The role of dopaminergic agonists in congestive heart failure.

Congestive Heart Failure is a clinical syndrome characterised by myocardial dysfunction and sympathetic activation. Plasma norepinephrine (NE) levels have been related to the poorest survival. Large-scale clinical trials have proved the clinical benefits of Angiotensin Converting Enzyme inhibitors in reducing the risk of death and hospitalisation. However, mortality remains high in the treated group underlining the need to explore new therapeutic approaches. Specific activation of peripheral dopamine receptors exerts profound hemodynamic effects and neurohormonal control such as peripheral and renal vasodilation, diuresis and natriuresis and inhibition of NE release. Z1046, a mixed D1/D2-like agonist, reduces peripheral and renal vascular resistance increasing renal blood flow. In anaesthetised dogs the compound strongly reduces plasma NE without increasing plasma renin activity and plasma aldosterone. The inhibition of NE could be the basis of Z1046 potent cardioprotective effect observed in a dog model of myocardial ischemia and reperfusion, in which the severity of ventricular arrhythmias was markedly reduced, resulting in higher survival. These findings suggest that chronic oral treatment with specific dopaminergic agonists is able to alleviate the hemodynamic burden on the myocardium, and to suppress the sympatho-adrenal activity.

Z1046: biochemical characterization of its dopaminergic activity.

Affinity of Z1046 for dopamine receptor subtypes, its ability to modulate D1- and D5-mediated AC stimulation and D1-induced cAMP accumulation were evaluated. On D1-like receptors Z1046 and fenoldopam (fen) showed a similar high affinity, being more potent than DP-5,6-ADTN and 5,6-ADTN. For the D2-like receptors, the affinity rank orders were: D2: Z1046 > or = DP-5,6-ADTN > fen = 5,6-ADTN; D3: Z1046 > DP-5,6-ADTN > fen = 5,6-ADTN; D4: Z1046 = DP-5,6-ADTN > fen = 5,6-ADTN. In AC studies the rank order was: Z1046 = fen > DP-5,6-ADTN > 5,6-ADTN. Z1046 was more efficient than fen in stimulating cAMP accumulation. These results make Z1046 an innovative agent combining D1-like and D2-like activities.

New insights into the biology of schizophrenia through the mechanism of action of clozapine.

Many studies have detected in the brain of schizophrenic patients various morphological and structural abnormalities in various regions and in particular in the cortical and limbic areas. These abnormalities might in part result from neurodevelopmental disturbances suggesting that schizophrenia might have organic causes. These abnormalities may be the primary event in schizophrenia and be responsible for altered dopaminergic, but not only dopaminergic, neurotransmission in these regions. If schizophrenia is in some way strictly related to brain morphological abnormalities it becomes hard to believe that a curative treatment will ever be possible. Considering this scenario, treatment of schizophrenia will be restricted to symptomatic and preventive therapy and therefore, more effective and better tolerated antipsychotics are necessary. The widely used classical antipsychotic drugs present some disadvantages. They do not improve all symptoms of schizophrenia, are not effective in all patients, produce a number of unpleasant and serious, and partly irreversible, motor side effects. The atypical antipsychotic clozapine constitutes a major advance in particular for patients not responding to conventional neuroleptics. To explain the unique therapeutic effect of clozapine many hypothesis have been proposed. Most of the explanations given so far assume that the D2 blockade is the basis for the antipsychotic activity of clozapine and that the difference in respect to other antipsychotics is due to the contribution of other receptor interactions. Considering the dopaminergic receptor, in particular the recently discovered D4 receptor subtype, it has been observed that even if several classical neuroleptics exhibit high affinity to the D4 receptor, clozapine is more selective for this subtype compared to D2 receptors. Moreover clozapine, differently from all other conventional neuroleptics, is a mixed but weak D1/D2 antagonist. This observation has prompted speculation that the synergism between D1 and D2 receptors might allow antipsychotic effects to be achieved below the threshold for unwanted motor side effects. Probably the D1 antagonistic activity exerted by clozapine at low doses enhances preferentially the extracellular concentration of dopamine in specific areas of the brain, such as the prefrontal cortex, where a dopaminergic hypoactivity has been suggested to be in part responsible for negative symptoms of schizophrenia. The clozapine enhancement of dopaminergic activity in this brain area might explain its efficacy against schizophrenia negative symptoms. However, it cannot be excluded that the affinities displayed by clozapine for other nondopaminergic receptors also contribute to its unique therapeutic profile. The various hypotheses mentioned in this review need to be further validated or disproved. The only way to do that is developing new drugs where the postulated mechanistic profile is specifically realized and to clinically test these compounds.

