replacement therapy is among the most effective strategies for managing substance use disorders including nicotine and opioid dependence. The present paper reviewed clinical data from human laboratory self-administration studies and clinical trials to determine whether agonist replacement therapy is a viable strategy for managing cocaine and/or amphetamine use disorders. The extant literature suggests that agonist replacement therapy may be effective for managing stimulant use disorders, however, the clinical selection of an agonist replacement medication likely needs to be based on the pharmacological mechanism of the medication and the stimulant abused by patients. Specifically, dopamine releasers appear most effective for reducing cocaine use whereas dopamine reuptake inhibitors appear most effective for reducing amphetamine use.
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Affiliation(s)
- William W Stoops
- Department of Behavioral Science, University of Kentucky Medical Center, Lexington, KY 40536- 0086.
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Caputo F, Vignoli T, Grignaschi A, Cibin M, Addolorato G, Bernardi M. Pharmacological management of alcohol dependence: from mono-therapy to pharmacogenetics and beyond. Eur Neuropsychopharmacol 2014; 24:181-91. [PMID: 24182622 DOI: 10.1016/j.euroneuro.2013.10.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 10/06/2013] [Accepted: 10/09/2013] [Indexed: 01/01/2023]
Abstract
Almost 10% of the world's population is affected by alcohol use disorders, and the treatment of alcohol dependence (AD) still remains a challenge. Patients with AD can differ in many traits. Three drugs (disulfiram, naltrexone, and acamprosate) have been approved by the FDA for the treatment of AD, and in some European countries sodium oxybate is also approved for this purpose. Combined pharmacological therapy has not provided such convincing results. Considering the fact that the "ideal" and effective drug for all types of alcoholic patients does not exists, the future challenge will be to identify a personalized approach. Recent data has shown that this objective can be achieved by investigating the genetic variability of the patient. Moreover, the use of replacement molecules can probably be considered an advantageous therapeutic opportunity (i.e. sodium oxybate). In addition, reduction of alcohol consumption is increasingly accepted as a viable treatment goal, and the use of nalmefene "as-needed" (a pharmacological approach similar to naltrexone, but, possibly, with lower hepatotoxicity) may help in the treatment of AD. Thus, it is important to stress that a pharmacological approach to treat AD should be preceded by the definition of patient characteristics; this may help in the choice of the most appropriate drug and it can be done more easily when more pharmacological options approved for the treatment of AD are also available.
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Affiliation(s)
- Fabio Caputo
- Department of Internal Medicine, SS Annunziata Hospital, Cento, Ferrara, Italy; "G. Fontana" Centre for the Study and Multidisciplinary Treatment of Alcohol Addiction, Department of Clinical Medicine, University of Bologna, Italy.
| | - Teo Vignoli
- Unit for Addiction Treatment, Department of Mental Health, Lugo, Ravenna, Italy
| | - Alice Grignaschi
- "G. Fontana" Centre for the Study and Multidisciplinary Treatment of Alcohol Addiction, Department of Clinical Medicine, University of Bologna, Italy
| | - Mauro Cibin
- Department of Addictive Behaviours, Dolo, Venice, Italy
| | | | - Mauro Bernardi
- "G. Fontana" Centre for the Study and Multidisciplinary Treatment of Alcohol Addiction, Department of Clinical Medicine, University of Bologna, Italy
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Fischer B, Cruz MS, Bastos FI, Tyndall M. Crack across the Americas – A massive problem in continued search of viable answers: Exemplary views from the North (Canada) and the South (Brazil). THE INTERNATIONAL JOURNAL OF DRUG POLICY 2013; 24:631-3. [DOI: 10.1016/j.drugpo.2013.09.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 09/04/2013] [Accepted: 09/06/2013] [Indexed: 11/30/2022]
