Current Pharmaceutical Design - Volume 19, Issue 40, 2013

Decades of experimentation with a variety of pharmacological treatments have identified some effective therapies for heroin addiction but not for cocaine addiction. This may be due, at least in part, to our incomplete understanding of the factors involved in the differential vulnerability to these addictions, which are often considered mere variations of the same disorder. Indeed, the preference for one drug or another has been variously attributed to factors such as drug availability or price, to the addict’s lifestyle, or even to chance. Yet, there is evidence of substance-specific influences on drug taking. Data from twin registries, for example, suggest that a sizeable portion of the variability in the susceptibility to drug abuse is due to environmental factors that are unique to opiates or to psychostimulants. Very little is known about the nature of these environmental influences. We report here original data, based on retrospective reports in human addicts, indicating that the setting of drug taking exerts a differential influence on heroin versus cocaine use. We also review additional clinical and pre-clinical data pointing to fundamental differences in the way in which the environment interacts with cocaine relative to heroin and other addictive drugs. These findings - as well as other evidence, including the lack of pharmacological treatments effective for both cocaine and heroin addiction - support the notion that much is to be gained by taking into account the substance-specific aspects of drug addiction. At a therapeutic level, for example, it appears reasonable to propose that cognitive-behavioral approaches should be tailored in a substance-specific manner in order to allow the addict to anticipate, and cope with, the risks associated to the various environmental settings of drug use.

Psychostimulant addiction, most notably cocaine and amphetamine - type stimulants are an important public health problem worldwide. It appears that social factors may influence the initiation, maintenance and recovery from addictions. Several animal models have been developed to study addiction, highlighting drug self-administration (SA) and the conditioned place preference (CPP) paradigms. These models have been modified to accurately reflect the characteristics of drug addiction in its different stages. One factor that clearly plays a major role in addiction is stress, which is a risk factor not only for the initiation, maintenance and escalation of drug consumption, but also for relapse. In animal models, stress for itself can provoke reinstatement of self-administration or CPP. The relationship between stress and addiction is very tight. One example is the close anatomical relationship of some areas that share these two phenomena. It seems obvious to think that the main source of stress in humans is social interaction. The aim of the present review is to gather the current information regarding the role of social stress in the addiction to psychostimulant drugs in animal models. First, we briefly describe the mechanisms by which stress exerts its effects and the basic concepts of addiction. We will try to establish common pathways of stress and addiction, to address later social stress effects on different stages of addiction. Then, we will address pharmacological therapies and preventive factors that counteract the enhancing effects of social stress in addiction. Finally, we will analyze how negative environmental conditions may induce individuals to increased vulnerability to drugs, and how favorable environmental conditions may have protective and curative effects against addiction. In this sense, we also analyze the importance of social interactions and their ability to modulate the different stages of addiction. As a conclusion, and despite the scarcity of the research, social stress exposure increases the initiation of psychostimulant consumption and the vulnerability to relapse in animal models of addiction. Studies on the mechanisms underlying the effects of social stress and how it can be counteracted pharmacologically, are research areas that should be explored in the future. At the same time, translational research on the effects of environmental conditions and positive social interactions, which have been shown to have a critical role in addictions, should be encouraged.

Stimulant use disorders are an unrelenting public health concern worldwide. Agonist replacement therapy is among the most effective strategies for managing substance use disorders including nicotine and opioid dependence. The present paper reviewed clinical data from human laboratory self-administration studies and clinical trials to determine whether agonist replacement therapy is a viable strategy for managing cocaine and/or amphetamine use disorders. The extant literature suggests that agonist replacement therapy may be effective for managing stimulant use disorders, however, the clinical selection of an agonist replacement medication likely needs to be based on the pharmacological mechanism of the medication and the stimulant abused by patients. Specifically, dopamine releasers appear most effective for reducing cocaine use whereas dopamine reuptake inhibitors appear most effective for reducing amphetamine use.

This review analyzes the roles of lipid transmitters, especially those derived from the cleavage of membrane phospholipids, in cocaine-associated behaviors. These lipid signals are important modulators of information processing in the brain, affecting transmitter release, neural plasticity, synaptogenesis, neurogenesis, and cellular energetics. This broad range of actions makes them suitable targets for pharmaceutical development of cocaine addiction therapies because they participate in the main cellular processes underlying the neuroadaptations associated with chronic use of this psychostimulant. The main lipid transmitters reviewed here include a) acylethanolamides and acylglycerols acting on cannabinoid receptors, such as anandamide and 2-arachidonoylglycerol; b) acylethanolamides that do not act on cannabinoid receptors, such as oleoylethanolamide; c) eicosanoids derived from arachidonic acid, including prostaglandins; and d) lysophosphatidic acid, focusing on the role of its LPA-1 receptor. Direct experimental evidence for the significance of these lipids in cocaine-related behaviors is presented and discussed. Additionally, the roles for both their biosynthesis and degradation pathways, as well as the participation of their receptors, are examined. Overall, lipid transmitter signaling can offer new targets for the development of therapies for cocaine addiction.

