Targeting systemic inflammation in patients with obesity-related pain: How best to prevent acute pain from becoming chronic?

The best approach is to find the individual risk factors and known predictors and manage them early on.

Antidepressant-like effects of tramadol and other central analgesics with activity on monoamines reuptake, in helpless rats

Affective states are regulated mainly by serotonin and noradrenaline. However the opioid system has been also related to antidepressant-induced mood improvement, and the mu-opioid receptor has been involved in affective responses to a sustained painful stimulus. Similarly, antidepressant drugs induce an antinociceptive effect via both the monoaminergic and opioid systems, probably involving sensorial and affective dimensions of pain. The aim of this study was to test three opiate analgesics, which also inhibit monoamine reuptake, in the learned helplessness model of depression in rats. Helpless rats receiving (+/-)tramadol (10, 20 mg/Kg) or (-)methadone (2, 4 mg/Kg) showed a decreased number of failures to avoid or escape aversive stimulus (shock) in both the second and the third daily sessions, compared with controls. Rats receiving levorphanol (0.5, 1 mg/Kg) showed a decreased number of such failures in the third session. The number of crossings in the intertrial interval (ITI) was not significantly modified by (+/-)tramadol or (-)methadone. Levorphanol enhanced ITI crosses at 1 mg/Kg. These results, together with other clinical and experimental data, suggest that analgesics with monoaminergic properties improve mood and that this effect may account for their analgesic effect in regulating the affective dimension of pain. From this, it seems probable that the analgesic effect of opiates could be induced by adding together the attenuation produced of both the sensorial and the affective dimensions of pain.

Tiagabine: a novel antiepileptic drug

OBJECTIVE

To provide a comprehensive review of tiagabine, including its pharmacology, toxicology, pharmacokinetics, drug interactions, efficacy, adverse effects, and dosing recommendations.

DATA SOURCES

A computerized search of the MEDLINE database from 1966 to December 1997 was used to identify publications related to tiagabine and nipecotic acid derivatives. Included in this review was information gathered from scientific meetings. Manufacturer's information was used when there was no primary literature.

DATA SYNTHESIS

Tiagabine amplifies gamma-aminobutyric acid (GABA) neurotransmission, the predominant inhibitory neurotransmitter in the brain. Its mechanism of action is selective and has shown promise as an antiepileptic drug (AED) in patients with seizures refractory to other pharmaceutical products. Tiagabine exhibits dose-independent absorption, 90-95% bioavailability, high protein binding (96%), metabolism via hepatic cytochrome P450 enzymes (CYP3A subfamily), and displays first-order elimination pharmacokinetics. The mean plasma half-life is 5-8 hours. Concomitant medications that induce hepatic metabolism enhance tiagabine elimination; metabolism is reduced in patients with hepatic dysfunction. Adverse events of tiagabine typically involve the central nervous system, have been mild to moderate in intensity, and also have been transient in nature.

CONCLUSIONS

Tiagabine has demonstrated a good safety profile and, while it has not been demonstrated to be superior to other second-line AEDs for partial seizures, its safety and select mechanism of action warrant its further evaluation in the clinical setting. Tiagabine should be a good alternative add-on agent for patients with unsatisfactory seizure control or intolerable adverse effects of traditional therapies; thus, this agent should be made available to these patients.

Limited proteolysis and physiological regulation: an example from thyrotropin-releasing hormone metabolism

Proteases like trypsin, elastase, and many others play important regulatory functions by generating new biologically active molecules through limited proteolysis of larger proteins and peptides. The limited proteolysis of thyrotropin-releasing hormone (TRH) by Pyroglutamate aminopeptidase yields cyclo(His-Pro) or CHP, a new biopeptide associated with a variety of pharmacological activities, including regulation of body temperature, inhibition of prolactin secretion, and modulation of motor functions. Although the mechanism by which CHP elicits these biological activities is not well understood, it appears that the cyclic peptide may function at least in part by modulating central amine transport mechanisms.

