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O'Sullivan S, McEnery C, Cagliarini D, Hinton JDX, Valentine L, Nicholas J, Chen NA, Castagnini E, Lester J, Kanellopoulos E, D'Alfonso S, Gleeson JF, Alvarez-Jimenez M. A Novel Blended Transdiagnostic Intervention (eOrygen) for Youth Psychosis and Borderline Personality Disorder: Uncontrolled Single-Group Pilot Study. JMIR Ment Health 2024; 11:e49217. [PMID: 38557432 PMCID: PMC11019426 DOI: 10.2196/49217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 12/05/2023] [Accepted: 01/12/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Integrating innovative digital mental health interventions within specialist services is a promising strategy to address the shortcomings of both face-to-face and web-based mental health services. However, despite young people's preferences and calls for integration of these services, current mental health services rarely offer blended models of care. OBJECTIVE This pilot study tested an integrated digital and face-to-face transdiagnostic intervention (eOrygen) as a blended model of care for youth psychosis and borderline personality disorder. The primary aim was to evaluate the feasibility, acceptability, and safety of eOrygen. The secondary aim was to assess pre-post changes in key clinical and psychosocial outcomes. An exploratory aim was to explore the barriers and facilitators identified by young people and clinicians in implementing a blended model of care into practice. METHODS A total of 33 young people (aged 15-25 years) and 18 clinicians were recruited over 4 months from two youth mental health services in Melbourne, Victoria, Australia: (1) the Early Psychosis Prevention and Intervention Centre, an early intervention service for first-episode psychosis; and (2) the Helping Young People Early Clinic, an early intervention service for borderline personality disorder. The feasibility, acceptability, and safety of eOrygen were evaluated via an uncontrolled single-group study. Repeated measures 2-tailed t tests assessed changes in clinical and psychosocial outcomes between before and after the intervention (3 months). Eight semistructured qualitative interviews were conducted with the young people, and 3 focus groups, attended by 15 (83%) of the 18 clinicians, were conducted after the intervention. RESULTS eOrygen was found to be feasible, acceptable, and safe. Feasibility was established owing to a low refusal rate of 25% (15/59) and by exceeding our goal of young people recruited to the study per clinician. Acceptability was established because 93% (22/24) of the young people reported that they would recommend eOrygen to others, and safety was established because no adverse events or unlawful entries were recorded and there were no worsening of clinical and social outcome measures. Interviews with the young people identified facilitators to engagement such as peer support and personalized therapy content, as well as barriers such as low motivation, social anxiety, and privacy concerns. The clinician focus groups identified evidence-based content as an implementation facilitator, whereas a lack of familiarity with the platform was identified as a barrier owing to clinicians' competing priorities, such as concerns related to risk and handling acute presentations, as well as the challenge of being understaffed. CONCLUSIONS eOrygen as a blended transdiagnostic intervention has the potential to increase therapeutic continuity, engagement, alliance, and intensity. Future research will need to establish the effectiveness of blended models of care for young people with complex mental health conditions and determine how to optimize the implementation of such models into specialized services.
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Chen NA, Mok K, McGillivray LJ, Konings P, Passioura J, Torok MH. Hotel Suicides in Australia 2006-2017. CRISIS 2023; 44:380-388. [PMID: 36537104 DOI: 10.1027/0227-5910/a000888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
Background: This study investigated the frequency, characteristics, and geospatial clustering of hotel suicides in Australia to inform suicide prevention efforts. Aims: (1) To determine the proportion of suicide deaths that occurred in hotels, (2) to determine differences in demographic characteristics of hotel deaths compared to other locations, (3) to assess level of planning, and (4) to determine whether these deaths form geographic clusters amenable to targeted suicide prevention activities. Methods: Archival data on suicide mortality were used to examine associations between incident location (hotels, home, away from home), demographic characteristics, and suicide means. Kernel density visualization was used to assess geospatial clustering of hotel suicides, and the degree of planning involved was assessed using the modified Suicide Intent Scale. Results: Hotels accounted for 2% of all suicide deaths and 6.2% of suicides occurring away from home. Females were over-represented (p < .0001), as were deaths by drug overdoses (p < .0001) and falls (p < .0001). Approximately 40% of incidents occurred within seven geospatial clusters. 85% of those who died were state residents, with a median distance from home of 13.0 km. Most individuals checked in to the hotel alone, for short stays, and displayed a high degree of suicidal planning. Limitations: Coronial records had limited information on narrative circumstances of deaths; other indicators of risk may not have been identified. A comparison against a general population of hotel guests, rather than all other suicide deaths would be more useful in terms of preventative activities, however these data were not readily available. Conclusion: This study identified characteristics, behaviors, and geographic locations associated with hotel suicides to inform training of hotel staff to recognize and respond to signs of risk. Males of working age who live locally and arrive alone for short stays could be considered at a higher risk of suicide, and prevention efforts should be prioritized in the identified high-risk areas.