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Disulfiram deregulates HIF-α subunits and blunts tumor adaptation to hypoxia in hepatoma cells. Acta Pharmacol Sin 2013; 34:1208-16. [PMID: 23852087 DOI: 10.1038/aps.2013.52] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 04/08/2013] [Indexed: 12/13/2022] Open
Abstract
AIM Disulfiram is an aldehyde dehydrogenase inhibitor that was used to treat alcoholism and showed anticancer activity, but its anticancer mechanism remains unclear. The aim of this study was to investigate the effects of disulfiram on the hypoxia-inducible factor (HIF)-driven tumor adaptation to hypoxia in vitro. METHODS Hep3B, Huh7 and HepG2 hepatoma cells were incubated under normoxic (20% O2) or hypoxic (1% O2) conditions for 16 h. The expression and activity of HIF-1α and HIF-2α proteins were evaluated using immunoblotting and luciferase reporter assay, respectively. Semi-quantitative RT-PCR was used to analyze HIF-mediated gene expression. Endothelial tubule formation assay was used to evaluate the anti-angiogenic effect. RESULTS Hypoxia caused marked expression of HIF-1α and HIF-1α in the 3 hepatoma cell lines, dramatically increased HIF activity and induced the expression of HIF downstream genes (EPO, CA9, VEGF-A and PDK1) in Hep3B cells. HIF-2α expression was positively correlated with the induction of hypoxic genes (CA9, VEGF-A and PDK1). Moreover, hypoxia markedly increased VEGF production and angiogenic potential of Hep3B cells. Disulfiram (0.3 to 2 μmol/L) inhibited hypoxia-induced gene expression and HIF activity in a dose-dependent manner. Disulfiram more effectively suppressed the viability of Hep3B cells under hypoxia, but it did not affect the cell cycle. Overexpression of HIF-2α in Hep3B cells reversed the inhibitory effects of disulfiram on hypoxia-induced gene expression and cell survival under hypoxia. CONCLUSION Disulfiram deregulates the HIF-mediated hypoxic signaling pathway in hepatoma cells, which may contribute to its anticancer effect. Thus, disulfiram could be used to treat solid tumors that grow in a HIF-dependent manner.
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Compton WM, Dawson DA, Goldstein RB, Grant BF. Crosswalk between DSM-IV dependence and DSM-5 substance use disorders for opioids, cannabis, cocaine and alcohol. Drug Alcohol Depend 2013; 132:387-90. [PMID: 23642316 PMCID: PMC3748225 DOI: 10.1016/j.drugalcdep.2013.02.036] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 02/20/2013] [Accepted: 02/23/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND Ascertaining agreement between DSM-IV and DSM-5 is important to determine the applicability of treatments for DSM-IV conditions to persons diagnosed according to the proposed DSM-5. METHODS Data from a nationally representative sample of US adults were used to compare concordance of past-year DSM-IV opioid, cannabis, cocaine and alcohol dependence with past-year DSM-5 disorders at thresholds of 3+, 4+, 5+ and 6+ positive DSM-5 criteria among past-year users of opioids (n=264), cannabis (n=1622), cocaine (n=271) and alcohol (n=23,013). Substance-specific 2 × 2 tables yielded overall concordance (kappa), sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV). RESULTS For DSM-IV alcohol, cocaine and opioid dependence, optimal concordance occurred when 4+ DSM-5 criteria were endorsed, corresponding to the threshold for moderate DSM-5 alcohol, cocaine and opioid use disorders. Maximal concordance of DSM-IV cannabis dependence and DSM-5 cannabis use disorder occurred when 6+ criteria were endorsed, corresponding to the threshold for severe DSM-5 cannabis use disorder. At these optimal thresholds, sensitivity, specificity, PPV and NPV generally exceeded 85% (>75% for cannabis). CONCLUSIONS Overall, excellent correspondence of DSM-IV dependence with DSM-5 substance use disorders was documented in this general population sample of alcohol, cannabis, cocaine and opioid users. Applicability of treatments tested for DSM-IV dependence is supported by these results for those with a DSM-5 alcohol, cocaine or opioid use disorder of at least moderate severity or severe cannabis use disorder. Further research is needed to provide evidence for applicability of treatments for persons with milder substance use disorders.
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Affiliation(s)
- Wilson M Compton
- Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA.