Effects of acute n-hexane and 2,5-hexanedione treatment on the striatal dopaminergic system in mice.

In order to investigate the effect of n-hexane and its metabolites on the Central Nervous System (CNS), we treated mice with n-hexane and 2,5-hexanedione (2,5-HD) by intraperitoneal (i.p.) administration. Gascromatographic mass spectrometric (GCMS) analyses of striatum and cerebellum revealed a consistent increase of 2,5-HD concentration at 0.5 and 2 hours after treatment and a decline to baseline levels at 24 hours. Traces of 2,5-HD were detected in the brain of control animals. Biochemical analyses revealed a precocious, short lasting, significant increase of striatal dopamine (DA) and homovanillic acid (HVA) levels. A significant increase of striatal synaptosomal DA uptake, suggesting a DA releasing effect on the dopaminergic terminals, was also observed. These results support the hypothesis of a possible role of n-hexane and its metabolites in inducing parkinsonism in humans and animals.

Comparative effects of verapamil and volume overload on atrial natriuretic factors and the renin-angiotensin aldosterone-vasopressin system.

The authors compared the effects of verapamil (120 mg three times daily for 3 days) with those of acute volume expansion with normal saline on the plasma levels of atrial natriuretic factors (ANF), renin (PRA), angiotensin II (AII), aldosterone (ALD), and arginine-vasopressin (AVP) in healthy subjects. A randomized, double-blind, placebo-controlled study of crossover design was employed, where each individual received two acute volume overloads 1 week apart, one during placebo and the other during treatment with verapamil. Verapamil reduced blood pressure (BP) and increased the plasma levels of ANF, PRA, AII, ALD, and AVP. Strong positive correlations were observed between PRA, AII, ALD, and AVP, but not with ANF. Acute volume expansion (1500 mL saline in 15 minutes, in supine legs-up position) similarly to verapamil increased ANF levels; however, opposite to verapamil, it reduced PRA-AII-ALD, did not modify AVP levels, and increased BP. The mechanisms of these changes are discussed. In verapamil-treated subjects, volume expansion produced an additional increase in ANF and inhibited the PRA-AII-ALD axis, suggesting that in young healthy individuals, verapamil does not interfere with the reflex compensatory hormonal mechanisms activated under circumstances of acute volume-salt overload, with rapid expansion of the central vascular compartment. Our study indicates that verapamil and volume expansion represent two different stimuli for ANF secretion associated with opposite changes in the PRA-AII-ALD axis. In addition, verapamil can be used as a tool to study and understand the simultaneous increases in ANF and in PRA, AII, and AVP, characteristics of congestive heart failure.

Evidence for a different sensitivity to various central effects of interleukin-1 beta in mice.

Interleukin 1 (IL-1) induces a series of metabolic and endocrine effects. Activation of the hypothalamus-pituitary-adrenal axis, inhibition of food and water intake, elevation of serum interleukin-6 (IL-6) concentration and hypoglycemia are some of the effects induced by IL-1. The purpose of this study was to compare the sensitivity of these effects following central and peripheral administration of IL-1 beta. Different doses of IL-1 beta (0.1-1000 ng/mouse) were centrally (ICV) or peripherally (IP) injected to male mice two hours prior to sacrifice. The ICV administration was more efficacious than the IP injection in elevating serum corticosterone and IL-6 concentrations, whereas no difference was evident in the IL-1 beta-induced hypoglycemia. Central IL-1 beta administration was also more potent than IP injection in inhibiting overnight food and water intake. A dose-dependent effect was evident in all these cases. In summary, our data compare effects elicited by central or peripheral administration of different doses of IL-1 beta. This comparison suggests that the IL-1 beta stimulation of serum corticosterone and IL-6 and inhibition of food and water intake are events more centrally mediated than the IL-1 beta-induced hypoglycemia.

n-hexane induces parkinsonism in rodents.