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McGillivray L, Shand F, Calear AL, Batterham PJ, Chen NA, Rheinberger D, Rosebrock H, Torok M. Profiles of Passive and Active Suicidal Ideation and Attempts Among Secondary School Students in Australia: A Cross-Sectional Analysis. Arch Suicide Res 2022; 26:1880-1894. [PMID: 34223811 DOI: 10.1080/13811118.2021.1945983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Suicide is a leading cause of death among young people (aged 15-24 years), and as such, identifying targets for early intervention is essential to reducing this risk. Using baseline data from a school-based universal suicide prevention trial, we investigate factors associated with different types of suicidal ideation in secondary school students with implications for youth suicide preventive efforts. METHODS A self-report questionnaire was administered to students aged 13-16 years (Year 9) before program delivery in four regions across New South Wales, Australia (N = 556). Multinomial logistic regression was used to identify correlates of suicidal ideation type (passive vs. active). RESULTS Approximately half the total sample reported recent suicidal ideation (51.6% in the previous two weeks), which included almost one-third reporting active suicidal ideation (32.2% seriously considered suicide or made plans). Participants that were significantly more likely to report active suicidal ideation compared to passive suicidal ideation identified as female (OR = 1.91, 95% CI = 1.02-3.59), Indigenous (OR = 0.21, 95% CI = 0.05-0.80), as sexual minorities (OR = 0.36, 95% CI = 0.13-0.97), and had greater depression severity (OR = 1.11, 95% CI = 1.04-1.19). CONCLUSIONS Suicidal thoughts are prevalent among young people. Universal and indicated preventive interventions that address depression, as well as bullying and discrimination of minority groups would benefit all young people, particularly those more vulnerable to severe suicidal ideation and suicide attempts.HighlightsActive suicidal ideation (SI) was reported by 32.2% of our student sample aged 13-16 years.Active SI is linked to sex (female), Indigeneity status, sexual minority status, and greater depression severity.Improved bullying and discrimination policy within schools, and well-being programs targeting depression and promoting help-seeking, would benefit youth.
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Walker LC, Campbell EJ, Huckstep KL, Chen NA, Langmead CJ, Lawrence AJ. M 1 muscarinic receptor activation decreases alcohol consumption via a reduction in consummatory behavior. Pharmacol Res Perspect 2021; 10:e00907. [PMID: 34962108 PMCID: PMC8929368 DOI: 10.1002/prp2.907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 11/21/2021] [Indexed: 11/07/2022] Open
Abstract
Muscarinic acetylcholine receptors (mAChRs) have been shown to mediate alcohol consumption and seeking. Both M4 and M5 mAChRs have been highlighted as potential novel treatment targets for alcohol use disorders (AUD). Similarly, M1 mAChRs are expressed throughout reward circuitry, and their signaling has been implicated in cocaine consumption. However, whether the same effects are seen for alcohol consumption, or whether natural reward intake is inadvertently impacted is still unknown. To determine the role of M1 mAChRs in alcohol consumption, we tested operant self-administration of alcohol under both fixed ratio (FR3) and progressive ratio (PR3-4) schedules. Enhancing M1 mAChR signaling (via the M1 PAM-Agonist PF-06767832, 1 mg/kg, i.p.) reduced operant alcohol consumption on a fixed schedule but had no effect on motivation to acquire alcohol. To determine whether these actions were specific to alcohol, we examined the effects of M1 enhancement on natural reward (sucrose) self-administration. Systemic administration of PF-06767832 (1 mg/kg, i.p.) also reduced operant sucrose self-administration, suggesting the actions of the M1 receptor may be non-selective across drug and natural rewards. Finally, to understand whether this reduction extended to natural consummatory behaviors, we assessed home cage standard chow and water consumption. M1 enhancement via systemic PF-06767832 administration reduced food and water consumption. Together our results suggest the M1 PAM-agonist, PF-06767832, non-specifically reduces consummatory behaviors that are not associated with motivational strength for the reward. These data highlight the need to further characterize M1 agonists, PAMs, and PAM-agonists, which may have varying degrees of utility in the treatment of neuropsychiatric disorders including AUD.