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[Cocaine addiction: current data for the clinician]. Presse Med 2013; 43:9-17. [PMID: 23727012 DOI: 10.1016/j.lpm.2013.01.069] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2012] [Revised: 12/24/2012] [Accepted: 01/14/2013] [Indexed: 11/23/2022] Open
Abstract
Cocaine remains the second most commonly used illicit drug worldwide after cannabis. Observed levels of cocaine use among countries considerably vary. An increased cocaine use is recorded in the general European population. Cocaine addiction is a worldwide public health problem, which has somatic, psychiatric, socio-economic and judicial complications. It is a multifactorial disorder variable in its clinical manifestations and heritable. Compared to the general population, there is a high prevalence of somatic and psychiatric disorders among cocaine-dependent patients. There are predictable dose-related effects of pharmacological action of cocaine and effects which are uncommon, unrelated to dose and occur randomly in this population. The number of patients entering drug treatment for primary cocaine use has been increasing in Europe for several years. However, there is no specific pharmacotherapy with established efficacy for the treatment of cocaine addiction, nor is any medication approved by regulatory authorities for such treatment. Recent controlled clinical studies and laboratory studies have highlighted some very promising medications. The perfect therapeutic platform for abstinence initiation and relapse prevention of cocaine addiction is a combination of pharmacological treatments and behavioral treatments. Targeting somatic and psychiatric comorbidity is another way to use pharmacological treatments in addictions.
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Cariprazine (RGH-188), a D₃-preferring dopamine D₃/D₂ receptor partial agonist antipsychotic candidate demonstrates anti-abuse potential in rats. Psychopharmacology (Berl) 2013; 226:285-93. [PMID: 23138433 DOI: 10.1007/s00213-012-2906-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 10/07/2012] [Indexed: 10/27/2022]
Abstract
RATIONALE Cariprazine (RGH-188) is a D₃-preferring dopamine D₃/D₂ receptor partial agonist antipsychotic candidate for the treatment of schizophrenia and bipolar mania. Substance abuse is a frequent comorbidity of both disorders and is associated with serious health issues. Based on preclinical efficacy, dopamine D₂ and D₃ receptor partial agonists and antagonists are assumed to have relapse-preventing potential in human cocaine addiction. OBJECTIVES We investigated the anti-abuse potential of cariprazine in cocaine self-administration paradigms. Aripiprazole and bifeprunox were used as comparators because of their pharmacological similarity to cariprazine. METHODS The effects of compounds on cocaine's rewarding effect were investigated in a continuous self-administration regimen. The relapse-preventing potential of drugs was studied in rats with a history of cocaine self-administration after a period of complete abstinence in a relapse to cocaine-seeking paradigm. RESULTS Cariprazine, as well as aripiprazole and bifeprunox, were able to reduce the rewarding effect of cocaine (minimum effective doses were 0.17, 1, and 0.1 mg/kg, respectively) and attenuated relapse to cocaine seeking with half maximal effective dose [ED₅₀] values of 0.2, 4.2, and 0.17 mg/kg, respectively. CONCLUSIONS These results may predict a relapse-preventing action for cariprazine in humans in addition to its already established antipsychotic and antimanic efficacy.
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Abstract
Substance dependence is characterized by a group of symptoms, according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR). These symptoms include tolerance, withdrawal, drug consumption for alleviating withdrawal, exaggerated consumption beyond original intention, failure to reduce drug consumption, expending a considerable amount of time obtaining or recovering from the substance's effects, disregard of basic aspects of life (for example, family), and maintenance of drug consumption, despite facing adverse consequences. The nucleus accumbens (NAc) is a brain structure located in the basal forebrain of vertebrates, and it has been the target of addictive drugs. Different neurotransmitter systems at the level of the NAc circuitry have been linked to the different problems of drug addiction, like compulsive use and relapse. The glutamate system has been linked mainly to relapse after drug-seeking extinction. The dopamine system has been linked mainly to compulsive drug use. The glutamate homeostasis hypothesis