Preliminary imaging studies of the kappa opioid receptors in schizophrenia and their relationship to dopamine function

尽管临床和临床前证据表明kappa的潜在作用 强啡肽系统在精神分裂症中的作用，目前还没有对此进行严格的体内研究 精神分裂症的系统。我们建议进行多模式成像研究以获取信息 关于精神分裂症和精神分裂症患者纹状体内kappa阿片受体(KOR)的可用性 探讨其与在相同受试者中测量的多巴胺能功能的关系 神经黑素敏感核磁共振(NM-MRI)扫描。我们最近验证了NM-MRI是一种 神经黑色素浓度的测量和多巴胺能功能的标志， 证实黑质NM信号与NM信号之间存在显著关系 正电子发射断层扫描测量纹状体中多巴胺的释放能力。在……里面 这项建议10名服用抗精神病药物的单纯精神分裂症患者和10名 人口统计学上匹配的健康对照组将接受PET扫描 [18F]选择性KOR拮抗剂放射性示踪剂LY2459989和NM-MRI扫描，以获得 在相同的受试者中，测量纹状体和神经黑素中KOR的有效性 黑质。我们预计，两个群体在这两个指标上都会有所不同，而 在SCZ患者中，KOR的上调与较高的神经黑素含量有关。这位飞行员 这项研究将为一项更大规模的研究的设计提供参考，并为生物标志物提供POC- 精神分裂症KOR拮抗剂体内给药的驱动性研究 分子测量以及KOR和多巴胺功能障碍之间的联系。今年5月 最终为推进特定KOR的新治疗测试提供支持 拮抗剂，通过使用潜在的生物标记物，我们将在这里探索， KOR和NM-MRI，以加强精神分裂症患者的设计和选择 这可能会成为攻击目标。这种疾病迫切需要新的治疗方法，特别是对 以D2为基础的一线治疗未完全缓解的患者 症状。D2药物的替代或附加疗法将改善生活质量 对于患有这种毁灭性疾病的患者来说。

Despite clinical and preclinical evidence suggesting a potential role for the kappa dynorphin system in schizophrenia, there are no rigorous in vivo investigations of this system in schizophrenia. We propose a multimodal imaging study to obtain information about the availability of kappa opioid receptors (KOR) in striatum in schizophrenia and explore its relationship to dopaminergic function measured in the same subjects, with a neuromelanin sensitive MRI (NM-MRI) scan. We recently validated NM-MRI as a measure of neuromelanin concentration and a marker of dopaminergic function, demonstrating a significant relationship between NM signal in the substantia nigra and Positron Emission Tomography measures of dopamine release capacity in the striatum. In this proposal 10 antipsychotic-drug naïve patients with schizophrenia and 10 demographically matched healthy controls will undergo a PET scan with [18F]LY2459989, a selective KOR antagonist radiotracer, and a NM-MRI scan to obtain in the same subjects a measure of KOR availability in the striatum and neuromelanin in the substantia nigra. We expect that groups will differ on both measures, and that upregulation of KOR will relate to higher neuromelanin in patients with SCZ. This pilot study will inform the design of a much larger study and provide POC for biomarker- driven investigations of KOR antagonists in schizophrenia by providing in vivo molecular measures and a link between KOR and dopamine dysfunction. This may ultimately provide support for advancing new therapeutic testing of specific KOR antagonists, informed by the use of potential biomarkers that we will probe here, the KOR and NM-MRI, to enhance the design and selection of patients with schizophrenia that could be targeted. New therapies are badly needed in this disease, particularly for patients in whom first-line D2-based treatments do not produce full remission of symptoms. Alternative or additional therapies to D2 drugs will improve the quality of life for patients suffering from this devastating disease.