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Huang Z, Pang X, Zhong T, Qu T, Jin C, Chen NA, He X, Xia D, Jin X, Wang Z, Xia X, Li B. 266 AK117, a CD47 blocking antibody with robust macrophage activation without red blood cell hemagglutination. J Immunother Cancer 2021. [DOI: 10.1136/jitc-2021-sitc2021.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BackgroundAK117 is a humanized monoclonal antibody targeting CD47 which widely expresses on innate immune cells, such as macrophages, and functions as a regulator of phagocytosis. CD47 serves as the ligand for a receptor on these innate immune cells, SIRPα, which in turn delivers an inhibitory signal for phagocytosis. Hematology toxicity is the major concern of an anti-CD47 antibody. As an agent targeting CD47 being investigated as an anti-tumor therapeutic, AK117 is engineered on a human IgG4 scaffold to minimize recruitment of Fc-dependent effector functions, as well as identified with favorable hematology safety profile and robust pro-phagocytosis activity.MethodsActivity of AK117 binding to CD47 to block the interaction between CD47 and SIRPα were determined by FACS, and binding of AK117 to human RBC was also evaluated. Raji cells, HT-29 cells, and HL-60 cells which highly express CD47 were used as target cells to evaluate a pro-phagocytic activity of AK117 as a monotherapy or in combination with anti-EGFR antibody, anti-CD20 antibody or azacitidine. In in-vivo pharmacology studies, anti-tumor activity of AK117 was investigated in SCID/beige mouse Raji tumor model. Effects of AK117 on hemagglutination of human RBC at was tested. Hemoglobin (HGB) and hematocrit (HCT) was evaluated after single dose of 10 mg/kg AK117 or Hu-5F9 in male and female cynomolgus monkeys (n=1/gender).ResultsAK117 could effectively binds to CD47, and competes with SIRPα for binding to the antigen on Raji cells (figure 1). AK117 alone or combines with anti-EGFR antibody, anti-CD20 antibody and azacitidine shows potent phagocytosis of tumor cells in a dose-dependent manner (figure 2). AK117 significantly inhibited tumor growth in these tumor models (figure 3). Favorable hematology safety profile of AK117 was observed. A significant weaker binding to human RBC of AK117 was identified (figure 4), and AK117 does not induce hemagglutination of human RBC up to a concentration of 1050 μg/mL, while Hu-5F9 triggers hemagglutination even at a low concentration of 1.44 μg/mL (figure 5). AK117 has minimal anemia effect in monkey studies compared to hu5F9-G4 after single dose in cynomolgus monkeys (figure 6). AK117 showed a rather superior safety profile to Hu5F9-G4 as a shorter duration of anemia.Abstract 266 Figure 1Binding and Competition activity of AK117 to CD47. (A) FACS binding curves of AK117 and Hu5F9-G4 to CD47 on raji cells. (B) FACS competitive binding curve of AK117 and Hu5F9-G4 with SIRPαECD-mFc to CD47 on raji cells.Abstract 266 Figure 2The pro-phagocytic activity against tumor cells. (A) The phagocytic index of raji cells by macrophages with AK117. (B) The phagocytic index of HL-60 cells by macrophages with AK117 and azacitidine. (C) The phagocytic index of HT-29 cells by macrophages with AK117 and cetuximab. (D) The phagocytic index of raji cells by macrophages with AK117 and rituximab.Abstract 266 Figure 3Anti-tumor activity in raji tumor mouse model. The (A) Tumor growth curves and (B) Body weight curves of different groups in SCID/Beige mice with subcutaneous raji tumor.Abstract 266 Figure 4Binding activity of AK117 to human RBCs. Binding Curves of Hu5F9-G4 and AK117 to CD47 on human RBCsAbstract 266 Figure 5Hemagglutination effect on human erythrocytes. Hemagglutination effect of AK117 on human erythrocytesAbstract 266 Figure 6HGB and HCT in cynomolgus monkeys. The curves of (A) hemoglobin and (B) Hematocrit at different times in cynomolgus monkeys.ConclusionsWith pre-clinical pharmacology activities comparable to Hu5F9-G4 as well as superior safety properties demonstrated in non-clinical pharmacodynamics studies, AK117 has emerged as a promising new treatment for solid tumor.