centers around the dynamics of synaptic and extrasynaptic levels of glutamate, and their impact on circuitry from the prefrontal cortex (PFC) to the NAc. After repetitive drug use, deregulation of this homeostasis increases the release of glutamate from the PFC to the NAc during drug relapse. Glial cells also play a fundamental role in this hypothesis; glial cells shape the interactions between the PFC and the NAc by means of altering glutamate levels in synaptic and extrasynaptic spaces. On the other hand, cocaine self-administration and withdrawal increases the surface expression of subunit glutamate receptor 1 (GluA1) of alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors at the level of the NAc. Also, cocaine self-administration and withdrawal induce the formation of subunit glutamate receptor 2 (GluA2), lacking the Ca(2+)-permeable AMPA receptors (CP-AMPARs) at the level of the NAc. Antagonism of the CP-AMPARs reduces cravings. It is necessary to pursue further exploration of the AMPA receptor subunit composition and variations at the level of the NAc for a better understanding of glutamatergic plastic changes. It is known that cocaine and morphine are able to induce changes in dendritic spine morphology by modifying actin cycling. These changes include an initial increase in spine head diameter and increases in AMPA receptor expression, followed by a second stage of spine head diameter retraction and reduction of the AMPA receptors' expression in spines. Besides glutamate and dopamine, other factors, like brain-derived neurotrophic factor (BDNF), can influence NAc activity and induce changes in dendritic spine density. BDNF also induces drug-related behaviors like self-administration and relapse. Neither apoptosis nor neurogenesis plays a relevant role in the neurobiological processes subjacent to cocaine addiction in adults (rodent or human). Different therapeutic drugs like N-acetylcysteine (NAC), modafinil, acamprosate, and topiramate have been tested in preclinical and/or clinical models for alleviating drug relapse. Moreover, these therapeutic drugs target the glutamatergic circuitry between the PFC and the NAc. NAC and acamprosate have shown inconsistent results in clinical trials. Modafinil and topiramate have shown some success, but more clinical trials are necessary. Based on the current review findings, it could be recommendable to explore therapeutic approaches that include synergism between different drugs and neurotransmitter systems. The discrepancy in the results of some therapeutic drugs between preclinical versus clinical trials for alleviating relapse or drug dependence could be linked to the scarce exploration of preclinical models that mimic polydrug abuse patterns, for example, cocaine plus alcohol. At the clinical level, the pattern of polydrug consumption is a phenomenon of considerable frequency. Finally, as a complement at the end, an updated summary is included about the role of glutamate in other neuropsychiatric disorders (for example, mood disorders, schizophrenia, and others).
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Affiliation(s)
- Gabriel C Quintero
- Florida State University - Panama, Clayton, Panama ; Medical University of South Carolina, Charleston, South Carolina, USA ; Smithsonian Tropical Research Institute, Ancon, Republic of Panama
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Abstract
Drug and alcohol addiction is a debilitating disorder characterized by persistent drug-seeking behaviors despite negative physiological, medical, or social consequences. Neurobiological models of addiction propose that the reinforcing effects of addictive drugs are associated with altered neurotransmission within the reward 'mesocorticolimbic' circuitry in the brain. Immense efforts are therefore designed to target the mesocorticolimbic circuitry in attenuating drug dependence and addiction-related behaviors. Yet, to date, most addiction treatments have demonstrated only limited success in reducing addiction-related behaviors. Accumulating and compelling evidence suggests that novel nonsurgical brain stimulation techniques, such as transcranial magnetic stimulation and transcranial direct current stimulation, could serve as promising tools for indexing altered neurotransmission associated with repetitive drug use, and moreover, may hold therapeutic potential for the treatment of drug dependence and addiction-related behaviors. This chapter reviews and discusses the current and potential applications of such techniques in the study and treatment of addiction; we focus on a number of common drugs of abuse, including nicotine, alcohol, cocaine, cannabis, and ecstasy.
