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Keyword: addiction

Fluorescent labeling of KV7 channel expression in neurons

 

Researchers at the Medical University of South Carolina identified potassium channel genes as novel preclinical pharmacogenetic targets that show early promise for reducing heavy alcohol drinking.

 

 

 

 

 

 

Fluorescent labeling of  KV7 channel expression in neurons. Image courtesy of Dr. Patrick Mulholland.

A handful of FDA-approved drugs exist for treating individuals with alcohol use disorder but they have been largely ineffective at reducing the high rates of relapse. As such, there remains a critical need to identify and develop alternative pharmacological treatment options.

Researchers at the Medical University of South Carolina (MUSC), through collaborative efforts with the NIH-funded INIAstress Consortium, have identified novel potassium (K+) channel genes within addiction brain circuitry that are altered by alcohol dependence and correlate with drinking levels in a mouse model of alcohol drinking. Significant reduction of heavy alcohol drinking after administration of a KV7 channel–positive modulator validated Kcnq, one of the identified genes that encodes KV7 type K+ channels, as a potential pharmacogenetic target. These preclinical findings, published in the February 2017 special issue of Alcohol on mouse genetic models of alcohol-stress interactions, suggest that K+ channels could be promising therapeutic targets that may advance personalized medicine approaches for treating heavy drinking in alcoholics.

Alcohol is known to change how neurons fire, and K+ channels play a crucial role in modulating a neuron’s excitability by returning the cell membrane potential back to baseline after the neuron has fired an action potential. Although there is an old literature that links K+ channels and alcohol use disorder, the alcohol field has not actively pursued this line of research.

Recently, the MUSC research team lead by Patrick J. Mulholland, Ph.D., associate professor of Neuroscience and Psychiatry & Behavioral Sciences and senior author on the article, revisited this research area in a novel way. By applying new genomic database technologies, the team became the first to use an experimental genetic bioinformatics approach to determine the relationship between expression levels of brain K+ channel genes with alcohol consumption.

“We looked at all 79 K+ channel genes in an alcohol drinking model using genetically diverse strains of mice and were trying to find the genes that might be risk genes for drinking and the genes that are changed by alcohol dependence,” said Mulholland. “More critically, we wanted to determine how alcohol changed expression of K+ channel genes and how those changes predicted how the mice drank after they were rendered dependent. In other words, we wanted to know what the mechanisms are that facilitate enhanced drinking in alcohol dependence.”

In this preclinical study, INIAstress researchers exposed strains of mice with diverse genetic backgrounds and varied drinking behaviors (BXD recombinant inbred) to alcohol drinking bottles. Half of the mice remained on this protocol and represented non-dependent mice (i.e., mice that consumed alcohol but were not rendered dependent). Alcohol dependence was induced in the other half of mice using a chronic intermittent ethanol exposure model. After 10 weeks, microarray analyses were completed in the prefrontal cortex and nucleus accumbens. Mulholland and colleagues then performed a targeted analysis of K+ channel genes and alcohol drinking in BXD strains using the GeneNetwork software system.

In non-dependent mice, expression levels of several K+ channel genes significantly correlated with the amount of alcohol consumed. Along with identifying novel genes (e.g., Kcnd2), the findings validated genes that were previously implicated in alcohol use disorder.

In particular, low expression levels of Kcnq genes were significantly correlated with high drinking levels. As these correlations were seen prior to dependence, they may represent risk markers for heavy alcohol consumption.

In dependent mice, the expression levels of Kcnq5 were significantly dysregulated across BXD strains, and as the researchers expected, these gene adaptations correlated with the degree of escalated drinking during dependence.

Mulholland and his team were particularly excited by the findings implicating Kcnq genes and KV7 channels in non-dependent and dependent drinking behavior as these findings replicated their previous study in rats (published November 2016 in Addiction Biology). In this prior study, retigabine, an FDA-approved KV7 channel–positive modulator, significantly reduced alcohol consumption in high-drinking non-dependent rats. This study was the first to identify KV7 channels and Kcnq genes as a potential target to reduce heavy drinking.

To further validate Kcnq as a therapeutic target, the researchers induced chronic alcohol drinking in a strain of mice with high drinking behavior (C57BL/6J). After seven weeks, the mice were treated with retigabine. Consistent with the rat studies, retigabine significantly reduced alcohol consumption in high-drinking non-dependent mice. These findings were also consistent with clinical evidence in humans that mutations in KCNQ genes associate with early-onset alcohol dependence.

Together, these studies provide, both genetically and pharmacologically, strong evidence that KV7 channels and KCNQ genes are promising pharmacogenetic targets for treating alcohol use disorder.

“With all of the preclinical and clinical genetic evidence linking KV7 channels and heavy drinking, it would be great to have a precision medicine follow-up study examining the relationship of KCNQ single-nucleotide polymorphisms (i.e., mutations) with retigabine’s response at reducing heavy alcohol drinking and alcohol relapse,” said Mulholland.

Given that retigabine is an FDA-approved drug, its use in a clinical trial on alcohol use disorder is theoretically feasible. However, there is a roadblock to clinical trial development since retigabine’s manufacturer recently announced they will stop making the drug due to commercial reasons.

Fortunately, the path to translating these promising preclinical findings to humans does not end here.  

