Pediatric suprasellar lesions.

Pediatric brain tumors have always been challenging as well as intriguing in their anatomical, surgical, and postsurgical management-related issues. They are a heterogeneous set of pathologies involving different age groups in childhood and also differ widely from their adult counterparts as far as adjuvant therapies are concerned. Though neurosurgeons across the world are radical in surgery for most of the pediatric tumors, it can often be at the cost of future quality of life in suprasellar tumors. As the time has gone by, the pendulum has swung toward rather conservative and maximal safe surgical resections with adjuvant therapies coming to the forefront. Hence, the aim is to achieve a good quality of life for these children along with a control of tumor growth (rather than cure) and to again tackle the tumors, if required, once these children reach adolescence or adulthood. We have reviewed the literature for different pediatric suprasellar tumors and discussed their current management giving our perspective with illustrative cases.

Diazepam during prior ethanol withdrawals does not alter seizure susceptibility during a subsequent withdrawal.

The number of cycles of alcohol detoxification is suggested to be an important variable in the predisposition to severe withdrawal seizures in alcohol-dependent individuals. Several clinical studies have suggested that exposure to repeated alcohol withdrawals may lead to increased severity of subsequent withdrawal episodes. Consistent with these observations, exposure to multiple cycles of ethanol withdrawal in our previous study significantly increased sensitivity to the convulsive effects of the GABA(A) receptor inverse agonist, Ro15-4513, in comparison to continuous ethanol exposure with no intermittent withdrawals. There was also a selective increase in the occurrence of spontaneous spike and sharp wave (SSW) activity in the EEG recorded from hippocampal area CA(3) in proportion to the number of withdrawal episodes experienced. It is hypothesized that during such repeated episodes of ethanol intoxication and withdrawal, changes in neuronal excitation during prior withdrawals could serve as initially subconvulsive kindling stimuli that might eventually result in the increased severity of the withdrawal syndrome. There is some evidence of the successful suppression of such neuronal excitation during acute ethanol withdrawal by positive modulators of the GABA(A) receptor. In the present study, the benzodiazepine agonist, diazepam, at a dose (4.0 mg/kg) that suppresses acute withdrawal symptoms, when administered during intermittent withdrawals, did not alter seizure sensitivity during a subsequent nonmedicated withdrawal. Diazepam treatment during prior withdrawals also did not have any effect on the multiple withdrawal-associated increase in SSW activity in hippocampal area CA(3) during an untreated withdrawal. This finding suggests that suppression of acute withdrawal symptoms by diazepam does not prevent long-lasting changes in CNS function resulting from repeated exposures to ethanol withdrawal.

5-HT 3 receptor antagonist ICS 205-930 alters the discriminative effects of ethanol.

The ability of a selective 5-hydroxytryptamine (5-HT(3)) receptor antagonist, ICS 205-930 (3-tropanyl-indole-1-carboxylate, tropisetron), to block the discriminative stimulus effects of ethanol was investigated in rats that were trained to discriminate ethanol (1.25 g/kg ip) from saline with food as the reinforcement. Prior administration of ICS 205-930, at the dose of 0.01 mg/kg, significantly decreased ethanol's discriminative stimulus effect at ED(75) dose of ethanol, while higher doses of ICS 205-930 (10 and 17 mg/kg) showed enhancement of ethanol's discriminative effects at ED(0), ED(25), and ED(50) doses of ethanol. Under conditions where ICS 205-930 (10, 17 mg/kg) was tested alone, rats responded exclusively on the saline-appropriate lever. These effects occurred without significantly altering response rates or blood ethanol concentrations. The results suggest that the 5-HT(3) antagonist ICS 205-930 at lower concentration decreases, and at higher concentration enhances the discriminative stimulus effects associated with a lower to moderate dose of ethanol.

Opiate delta-2-receptor antagonist naltriben does not alter discriminative stimulus effects of ethanol.