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McGillivray L, Shand F, Calear AL, Batterham PJ, Rheinberger D, Chen NA, Burnett A, Torok M. The Youth Aware of Mental Health program in Australian Secondary Schools: 3- and 6-month outcomes. Int J Ment Health Syst 2021; 15:79. [PMID: 34674726 PMCID: PMC8529373 DOI: 10.1186/s13033-021-00503-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 10/13/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The evidence base for suicide prevention programs in Australian schools is limited. The aim of this study was to examine the impact of a universal, mental health promotion and suicide prevention program-Youth Aware of Mental Health (YAM)-on suicidal ideation, mental health, and help-seeking in Australian secondary school students from baseline to post-intervention and 6-month follow up. METHODS Using a single-arm design, the YAM program was delivered to Year 9 students (13-16 years) in secondary schools located within four regions across New South Wales, Australia. A structured self-report questionnaire using validated scales was administered at each time point. Linear mixed-effects modelling was used to examine differences in suicidal ideation scores across time, while accounting for random effects of individual schools. RESULTS Suicidal ideation reduced significantly from baseline to post, and from baseline to follow-up (p < 0.001). Depression severity declined (p < 0.001) and help-seeking intentions increased (p < 0.001) at post-intervention and 6- months following the intervention period. No suicide deaths were reported for any study participants. CONCLUSION The current findings provide preliminary evidence that the YAM program is a promising preventive intervention for Australian schools, particularly for reducing suicidal ideation, depression and increasing help-seeking intentions in young people. The implementation of YAM in a large number of schools across New South Wales demonstrates the feasibility, and acceptability by schools, of implementing this program at scale. TRIAL REGISTRATION ANZCTR, ACTRN12619000338167. Registered 5 March 2019-Retrospectively registered, http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376989&isReview=true .
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Rosebrock HY, Batterham PJ, Chen NA, McGillivray L, Rheinberger D, Torok MH, Shand FL. Nonwillingness to Return to the Emergency Department and Nonattendance of Follow-Up Care Arrangements Following an Initial Suicide-Related Presentation. CRISIS 2021; 43:442-451. [PMID: 34547919 DOI: 10.1027/0227-5910/a000812] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Background: For people experiencing a suicidal crisis the emergency department (ED) is often the only option to find help. Aims: The aims of this study were (a) to identify predictors of patients' nonwillingness to return to the ED for help with a future suicidal crisis, and (b) whether nonwillingness to return was associated with follow-up appointment nonattendance. Method: This study utilized baseline data from the RESTORE online survey, and included 911 participants who had presented to an ED for suicidal crisis in the past 18 months, across participating local health districts in the Australian Capital Territory and New South Wales. Results: Patients who reported a more negative ED experience and longer triage wait times were less willing to return. Those who were less willing to return were also less likely to attend their follow-up appointment. Limitations: Due to the cross-sectional study design, causal inferences are not possible. Additionally, the self-report measures used are susceptible to recall bias. Conclusion: Patients' experience of service at EDs is a key indicator to drive improvement of patient outcomes for individuals experiencing a suicidal crisis.