The effects of RS-8359 on cardiovascular function in healthy subjects and depressed patients

The potential liability of RS-8359 for the 'cheese' effect that is characteristic of the classical monoamine oxidase inhibitors has been compared with placebo and moclobemide in the tyramine test. Both RS-8359 and moclobemide reduce the dose of tyramine required to raise systolic blood pressure by 30 mmHg by about half, but the risk of the tyramine interaction is not clinically significant at this level. This low risk is confirmed by the very low incidence of cardiovascular adverse events reported in early clinical studies and by the lack of any material changes in blood pressure. These results indicate that no dietary restrictions will be required when RS-8359 is used clinically.

Effects of gamma-aminobutyric acid (GABA) agonists and GABA uptake inhibitors on pharmacosensitive and pharmacoresistant epileptiform activity in vitro

1. Lowering of the extracellular Mg(2+)-concentration induces various patterns of epileptiform activity in combined rat entorhinal cortex-hippocampal brain slices. After a prolonged period of exposure to Mg(2+)-free medium seizure-like events in the entorhinal cortex change to a state of late recurrent discharges which cannot be blocked by clinically available antiepileptic drugs. This late epileptiform activity thus represents a useful model to test the effects of new anticonvulsant substances. 2. A mechanism possibly underlying the development of sustained seizure-like activity is the loss of synaptically released gamma-aminobutyric acid (GABA). Drugs which increase the amount of GABA available in presynaptic endings might thus be useful in the treatment of these therapeutically complicated forms of epilepsy. 3. Therefore, we studied the effects of various substances increasing GABA-mediated inhibition on early and late forms of epileptiform activity. GABA and the GABAA receptor agonist muscimol blocked both the pharmacosensitive discharges in the hippocampus and entorhinal cortex as well as the late recurrent discharges in the medial entorhinal cortex. The GABAB receptor agonist baclofen blocked the recurrent short discharges very potently, but did not consistently block seizure-like events and late recurrent discharges in the entorhinal cortex. 4. GABA uptake blockers showed a differential potency to block the various discharge patterns. Whereas nipecotic acid and beta-alanine suppressed all forms of epileptiform activity albeit at high concentrations (1-5 mM), tiagabine was much more potent in blocking the hippocampal recurrent short discharges and the seizure-like events in the medial entorhinal cortex, but could not block the late recurrent discharges. 5. Our data support the idea that prolonged neuronal overactivity might result in a loss of synaptically available GABA. Selective block of uptake into glia cells or substitution of the transmitter may therefore be an efficient strategy for the treatment of severe prolonged epileptic discharges whereas block of neuronal GABA uptake fails to counteract synchronized discharges in this situation.

The role of extraneuronal amine transport systems for the removal of extracellular catecholamines in the rabbit

As selective inhibitors of the extraneuronal monoamine uptake system (uptake2) suitable for in-vivo studies were not available, the question of whether uptake2 plays a definite role in vivo is largely unresolved. We attempted to resolve the question by using 1,1'-diisopropyl-2,4'-cyanine iodide (disprocynium24), a novel agent that blocks uptake2 in vitro with high potency. Anaesthetized rabbits were infused with 3H-labelled noradrenaline, adrenaline and dopamine, and catecholamine plasma clearances as well as rates of spillover of endogenous catecholamines into plasma were measured before and during treatment with either disprocynium24 or vehicle. Four groups of animals were studied: group I, no further treatment: group II, monoamine oxidase (MAO) and catechol-O-methyltransferase (COMT) inhibited; group III, neuronal uptake (uptake1) inhibited; group IV, uptake1 as well as MAO and COMT inhibited. Disprocynium24 (270 nmol kg-1 i.v. followed by an i.v. infusion of 80 nmol kg-1 min-1) did not alter heart rate and mean arterial blood pressure, but increased cardiac output by 22% and decreased the total peripheral vascular resistance by 16% with no difference between groups. When compared with vehicle controls, catecholamine clearances (normalized for the cardiac output of plasma) were decreased and spillover rates increased in response to disprocynium24. Although there were statistically significant between-group differences in baseline clearances (which decreased in the order: group I > group II > group III > group IV), the drug-induced clearance reductions relative to vehicle controls were similar in groups I to IV and amounted to 29-38% for noradrenaline, 22-31% for adrenaline and 16-22% for dopamine. Hence, there was still a significant % reduction in catecholamine clearances even after the combined inhibition of MAO and COMT, and there was no increase in the % reduction of clearances after inhibition of uptake1. Noradrenaline spillover increased in response to disprocynium24 in all four groups by 1.6- to 1.9-fold, whereas a 1.5- to 2.0-fold increase in adrenaline and dopamine spillover was observed in groups II and IV only. The results indicate that disprocynium24 interferes with the removal of circulating catecholamines not only by inhibiting uptake2, but also by inhibiting related organic cation transporters. As disprocynium24 increased the spillover of endogenous catecholamines into plasma even after inhibition of MAO and COMT, organic cation transporters may also be involved in the removal of endogenous catecholamines before they enter the circulation.

