Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Laboratory for Psychiatric and Molecular Neuroscience, McLean Hospital, Belmont, MA, USA.
Addict Biol. 2019 Jan;24(1):40-50. doi: 10.1111/adb.12577. Epub 2017 Nov 23.
Both schizophrenia (SZ) and substance abuse (SA) exhibit significant heritability. Moreover, N-methyl-d-aspartate receptors (NMDARs) have been implicated in the pathophysiology of both SZ and SA. We hypothesize that the high prevalence of comorbid SA in SZ is due to dysfunction of NMDARs caused by shared risk genes. We used transgenic mice with a null mutation of the gene encoding serine racemase (SR), the enzyme that synthesizes the NMDAR co-agonist d-serine and an established risk gene for SZ, to recreate the pathology of SZ. We determined the effect of NMDAR hypofunction resulting from the absence of d-serine on motivated behavior by using intracranial self-stimulation and neurotransmitter release in the nucleus accumbens by using in vivo microdialysis. Compared with wild-type mice, SR-/- mice exhibited similar baseline intracranial self-stimulation thresholds but were less sensitive to the threshold-lowering (rewarding) and the performance-elevating (stimulant) effects of cocaine. While basal dopamine (DA) and glutamate release were elevated in the nucleus accumbens of SR-/- mice, cocaine-induced increases in DA and glutamate release were blunted. γ-Amino-butyric acid efflux was unaffected in the SR-/- mice. Together, these findings suggest that the impaired NMDAR function and a consequent decrease in sensitivity to cocaine effects on behavior are mediated by blunted DA and glutamate responses normally triggered by the drug. Projected to humans, NMDAR hypofunction due to mutations in SR or other genes impacting glutamatergic function in SZ may render abused substances less potent and effective, thus requiring higher doses to achieve a hedonic response, resulting in elevated drug exposure and increased dependence/addiction.
精神分裂症(SZ)和物质滥用(SA)均表现出显著的遗传性。此外,N-甲基-D-天冬氨酸受体(NMDAR)已被牵涉到 SZ 和 SA 的病理生理学中。我们假设 SZ 中 SA 共病的高患病率是由于共同风险基因导致的 NMDAR 功能障碍。我们使用编码丝氨酸 racemase(SR)的基因缺失突变的转基因小鼠,该基因是合成 NMDAR 共激动剂 D-丝氨酸的酶,也是 SZ 的一个既定风险基因,来重现 SZ 的病理学。我们通过使用颅内自我刺激和活体微透析来确定 NMDAR 功能低下对动机行为的影响,由于缺乏 D-丝氨酸。与野生型小鼠相比,SR-/- 小鼠表现出相似的基础颅内自我刺激阈值,但对可卡因降低阈值(奖励)和提高性能(兴奋剂)的作用的敏感性降低。虽然 SR-/- 小鼠的伏隔核中基底多巴胺(DA)和谷氨酸释放增加,但可卡因诱导的 DA 和谷氨酸释放增加减弱。SR-/- 小鼠中的γ-氨基丁酸流出不受影响。总之,这些发现表明,NMDAR 功能受损以及对可卡因对行为影响的敏感性降低是由药物正常触发的 DA 和谷氨酸反应减弱介导的。投射到人类身上,由于 SR 或其他影响 SZ 中谷氨酸能功能的基因突变导致的 NMDAR 功能低下,可能会使滥用物质的效力降低,因此需要更高的剂量才能产生欣快感反应,从而导致药物暴露增加,依赖性/成瘾性增加。