The ability of a selective 2-opiate receptor antagonist, naltriben, to modulate ethanol discrimination was investigated in a rat model using a drug discrimination procedure. Rats were trained to discriminate ethanol (1.25 g/kg, IP) from saline on a fixed-ratio schedule, FR10. Once rats had acquired the ethanol-saline discrimination, ethanol dose-response tests were conducted with 15-min pretest injections. Following the characterization of the ethanol dose-response curve, the effect of naltriben on ethanol's discriminative stimulus was assessed by administering naltriben (0. 032-5.6 mg/kg, IP) 15 min before the ethanol administration. In the present study, naltriben did not have any modulatory effect on ethanol discrimination, suggesting that either Delta(2)-opiate receptors are not involved in the formation of ethanol's discriminative stimulus or the antagonism of Delta(2)-opiate receptors is not sufficient to alter ethanol's compound discriminative stimulus.

Increased Ro15-4513-induced seizures following multiple ethanol withdrawals.

Clinical research into the etiology of ethanol withdrawal seizures has shown an increase in the number and severity of seizures with increasing numbers of withdrawal episodes. The aim of the present study was to determine the effects of multiple ethanol withdrawals on the seizure sensitivity to the GABA(A) receptor inverse agonist Ro15-4513. In this study, three groups of laboratory rats received varying amounts of either continuous or intermittent ethanol exposure. A fourth group (Naive) received no ethanol exposure. Eight hours following the last withdrawal from chronic ethanol exposure, animals were tested for sensitivity to Ro15-4513-induced motor convulsions. Seizure sensitivity was significantly increased in all ethanol-treated groups compared to ethanol-naive controls, which did not exhibit any convulsive responses to this dose of Ro15-4513. Furthermore, rats exposed to multiple ethanol withdrawals exhibited significantly higher sensitivity to drug-induced seizures than did animals experiencing only a single ethanol withdrawal. Although the specific mechanism of this enhanced convulsant effect of Ro15-4513 following multiple ethanol withdrawals remains to be determined, these results suggest an involvement of GABA(A)-benzodiazepine receptors in this multiple withdrawal phenomenon.

Caloric restriction retards the aging associated changes in gamma-aminobutyric acidA receptor gene expression in rat cerebellum.

It is widely accepted that calorie restriction is an effective way of delaying the aging process. Also, there is an indication that the beneficial effects exerted by dietary manipulation may be due to a direct effect at the molecular level like gene expression. The studies were conducted to determine whether calorie restriction prevents any age-related changes in the structural and molecular aspects of the GABAA-BZ receptor. In aged (24-month old diet ad libitum) rats, the binding of [35S]t-butyl-bicyclophosphorothionate (TBPS) was significantly reduced in the cerebellum. In contrast, [35S]TBPS binding remained unchanged in the cerebellum of calorie restricted old rats. In order to evaluate the molecular basis of these changes, the alpha sub-unit mRNA levels were measured. The GABAA receptor alpha1 sub-unit mRNA level remained unchanged in both the old groups of rats. The alpha2 subunit mRNA level was significantly decreased in the cerebellum of aged rats (24-month old ad libitum), whereas it remained unchanged in the cerebellum of calorie restricted old animals. These findings indicate a selective age and diet related modulation in the stoichiometry of the GABAA receptor in aging.

Chronic GABA treatment downregulates the GABAA receptor alpha 2 and alpha 3 subunit mRNAS as well as polypeptide expression in primary cultured cerebral cortical neurons.

Chronic GABA exposure of mammalian primary cultured cortical neurons results in a downregulation of the GABA-benzodiazepine receptor complex. In the present study, the mRNA levels, as well as polypeptide expression, for the GABAA receptor alpha 2 and alpha 3 subunits in cultured embryonic mouse cerebral cortical neurons (7 day old) were examined using northern analysis and immunoblotting techniques following chronic GABA treatment. The alpha 1 subunit mRNA or polypeptide could not be detected in these neurons. The steady state levels of mRNA for the GABAA receptor alpha 2 and alpha 3 subunits showed a decrease in comparison with untreated neurons. There was no change in the level of the beta actin or poly(A)+ RNA under the same experimental conditions. This agonist-induced reduction in the GABAA receptor alpha 2 and alpha 3 subunit mRNA was blocked by the concomitant exposure of neurons to R 5135, an antagonist of GABAA receptor. The polypeptide expression for the GABAA receptor alpha 2 and alpha 3 subunits in chronically GABA-treated neurons also showed a decline and this change was also blocked by the concomitant exposure of cells to GABA and R 5135. These results indicate that the chronic exposure of the GABAA receptor complex to agonist downregulates the expression of the alpha subunits of the receptor complex, which may be related to an observed decreases in the number of binding sites and GABA-induced 36Cl-influx in the cortical neurons.