beta-Amyloid peptide-derived, oxygen-dependent free radicals inhibit glutamate uptake in cultured astrocytes: implications for Alzheimer's disease

beta-Amyloid (A beta), the central constituent of senile plaques in Alzheimer's disease (AD) brains, was shown by us recently to generate free radicals in an oxygen dependent mechanism. A beta-derived free radicals were detected directly using electron paramagnetic resonance (EPR) spin trapping techniques employing the spin trap phenyl-alpha-tert-butylnitrone (PBN). We have extended these studies to investigate the nature of the oxyradicals derived from A beta peptides, and we show that these free radicals are able to inhibit glutamate uptake in cultured astrocytes. An implication of inhibited astrocyte glutamate uptake in brain is increased extracellular levels of glutamate, which is excitotoxic to neurons. These results support the hypothesis that A beta neurotoxicity in AD may be due in part to A beta-derived, oxygen-dependent free radical inhibition of glutamate uptake.

Angiotensin III modulates noradrenaline uptake and release in the rat hypothalamus

1. Effects of angiotensin III (A III) on 3H-noradrenaline (3H-NA) total, neuronal and non-neuronal uptake, 3H intracellular distribution and release were studied in vitro in the rat hypothalamus. 2. A III (1 microM) decreased total, neuronal and non-neuronal 3H-NA uptake when hypothalamic slices were incubated with 3H-NA for 30 min. A III effects on neuronal and non-neuronal 3H-NA uptake were determined in the presence of 100 microM hydrocortisone or 10 microM cocaine hydrochloride, respectively. The effect of A III on total 3H-NA uptake was blocked by 10 microM Ile7 angiotensin III (Ile7 A III), an antagonist at A III receptors. In contrast, 100 nM A III had no effect on 3H-NA uptake. 3. The study of the 3H-NA uptake time course showed that 1 microM AIII decreased NA uptake at 1, 3, 7, 15 and 30 min incubation. 4. In hypothalamic slices preloaded with 3H-NA for 30 min, 1 microM AIII increased the 3H content in the granular pool and decreased it in the cytosolic pool. 5. Spontaneous 3H release was also modified by 1 microM A III when hypothalami were preloaded with 3H-NA for 30 min. A III increased the spontaneous output of 3H. This effect was receptor-mediated since the effect of A III on 3H release was antagonized by Ile7 A III. 6. The present results suggest that the effects of A III on NA neurotransmission, may be involved in the regulation of central angiotensin effects such as blood pressure control, hydrosaline balance and dipsogenesis, through modulation of central sympathetic activity.