A case of human parkinsonism, due to n-hexane exposure, was recently described. On the basis of this observation, we treated mice and rats with n-hexane and its principle toxic metabolite 2,5-hexanedione. The mice underwent a chronic treatment intraperitoneum, the rats were treated stereotaxically into the substantia nigra. At biochemical analysis of the striata, dopamine and homovanillic acid levels were significantly lower compared with control animals; norepinephrine, serotonin, 5-hydroxindolacetic acid levels were unchanged. The rats treated with 2,5-hexanedione showed an apomorphine-induced rotational behavior significantly higher compared to controls. Since n-hexane and its metabolites are environmental contaminants and by-products of endogenous metabolic pathways, we propose that they may play a role in inducing parkinsonism in humans.

A decrease in opioid tone amplifies the luteinizing hormone surge in estrogen-treated ovariectomized rats: comparisons with progesterone effects.

It is well known that the estrogen-induced LH surge in ovariectomized (ovx) rats is invariably far less in magnitude than the preovulatory LH surge or that induced by progesterone (P) in estrogen-primed ovx rats. Recent studies show that a decrease in hypothalamic inhibitory opioid tone by the neural clock (NC) is responsible for the induction of the preovulatory LH surge on proestrus. Therefore, we hypothesized that the diminished LH response in estrogen-treated ovx rats may be due to an inadequate reduction in opioid tone. To test this hypothesis the effects of transiently decreasing the opioid tone with an opiate receptor antagonist, naloxone (NAL), on LH secretion in estrogen-primed, short term (5 days) and long term (4 weeks) ovx rats were examined. NAL (2 mg/h) was infused iv from 1100-1400 h on day 2 in rats receiving either sc implants (two, 15 mm each) filled with 17 beta-estradiol (300 micrograms/ml in oil) or sc estradiol benzoate (EB; 10 micrograms/rat) injections at 1000 h on day 0. For comparison of NAL- and P-induced LH responses, EB-primed short and long term ovx rats received P injection (2 mg/rat, sc) instead of NAL infusion at 1100 h. Estrogen treatment alone induced a spontaneous rise in plasma LH on the afternoon of day 2, with peak LH levels ranging between 1.5-2.4 ng/ml. NAL infusion markedly enhanced the LH surge in both groups of ovx rats. In short term ovx rats NAL-induced peak LH levels (5-6 ng/ml) were less than those observed in rats receiving supplemental P treatment or that observed previously on proestrus (10-15 ng/ml). However, in long term EB-primed ovx rats, NAL infusion evoked LH surges equivalent to those observed after P injection. In addition, analysis of the episodic LH secretion pattern showed that NAL infusion accelerated the frequency and amplitude of LH discharge and significantly changed the contour of LH episodes. These results show that a transient decrease in inhibitory opioid tone before a spontaneous LH rise in estrogen-treated ovx rats can accelerate episodic LH secretion to culminate in LH surges that resemble those induced by P and the preovulatory LH surge. Therefore, these observations are in accord with the view that the NC-induced curtailment in the inhibitory opioid tone may be inadequate in estrogen-treated rats; NAL infusion and P treatment intensify decrements in inhibitory opioid tone to reinstate the preovulatory-type LH surge in these rats.

Different gamma-aminobutyric acid receptor subtypes are involved in the regulation of opiate-dependent and independent luteinizing hormone-releasing hormone secretion.