Chronic ethanol treatment upregulates the GABA receptor beta subunit expression.

The molecular mechanisms associated with ethanol-induced tolerance and physical dependence have yet to be elucidated. In previous studies we have demonstrated that chronic ethanol administration produced a decrease in the GABAA receptor mRNA level of alpha 1, alpha 2, alpha 5 subunits, and a decrease in the polypeptide (alpha 1, alpha 2, and alpha 3) expression in the rat cerebral cortex. In this study we examined the effect of chronic ethanol treatment on the mRNA levels and the expressions of the beta-subunits of the GABAA receptors in rat cerebral cortex. The results indicate that chronic ethanol administration produced an upregulation of the beta 1 subunit mRNA (12 kb) by 29 +/- 10%, beta 2 mRNA (8 kb) by 55 +/- 6% and the beta 3-subunit (6 kb) mRNA by 72 +/- 9% in cerebral cortex. The levels of the beta 2 and beta 3 subunit mRNAs remains elevated at 24 hr withdrawal. We also investigated the effect of chronic ethanol administration on the beta-subunit polypeptide expression using monoclonal antibody BD17, which recognizes the beta 2 (P56) and beta 3 (P58) polypeptides. Chronic ethanol treatment increased the levels of both of these polypeptides in cerebral cortex. Taken together, chronic ethanol administration produced an upregulation of the beta-subunit mRNA and the polypeptide expression of these subunits in rat cerebral cortex. In contrast, chronic ethanol treatment decreased the expression of various alpha-subunits in the cerebral cortex.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies specific for GABAA receptor alpha subunits reveal that chronic alcohol treatment down-regulates alpha-subunit expression in rat brain regions.

Chronic administration of ethanol results in the development of tolerance and dependence. The molecular mechanism underlying these behavioral actions of ethanol is poorly understood. Several lines of evidence have suggested that some of the pharmacological actions of ethanol are mediated via a potentiation of GABAergic transmission. Chronic ethanol administration results in a reduction in the GABAA receptor-mediated 36Cl- uptake in cortical synaptoneurosomes and primary cultured neurons. We and others have shown that it also results in a 40-50% reduction in GABAA receptor alpha-subunit mRNA levels in the rat cerebral cortex. In the present study, we investigated the expression of alpha 1, alpha 2, and alpha 3 subunits of the GABAA receptor in the cerebral cortex and the alpha 1 subunit in the cerebellum by immunoblotting using polyclonal antibodies raised against alpha 1-, alpha 2-, and alpha 3-subunit polypeptides following chronic ethanol treatment. These results reveal that chronic ethanol administration to rats results in a 61 +/- 4% reduction in level of the GABAA receptor alpha 1 subunit (51 kDa), 47 +/- 8% reduction in level of the alpha 2 subunit (53 kDa), and 30 +/- 7% reduction in level of the alpha 3 subunit (59 kDa) in the cerebral cortex and a 56 +/- 5% reduction in content of the alpha 1 subunit in the cerebellum. In summary, this ethanol-induced reduction in content of the GABAA receptor alpha subunits may underlie alterations in the GABAA receptor function and could be related to cellular adaptation to the functional disturbance caused by ethanol.

Alcohol: effects on GABAA receptor function and gene expression.