Complementary and synergistic antinociceptive interaction between the enantiomers of tramadol

The explanation for the co-existence of opioid and nonopioid components of tramadol-induced antinociception appears to be related to the different, but complementary and interactive, pharmacologies of its enantiomers. The (+) enantiomer had Ki values of only 1.33, 62.4 and 54.0 microM at mu, delta and kappa receptors, respectively. The (-) enantiomer had even lower affinity at the mu and delta sites (Ki = 24.8, 213 and 53.5 microM, respectively. The (+) enantiomer was the most potent inhibitor of serotonin uptake (Ki = 0.53 microM) and the (-) enantiomer was the most potent inhibitor of norepinephrine uptake (Ki = 0.43 microM). Basal serotonin release was preferentially enhanced by the (+) enantiomer and stimulation-evoked norepinephrine release was preferentially enhanced by the (-) enantiomer. The (+) and (-) enantiomers each independently produced centrally mediated antinociception in the acetylcholine-induced abdominal constriction test (ED50 = 14.1 and 35.0 micrograms i.t., respectively). Racemic tramadol was significantly more potent (P < .05) than the theoretical additive effect of the enantiomers (antinociceptive synergy). Synergy was also demonstrated (P < .1) in the mouse 55 degrees C hot-plate test (i.p. route) and (P < .05) the rat Randall-Selitto yeast-induced inflammatory nociception model (i.v. and i.p. routes). Critically, the enantiomers interacted less than synergistically in two side-effects of inhibition of colonic propulsive motility and impairment of rotarod performance. The racemate and the (+) enantiomer were active in a chronic (arthritic) inflammatory pain model. Taken together, these findings provide a rational explanation for the coexistence of dual components to tramadol-induced antinociception and might form the basis for understanding its clinical profile.

Synthesis of [11C]tetrabenazine, a vesicular monoamine uptake inhibitor, for PET imaging studies

Tetrabenazine (TBZ), a high affinity and specific inhibitor of the vesicular monoamine transporter, has been labeled with carbon-11 as a potential probe for in vivo positron emission tomographic imaging of monoaminergic neuronal losses in neurodegenerative diseases. [11C]TBZ was synthesized by O-[11C]methylation of the 9-O-desmethylTBZ using [11C]methyl iodide in the presence of tetrabutylammonium hydroxide. The radiochemical yields were 35-55% (decay corrected) and the synthesis time 32-37 min from EOB. [11C]TBZ was obtained with specific activities of 2000-2500 Ci/mmol (EOS) and radiochemical and chemical purities were > 95%. [11C]Tetrabenazine is a promising new radioligand for the in vivo study of monoaminergic neurons using PET.

Localization of dopamine carriers by BTCP, a dopamine uptake inhibitor, on nigral cells cultured in vitro

BTCP, N-[1-(2-benzo(b)thiopenyl)cyclohexyl]piperidine, a derivative of phencyclidine, acted as a potent dopamine (DA) uptake blocking agent on primary cultures of dopaminergic neurons obtained from substantia nigra (IC50 = 70 nM). This value was closely related to IC50 determined for reference DA uptake inhibitors such as nomifensine (70 nM) or benztropine (50 nM), showing the specificity of BTCP towards the DA carrier. Thus, we used BTCP as a tool to visualize the DA uptake complexes on cultures, a model which preserves the integrity of the neurons. The [3H]BTCP binding sites directly visualized by radioautographical (RAG) labelling seemed to follow the fibres (axons or dendrites) of neurons in culture whereas the cell bodies were not labelled. The [3H]DA uptake visualized by RAG labelling, was inhibited either partially by BTCP at a concentration near its IC50 or totally by a high concentration of BTCP, all over the dopaminergic neurons (neurites and somas) immunostained with an anti-DA antiserum. Thus, the distribution of DA carriers can be investigated by a suitable tool, BTCP, a powerful and selective DA uptake blocker. These carriers have been visualized by radioautography with tritiated BTCP along the neurites, and the uptake can be totally blocked by a high concentration of BTCP all over DA neurons in vitro.

