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Ford MM, George BE, Van Laar VS, Holleran KM, Naidoo J, Hadaczek P, Vanderhooft LE, Peck EG, Dawes MH, Ohno K, Bringas J, McBride JL, Samaranch L, Forsayeth JR, Jones SR, Grant KA, Bankiewicz KS. GDNF gene therapy for alcohol use disorder in male non-human primates. Nat Med 2023; 29:2030-2040. [PMID: 37580533 PMCID: PMC10602124 DOI: 10.1038/s41591-023-02463-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 06/15/2023] [Indexed: 08/16/2023]
Abstract
Alcohol use disorder (AUD) exacts enormous personal, social and economic costs globally. Return to alcohol use in treatment-seeking patients with AUD is common, engendered by a cycle of repeated abstinence-relapse episodes even with use of currently available pharmacotherapies. Repeated ethanol use induces dopaminergic signaling neuroadaptations in ventral tegmental area (VTA) neurons of the mesolimbic reward pathway, and sustained dysfunction of reward circuitry is associated with return to drinking behavior. We tested this hypothesis by infusing adeno-associated virus serotype 2 vector encoding human glial-derived neurotrophic factor (AAV2-hGDNF), a growth factor that enhances dopaminergic neuron function, into the VTA of four male rhesus monkeys, with another four receiving vehicle, following induction of chronic alcohol drinking. GDNF expression ablated the return to alcohol drinking behavior over a 12-month period of repeated abstinence-alcohol reintroduction challenges. This behavioral change was accompanied by neurophysiological modulations to dopamine signaling in the nucleus accumbens that countered the hypodopaminergic signaling state associated with chronic alcohol use, indicative of a therapeutic modulation of limbic circuits countering the effects of alcohol. These preclinical findings suggest gene therapy targeting relapse prevention may be a potential therapeutic strategy for AUD.
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Affiliation(s)
- Matthew M Ford
- Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Portland, OR, USA
- Department of Psychology, Lewis & Clark College, Portland, OR, USA
| | - Brianna E George
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Victor S Van Laar
- Department of Neurological Surgery, The Ohio State University, Columbus, OH, USA
| | - Katherine M Holleran
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Jerusha Naidoo
- Department of Neurological Surgery, The Ohio State University, Columbus, OH, USA
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | - Piotr Hadaczek
- Department of Neurological Surgery, The Ohio State University, Columbus, OH, USA
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | - Lauren E Vanderhooft
- Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Portland, OR, USA
| | - Emily G Peck
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Monica H Dawes
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Kousaku Ohno
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | - John Bringas
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | - Jodi L McBride
- Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Portland, OR, USA
| | - Lluis Samaranch
- Department of Neurological Surgery, The Ohio State University, Columbus, OH, USA
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | - John R Forsayeth
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | - Sara R Jones
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Kathleen A Grant
- Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Portland, OR, USA.
| | - Krystof S Bankiewicz
- Department of Neurological Surgery, The Ohio State University, Columbus, OH, USA.
- Department of Neurological Surgery, University of California, San Francisco, CA, USA.
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Walker NB, Yan Y, Tapia MA, Tucker BR, Thomas LN, George BE, West AM, Marotta CB, Lester HA, Dougherty DA, Holleran KM, Jones SR, Drenan RM. β2 nAChR Activation on VTA DA Neurons Is Sufficient for Nicotine Reinforcement in Rats. eNeuro 2023; 10:ENEURO.0449-22.2023. [PMID: 37193602 PMCID: PMC10216253 DOI: 10.1523/eneuro.0449-22.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 05/01/2023] [Accepted: 05/08/2023] [Indexed: 05/18/2023] Open
Abstract
Mesolimbic nicotinic acetylcholine receptor (nAChRs) activation is necessary for nicotine reinforcement behavior, but it is unknown whether selective activation of nAChRs in the dopamine (DA) reward pathway is sufficient to support nicotine reinforcement. In this study, we tested the hypothesis that activation of β2-containing (β2*) nAChRs on VTA neurons is sufficient for intravenous nicotine self-administration (SA). We expressed β2 nAChR subunits with enhanced sensitivity to nicotine (referred to as β2Leu9'Ser) in the VTA of male Sprague Dawley (SD) rats, enabling very low concentrations of nicotine to selectively activate β2* nAChRs on transduced neurons. Rats expressing β2Leu9'Ser subunits acquired nicotine SA at 1.5 μg/kg/infusion, a dose too low to support acquisition in control rats. Saline substitution extinguished responding for 1.5 μg/kg/inf, verifying that this dose was reinforcing. β2Leu9'Ser nAChRs also supported acquisition at the typical training dose in rats (30 μg/kg/inf) and reducing the dose to 1.5 μg/kg/inf caused a significant increase in the rate of nicotine SA. Viral expression of β2Leu9'Ser subunits only in VTA DA neurons (via TH-Cre rats) also enabled acquisition of nicotine SA at 1.5 μg/kg/inf, and saline substitution significantly attenuated responding. Next, we examined electrically-evoked DA release in slices from β2Leu9'Ser rats with a history of nicotine SA. Single-pulse evoked DA release and DA uptake rate were reduced in β2Leu9'Ser NAc slices, but relative increases in DA following a train of stimuli were preserved. These results are the first to report that β2* nAChR activation on VTA neurons is sufficient for nicotine reinforcement in rats.