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Walker LC, Huckstep KL, Chen NA, Hand LJ, Lindsley CW, Langmead CJ, Lawrence AJ. Muscarinic M 4 and M 5 receptors in the ventral subiculum differentially modulate alcohol seeking versus consumption in male alcohol-preferring rats. Br J Pharmacol 2021; 178:3730-3746. [PMID: 33942300 DOI: 10.1111/bph.15513] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/11/2021] [Accepted: 04/20/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND PURPOSE Muscarinic acetylcholine receptors mediate alcohol consumption and seeking in rats. While M4 and M5 receptors have recently been implicated to mediate these behaviours in the striatum, their role in other brain regions remain unknown. The ventral tegmental area (VTA) and ventral subiculum (vSub) both densely express M4 and M5 receptors and modulate alcohol-seeking, via their projections to the nucleus accumbens shell (AcbSh). EXPERIMENTAL APPROACH In Indiana alcohol-preferring (iP) male rats, we examined Chrm4 (M4 ) and Chrm5 (M5 ) expression in the VTA and vSub following long-term alcohol consumption and abstinence using RT-qPCR. Using a combination of retrograde tracing and RNAscope, we examined the localisation of Chrm4 and Chrm5 on vSub cells that project to the AcbSh. Using selective allosteric modulators, we examined the functional role of M4 and M5 receptors within the vSub in alcohol consumption, context-induced alcohol-seeking, locomotor activity, and food/water consumption. KEY RESULTS Long-term alcohol and abstinence dysregulated the expression of genes for muscarinic receptors in the vSub, not in the VTA. Chrm4 was down-regulated following long-term alcohol and abstinence, while Chrm5 was up-regulated following long-term alcohol consumption. Consistent with these data, a positive allosteric modulator (VU0467154) of intra-vSub M4 receptors reduced context-induced alcohol-seeking, but not motivation for alcohol self-administration, while M5 receptor negative allosteric modulator (ML375) reduced initial motivation for alcohol self-administration, but not context-induced alcohol-seeking. CONCLUSION AND IMPLICATIONS Collectively, our data highlight alcohol-induced cholinergic dysregulation in the vSub and distinct roles for M4 and M5 receptor allosteric modulators to reduce alcohol consumption or seeking.
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Burnett ACR, Chen NA, McGillivray L, Larsen ME, Torok M. Surveillance of suicide deaths involving gases in Australia using the National Coronial Information System, 2006 to 2017. Aust N Z J Public Health 2021; 45:242-247. [PMID: 33749955 DOI: 10.1111/1753-6405.13087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/01/2020] [Accepted: 01/01/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND There have been concerns about the increased use of helium and nitrogen gas as a suicide mechanism in Australia. METHODS National Coronial Information System data were used to investigate gas-specific suicides in Australia over the period 2006-2017. Characteristics were compared between helium or nitrogen, carbon monoxide and seven other gases. RESULTS Gas inhalation accounted for 10% (3,103/31,002) of all suicide deaths in Australia between 2006 and 2017. The mean age of individuals who died by suicide was 47.6 years (SD 16.9, R 14-97) and 83.3% were male. The number of gas suicides declined over the study period (IRR=0.96). The fall was associated with a 47% decline in carbon monoxide suicides (IRR=0.93). There was an increase in deaths due to argon (IRR=1.60) and nitrogen (IRR=1.27). Compared to individuals using other non-carbon monoxide gases, individuals who died by suicide from helium or nitrogen were significantly more likely to be older, have a physical illness and/or disability, have contacted a euthanasia group and have accessed instructional material and purchased gas online. CONCLUSIONS Suicides by carbon monoxide decreased between 2006 and 2017 alongside an increase in argon and nitrogen gas use - particularly among older adults. The ease of access to these gases points to new targets for means restriction. Implications for public health: Identifying the types of gases used in suicide deaths and emerging trends may enable targeted interventions that could potentially reduce access.
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Walker LC, Berizzi AE, Chen NA, Rueda P, Perreau VM, Huckstep K, Srisontiyakul J, Govitrapong P, Xiaojian J, Lindsley CW, Jones CK, Riddy DM, Christopoulos A, Langmead CJ, Lawrence AJ. Acetylcholine Muscarinic M 4 Receptors as a Therapeutic Target for Alcohol Use Disorder: Converging Evidence From Humans and Rodents. Biol Psychiatry 2020; 88:898-909. [PMID: 32331824 PMCID: PMC11390032 DOI: 10.1016/j.biopsych.2020.02.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/03/2020] [Accepted: 02/19/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Alcohol use disorder (AUD) is a major socioeconomic burden on society, and current pharmacotherapeutic treatment options are inadequate. Aberrant alcohol use and seeking alters frontostriatal function. METHODS We performed genome-wide RNA sequencing and subsequent quantitative polymerase chain reaction and receptor binding validation in the caudate-putamen of human AUD samples to identify potential therapeutic targets. We then back-translated our top candidate targets into a rodent model of long-term alcohol consumption to assess concordance of molecular adaptations in the rat striatum. Finally, we adopted rat behavioral models of alcohol intake and seeking to validate a potential therapeutic target. RESULTS We found that G protein-coupled receptors were the top canonical pathway differentially regulated in individuals with AUD. The M4 muscarinic acetylcholine receptor (mAChR) was downregulated at the gene and protein levels in the putamen, but not in the caudate, of AUD samples. We found concordant downregulation of the M4 mAChR, specifically on dopamine D1 receptor-expressing medium spiny neurons in the rat dorsolateral striatum. Systemic administration of the selective M4 mAChR positive allosteric modulator, VU0467154, reduced home cage and operant alcohol self-administration, motivation to obtain alcohol, and cue-induced reinstatement of alcohol seeking in rats. Local microinjections of VU0467154 in the rat dorsolateral striatum reduced alcohol self-administration and cue-induced reinstatement of alcohol seeking. CONCLUSIONS Collectively, these results identify the M4 mAChR as a potential therapeutic target for the treatment of AUD and the D1 receptor-positive medium spiny neurons in the dorsolateral striatum as a key site mediating the actions of M4 mAChR in relation to alcohol consumption and seeking.