A role for the serotonin system in the mechanism of action of antidepressant treatments: preclinical evidence

The electrophysiologic assessment of the action of different types of antidepressant treatments on the serotonin (5-hydroxytryptamine [5-HT]) system revealed as a common effect an enhancement of 5-HT neurotransmission, albeit each treatment achieved this result via a different mechanism. Tricyclic antidepressant drugs and electroconvulsive shock treatment sensitize postsynaptic neurons to 5-HT. Monoamine oxidase inhibitors enhance the availability of releasable 5-HT. Serotonin reuptake blockers increase the efficacy of 5-HT neurons by desensitizing 5-HT autoreceptors located on 5-HT nerve terminals. Serotonin1A receptor agonists would enhance the tonic activation of postsynaptic 5-HT1A receptors. Such results suggest that this effect of antidepressant treatments on the 5-HT system might be intimately related to their therapeutic effect in major depression.

Effect of calcium channel blockers on serotonin uptake

We previously demonstrated that verapamil inhibits serotonin uptake by bovine pulmonary arterial endothelial cells by a mechanism not involving alterations in calcium fluxes. In this study, we determine whether verapamil inhibition of serotonin uptake occurs in other pulmonary cell types (bovine pulmonary artery smooth muscle cells), in cells from other organs and species (rat epididymal endothelial cells), and in intact organs (isolated rat lungs). We also compare the effects of verapamil with those of nifedipine and diltiazem. At concentrations of 10(-6) M or greater, verapamil is an inhibitor of serotonin uptake by cultured cells and isolated lungs. Nifedipine and diltiazem are weak inhibitors of serotonin uptake by cultured bovine cells only at suprapharmacologic doses and have no effect on serotonin uptake by isolated lungs. Surprisingly, nifedipine stimulates serotonin uptake by rat epididymal endothelial cells. We conclude that inhibition of serotonin uptake by verapamil is a generalized phenomenon, occurring in a variety of cell types, in intact organs, and in different species that does not occur consistently with other calcium channel blockers.

Serotonin receptor and reuptake sites: pharmacologic significance

The past decade has seen important advances in the clinical use of serotonergic agents. The authors summarize the current status of selective agents for 5-HT receptor subtypes and their utility in the treatment of human neuropsychiatric disorders. The putative novel anxiolytic effects of 5-HT1A partial agonists such as buspirone, the unique and potent antiemetic effects of 5-HT3 antagonists in cancer chemotherapy, and the antidepressant effects of selective 5-HT uptake blockers such as fluoxetine are excellent examples of the clinical relevance of selective 5-HT receptor agents. The increasing ability to modulate serotonergic neurotransmission via distinct serotonin (5-HT) receptor subtypes should greatly facilitate the analysis of the role of 5-HT in both normal and abnormal human brain function.

A comparative examination of a role for serotonin in obsessive compulsive disorder, panic disorder, and anxiety

Recent clinical and laboratory studies have suggested that changes in brain serotonin (5-HT) function may contribute to anxiety symptoms and anxiety-type behaviors. Among the anxiety disorders, perhaps the most compelling evidence implicating 5-HT exists for obsessive compulsive disorder (OCD). In controlled trials, patients with OCD were markedly more responsive to treatment with 5-HT-selective uptake inhibitors such as clomipramine, fluvoxamine, or fluoxetine than to norepinephrine-selective or nonselective uptake inhibitors or to other psychoactive drugs. Studies with 5-HT agonists and antagonists also support a role for 5-HT in OCD. In this review, pharmacologic studies involving 5-HT-selective therapeutic and anxiogenic agents and non-5-HT-selective anxiogenic agents in patients with OCD are compared and contrasted with similar studies in patients with anxiety and panic disorder.

Interaction of [3H]GBR 12935 and GBR 12909 with the dopamine uptake complex in nucleus accumbens

Although some behavioral effects of cocaine are hypothesized to be due to blockade of dopamine uptake in nucleus accumbens, it has been reported that in nucleus accumbens there are no specific cocaine binding sites and that cocaine is a weak inhibitor of dopamine uptake. [3H]GBR 12935 and an unlabelled analog, GBR 12909, are ligands that bind with great affinity and specificity to a site on dopamine uptake complex in striatum. We therefore investigated the interaction of these GBR compounds with the dopamine uptake complex in nucleus accumbens. We found specific high affinity [3H]GBR 12935 binding and a significant correlation between displacement of [3H]GBR 12935 binding by a series of compounds in striatum and nucleus accumbens. GBR 12909 inhibited dopamine uptake with equal potency in nucleus accumbens and striatum. Thus, there appear to be some aspects of the dopamine uptake complex in nucleus accumbens and striatum that are similar.