The neurotransmitter gamma-aminobutyric acid (GABA) appears to be involved in the control of gonadotropin secretion. These studies were conducted 1) to evaluate the effect of GABAergic drugs on in vitro LHRH secretion and 2) to characterize the role of different types of GABA receptors (the GABA-A and GABA-B subtypes) in these actions. Arcuate nuclei-median eminence fragments were incubated in vitro, and the release of LHRH, prostaglandin E2 (PGE2), arginine vasopressin, and oxytocin was measured by RIA. Both GABA and muscimol at different concentrations induced an increase in LHRH release, but did not affect the release of arginine vasopressin and oxytocin. This stimulatory effect was blocked by the specific GABA antagonist bicuculline, suggesting the involvement of GABA-A type receptors. Muscimol-stimulated LHRH release was not affected by the presence of phentolamine, suggesting that the stimulatory effect of GABA-A receptors on LHRH release is not mediated by interactions with the noradrenergic system. PGE2 has been shown to be a potent secretagogue of LHRH from the median eminence in vitro, and in this model the stimulatory effect of PGE2 was enhanced by muscimol. Baclofen, a specific GABA-B type receptor agonist, had no effect on basal LHRH release, but completely suppressed naloxone-stimulated LHRH and PGE2 secretion. The inhibitory effect of baclofen was blocked by the presence of 5-aminovalerate, a drug that has been shown to block the inhibitory effect of baclofen on NE release from noradrenergic terminals. This suggests the possibility that GABA-B receptors interacting with noradrenergic terminals may be responsible for the inhibitory effect of baclofen on naloxone stimulation. This study uncovered both stimulatory and inhibitory effects of GABA on LHRH release after activation of GABA-A or GABA-B receptors, respectively. Further, the data show possible relationships among the GABAergic, endogenous opiate peptide, and noradrenergic systems in the control of LHRH release from the hypothalamus.

Biochemical and functional aspects on the control of prolactin release by the hypothalamo-pituitary GABAergic system.

A growing body of biochemical, immunohistochemical, and autoradiographic evidence indicates the presence of two different GABAergic systems in the mediobasal hypothalamus: one intrinsic, the tuberoinfundibular GABAergic system, and the other extrinsic, whose cell bodies are located outside the mediobasal hypothalamus and which projects to this area and establishes synaptic contacts with aminergic and peptidergic neurons involved in endocrine function. This particular anatomical configuration provides a rational basis to explain the dual action of GABA (inhibitory and stimulatory) on prolactin release. Different studies aimed at identifying the precise role of GABA on prolactin function have demonstrated that this system can be modulated, at the pre- and/or post-synaptic level, by different experimental maneuvers in which prolactin secretion is physiologically and pharmacologically altered. GABA mainly appears to be involved in feedback mechanisms preventing an exaggerated prolactin output during specific physiological situations. The ability of clinically tested, direct GABAmimetic compounds to lower prolactin secretion in the rat points towards a clinical usefulness of these drugs in particular spontaneous or induced neuroendocrine disorders. However, the possibility of a widespread use of this type of compounds is hampered by the lack of potent, specific and non-toxic GABA agonists suitable for clinical purposes.

Gonadectomy influences the inhibitory effect of the endogenous opiate system on pulsatile gonadotropin secretion.

These studies were designed to evaluate the importance of the gonads on the inhibitory influence exerted by the endogenous opiate system on gonadotropin secretion. The effect of the opioid receptor antagonist naloxone on pulsatile LH secretion was evaluated in 1-, 2-, and 8-week orchidectomized (ORDX) rats. Freely moving rats bearing a Silastic cannula in the right jugular vein were bled every 6 min for 3 h. Saline was injected during the first 90 min, while during the last 90 min naloxone was given as an initial iv bolus injection dose of 2 mg/kg, followed by injections of 0.1 mg/kg every 6 min. In addition, another group of rats was treated, from the beginning of the 3-h bleeding period, with naloxone at an initial iv dose of 2 mg/kg, followed by injections of 0.1 mg/kg every 6 min. Analysis of pulsatile LH secretion showed enhanced mean LH levels, peak and trough values, and pulse duration in 1- and 2-week ORDX rats during the first 40 min of naloxone administration. These changes were essentially restricted to the first pulse that occurred immediately after naloxone administration. No changes in any of the parameters evaluated were observed in 8-week ORDX rats. Different regimens of testosterone replacement (capsules or sc injections) in 8-week ORDX rats significantly reduced the elevated LH value and completely suppressed pulsatile LH secretion. However, in these animals the response of LH to naloxone administration was restored in a limited number of animals among those receiving sc injections. The results indicate that the gonads play a permissive role in the inhibitory action of the endogenous opiate system on gonadotropin secretion, since a loss of sensitivity to opiate receptor blockade takes place after long term gonadectomy. The delayed loss of the response to naloxone after gonadectomy suggests that gonadal factors may have an activational and/or organizational effect on the opiate neurons involved in gonadotropin regulation. The precise mechanism(s) responsible for this loss of sensitivity is still unknown.