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Affiliation(s)
- Noah B Walker
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC 27157
| | - Yijin Yan
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC 27157
| | - Melissa A Tapia
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC 27157
| | - Brenton R Tucker
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC 27157
| | - Leanne N Thomas
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC 27157
| | - Brianna E George
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC 27157
| | - Alyssa M West
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC 27157
| | - Christopher B Marotta
- Division of Chemistry and Chemical Engineering, California Institute of Technology, Pasadena, CA 91106
| | - Henry A Lester
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91106
| | - Dennis A Dougherty
- Division of Chemistry and Chemical Engineering, California Institute of Technology, Pasadena, CA 91106
| | - Katherine M Holleran
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC 27157
| | - Sara R Jones
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC 27157
| | - Ryan M Drenan
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC 27157
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Say FM, Tryhus AM, Epperly PM, Nader SH, Solingapuram Sai KK, George BE, Kirse HA, Czoty PW. Effects of chronic cocaine and ethanol self‐administration on brain dopamine receptors in a rhesus monkey model of polysubstance abuse. Addict Biol 2022; 27:e13219. [PMID: 36001440 PMCID: PMC9413385 DOI: 10.1111/adb.13219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/20/2022] [Accepted: 07/19/2022] [Indexed: 11/30/2022]
Abstract
Most individuals with cocaine use disorder also use alcohol; however, little is known about the behavioural and pharmacological mechanisms that promote co‐abuse. For example, although studies in humans and animals have documented that chronic use of either alcohol or cocaine alone decreases D2‐like receptor (D2R) availability, effects of co‐abuse of these substances on dopamine receptor function have not been characterized. These studies examined the effects of long‐term cocaine self‐administration in 12 male rhesus monkeys who also consumed either ethanol or an ethanol‐free solution each day (n = 6 per group). Specifically, all monkeys self‐administered cocaine (0.1 mg/kg per injection) 5 days per week in the morning. In the afternoon, six monkeys consumed 2.0 g/kg ethanol over 1 h to model binge drinking and six monkeys drank an ethanol‐free solution. Assessment of D2R availability using positron emission tomography (PET) and [11C]raclopride occurred when monkeys were drug‐naïve and again when monkeys had self‐administered approximately 400‐mg/kg cocaine. D3R function was assessed at the same time points by determining the potency of the D3R‐preferring agonist quinpirole to elicit yawns. Chronic cocaine self‐administration decreased D2R availability in subregions of the basal ganglia in control monkeys, but not those that also drank ethanol. In contrast, D3R sensitivity increased significantly after chronic cocaine self‐administration in ethanol‐drinking monkeys but not controls. These results suggest that co‐use of ethanol substantially changes the effects of chronic cocaine self‐administration on dopamine receptors, specifically implicating D3R as a target for medications in these individuals.