Synthesis of a selective serotonin uptake inhibitor: [11C]citalopram

Citalopram, a selective serotonin uptake inhibitor, was labeled with 11C for non-invasive in vivo studies of serotonin uptake sites in the human brain using positron emission tomography. The synthesis was completed in approximately 17 min using [11C]methyl iodide as the precursor. The synthesis, purification, characterization, and determination of specific activity are described.

Possible existence of a presynaptic positive feedback mechanism enhancing dopamine transmission in the anterior cingulate cortex of the rat

A series of microiontophoretic and VTA stimulation experiments, conducted in intact, GBR-12909-treated, alpha-methylparatyrosine-depleted or 6-hydroxydopamine-denervated rats, provide suggestive evidence for the existence of a presynaptic, positive feedback mechanism triggered by dopamine reuptake and favoring the release of this transmitter in the anterior cingulate cortex.

Norepinephrine overflow and re-uptake in perfused mesenteric arteries of Dahl salt-sensitive and salt-resistant rats

We compared the overflow of endogenous norepinephrine (NE) upon electrical stimulation, the associated pressor response and rate of initial neuronal uptake of 3H-I-NE in the perfused mesenteric arteries of Dahl salt-sensitive (DS) and salt-resistant (DR) rats on two dietary NaCl regimens (0.4 and 8.0% for 2 weeks) from 4 weeks of age. The tissues of two rats, a DS and a DR control, were simultaneously processed and subjected to the same electrical stimulation. The pressor response and overflow of endogenous NE during periarterial nerve stimulation (5, 10 Hz, 1 min) in the tissue of DS rats on a high-salt diet (HS) were significantly greater, while those of DS on a low-salt diet (LS) were moderately but significantly higher than those of DR rats on either a high (HR) or a low-salt diet (LR). The tissue content of NE in DS rats was significantly lower than DR groups. There was a significantly reduced 3H-I-NE uptake in the tissues of DS rats on both salt diet groups compared with DR rats. A submaximal dose of exogenous NE evoked a significantly greater pressor response amplitude in mesenteric tissues from DS rats on a high-salt diet than in any of the other three groups, suggesting that smooth muscle supersensitivity, either in the density of the NE receptor or in the excitation-contraction coupling system, had been induced in the vasculature of DS rats by feeding them on a high-salt diet for 2 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

The receptor binding profile of the new antihypertensive agent nebivolol and its stereoisomers compared with various beta-adrenergic blockers

Nebivolol [the (S,R,R,R)- + (R,S,S,S)-racemic mixture], the 10 stereoisomers, and known beta-adrenergic blockers were investigated in vitro for binding to beta 1- and beta 2-adrenergic receptor sites and various neurotransmitter, peptide, and ion channel binding sites and for inhibition of neurotransmitter uptake. Selective labeling of beta 1- and beta 2-adrenergic receptor sites in rabbit and rat lung, respectively, was obtained with [3H]CGP-12177 and [3H] dihydroalprenololin the presence of an appropriate concentration of the selective beta 2-adrenergic blocker ICI 118-551 or the selective beta 1-adrenergic blocker CGP 20712-A. Nebivolol revealed high affinity and selectivity for beta 1-adrenergic receptor sites in the rabbit lung membrane preparation (Ki value = 0.9 nM and beta 2/beta 1 ratio = 50). The drug dissociated slowly from these receptor sites. The activity resided in the (S,R,R,R)-enantiomer (R 67 138); the (R,S,S,S)-enantiomer (R 67 145) revealed 175 times lower beta 1-adrenergic binding affinity. Within the series of stereoisomers, nebivolol and R 67 138 showed the best combination of high affinity and selectivity. Among the reference compounds, only CGP 20712-A shared these properties. Nebivolol bound to S1A binding sites with a Ki value of 20 nM. The stereospecific requirements for interaction with these sites were different from those for the beta 1-adrenergic receptor site. S1A binding site affinity was also observed with the potent but nonselective beta-adrenergic blockers carvedilol, pindolol, and propranolol. In the various other investigated radioligand binding and neurotransmitter uptake assays, nebivolol and its stereoisomers showed activity only at micromolar concentrations or were inactive. Clinical studies have shown an interesting hemodynamic profile of nebivolol, offsetting the negative effects on left ventricular performance generally observed with classical beta-adrenergic blockers. Several hypotheses regarding the mechanism of action of nebivolol are summarized.