Activation of gamma-aminobutyric acid B-receptors abolishes naloxone-stimulated luteinizing hormone release.

Recent evidence suggests that the neurotransmitter gamma-aminobutyric acid (GABA) plays an important role in the control of gonadotropin secretion. The present study was conducted to identify the effect and site of action of different GABAergic drugs on LH secretion in vivo and to characterize the precise roles of different GABA receptors in these actions. Three different GABAergic drugs were used: muscimol and baclofen, which act at the level of the GABA A- and GABA B-receptors, respectively, and aminooxyacetic acid (AOAA), which increases the GABA content in the brain. The effects of these drugs were investigated in situations of enhanced LH secretion due to administration of naloxone or LHRH. In an initial experiment, adult male rats were treated ip with AOAA, followed by naloxone. AOAA treatment decreased basal LH levels and prevented naloxone-stimulated LH release. PRL levels were decreased by either AOAA or naloxone; however, the combination of these two drugs did not induce an additional or synergistic effect on the decreased PRL levels. In subsequent experiments, freely moving rats bearing Silastic cannulae in the right jugular vein received AOAA, muscimol, or baclofen a few minutes before either naloxone or LHRH administration. Baclofen and AOAA completely suppressed the naloxone-stimulated LH increase. Muscimol did not prevent the effect of naloxone. None of the three GABAergic drugs affected LH release in rats receiving LHRH. The results of these in vivo experiments suggest that the GABAergic system exerts primarily an inhibitory effect on gonadotropin secretion which is mediated at a central level, since pituitary responsiveness to LHRH is not affected by GABAergic drug treatment. GABA B-receptors are responsible for the inhibitory action of GABA.

Effect of THIP and SL 76002, two clinically experimented GABA-mimetic compounds, on anterior pituitary GABA receptors and prolactin secretion in the rat.

In the present study, the ability of three direct GABA agonists, muscimol, THIP and SL 76002 to displace 3H-GABA binding from anterior pituitary and medio-basal hypothalamus membranes was evaluated. Further, the effect of both THIP and SL 76002 on baseline prolactin levels or after stimulation of hormone release with haloperidol has been also studied. Either muscimol, THIP or SL 76002 have shown to posses 7-, 7- and 3-fold higher affinity, respectively, for the central nervous system than for the anterior pituitary 3H-GABA binding sites. Moreover, THIP and SL 76002 have demonstrated to be respectively, 25- and 1000- fold less potent than muscimol in inhibiting 3H- GABA binding at the level of the anterior pituitary and about 25- and 2700- fold less potent at the level of the medio-basal hypothalamus. Under basal conditions, either THIP or SL 76002 were ineffective to reduce prolactin release. However, after stimulation of prolactin secretion through blockade of the dopaminergic neurotransmission with haloperidol (0.1 mg/kg), both THIP (10 mg/kg) and SL 76002 (200 mg/kg) significantly counteracted the neuroleptic-induced prolactin rise with a potency which is in line with their ability to inhibit 3H-GABA binding in the anterior pituitary. The present results indicate that both compounds inhibit prolactin release under specific experimental situations probably through a GABAergic mechanism. In view of the endocrine effects of these GABA-mimetic compounds, the possibility arises for an application of these type of drugs in clinical neuroendocrinology.

Effects of repeated tiapride administration on anterior pituitary dopamine receptors and prolactin release in the rat.

The substituted benzamides tiapride and sulpiride, and the classic neuroleptic haloperidol, were studied in the rat to assess their interaction with the anterior pituitary (AP) dopamine (DA) receptors both in vitro ([3H]spiperone binding) and in vivo prolactin-PRL-release). Tiapride weakly inhibited [3H]spiperone binding in both pituitary and striatal membranes with affinity 5-7 times lower than sulpiride and 400-300 times lower than haloperidol. All three drugs were more potent in displacing [3H]spiperone from striatum than from AP. In vivo, tiapride produced weak and transient stimulation of PRL release reaching a full effect at 2 mg/kg i.p. Similar doses of sulpiride produced longer-lasting effects. Haloperidol was more potent than both benzamides. In prolonged treatments (15 or 60 days), tiapride, given twice daily at 0.5 mg/kg i.p., did not modify [3H]spiperone binding in either AP or striatum, nor did it induce significant changes of basal PRL levels. The challenge with a low threshold dose of TIA (0.2 mg/kg ip) produced similar increases of PRL release in the group either treated with TIA or saline. The data indicate that the benzamides examined have low potency for interaction with DA receptors in pituitary and striatum. In particular, tiapride displayed weaker affinity for AP-DA receptors than the other drugs and induced only slight stimulation of PRL levels. Results from repeated tiapride administration indicate that the drug, at a clinically relevant dose, is unable to modify either kinetic characteristics of DA receptors in the pituitary or plasma PRL levels.

