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Sabbagh JJ, Cordova RA, Zheng D, Criado-Marrero M, Lemus A, Li P, Baker JD, Nordhues BA, Darling AL, Martinez-Licha C, Rutz DA, Patel S, Buchner J, Leahy JW, Koren J, Dickey CA, Blair LJ. Targeting the FKBP51/GR/Hsp90 Complex to Identify Functionally Relevant Treatments for Depression and PTSD. ACS Chem Biol 2018; 13:2288-2299. [PMID: 29893552 DOI: 10.1021/acschembio.8b00454] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Genetic and epigenetic alterations in FK506-binding protein 5 ( FKBP5) have been associated with increased risk for psychiatric disorders, including post-traumatic stress disorder (PTSD). Some of these common variants can increase the expression of FKBP5, the gene that encodes FKBP51. Excess FKBP51 promotes hypothalamic-pituitary-adrenal (HPA) axis dysregulation through altered glucocorticoid receptor (GR) signaling. Thus, we hypothesized that GR activity could be restored by perturbing FKBP51. Here, we screened 1280 pharmacologically active compounds and identified three compounds that rescued FKBP51-mediated suppression of GR activity without directly activating GR. One of the three compounds, benztropine mesylate, disrupted the association of FKBP51 with the GR/Hsp90 complex in vitro. Moreover, we show that removal of FKBP51 from this complex by benztropine restored GR localization in ex vivo brain slices and primary neurons from mice. In conclusion, we have identified a novel disruptor of the FKBP51/GR/Hsp90 complex. Targeting this complex may be a viable approach to developing treatments for disorders related to aberrant FKBP51 expression.
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Affiliation(s)
- Jonathan J. Sabbagh
- Department of Molecular Medicine, University of South Florida, Tampa, Florida, United States of America
- USF Health Byrd Institute, University of South Florida, Tampa, Florida, United States of America
| | - Ricardo A. Cordova
- Department of Molecular Medicine, University of South Florida, Tampa, Florida, United States of America
- USF Health Byrd Institute, University of South Florida, Tampa, Florida, United States of America
| | - Dali Zheng
- Department of Molecular Medicine, University of South Florida, Tampa, Florida, United States of America
- USF Health Byrd Institute, University of South Florida, Tampa, Florida, United States of America
| | - Marangelie Criado-Marrero
- Department of Molecular Medicine, University of South Florida, Tampa, Florida, United States of America
- USF Health Byrd Institute, University of South Florida, Tampa, Florida, United States of America
| | - Andrea Lemus
- Department of Chemistry, University of South Florida, Tampa, Florida, United States of America
| | - Pengfei Li
- Department of Molecular Medicine, University of South Florida, Tampa, Florida, United States of America
| | - Jeremy D. Baker
- Department of Molecular Medicine, University of South Florida, Tampa, Florida, United States of America
- USF Health Byrd Institute, University of South Florida, Tampa, Florida, United States of America
| | - Bryce A. Nordhues
- Department of Molecular Medicine, University of South Florida, Tampa, Florida, United States of America
- USF Health Byrd Institute, University of South Florida, Tampa, Florida, United States of America
| | - April L. Darling
- Department of Molecular Medicine, University of South Florida, Tampa, Florida, United States of America
- USF Health Byrd Institute, University of South Florida, Tampa, Florida, United States of America
| | - Carlos Martinez-Licha
- Department of Molecular Medicine, University of South Florida, Tampa, Florida, United States of America
- USF Health Byrd Institute, University of South Florida, Tampa, Florida, United States of America
| | - Daniel A. Rutz
- Department Chemie, Technische Universität München, 85748 Munich, Germany
| | - Shreya Patel
- Department of Chemistry, University of South Florida, Tampa, Florida, United States of America
| | - Johannes Buchner
- Department Chemie, Technische Universität München, 85748 Munich, Germany
| | - James W. Leahy
- Department of Molecular Medicine, University of South Florida, Tampa, Florida, United States of America
- Department of Chemistry, University of South Florida, Tampa, Florida, United States of America
- Center for Drug Discovery and Innovation, University of South Florida, Tampa, Florida, United States of America
| | - John Koren
- Department of Molecular Medicine, University of South Florida, Tampa, Florida, United States of America
- USF Health Byrd Institute, University of South Florida, Tampa, Florida, United States of America
| | - Chad A. Dickey
- Department of Molecular Medicine, University of South Florida, Tampa, Florida, United States of America