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Zbukvic IC, Mok K, McGillivray L, Chen NA, Shand FL, Torok MH. Short report: Understanding the process of multilevel suicide prevention research trials. EVALUATION AND PROGRAM PLANNING 2020; 82:101850. [PMID: 32721594 DOI: 10.1016/j.evalprogplan.2020.101850] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 12/19/2019] [Accepted: 07/11/2020] [Indexed: 06/11/2023]
Abstract
This paper reviews process evaluations associated with multilevel suicide prevention research trials. Process evaluations can provide important information about how multilevel suicide prevention models are implemented, their mechanisms of impact, and the context and elements of implementation that mediate effectiveness. Out of 42 papers identified, only four met selection criteria for including a process evaluation. Of these four, there was large variation in the level of detail provided, and only two studies specifically focused on the process of implementing a multilevelsuicide prevention model. Future trials should include targeted process evaluation, which can benefit a range of knowledge users.
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Berizzi AE, Perry CJ, Shackleford DM, Lindsley CW, Jones CK, Chen NA, Sexton PM, Christopoulos A, Langmead CJ, Lawrence AJ. Muscarinic M 5 receptors modulate ethanol seeking in rats. Neuropsychopharmacology 2018; 43:1510-1517. [PMID: 29483658 PMCID: PMC5983544 DOI: 10.1038/s41386-017-0007-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 12/26/2017] [Accepted: 12/29/2017] [Indexed: 12/16/2022]
Abstract
Despite the cost to both individual and society, alcohol use disorders (AUDs) remain a major health risk within society, and both relapse and heavy drinking are still poorly controlled with current medications. Here we demonstrate for the first time that a centrally active and selective negative allosteric modulator for the rat M5 muscarinic acetylcholine receptor (mAChR), ML375, decreases ethanol self-administration and attenuates cue-induced reinstatement of ethanol seeking in ethanol-preferring (iP) rats. Importantly, ML375 did not affect sucrose self-administration or general locomotor activity indicative of a selective effect on ethanol seeking. Based on the expression profile of M5 mAChRs in the brain and the distinct roles different aspects of the dorsal striatum have on long-term and short-term ethanol use, we studied whether intra-striatal microinjection of ML375 modulated ethanol intake in rats. We show in iP rats with an extensive history of ethanol intake that intra-dorsolateral (DL), but not intra-dorsomedial, striatal injections of ML375 reduced ethanol self-administration to a similar extent as the nicotinic acetylcholine receptor ligand varenicline, which has preclinical and clinical efficacy in reducing the reinforcing effects of ethanol. These data implicate the DL striatum as a locus for the effects of cholinergic-acting drugs on ethanol seeking in rats with a history of long-term ethanol use. Accordingly, we demonstrate in rats that selectively targeting the M5 mAChR can modulate both voluntary ethanol intake and cue-induced ethanol seeking and thereby provide direct evidence that the M5 mAChR is a potential novel target for pharmacotherapies aimed at treating AUDs.