Peptide-steroid interactions in brain regulation of pulsatile gonadotropin secretion.

Reproductive function is regulated by an intricate system of peptide, steroid and amine factors interacting within the brain, pituitary and gonads. At no point is the complexity of the reproductive system better exemplified than in the exquisite interplay of factors required to produce and modulate pulsatile gonadotropin secretion. By extension, analysis of the pulsatile secretory pattern of the gonadotropins, as a means of assessing the contribution of these various factors, can reveal interactions too subtle to be detected by the conventional examination of mean gonadotropin concentration. Analysis of the pulsatile secretory patterns of both LH and FSH reveals striking differences between the two gonadotropins in their response to inhibitory, gonadal peptide and steroid factors, suggesting divergent paths of brain-pituitary regulation. Further studies to clarify this disparity in regulation have demonstrated that neutralization of endogenous LHRH completely abolishes pulsatile LH secretion without affecting pulsatile FSH secretion, suggesting the existence of another, as of yet unknown, brain factor which regulates FSH secretion. The feedback signals provided by gonadal steroids can induce both inhibition and facilitation of LHRH and LH secretion. Neurons of the central opiatergic system exert a tonic inhibitory influence on the catecholaminergic neurons regulating LHRH secretion, and are believed to mediate the inhibitory actions of the gonadal steroids on the LHRH system. Withdrawal of the gonadal steroids has been reported to cause a rapid loss of the tonic inhibitory control of the opiate system on LHRH secretion as revealed by a lack of response to naloxone. Reassessment of this system by analyzing the pulsatile pattern of LH secretion, however, reveals that the loss of naloxone effect after gonadectomy occurs very gradually and that an effect can still be obtained up to 2 weeks after the removal of gonadal steroids. These studies provide excellent examples of the complex interplay observed just between selected factors regulating pulsatile gonadotropin secretion. The use of pulsatile gonadotropin analysis is a powerful model, not only for providing greater clarity of known regulatory interactions, but also for revealing new and more subtle levels of control in the brain-pituitary-axis.

Endocrine modulation of gamma-aminobutyric acidergic innervation in the rat fallopian tube.

The present study investigates the effect of different endocrine manipulations on the gamma-aminobutyric acid (GABA)-ergic system in the rat fallopian tube. Either hypophysectomy or ovariectomy induced a significant decrease of glutamic acid decarboxylase (GAD) activity and of GABA levels in in situ tubes. This effect was completely reversed by either gonadotropins or combined estrogen-progesterone administration, respectively. Estrogen or progesterone alone proved less effective than the administration of both steroids in counteracting the effect of ovariectomy on GAD activity. The in vitro incubation of ovariectomized rat fallopian tubes with estrogen-progesterone for 1 h failed to counteract the reduction of the GAd activity induced by surgical manipulation. The in vivo effect of estrogen-progesterone administration on the GABA-ergic system seems to be specific since steroid treatment induced the synthesis of an enzyme which was immunologically identical to the GAD present in the fallopian tube and brain of normal diestrous rat. Autotransplantation of the fallopian tube under the skin brought about a decrease of GAD activity similar to that obtained after ovariectomy. In this situation, however, estrogen-progesterone administration did not counteract the decrease of GAD activity induced by fallopian tube deafferentation. The present results demonstrate that an interaction between the GABA-ergic system and the hypothalamo-pituitary-gonadal axis seems to be operative at the level of the rat fallopian tube. However, the physiological meaning of this interrelationship between the endocrine and the peripheral nervous systems remains to be clarified.