- USF Health Byrd Institute, University of South Florida, Tampa, Florida, United States of America
| | - Laura J. Blair
- Department of Molecular Medicine, University of South Florida, Tampa, Florida, United States of America
- USF Health Byrd Institute, University of South Florida, Tampa, Florida, United States of America
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Valsalan R, Varghese B, Soman D, Buckmaster J, Yew S, Cooper D. Multi-organ dysfunction due to bath salts: are we aware of this entity? Intern Med J 2017; 47:109-111. [PMID: 28076917 DOI: 10.1111/imj.13307] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 05/23/2016] [Accepted: 06/12/2016] [Indexed: 11/29/2022]
Abstract
Methylenedioxypyrovalerone (MDPV) is a synthetic, cathinone-derivative, central nervous system stimulant taken to produce a cocaine- or methamphetamine-like high. Physical manifestations include tachycardia, hypertension, arrhythmias, hyperthermia, sweating, rhabdomyolysis, hyperkalaemia, disseminated intravascular coagulation, oliguria and seizures. We report a patient who presented with severe metabolic acidosis, multi-organ dysfunction, rhabdomyolysis, hyperkalaemia and seizures. This case highlights that even though a urine drug screen for routine psychostimulant drugs is negative, clinicians need to be vigilant about the adverse effects of MDPV as a possible cause of multi-organ dysfunction. Substances such as this can only be detected by special tests, such as gas/liquid chromatography mass spectrometry. This is the first reported case of MDPV toxicity successfully treated in Australia to the best of our knowledge.
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Affiliation(s)
- Rohith Valsalan
- Department of Medicine, Angliss Hospital, Melbourne, Victoria, Australia
| | - Benoj Varghese
- Department of Critical Care Medicine, Royal Hobart Hospital, Hobart, Tasmania, Australia
| | - Diya Soman
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Jonathan Buckmaster
- Department of Critical Care Medicine, Royal Hobart Hospital, Hobart, Tasmania, Australia
| | - Steven Yew
- Department of Nephrology, Royal Hobart Hospital, Hobart, Tasmania, Australia
| | - David Cooper
- Department of Critical Care Medicine, Royal Hobart Hospital, Hobart, Tasmania, Australia
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Bath salts: a newly recognized cause of acute kidney injury. Case Rep Nephrol 2012; 2012:560854. [PMID: 24555135 PMCID: PMC3914251 DOI: 10.1155/2012/560854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2012] [Accepted: 10/03/2012] [Indexed: 11/17/2022] Open
Abstract
Bath salts are substance of abuse that are becoming more common and are difficult to recognize due to negative toxicology screening. Acute kidney injury due to bath salt use has not previously been described. We present the case of a previously healthy male who developed acute kidney injury and dialysis dependence after bath salt ingestion and insufflation. This was self-reported with negative toxicology screening. Clinical course was marked by severe hyperthermia, hyperkalemia, rhabdomyolysis, disseminated intravascular coagulation, oliguria, and sepsis. We discuss signs and symptoms, differential diagnoses, potential mechanisms of injury, management, and review of the literature related to bath salt toxicity.
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Isbister GK, Oakley P, Whyte I, Dawson A. Treatment of anticholinergic-induced ileus with neostigmine. Ann Emerg Med 2001; 38:689-93. [PMID: 11719751 DOI: 10.1067/mem.2001.119458] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A 33-year-old man with a history of recreational benztropine abuse presented to the emergency department with confusion, abdominal pain, and distention. An abdominal radiograph revealed gross fecal loading. He was initially treated with intravenous fluids and opiate analgesia. Subsequently, a diagnosis of anticholinergic poisoning was made, based on tachycardia, delirium, dry mucosa, and reduced bowel sounds. Treatment with tacrine reversed the delirium, and a history of repeated benztropine use was obtained. Persistent ileus was treated with repeated doses of neostigmine, and gastrointestinal motility returned with prompt defecation. Neostigmine appears to be useful in reversing ileus caused by anticholinergic drug overdose. Theoretically, it may be useful in reversing anticholinergic ileus resulting from acute drug overdose, allowing or enhancing decontamination, but the safety and potential efficacy of neostigmine in this scenario have not been established.
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Affiliation(s)
- G K Isbister
- Department of Clinical Toxicology and Pharmacology, Newcastle Mater Hospital, Newcastle, New South Wales, Australia.
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