Chronic ethanol treatment increased the binding of [3H]Ro15-4513 in cerebral cortex and cerebellum of rats and produced a reduction in the alpha 1, alpha 2, alpha 5 GABAA receptor subunits mRNAs in the cerebral cortex and alpha 1 subunit mRNA in the cerebellum, and an increase in alpha 6 subunit mRNA in the cerebellum. An increase in the alpha 6 subunit mRNA which selectively encodes Ro15-4513 binding in the cerebellum is consistant with an increase in the photolabelling of [3H]Ro15-4513 to the 55 KDa band in the cerebellum of chronic ethanol treated rats. Using polyclonal antibodies, we have confirmed that chronic ethanol treatment decreased alpha 1 subunit (51 KDa), alpha 2 subunit (53 KDa) and alpha 3 subunit (59 KDa) in cerebral cortex. These results suggest that chronic ethanol treatment produces a decrease in the expression of GABAA receptor subunit which may underlie a molecular basis for ethanol tolerance.

Chronic ethanol administration alters gamma-aminobutyric acidA receptor gene expression.

Chronic ethanol (alcohol) administration has been associated with alterations in the binding and function of the gamma-aminobutyric acid (GABAA) receptor. To evaluate the mechanism underlying these changes, we measured the steady state levels of the mRNAs for the alpha 1, alpha 2, alpha 3, alpha 5, and alpha 6 subunits of the GABAA receptor after chronic ethanol administration to rats and ethanol withdrawal for 24 hr. The results indicated that chronic ethanol administration resulted in a 61% decline in the level of the GABAA receptor alpha 1 subunit mRNAs [3.8 and 4.3 kilobases (kb)] in the cerebral cortex in rats. The levels of the alpha 2 subunit mRNAs (6 and 3 kb) and the alpha 5 subunit mRNA (2.8 kb) were also reduced, by 61, 45, and 51%, respectively, whereas there was no change in the level of the alpha 3 subunit mRNA (3 kb). Furthermore, the ethanol-induced decrease in receptor mRNA levels persisted for 24 hr, after withdrawal of ethanol and returned to control values at 36 hr of withdrawal. alpha 1 mRNA levels in cerebellum also decreased by 28%. The level of the alpha 6 subunit mRNA, which selectively encodes Ro15-4513 binding sites, was found to be increased by approximately 76% in the cerebellum. Also, the photoaffinity labeling studies using [3H]Ro15-4513 indicated an increase in the levels of various protein components of the GABAA receptor, in the cerebellum and the cerebral cortex (e.g., 50- and 55-kDa proteins in the cerebellum and 41- and 50-kDa proteins in the cortex), after chronic ethanol treatment. The increase in alpha 6 mRNA in the cerebellum might be related to the increased labeling of the 55-kDa (approximately 56-kDa) protein and partially responsible for the increased binding, as reported previously by us. Because the alpha 6 subunit is not expressed in cortex, involvement of an as yet unknown subunit in this region cannot be ruled out. The effect of chronic ethanol treatment appears to be specific for GABAA receptor subunit mRNAs, because the same treatment did not alter the levels of glyceraldehyde-3-dehydrogenase mRNA or poly(A)+ RNA. In summary, these data indicate that chronic ethanol treatment results in an alteration in the regulation of expression of GABAA receptor subunit-encoding mRNAs, which could be due to alterations in transcription or mRNA stability.

Aging related alterations in GABAA receptor subunit mRNA levels in Fischer rats.

The influence of aging on the binding of ligands to picrotoxin binding sites as well as steady state levels of mRNA for various alpha subunits of gamma-aminobutyric acid (GABA) receptor complex was investigated in male Fischer F-344 rats. In aged rats, the binding of [35S]t-butyl-bicyclophosphorothionate (TBPS) was significantly reduced. This decrease in TBPS binding derived from a reduced density of binding sites, rather than from affinity changes, in both cerebral cortex and cerebellum. In aged rats, alpha 1 mRNA level decreased approximately 70% between age 6 months and 24 months in the cerebral cortex (P less than 0.005). In contrast, alpha 1 mRNA remained unchanged in the cerebellum of old rats. The association of a decrease in picrotoxin binding sites in the cerebral cortex with a decline in alpha 1 mRNA level in the cerebral cortex and in alpha 2 mRNA level in the cerebellum is indicated. alpha 6 mRNA level increased with age in the cerebellum. These findings indicate a selective age related modulation in the stoichiometry of GABAA receptor in aging.