Inhibition of 5-hydroxytryptamine accumulation and deamination by substituted phenylalkylamines in hypothalamic synaptosomes from normal and reserpine-pretreated rats

1. In the present study the abilities of different compounds to inhibit MAO inside and outside the serotonergic neurons, to inhibit the accumulation of 5-HT and to release 5-HT were separated by using different in vitro techniques. With these methods a number of substituted phenylalkylamines, which are reversible inhibitors of monoamine oxidase (MAO) type A, were characterized. 2. The compounds were examined regarding their ability to inhibit the accumulation of 5-HT and to inhibit MAO in the same synaptosomal preparation of hypothalamus from normal and reserpine-pretreated rats. The difference in the uptake of 14C-5-HT (0.1 mumol/l) in the absence and presence of citalopram (0.25 mumol/l) was taken as a measure of the accumulation into the serotonergic synaptosomes. The deamination of 14C-5-HT (0.1 mumol/l) in the presence of citalopram (0.25 mumol/l) was considered as that brought about outside the serotonergic synaptosomes, whereas the difference between the deamination in the absence and presence of citalopram was taken as the MAO activity inside the serotonergic synaptosomes. 3. Most of the phenylalkylamines were slightly more potent as MAO inhibitors outside serotonergic synaptosomes than as inhibitors of 5-HT accumulation in normal rats. The most potent MAO inhibitors, both in absolute terms and in comparison with uptake inhibitory potency, were the 2,6-dichloro-(FLA 365) and the phenylpropylene-(FLA 417) derivatives. 4. A difference in potency on the accumulation in synaptosomes from normal and reserpine-pretreated rats was found for many of the phenylalkylamines with the exception of FLA 365, FLA 417 and the 2,5-dimethyl derivative RAN 113.(ABSTRACT TRUNCATED AT 250 WORDS)

In vivo evaluation of striatal dopamine reuptake sites using 11C-nomifensine and positron emission tomography

In vitro nomifensine demonstrates high affinity and specificity for dopamine reuptake sites in the brain. In the present study 11C-nomifensine was administered i.v. in trace amounts (10-50 micrograms) to ketamine anaesthetized Rhesus monkeys (6-10 kg b.w.) and the time-course of radioactivity within different brain regions was measured by positron emission tomography (PET). Six base-line experiments lasting for 60-80 min were performed. The procedure was repeated after pretreatment with nomifensine (2-6 mg/kg i.v.), another reuptake inhibitor, mazindol (0.3 mg/kg i.v.), desipramine (0.5 mg/kg i.v) or spiperone (0.3 mg/kg i.v.) before the administration of a second 11C-nomifensine dose. The highest radioactivity uptake was found in the dopamine innervated striatum and the lowest in a region containing the cerebellum, known to be almost devoid of dopaminergic neurons. The difference between striatal and cerebellar uptake of 11C-nomifensine derived radioactivity was markedly reduced after nomifensine and mazindol but not after desipramine and spiperone. These results indicate that in vivo the striatal uptake of 11C-nomifensine, as measured with PET, involves specific binding with the dopamine reuptake sites. In the first human applications of 11C-nomifensine and PET in a healthy volunteer, the regional uptake of radioactivity was similar to that in base-line experiments with Rhesus monkeys. In the healthy subject the striatal/cerebellar ratio was 1.6, 50 min after the injection of 11C-nomifensine. In a hemi-parkinsonian patient this ratio was 1.1 contralaterally and 1.3 ipsilaterally to the affected side. 11C-nomifensine and PET seems to be an auspicious method to measure the striatal dopaminergic nerve terminals of man in vivo.