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Chen NA, Ganella DE, Bathgate RAD, Chen A, Lawrence AJ, Kim JH. Knockdown of corticotropin-releasing factor 1 receptors in the ventral tegmental area enhances conditioned fear. Eur Neuropsychopharmacol 2016; 26:1533-1540. [PMID: 27397862 DOI: 10.1016/j.euroneuro.2016.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 04/14/2016] [Accepted: 06/06/2016] [Indexed: 12/01/2022]
Abstract
The neuropeptide corticotropin-releasing factor (CRF) coordinates the physiological and behavioural responses to stress. CRF receptors are highly expressed in the ventral tegmental area (VTA), an important region for motivated behaviour. Therefore, we examined the role of CRF receptor type 1 (CRFR1) in the VTA in conditioned fear, using a viral-mediated RNA interference approach. Following stereotaxic injection of a lentivirus that contained either shCRF-R1 or a control sequence, mice received tone-footshock pairings. Intra-VTA shCRF-R1 did not affect tone-elicited freezing during conditioning. Once conditioned fear was acquired, however, shCRF-R1 mice consistently showed stronger freezing to the tone even after extinction and reinstatement. These results implicate a novel role of VTA CRF-R1 in conditioned fear, and suggest how stress may modulate aversive learning and memory.
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Wang L, Li X, Liu X, Lu K, Chen NA, Li P, Lv X, Wang X. Enhancing effects of indirubin on the arsenic disulfide-induced apoptosis of human diffuse large B-cell lymphoma cells. Oncol Lett 2015; 9:1940-1946. [PMID: 25789073 PMCID: PMC4356417 DOI: 10.3892/ol.2015.2941] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 01/16/2015] [Indexed: 01/01/2023] Open
Abstract
The aim of the present study was to investigate the indirubin-enhanced effects of arsenic disulfide (As2S2) on the proliferation and apoptosis of diffuse large B-cell lymphoma (DLBCL) cells in order to identify an optimum combination therapy. The human DLBCL cells, LY1 and LY8, were treated with different concentrations of indirubin for 24, 48 and 72 h. Next, the cells were treated with 10 μM As2S2 or a combination of 10 μM As2S2 and 20 μM indirubin for 48 h. Cell proliferation inhibition was detected using cell counting kit-8 and cell apoptosis was determined using flow cytometry. The expression levels of Bcl-2, Bcl-2-associated X protein (Bax) and caspase-3 were analyzed by quantitative polymerase chain reaction (qPCR) and western blotting. The DLBCL cell viability exhibited no significant changes at 24, 48 or 72 h with increasing indirubin concentration. In addition, the apoptotic rates of the LY1 and LY8 cells demonstrated no noticeable effects at 48 h with increasing indirubin concentration. Following treatment with the combination of indirubin and As2S2, the inhibitory and apoptotic rates of the cells were notably increased compared with those of the As2S2-treated group. The qPCR results revealed that indirubin alone had no enhancing effect upon the Bax/Bcl-2 mRNA expression ratio and caspase-3 mRNA expression. Western blot analysis revealed that indirubin alone had an enhancing effect upon the Bax/Bcl-2 protein ratio and procaspase-3 protein expression. In addition, the results demonstrated that the 21-KDa Bax protein was proteolytically cleaved into an 18-KDa Bax in the DLBCL cells treated with the combination of indirubin and As2S2. Indirubin alone did not inhibit proliferation or induce the apoptosis of the LY1 and LY8 cells. However, the combination of indirubin and As2S2 yielded enhancing effects. Therefore, the results of the present study demonstrated that with regard to antitumor activities, As2S2 served as the principal drug, whereas indirubin served as the adjuvant drug. The enhancing effect was due, in part, to the induction of the mitochondrial apoptotic pathway, which involves the cleavage of Bax.
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Korot'ko GF, Chen NA, Korochanskaia NV. [Salivation in healthy volunteers and patients with complicated duodenal ulcer depending on Helicobacter pylori contamination of the stomach mucous coat]. EKSPERIMENTAL'NAIA I KLINICHESKAIA GASTROENTEROLOGIIA = EXPERIMENTAL & CLINICAL GASTROENTEROLOGY 2006:20-3, 126. [PMID: 16866259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Such salivation parameters as saliva volume, total protein saliva concentration and amylolytic enzyme activity as well as their discharge levels were compared to the level of H. pylori contamination of the stomach mucous coat in clinically healthy people (30 people) and patients with complicated duodenum ulcer (142 patients) within various terms after the duodenoplasty eradication and within long-term periods after the selective proximal vagotomy (50 patients). The amylolytic enzyme activity and ptyalin discharge was higher in clinically healthy but HP-contaminated subjects than HP-negative people. A direct relationship that was expressed by the salivation volume and ptyalin discharge best of all with the level of the stomach mucous coat contamination in healthy volunteers and patients with duodenal ulcer was established.
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