Aging reduces the mRNA of alpha 1 GABAA receptor subunit in rat cerebral cortex.

The effect of aging on the binding of ligands to the GABA, benzodiazepine and picrotoxin binding sites as well as alpha subunit mRNA level of GABAA receptor was investigated in cerebral cortex of male Fischer F-344 rats. In aged (730- to 770-day-old) rats, the binding of [35S]t-butylbicyclophosphorothionate (TBPS) was significantly reduced. Also, alpha 1 mRNA level was markedly decreased (86% suppression). In contrast, alpha 1 mRNA remained unchanged in cerebellum. These findings indicate a selective age-related structural change in GABAA receptor in rat cerebral cortex.

Chronic ethanol treatment selectively increases the binding of inverse agonists for benzodiazepine binding sites in cultured spinal cord neurons.

The effect of chronic ethanol treatment, and its withdrawal on the binding of ligands to the benzodiazepine binding sites of gamma-aminobutyric acid (GABA) receptor complex, was investigated in C57BL/6J mice spinal cord cultured neurons. Chronic ethanol (50 mM) treatment increased the specific binding of inverse agonists of the benzodiazepine binding sites, without affecting the binding of agonist or antagonist to this site. Thus, chronic ethanol exposure of the neurons increased the binding of [3H] Ro 15-4513 [ethyl-8-azido-5,6-dihydro-5-methyl-6-oxo-4H-imidazo [1,5-alpha][1,4]benzodiazepine-3-carboxylate] and methyl-1-beta carboline-3-carboxylate [( 3H]beta-CCM), but not the binding of [3H]flunitrazepam or [3H]Ro 15-1788 [ethyl-8-fluro-5-6-dihydro-5-methyl-6-OxO-4H-imidazo[1,5-alpha][1, 4] benzodiazepine-3-carboxylate]. This increase was due to an increase in the number of binding sites for Ro 15-4513 and beta-CCM, and not due to a change in receptor affinity. The increase was observed as early as after a 12-hr exposure of the neurons with ethanol, and remained elevated at 24-hr withdrawal, returning to control values at 48-hr withdrawal. These results further strengthen the notion that Ro 15-4513 and related inverse agonists binding site on the GABA-benzodiazepine receptor complex may be involved in ethanol-s behavioral, biochemical and pharmacological effects which are mediated via GABAA receptor system. The significance of the enhanced binding sites for Ro 15-4513 and beta-CCM in the actions of ethanol, tolerance and withdrawal is discussed.

Chronic ethanol administration increases the binding of the benzodiazepine inverse agonist and alcohol antagonist [3H]RO15-4513 in rat brain.

Chronic ethanol treatment which produced intoxication and physical dependence in rats, produced an increase in the specific binding of ethanol antagonist [3H]RO15-4513 in rat brain cerebral cortex and cerebellum, but not in hippocampus and striatum. The increase in both the regions was due to an increase in the number (Bmax) of receptor sites. These results suggest that the RO15-4513 binding sites on the oligomeric GABA receptor complex are altered following chronic ethanol administration, and support the notion of a unique role of RO15-4513 as an ethanol antagonist.

Melatonin in the lacrimal gland: first demonstration and experimental manipulation.

NAT, HIOMT and melatonin are described in the extra-orbital lacrimal glands. The extra-orbital lacrimal glands of female Syrian hamsters contain higher NAT activity and melatonin levels than those in male glands, while male glands have higher HIOMT activity. Castration did not change melatonin in the lacrimal glands, although NAT and HIOMT activities were altered. The exposure of female hamsters to light in the morning (0600h) was associated with a reduction in both NAT activity and melatonin levels. Porphyrins were not detected in the lacrimal glands of either male or female hamsters.