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Affiliation(s)
- Felicity M. Say
- Department of Physiology & Pharmacology Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Aaron M. Tryhus
- Department of Physiology & Pharmacology Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Phillip M. Epperly
- Department of Physiology & Pharmacology Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Susan H. Nader
- Department of Physiology & Pharmacology Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Kiran K. Solingapuram Sai
- Department of Physiology & Pharmacology Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Brianna E. George
- Department of Physiology & Pharmacology Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Haley A. Kirse
- Department of Physiology & Pharmacology Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Paul W. Czoty
- Department of Physiology & Pharmacology Wake Forest School of Medicine Winston‐Salem North Carolina USA
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George BE, Barth SH, Kuiper LB, Holleran KM, Lacy RT, Raab-Graham KF, Jones SR. Enhanced heroin self-administration and distinct dopamine adaptations in female rats. Neuropsychopharmacology 2021; 46:1724-1733. [PMID: 34040157 PMCID: PMC8358024 DOI: 10.1038/s41386-021-01035-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 05/03/2021] [Accepted: 05/07/2021] [Indexed: 02/04/2023]
Abstract
Increasing evidence suggests that females are more vulnerable to the harmful effects of drugs of abuse, including opioids. Additionally, rates of heroin-related deaths substantially increased in females from 1999 to 2017 [1], underscoring the need to evaluate sex differences in heroin vulnerability. Moreover, the neurobiological substrates underlying sexually dimorphic responding to heroin are not fully defined. Thus, we evaluated male and female Long Evans rats on acquisition, dose-responsiveness, and seeking for heroin self-administration (SA) as well as using a long access model to assess escalation of intake at low and high doses of heroin, 0.025 and 0.1 mg/kg/inf, respectively. We paired this with ex vivo fast-scan cyclic voltammetry (FSCV) in the medial nucleus accumbens (NAc) shell and quantification of mu-opioid receptor (MOR) protein in the ventral tegmental area (VTA) and NAc. While males and females had similar heroin SA acquisition rates, females displayed increased responding and intake across doses, seeking for heroin, and escalation on long access. However, we found that males and females had similar expression levels of MORs in the VTA and NAc, regardless of heroin exposure. FSCV results revealed that heroin exposure did not change single-pulse elicited dopamine release, but caused an increase in dopamine transporter activity in both males and females compared to their naïve counterparts. Phasic-like stimulations elicited robust increases in dopamine release in heroin-exposed females compared to heroin-naïve females, with no differences seen in males. Together, our results suggest that differential adaptations of dopamine terminals may underlie the increased heroin SA behaviors seen in females.
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Affiliation(s)
- Brianna E. George
- grid.241167.70000 0001 2185 3318Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC USA
| | - Samuel H. Barth
- grid.241167.70000 0001 2185 3318Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC USA
| | - Lindsey B. Kuiper
- grid.241167.70000 0001 2185 3318Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC USA
| | - Katherine M. Holleran
- grid.241167.70000 0001 2185 3318Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC USA
| | - Ryan T. Lacy
- grid.256069.eDepartment of Psychology, Franklin and Marshall College, Lancaster, PA USA
| | - Kimberly F. Raab-Graham
- grid.241167.70000 0001 2185 3318Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC USA
| | - Sara R. Jones
- grid.241167.70000 0001 2185 3318Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC USA
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Layon AJ, George BE, Hamby B, Gallagher TJ. Do elderly patients overutilize healthcare resources and benefit less from them than younger patients? A study of patients who underwent craniotomy for treatment of neoplasm. Crit Care Med 1995; 23:829-34. [PMID: 7736739 DOI: 10.1097/00003246-199505000-00009] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Some physicians and academicians have suggested that limiting selected healthcare resources to the elderly will help curtail the rising cost of health care in the United States. In order to test this hypothesis in a specific medical context, we compared the cost of caring for younger (< 65 yrs) patients with that of caring for older (> or = 65 yrs) patients who underwent craniotomy for treatment of brain tumors. DESIGN Prospective collection and review of data on patients undergoing craniotomy for tumor in our institution between February 1989 and December 1991. SETTING University teaching hospital. METHODS Patients were divided into two groups: those < 65 yrs, and those > or = 65 yrs. Demographics, severity of illness, length of stay, hospital and surgical intensive care unit (ICU) costs and charges, ICU complications, procedures, and outcome variables were analyzed. RESULTS Of 3,265 ICU patients admitted during the study period, data on 123 (3.8%) undergoing craniotomy for brain tumor were analyzed. There were no differences between the patient groups in length of ICU stay or hospital stay, final outcome at discharge from the hospital, quality of life, or hospital or ICU costs, despite the fact that elderly patients had a greater number of procedures and complications per patient, and higher Acute Physiology and Chronic Health Evaluation II (APACHE II) severity of illness scores on admission and discharge than younger patients. CONCLUSIONS The assertion that the elderly may, under certain conditions, consume more healthcare resources and benefit less from them than younger patients must be tested for accuracy with regard to specific disease states. In the context of the disorder studied herein, the elderly do as well as the young. Without specific study of specific pathologic processes or surgical procedures, using age to limit access to resources remains an unsubstantiated, ideologic concept, rather than a scientifically proven cost-saving measure.
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Affiliation(s)
- A J Layon
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, USA
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