Different neurotransmitter brain systems have been implicated in the rewarding effects of 3,4-methylenedioxymetamphetamine (MDMA), including dopamine or serotonin. Serotonin selective reuptake inhibitors (SSRI) are a commonly prescribed therapy for psychiatric disorders, and the SSRI fluoxetine is recommended for MDMA users due to its neuroprotective effect against MDMAinduced neurotoxicity. In the present work, we employed the conditioned place preference (CPP) paradigm to study how the inhibition of serotonin reuptake with fluoxetine affected the rewarding and reinstating effects of MDMA in adolescent male mice. Firstly, we evaluated the motivational effects of fluoxetine (1 and 10 mg/kg), administered alone or with a sub-threshold dose of MDMA (1.25 mg/kg). In a second experiment we evaluated the effects of a pretreatment with fluoxetine (1 and 10 mg/kg) on the subsequent acquisition of a CPP induced by MDMA (1.25 mg/kg). The effects of a priming dose of fluoxetine (1 and 10 mg/kg), MDMA (5 or 1.25 mg/kg) or both drugs together on the reinstatement of a previously extinguished CPP induced by MDMA (10 mg/kg) were studied in a third experiment. Fluoxetine did not induce motivational effects but did increase the rewarding effects of a sub-threshold dose of MDMA, and pretreatment with the high dose of fluoxetine had the same effect. Fluoxetine did not induce cross-reinstatement of the MDMA CPP, but the combination of an ineffective priming dose of MDMA and the highest dose of fluoxetine did induce reinstatement of CPP. Neurochemical experiments demonstrated alterations in monoamine levels of MDMA treated mice produced by fluoxetine. As a whole, these results show that the inhibition of serotonin reuptake potentiates the acquisition and reinstatement of MDMA-induced CPP and supports a role for serotonin in MDMA-induced reward.

Addictions are chronic relapsing brain diseases, with behavioral manifestations. Three main factors contribute to the development of an addiction: environment, including stress, the reinforcing effects of the drug, and genetics. In this review we will discuss the involvement of the dysregulation of the stress responsive hypothalamic-pituitary-adrenal (HPA) axis in the acquisition of, and persistence to drug addiction (Section B). Addictions to specific drugs such as cocaine/psychostimulants, alcohol, and mu-opioid receptor agonists (e.g., heroin) have some common direct or downstream effects, including modulation of dopaminergic systems. Through its action on the dopaminergic signaling pathways, cocaine affects the HPA axis, and brain nuclei responsible for movements, and rewarding effects. Several neurobiological systems have been implicated with cocaine addiction, including dopamine, serotonin and glutamate systems, opioid receptor and opioid neuropeptide gene systems, stress-responsive systems including CRF, vasopressin and orexin. The use of animal models (Sections C and D) has been essential for studying the individual vulnerabilities to the effects of drugs of abuse and the neural pathways and neurotransmitters affected by these drugs. Basic clinical research has revealed important relationship between cocaine use, HPA axis responsiveness, and gender (Section E). Finally, we will discuss gene polymorphisms that are associated with drug use (Section F). Results from animal models and basic clinical research have shown important interactions between the dopaminergic and the opioid systems. Hence, compounds modulating the opioid system may be beneficial in treating cocaine addiction.

The amphetamine derivative 3, 4 Methylenedioxymethanphetamine (MDMA) is a powerful central nervous system stimulant that displays numerous pharmacological effects, including neurotoxicity. MDMA, or ecstasy, acts by inducing the release of different neurotransmitters depending on the animal species and, in particular, it produces the release of serotonin and dopamine. MDMA induces rewarding and reinforcing effects in rodents, primates and humans, and is currently consumed as an illicit psychostimulant among young people. One of the most reported side effects is the hyperthermic effect and the neurotoxicity on central serotonergic and dopaminergic neurons, depending on the species of animal. It seems that MDMA may also produce neurotoxic effects in humans. To date, the most consistent findings associated to MDMA consumption in humans relate to cognitive deficits in heavy users. MDMA when consumed as an illicit psychostimulant is commonly co-used with other abusers, being frequently associated with cannabinoids. The interaction between MDMA and cannabis effects is complex. Cannabis derivatives act on endocannabinoid system. Thus, at cellular levels, cannabinoids acting through CB1 cannabinoid receptors display opposite effects to those induced by MDMA, and they have been reported to develop neuroprotective actions, including the blockage of MDMA induced neurotoxicity, in laboratory animals. However, cannabis use is a recognized risk factor in the presentation and development of neuropsychiatric disorders, and also contributes to the development of psychological problems and cognitive failures observed in MDMA users. This paper represents a brief overview of the pharmacological interaction between MDMA and cannabis derivatives acting in the endocannabinoid system. We have evaluated recent findings in the literature of the most representative pharmacological effects displayed by both types of drugs. We analyze both, the synergic and opposite effects produced by these two compounds and we have found a gap regarding the negative consequences of long-term human consumption of MDMA alone or in combination with cannabis.