“There are better drugs that target KV7 channels that are available on the preclinical side,” said Jennifer A. Rinker, Ph.D., postdoctoral fellow in the Department of Neuroscience and first author on the Alcohol paper. “For example, retigabine hits most of the KV7 channel subtypes. There are selective drugs that target just two of the subunits instead of all of them. That’s where we are headed, to figure out which of the subunits are critical for the effects of retigabine to reduce drinking.”

Stock-Image-of-Brain

Researchers at the Medical University of South Carolina (MUSC) have used viruses to infect neurons with genes that allow them to switch on brain receptors involved in suppressing addiction relapse. Results of these preclinical studies were published in the September 28th, 2016 issue of the Journal of Neuroscience. The technology, called designer receptors exclusively activated by designer drugs, or DREADDs, is one of the most promising gene therapies for the future treatment of addiction in humans.

 The brains of people who use cocaine become hijacked by drug cues. Powerful memories are formed between these cues–such as the using environment and drug paraphernalia–and the dopamine flood that occurs from using the drug itself. In users trying to quit, these drug cues activate an intense desire to seek cocaine again.

 Resistance to relapse is partly mediated in the ventromedial prefrontal cortex–the brain region slightly above and behind our eyes, where previously learned associations are broken. This region of the brain stores extinction memory, which works to suppress the emotional response to drug cues, according to Jamie Peters, Ph.D., Research Assistant Professor in the MUSC Department of Neuroscience.

 “Extinction doesn’t overwrite the original memory,” explained Peters. “It just helps suppress the pathological component of the response.” 

 Peters and her colleague Peter W. Kalivas, Ph.D., Chair of the MUSC Department of Neuroscience, wanted to know if the response to drug cues associated with the dopamine rush of cocaine could be suppressed when the extinction memory region was activated. To test their hypothesis, they obtained viruses carrying the DREADD gene from Bryan L. Roth, M.D., Ph.D., in the Department of Pharmacology at the University of North Carolina Chapel Hill. The DREADD technology is openly accessible to researchers around the world through the National Institutes of Mental Health Psychoactive Drug Screening Program, where Roth serves as director.

 The viruses work by inserting the DREADD gene directly into the genome of cells, causing them to grow receptors on their surface that are normal except for a slight alteration. These receptors express a protein encoded by the DREADD gene that allows them to be activated by a single drug designed to bind that protein. In this case, the Peters lab infused a virus carrying a DREADD gene designed to change surface receptors on neurons. After the neurons were infected, they would fire in response to administration of the designer drug. Because the body’s other cells had not been infected with the DREADD gene, they would remain unaffected.

 “This new approach for treating drug addiction is exactly what is needed because it is targeted to a specific circuit in the brain regulating addiction,” said Kalivas. “This may allow the circuit to be selectively regulated with minimum side effects on other circuits and brain functions.”

 The researchers allowed rats to self-administer cocaine by pressing one of two levers, one active and one inactive. Once a rat pressed the active lever, cocaine was delivered along with a brief audio tone and a pulse of light that would serve as the drug cues. After a series of daily cocaine exposure sessions, the rats had learned to associate the simple drug cues with cocaine availability. Then they were removed from the drug. Next a surgical technician infused virus carrying the DREADD gene directly into the rats’ ventromedial prefrontal cortices. After two weeks of cocaine abstinence, the rats were placed back in front of the two levers in ten daily sessions, but this time the levers produced neither cues nor cocaine. The next day, rats were subjected to a relapse test where the cues were returned. Before testing, half of the rats were given designer drug and half were not. Next, rats underwent an additional relapse test where they were given a low dose of cocaine to trigger relapse.

 The experiments worked. Rats that were given the designer drug relapsed less in the presence of drug reminder cues. However, when exposed to cocaine again, rats relapsed regardless of whether they were given the designer drug. In other words, Peters’ hypothesis was correct: rats with activated extinction memories weren’t as susceptible to relapse triggered by cocaine-associated cues but were still vulnerable when exposed to cocaine again. This meant that extinction memory retrieval reduced relapse triggered by reminder cues.

 This study shows that it is possible to use this technology to target a small population of cells in the brain that is important for regulating addiction, thereby inhibiting the drive to relapse to addictive drug use. In the future, Peters hopes that safe and effective viruses of this kind can be infused into the brains of human addicts during neurosurgery. A person would simply take a pill to activate the extinction memory region of their brain, helping them to suppress the urge to seek out drug in the face of those reminder cues. Since extinction memory isn’t as powerful as the emotional response to a drug, this strategy could work when paired with effective psychological counseling approaches such as cognitive behavioral therapy.

Clinicians interested in using DREADDs in humans will have to remain patient, however. DREADDs have to be designed to match drugs that suppress only memories of drug cues while leaving other memories unaffected. And the crystal structure of newer human-appropriate designer drugs bound with the special receptors is being actively investigated in order to visualize exactly how they might work some day in patients with cocaine addiction.

 “Certainly within my lifetime I would expect to see these virus-mediated gene therapies start to be used in the brain, in a neurosurgical setting,” said Peters. “You can envision a person ultimately taking a pill to activate this very specific part of his or her brain.”

Image licensed from iStock.com.

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