PC12 variants deficient in norepinephrine transporter mRNA have wild type activities of several other related transporters

Behavioral effects of alpha-alkylated amino acid analogs in the C57BL/6J mouse

Although a series of amino acid analogs have been shown to modulate brain function, information on the pharmacology of alpha-alkylated amino acids (AAAA) is limited. In particular there is no information on the effect of these amino acid analogs (AAA) on the elevated plus maze, the tail suspension test and the forced swim test. It was therefore the aim of the study to test a series of AAAA in these paradigms in order to explore behavioral activities of this compound class. 10 male mice per group aged between 10 and 14 weeks were used. Vehicle-treated controls were used in addition to intraperitoneal injections of 1, 10 and 100mg/kg body weight of each, alpha-amino-isobutyic acid (AIB), isovaline (IVA), alpha-propyl-alanine (APA), alpha-butyl-alanine (ABA), alpha-pentyl-alanine (APnA), alpha-ethylphenylglycine (AEPG) and alpha-methyl-valine (AMV). The elevated plus maze (EPM), the tail suspension test (TST) and forced swim test (FST) were used for behavioral testing. There were dose-dependent results: all compounds increased time and pathlength in the open arm of the EPM at least at one dose administered. In the TST and in the FST only the 100mg dose was showing an effect. The results show pharmacological activity modifying the EPM in low doses suggesting the use in treatment of behavioral traits and symptoms represented by or linked to the EPM including anxiety-related behavior including depression. Compounds acting at higher doses may be used to induce behavioral changes and thus serve as neurobiological-neuropharmacological tools.

Adrenal incidentaloma: a diagnostic challenge

The widespread application of abdominal imaging procedures has resulted in an increased frequency of clinically silent adrenal masses. Adrenal incidentaloma (AI) is a term applied to an accidentally discovered adrenal mass on imaging performed for the investigation of an unrelated complaint. Adrenal incidentalomas (AIs) are a cluster of different pathologies, the majority of which are benign and non-functioning adrenal adenomas. However, mild hormonal alterations as well as metabolic abnormalities may be present in patients with AIs. Thus, a multidisciplinary approach with biochemical and radiologic evaluation is needed to characterize these lesions and identify patients who are at high risk for hormonal or malignant evolution. Significant new information has helped resolve controversies regarding the most reliable approach to this clinical problem. The present review considers the prevalence, pathology and natural history of AIs. We also discuss the reliability of available screening methods and localization techniques and consider optimal management and follow-up strategies.

The many faces of pheochromocytoma

OBJECTIVE

To recognize and manage pheochromocytomas in unusual settings.

METHODS

Three case reports are presented with clinical, biochemical, imaging, and operative findings. The pitfalls in diagnosis of pheochromocytomas and management are addressed.

RESULTS

We begin with a 27-yr-old gravida 2, para 1 Caucasian woman with unexplained tachycardia and hypertension during a routine pre-natal visit at 30 weeks estimated gestational age. Urinary studies revealed elevated catecholamines. Magnetic resonance imaging localized a 6.6-cm right adrenal mass with features consistent with a pheochromocytoma. She was medically managed with phenoxybenzamine and propranolol until 35 weeks, after which she underwent a combined Cesarean section, and open right adrenalectomy. Another patient, a 36-yr-old African-American woman presented to a hospital in cardiac arrest, with elevated serum troponins, and underwent cardiac catheterization, which revealed normal coronary arteries. A computed tomography (CT) scan revealed a left adrenal mass and CT-guided biopsy was consistent with a pheochromocytoma, although prior studies were negative. Finally, we present a 49-yr-old Caucasian woman who had a right adrenalectomy 10 yr prior and presented to the clinic with fluctuating blood pressures, headaches, and palpitations. Further testing revealed she had a recurrent metastatic pheochromocytoma. The challenges behind treating these patients are further explored.

CONCLUSION

Antenatal diagnosis of pheochromocytoma, though challenging, is associated with lower maternal and fetal morbidity and mortality. The differential diagnosis for cardiac arrest in the presence of normal coronary arteries should include a pheochromocytoma. Finally, treatment with iodinated metaiodobenzylguanidine may be a therapeutic option for those patients with metastatic pheochromocytomas.