Abuse of psychostimulants presents a significant health and social problem worldwide. Traditionally, the dopaminergic system has received much attention for its role in the development and manifestation of addictive behavior. The identification of the close interaction between the dopaminergic and glutamatergic pathway and by extension the nitric oxide (NO) signaling pathway (the nitrergic system) have provided a broader scope on the mechanisms underlying the development of addictive behavior following exposure to cocaine and methamphetamine. NO signaling is associated with the acquisition and maintenance of several behavioral phenotypes induced by cocaine and methamphetamine (METH), as well as in METH-induced dopaminergic depletion. Because it appears that NO signaling influences response to reward, memory formation, and free radical-induced neurotoxicity, pharmacotherapies targeting NO signaling pathway may prove beneficial in the treatment of psychostimulants abuse.

The role of the renin-angiotensin system (RAS) in the development of various malignancies has recently been extensively examined and, since it has been shown to significantly influence many aspect of cancer initiation and progression, the idea of RAS-targeted anticancer therapy has arisen. This article reviews the mechanisms underlying RAS-induced physiological and pathological responses related to cancer biology, including tumor growth, cell proliferation, apoptosis, angiogenesis, inflammation, and protein degradation, emphasizing the associated cellular transduction schemes activated by main RAS effectors. Also the dual nature of RAS-dependent effects, resulting from its complex physiology has been commented. Finally, based on the available data from clinical trials and experimental studies, the possibilities of the introduction of RAS-modulating drugs into standard clinical practice in oncology have been discussed with the focus on both, positive and negative effects associated with the administration of various classes of pharmaceuticals to cancer patients.

Cancer remains one of the major leading causes of death worldwide. Acquisition of multidrug resistance (MDR) remains a major impediment to successful chemotherapy. As the name implies, MDR is not limited only to one drug but often associated to structurally and functionally unrelated chemotherapeutics. Extensive research and investigations have identified several mechanisms underlying the development of MDR. This process of drug resistance is considered to be multifactorial including decreased drug accumulation, increased efflux, increased biotransformation, drug compartmentalization, modification of drug targets and defects in cellular pathways. In the first part of the review, these pharmacokinetic and pharmacodynamic mechanisms have been described in brief. Although the pathways can act independently, they are more often intertwined. Of the various mechanisms involved, up-regulation of efflux transporters and metabolizing enzymes constitute a major resistance phenotype. This review also provides a general biological overview of important efflux transporters and metabolizing enzymes involved in MDR. Further, synergistic action between efflux transporters and metabolizing enzymes leading to MDR could possibly arise due to two different factors; overlapping substrate specificity and coordinated regulation of their expression. The expression of efflux transporters and metabolizing enzymes is governed by nuclear receptors, mainly pregnane X receptor (PXR). The pharmacological role of PXR and advances in the development of PXR antagonists to overcome MDR are outlined.

Privileged structures can bind to multiple targets with high affinity, thus aiding the discovery of novel bioactive agents. Heterocycle- thioacetic acid derivatives, a group of molecules containing a heterocycle core linked with a thioacetic acid-derived fragment, represent an important type of “privileged scaffold” possessing a wide spectrum of biological properties. Numerous encouraging investigations demonstrated that this privileged structure should be extensively exploited.for the therapeutic benefits. In view of its predominance, and on the basis of our research interest involved in this scaffold, an updated and detailed account of the pharmacological properties of heterocycle-thioacetic acid derivatives is described in this article.

Glioma is still one of the most aggressive forms of brain tumors. Understanding of the biological and pathophysiological mechanisms of survival can help the researchers to develop new management modalities. Industrial toxins could be one of the most important causes for brain tumors, such as dioxin and other aryl hydrocarbon receptor (AhR) ligands. Toxicity of these compounds includes a series of cellular events starting from binding with AhR and ending with the increased expression of a group of xenobiotic metabolizing enzymes (XME) such as the cytochrome P450 (CYPs), CYP1A1, CYP1A2, and CYP1B1. Therefore, identification of the localizations and expressions of the AhR and its regulated CYPs in the central nervous system (CNS) and neuronal cells is of major importance in understanding their physiological and pathological roles. Generally, low but significant level of CYPs expression is demonstrated in the brain in a tissue- and species-specific manner. Moreover, most, but not all, AhR-regulated CYPs are expressed differently in most of the neuronal and glial cells. Although the exact mechanisms of AhR-mediated glioma and neurotoxicity are not fully understood, the present review proposes several mechanisms which include generating reactive oxygen species, activating glutamate receptors, peroxisome proliferator- activated receptors, histone acetylation, and signal transducer and activator of transcription 3.