Choline+: a substrate of the neuronal noradrenaline carrier in the rat vas deferens

The effects of choline+ (10-40 mmol/l) on 3H-noradrenaline uptake by, and 3H-noradrenaline efflux from, noradrenergic neurones were studied in vasa deferentia of reserpine-pretreated rats at an external Na+ concentration of 100 mmol/l. Monoamine oxidase and catechol-O-methyltransferase were inhibited. Choline+ (20 and 40 mmol/l) competitively inhibited the neuronal uptake of 3H-noradrenaline. From the choline+-induced changes in the apparent Km for 3H-noradrenaline transport, a Ki of 35 mmol/l was obtained. Choline+ (10, 20 and 40 mmol/l) accelerated the neuronal efflux of 3H-noradrenaline in a concentration-dependent manner. This acceleration of efflux was greatly reduced in the presence of 1 mumol/l desipramine, indicating that choline+ is capable of eliciting "accelerative exchange diffusion". Choline+ (40 mmol/l) and (-)noradrenaline (4.5 mumol/l) (i.e., concentrations about equivalent to the Ki and Km for choline+ and (-)noradrenaline, respectively) produced virtually identical increases in the neuronal efflux of 3H-noradrenaline. Choline+ (3-300 mmol/l) inhibited the specific binding of 3H-desipramine to plasma membranes derived from cultured rat phaeochromocytoma (PC-12) cells. The Ki for this interaction was 48 mmol/l. This results suggest that choline+ acts as alternative substrate of the neuronal noradrenaline transport system and should, therefore, not be used in transport studies with noradrenaline as substitute for Na+ in Na+-deficient media.

The effect of phenytoin on glutamate and GABA transport

Phenytoin was observed to inhibit competitively the sodium dependent high affinity synaptosomal transport of both glutamate (Glu) and gamma-aminobutyric acid (GABA) with Ki values of 66 +/- 10 and 185 +/- 65 microM, respectively. This contrasted with a previous report that the uptakes of Glu and GABA were enhanced by phenytoin. The degree of inhibition is dependent on the concentrations of the competing drug and substrate present. Taking the therapeutic levels of phenytoin and the overall brain Glu and GABA contents, the degrees of inhibition obtainable appear to be negligible. However, as most of the high levels of Glu and GABA in the brain are intracellular, Glu, and GABA concentrations in the microenvironment of the uptake sites may be sufficiently small so that the ability of phenytoin to inhibit Glu and GABA transport may contribute significantly to the anticonvulsant property of this drug.

Effects of a monoamine oxidase A inhibitor, FLA 668 (+) on the adrenergic mechanisms of the dog saphenous vein

FLA 668 (+) [(S)-(+)-4-amino-2, alpha-dimethylethylphenethylamine (+)-hydrogen bitartrate] selectively inhibited MAO type A in homogenates of dog saphenous vein, with a IC50 of 1 mumol/l for MAO A and greater than 1 mmol/l for MAO B. At concentrations of 1 mumol/l and higher, FLA 668(+) progressively decreased the formation of deaminated metabolites by saphenous vein strips incubated with 3H-noradrenaline, with a preferential action on DOPEG formation. Normetanephrine formation increased but this increase did not wholly compensate for the reduction in the formation of deaminated metabolites. FLA 668(+) caused increased reactivity of saphenous vein strips to noradrenaline and markedly reduced the accumulation of 3H-noradrenaline in the incubated tissue; both effects were still evident in the presence of clorgyline. After cocaine, FLA 668(+) caused no further increase in sensitivity. It is concluded that FLA 668(+) is, in the saphenous vein of the dog, a selective inhibitor of MAO type A and that it exerts a cocaine-like effect.