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Ferris MJ, Calipari ES, Mateo Y, Melchior JR, Roberts DCS, Jones SR. Cocaine self-administration produces pharmacodynamic tolerance: differential effects on the potency of dopamine transporter blockers, releasers, and methylphenidate. Neuropsychopharmacology 2012; 37:1708-16. [PMID: 22395730 PMCID: PMC3358740 DOI: 10.1038/npp.2012.17] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The dopamine transporter (DAT) is the primary site of action for psychostimulant drugs such as cocaine, methylphenidate, and amphetamine. Our previous work demonstrated a reduced ability of cocaine to inhibit the DAT following high-dose cocaine self-administration (SA), corresponding to a reduced ability of cocaine to increase extracellular dopamine. However, this effect had only been demonstrated for cocaine. Thus, the current investigations sought to understand the extent to which cocaine SA (1.5 mg/kg/inf × 40 inf/day × 5 days) altered the ability of different dopamine uptake blockers and releasers to inhibit dopamine uptake, measured using fast-scan cyclic voltammetry in rat brain slices. We demonstrated that, similar to cocaine, the DAT blockers nomifensine and bupropion were less effective at inhibiting dopamine uptake following cocaine SA. The potencies of amphetamine-like dopamine releasers such as 3,4-methylenedioxymethamphetamine, methamphetamine, amphetamine, and phentermine, as well as a non-amphetamine releaser, 4-benzylpiperidine, were all unaffected. Finally, methylphenidate, which blocks dopamine uptake like cocaine while being structurally similar to amphetamine, shared characteristics of both, resembling an uptake blocker at low concentrations and a releaser at high concentrations. Combined, these experiments demonstrate that after high-dose cocaine SA, there is cross-tolerance of the DAT to other uptake blockers, but not releasers. The reduced ability of psychostimulants to inhibit dopamine uptake following cocaine SA appears to be contingent upon their functional interaction with the DAT as a pure blocker or releaser rather than their structural similarity to cocaine. Further, methylphenidate's interaction with the DAT is unique and concentration-dependent.
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Affiliation(s)
- Mark J Ferris
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Erin S Calipari
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Yolanda Mateo
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - James R Melchior
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - David CS Roberts
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Sara R Jones
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Hess ARB, Almeida RMMD, Moraes AL. Comorbidades psiquiátricas em dependentes químicos em abstinência em ambiente protegido. ESTUDOS DE PSICOLOGIA (NATAL) 2012. [DOI: 10.1590/s1413-294x2012000100021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
O objetivo desta pesquisa foi verificar a frequência de comorbidades psiquiátricas, utilizando Mini International Neuropsychiatric Interview, em diferentes grupos de dependentes químicos em abstinência, em ambiente protegido, classificados de acordo com o tipo de droga utilizada: (1) grupo controle (n = 37); (2) dependentes em abstinência de álcool (n = 8); (3) dependentes em abstinência de álcool, maconha e crack/cocaína (n = 24); e (4) dependentes em abstinência de múltiplas substâncias psicoativas (n=25), ou seja, indivíduos que faziam uso de vários tipos de drogas sem apresentar uma droga de escolha. Participaram 94 homens, com idade média de 30,41 anos (DP = 9,88). O período de abstinência variou entre 30 e 240 dias. A maioria dos participantes tinha baixa escolaridade e era solteira. Os resultados apontaram maior ocorrência de psicopatologias e risco de suicídio nos grupos formados por pacientes com histórico de consumo múltiplo de substâncias, sugerindo a importância da avaliação de outros transtornos associados à dependência química.
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Rush CR, Stoops WW. Agonist replacement therapy for cocaine dependence: a translational review. Future Med Chem 2012; 4:245-65. [PMID: 22300101 PMCID: PMC3292908 DOI: 10.4155/fmc.11.184] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Cocaine use disorders are prevalent throughout the world. Agonist replacement therapy is among the most effective strategies for managing substance use disorders including nicotine and opioid dependence. This paper reviews the translational literature, including preclinical experiments, human laboratory studies and clinical trials, to determine whether agonist-replacement therapy is a viable strategy for managing cocaine dependence. Discussion is limited to transporter blockers (i.e., methylphenidate) and releasers (i.e., amphetamine analogs) that are available for use in humans in the hope of impacting clinical research and practice more quickly. The translational review suggests that agonist-replacement therapy, especially monoamine releasers, may be effective for managing cocaine dependence. Future directions for medications development are also discussed because the viability of agonist-replacement therapy for cocaine dependence may hinge on identifying novel compounds or formulations that have less abuse and diversion potential.
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Affiliation(s)
- Craig R Rush
- Department of Behavioral Science, University of Kentucky, College of Medicine, Medical Behavioral Science Building, Lexington, KY 40536-0086, USA.