Norepinephrine transporter function and desipramine: residual drug effects versus short-term regulation

Previous research has shown that exposure of norepinephrine transporter (NET)-expressing cells to desipramine (DMI) downregulates the norepinephrine transporter, although changes in the several transporter parameters do not demonstrate the same time course. Exposures to desipramine for <1 day reduces only radioligand binding and uptake capacity while transporter-immunoreactivity is unaffected. Recent demonstration of persistent drug retention in cells following desipramine exposures raises the possibility that previous reported changes in the norepinephrine transporter may be partly accountable by residual drug. In this study, potential effects of residual desipramine on norepinephrine transporter binding and uptake were re-evaluated following exposures of PC12 cells to desipramine using different methods to remove residual drug. Using a method that minimizes residual drug, exposure of intact PC12 cells to desipramine for 4h had no effect on uptake capacity or [(3)H]nisoxetine binding to the norepinephrine transporter, while exposures for > or =16 h reduced uptake capacity. Desipramine-induced reductions in binding to the transporter required >24 h or greater periods of desipramine exposure. This study confirms that uptake capacity of the norepinephrine transporter is reduced earlier than changes in radioligand binding, but with a different time course than originally shown. Special pre-incubation procedures are required to abolish effects of residual transporter inhibitor when studying inhibitor-induced transporter regulation.

Biochemical diagnosis, localization and management of pheochromocytoma: focus on multiple endocrine neoplasia type 2 in relation to other hereditary syndromes and sporadic forms of the tumour

Approximately 50% of patients with multiple endocrine neoplasia (MEN) 2A or 2B develop pheochromocytoma. These tumours are almost exclusively benign and localized in the adrenal glands. About one-third are bilateral at initial diagnosis. Amongst patients with pheochromocytoma, those with MEN 2A have subtler symptoms compared to those with sporadic disease. Since pheochromocytomas in patients with MEN 2 often secrete catecholamines episodically (but metabolize them continuously to metanephrines), the first choice for biochemical diagnosis is the measurement of free metanephrines in plasma, with urinary fractionated metanephrines being the second choice. In patients with pheochromocytomas that produce exclusively normetanephrine, MEN 2 can be excluded. In patients with biochemically proven MEN 2-related pheochromocytoma, anatomical imaging of the adrenals (with either computerized tomography or magnetic resonance) should be obtained next. Functional imaging with specific ligands (e.g. scintigraphy with [(123)I]-metaiodobenzylguanidine or, if available, positron emission tomography with [(18)F]-fluorodopamine, [(18)F]-dihydroxyphenylalanine, [(11)C]-adrenaline or [(11)C]-hydroxyephedrine) may then be particularly useful in patients with distorted anatomy from previous surgery, in cases of equivocal biochemical data despite high clinical suspicion for a tumour, to rule out multifocal disease, or where there is suspicion of metastatic disease (e.g. tumours larger than 5 cm). Laparoscopic surgery is the treatment of choice and subtotal (cortical-sparing) adrenalectomy is the procedure of choice in bilateral pheochromocytomas.

Anatomical and Functional Imaging of Metastatic Pheochromocytoma

Although in the majority of patients with pheochromocytoma the tumor is localized in the adrenal, up to 26% of patients have malignant/metastatic disease. Metastatic disease should be ruled out before initial surgery is attempted. Anatomical imaging modalities (computed tomography or magnetic resonance imaging) should be done first over the adrenals, and if negative over the abdomen and if no tumor is found, then the chest and neck should be covered. Regardless of the anatomical imaging results functional imaging with [123-I]- or [131-I]-metaiodobenzylguanidine (MIBG) scintigraphy should be done to corroborate the diagnosis. Negative MIBG scans should be followed by positron emission tomography (PET) studies with specific ligands like [18-F]-dopamine. Persistently negative evaluations should be followed by PET studies with non-specific ligands such as [18-F]-deoxyglucose or somatostatin receptor scintigraphy.

Expression and regulation of the human dopamine transporter in a neuronal cell line

Human cocaine users exhibit increased striatal [3H]WIN35428 binding to the dopamine transporter (DAT). However, the nature of the changes induced in the DAT are complex and may not result from a simple increase in number of DAT molecules. To better understand the regulation of DAT inhibitor binding sites and their relationship to the overall process of dopamine uptake, a neuronal model system expressing the human DAT has been developed. Initial experiments were attempted with native dopaminergic neurons so as to allow examination of DAT interactions with vesicular release and storage mechanisms. Dissociated fetal rat mesencephalic neurons, of various ages and mixtures with target cells, were grown to confluence. However, [3H]WIN35428 binding was of low affinity at all levels of maturity. Following this, a simpler model was assessed, using DAT cDNA transfected into neuroblastoma-derived Neuro2A cells. Initially, no specific and little non-specific [3H]WIN35428 or [3H]paroxetine binding was found in non-transfected cells. After transfection with the human DAT inserted in the pcDNA vector, both DAT binding and dopamine uptake were significantly and stably present. Treatment with (-)cocaine, 10-6 M for 24 h, increased DAT binding and uptake, which did not occur in parallel COS-7 experiments. Other experiments with Neuro2A cells also found that dopamine uptake was down-regulated by treatment with a PKC activator. These results suggest that the transfected Neuro2A neurons should be useful for ongoing experiments examining the regulation of the DAT by assorted treatments.