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急性静脉注射突触素复合物变体 KB220™“使”酒精和阿片类药物戒断期间的神经调节紊乱“正常化”:使用定量脑电图和遗传分析奖励多态性观察到的,第 1 部分,2 例病例报告的初步研究。

Acute intravenous synaptamine complex variant KB220™ "normalizes" neurological dysregulation in patients during protracted abstinence from alcohol and opiates as observed using quantitative electroencephalographic and genetic analysis for reward polymorphisms: part 1, pilot study with 2 case reports.

机构信息

LifeStream Solutions, Inc., Prescott, AZ, USA.

出版信息

Postgrad Med. 2010 Nov;122(6):188-213. doi: 10.3810/pgm.2010.11.2236.

DOI:10.3810/pgm.2010.11.2236
PMID:21084795
Abstract

It is well established that in both food- and drug-addicted individuals, there is dopamine resistance due to an association with the DRD2 gene A1 allele. Evidence is emerging whereby the potential of utilizing a natural, nonaddicting, safe, putative D2 agonist may find its place in recovery from reward deficiency syndrome (RDS) in patients addicted to psychoactive chemicals. Utilizing quantitative electroencephalography (qEEG) as an imaging tool, we show the impact of Synaptamine Complex Variant KB220™ as a putative activator of the mesolimbic system. We demonstrate for the first time that its intravenous administration reduces or "normalizes" aberrant electrophysiological parameters of the reward circuitry site. For this pilot study, we report that the qEEGs of an alcoholic and a heroin abuser with existing abnormalities (ie, widespread theta and widespread alpha activity, respectively) during protracted abstinence are significantly normalized by the administration of 1 intravenous dose of Synaptamine Complex Variant KB220™. Both patients were genotyped for a number of neurotransmitter reward genes to determine to what extent they carry putative dopaminergic risk alleles that may predispose them for alcohol or heroin dependence, respectively. The genes tested included the dopamine transporter (DAT1, locus symbol SLC6A3), dopamine D4 receptor exon 3 VNTR (DRD4), DRD2 TaqIA (rs1800497), COMT val158 met SNP (rs4680), monoamine oxidase A upstream VNTR (MAOA-uVNTR), and serotonin transporter-linked polymorphic region (5HTTLPR, locus symbol SLC6A4). We emphasize that these are case studies, and it would be unlikely for all individuals to carry all putative risk alleles. Based on previous research and our qEEG studies (parts 1 and 2 of this study), we cautiously suggest that long-term activation of dopaminergic receptors (ie, DRD2 receptors) will result in their proliferation and lead to enhanced "dopamine sensitivity" and an increased sense of happiness, particularly in carriers of the DRD2 A1 allele. This is supported by a clinical trial on Synaptamine Complex Variant KB220™ using intravenous administration in > 600 alcoholic patients, resulting in significant reductions in RDS behaviors. It is also confirmed by the expanded oral study on Synaptose Complex KB220Z™, published as part 2 of this study. Future studies must await both functional magnetic resonance imaging and positron emission tomography scanning to determine the acute and chronic effects of oral KB220™ on numbers of D2 receptors and direct interaction at the nucleus accumbens. Confirmation of these results in large, population-based, case-controlled experiments is necessary. These studies would provide important information that could ultimately lead to significant improvement in recovery for those with RDS and dopamine deficiency as a result of a multiple neurotransmitter signal transduction breakdown in the brain reward cascade.

摘要

已经证实,在食物和药物成瘾者中,由于与 DRD2 基因 A1 等位基因有关,多巴胺抵抗。有证据表明,利用天然、无成瘾、安全、潜在的 D2 激动剂可能在治疗因奖励缺乏综合征(RDS)而成瘾的患者方面找到其位置。利用定量脑电图(qEEG)作为成像工具,我们展示了 Synaptamine Complex Variant KB220™作为中脑边缘系统潜在激活剂的作用。我们首次证明,其静脉给药可减少或“正常化”奖励回路部位异常的电生理参数。在这项初步研究中,我们报告说,在长期戒断期间存在异常的酒精和海洛因滥用者(即广泛的θ和广泛的α活动)的 qEEG 通过 1 次静脉注射 Synaptamine Complex Variant KB220™显著正常化。对两名患者进行了多种神经递质奖励基因的基因分型,以确定他们携带多少潜在的多巴胺风险等位基因,这些等位基因可能使他们分别容易患酒精或海洛因依赖。测试的基因包括多巴胺转运蛋白(DAT1,基因座符号 SLC6A3),多巴胺 D4 受体外显子 3 VNTR(DRD4),DRD2 TaqIA(rs1800497),COMT val158 met SNP(rs4680),单胺氧化酶 A 上游 VNTR(MAOA-uVNTR)和 5-羟色胺转运体相关多态性区域(5HTTLPR,基因座符号 SLC6A4)。我们强调这是案例研究,并非所有个体都有可能携带所有潜在的风险等位基因。基于以前的研究和我们的 qEEG 研究(本研究的第 1 部分和第 2 部分),我们谨慎地认为,多巴胺受体(即 DRD2 受体)的长期激活将导致其增殖,并导致“多巴胺敏感性”增强和幸福感增强,特别是在携带 DRD2 A1 等位基因的个体中。这得到了一项针对超过 600 名酒精患者的静脉注射 Synaptamine Complex Variant KB220™的临床试验的支持,该试验导致 RDS 行为显著减少。这也得到了本研究第 2 部分发表的 Synaptose Complex KB220Z™扩展口服研究的证实。未来的研究必须等待功能磁共振成像和正电子发射断层扫描,以确定口服 KB220™对伏隔核中 D2 受体数量的急性和慢性影响及其直接相互作用。在大规模、基于人群的病例对照实验中证实这些结果是必要的。这些研究将提供重要信息,最终可能会导致那些因大脑奖励级联中多种神经递质信号转导中断而导致 RDS 和多巴胺缺乏的患者的康复得到显著改善。

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