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Rejdak K, Luszczki JJ, Błaszczyk B, Chwedorowicz R, Czuczwar SJ. Clinical utility of adjunctive retigabine in partial onset seizures in adults. Ther Clin Risk Manag 2012; 8:7-14. [PMID: 22298949 PMCID: PMC3269346 DOI: 10.2147/tcrm.s22605] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
In ~30% of epileptic patients, full seizure control is not possible, which is why the search for novel antiepileptic drugs continues. Retigabine exhibits a mechanism of action that is not shared by the available antiepileptic drugs. This antiepileptic enhances potassium currents via Kv7.2–7.3 channels, which very likely results from destabilization of a closed conformation or stabilization of the open conformation of the channels. Generally, the pharmacokinetics of retigabine are linear and the drug undergoes glucuronidation and acetylation. Results from clinical trials indicate that, in the form of an add-on therapy, retigabine proves an effective drug in refractory epileptic patients. The major adverse effects of the add-on treatment are dizziness, somnolence, and fatigue. This epileptic drug is also considered for other conditions – neuropathic pain, affective disorders, stroke, or even Alzheimer’s disease.
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Affiliation(s)
- Konrad Rejdak
- Department of Neurology, Medical University of Lublin, Lublin
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Bauzo RM, Kimmel HL, Howell LL. The cystine-glutamate transporter enhancer N-acetyl-L-cysteine attenuates cocaine-induced changes in striatal dopamine but not self-administration in squirrel monkeys. Pharmacol Biochem Behav 2011; 101:288-96. [PMID: 22244740 DOI: 10.1016/j.pbb.2011.12.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 12/21/2011] [Accepted: 12/23/2011] [Indexed: 10/14/2022]
Abstract
Extrasynaptic glutamate has been shown to regulate dopamine function in the mesocorticolimbic pathway, which plays an important role in the behavioral pharmacology of psychostimulants. Basal levels of glutamate are primarily regulated by the cystine-glutamate transporter and provide glutamatergic tone on extrasynaptic glutamate receptors. The present study examined the effects of a cystine-glutamate transporter enhancer on the neurochemical and behavioral effects of cocaine and amphetamine in nonhuman primates. It was hypothesized that augmenting extrasynaptic glutamate release with N-acetyl-L-cysteine (NAC), a cystine prodrug, would attenuate cocaine- or amphetamine-induced increases in extracellular dopamine and their corresponding behavioral-stimulant and reinforcing effects. In vivo microdialysis was used to evaluate cocaine-induced changes in extracellular dopamine (DA) in the caudate nucleus (n=3). NAC significantly attenuated cocaine-induced increases in dopamine but had inconsistent effects on amphetamine-induced increases in dopamine (n=4). Separate groups of subjects were either trained on a fixed-interval schedule of stimulus termination (n=6) or on a second-order schedule of self-administration (n=5) to characterize the behavioral-stimulant and reinforcing effects of psychostimulants, respectively. Systemic administration of NAC did not alter the behavioral-stimulant effects of either cocaine or amphetamine. Furthermore, cocaine self-administration and reinstatement of previously extinguished cocaine self-administration were not altered by pretreatment with NAC. Hence, drug interactions on caudate neurochemistry in vivo were not reflected in behavioral measures in squirrel monkeys. The present results in nonhuman primates do not support the use of NAC as a pharmacotherapy for cocaine abuse, although rodent and clinical studies suggest otherwise.
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Affiliation(s)
- Rayna M Bauzo
- Division of Neuropharmacology and Neurologic Diseases, Yerkes National Primate Research Center, Emory University, 954 Gatewood Rd., NE, Atlanta, GA 30329-4208, USA.
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Neural Changes Developed during the Extinction of Cocaine Self-Administration Behavior. Pharmaceuticals (Basel) 2011; 4:1315-27. [PMID: 26791639 PMCID: PMC4060127 DOI: 10.3390/ph4101315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Accepted: 09/20/2011] [Indexed: 02/06/2023] Open
Abstract
The high rate of recidivism in cocaine addiction after prolonged periods of abstinence poses a significant problem for the effective treatment of this condition. Moreover, the neurobiological basis of this relapse phenomenon remains poorly understood. In this review, we will discuss the evidence currently available regarding the neurobiological changes during the extinction of cocaine self-administration. Specifically, we will focus on alterations in the dopaminergic, opioidergic, glutamatergic, cholinergic, serotoninergic and CRF systems described in self-administration experiments and extinction studies after chronic cocaine administration. We will also discuss the differences related to contingent versus non-contingent cocaine administration, which highlights the importance of environmental cues on drug effects and extinction. The findings discussed in this review may aid the development of more effective therapeutic approaches to treat cocaine relapse.
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