<p>Anabolic-androgenic steroids (AAS) have been used in clinics for decades. The misuse of AAS has previously been attributed merely to sport athletes, taking AAS with intentions to increase muscle mass, enhance physical performance and to improve results in competitions. Today, the misuse of AAS has spread to adolescents and young adults not connected to sports. Alarmingly, many reports are pointing at severe psychiatric adverse effects among AAS abusers, which include mood swings, mania, anxiety, depression and aggression. Numerous examples of severe and often unprovoked violence and brutal crimes have been connected to AAS abuse and there is a strong need for a better understanding of the underlying biochemical events that might account for the adverse behaviors induced by AAS. The general aim of this thesis was to study the effect of chronic AAS administration on neuropeptide circuits in the rat brain associated with the regulation of rewarding effects, memory, anxiety, depression and aggression, using nandrolone decanoate as a prototype AAS.</p><p>Results demonstrated that daily administration of AAS to rats in doses comparable to those taken by AAS abusers, in certain brain structures significantly affected, <i>a</i>) the levels of the opioid peptides dynorphin B and Met-enkephalin-Arg⁶Phe⁷, <i>b</i>) the levels of the tachykinin substance P (SP), <i>c</i>) the density of the SP neurokinin 1 (NK1) receptor, <i>d</i>) the level of the SP metabolite SP_1-7that frequently exerts opposite effects to SP, <i>e</i>) the SP_1-7generating enzyme substance P endopeptidase (SPE) and finally, <i>f</i>) the levels of the neuropeptide calcitonin gene-related peptide (CGRP) often co-localized with SP. The alterations seen in the levels and activities of these neurochemical components are in many aspects compatible with behaviors typified among AAS abusers.</p>

Anabolic-androgenic steroids (AAS) have been used in clinics for decades. The misuse of AAS has previously been attributed merely to sport athletes, taking AAS with intentions to increase muscle mass, enhance physical performance and to improve results in competitions. Today, the misuse of AAS has spread to adolescents and young adults not connected to sports. Alarmingly, many reports are pointing at severe psychiatric adverse effects among AAS abusers, which include mood swings, mania, anxiety, depression and aggression. Numerous examples of severe and often unprovoked violence and brutal crimes have been connected to AAS abuse and there is a strong need for a better understanding of the underlying biochemical events that might account for the adverse behaviors induced by AAS. The general aim of this thesis was to study the effect of chronic AAS administration on neuropeptide circuits in the rat brain associated with the regulation of rewarding effects, memory, anxiety, depression and aggression, using nandrolone decanoate as a prototype AAS. Results demonstrated that daily administration of AAS to rats in doses comparable to those taken by AAS abusers, in certain brain structures significantly affected, a) the levels of the opioid peptides dynorphin B and Met-enkephalin-Arg6Phe7, b) the levels of the tachykinin substance P (SP), c) the density of the SP neurokinin 1 (NK1) receptor, d) the level of the SP metabolite SP1-7 that frequently exerts opposite effects to SP, e) the SP1-7 generating enzyme substance P endopeptidase (SPE) and finally, f) the levels of the neuropeptide calcitonin gene-related peptide (CGRP) often co-localized with SP. The alterations seen in the levels and activities of these neurochemical components are in many aspects compatible with behaviors typified among AAS abusers.

Genes and environment interact to determine an individual’s vulnerability or resilience to several psychiatric disorders, including alcohol use disorder (AUD). Alcohol use is often initiated during adolescence and early onset drinking is associated with increased risk for later AUD. Childhood and adolescence are periods of extensive brain maturation, which makes young individuals more susceptible to environmental influence. However, little is known about early environmental influence on reward pathways and behaviors involved in the development of AUD. Changes in the endogenous opioid and dopamine systems, as well as individual differences in risk behaviors are all believed to play important roles in the increased vulnerability seen after adverse early life events and early onset drinking. The overall aim of the thesis was therefore to investigate the influence of early environmental factors on adolescent alcohol intake, endogenous opioids, dopamine dynamics and alcohol-induced effects in rats to increase our knowledge of neurobiological factors underlying vulnerability to AUD. Furthermore, individual behavioral differences and their correlation to basal and drug-induced neurobiological responses in rats were also investigated. Animal models of different early environments, e.g. maternal separation and social vs. single housing, and adolescent alcohol consumption have been used to study effects on behavior, endogenous opioid peptides and dopamine dynamics. The results identified the amygdala and dorsal striatum as interesting brain regions in which endogenous opioids and dopamine, respectively, are impacted by early environmental factors. The amygdala and the dorsal striatum are both hypothesized to be involved in the shift from initial drug use to compulsive use and changes in these areas may be underlying environmentally increased vulnerability to AUD. Furthermore, behavioral phenotypes in relation to individual neurobiological responses were identified. High risk-taking behavior was associated with a more pronounced response to amphetamine, but the inherent dopamine response was instead associated with risk-assessment behavior. In conclusion, several brain regions of interest for future research were identified. Furthermore, the results contribute to increased understanding of factors involved in the development of vulnerability for AUD in adolescents and young adults.

Made available in DSpace on 2016-06-02T19:22:13Z (GMT). No. of bitstreams: 1 6708.pdf: 2113975 bytes, checksum: 30511a391fdfda439671c285b41c07c1 (MD5) Previous issue date: 2015-02-27 / Financiadora de Estudos e Projetos / The central nucleus of the amygdala (CeA) and the lateral parabrachial nucleus (LPBN) are important areas for the control of sodium appetite. The functional integrity of the CeA is critical to sodium and water intake when LPBN the inhibitory mechanisms are deactivated. Therefore, the aims of this study were to investigate the role of different neurotransmitters of the CeA in the control of sodium and water intake induced by a) sodium depletion and b) after blockade of LPBN inhibitory mechanisms. Male Holtzman rats with stainless steel guide cannula implanted bilaterally only in CeA or both into the CeA and LPBN were used. Sodium (0.3 M NaCl) intake was evaluated in satiated, hyperosmotic and sodium-depleted rats. In sodium-depleted animals, bilateral administration of &#945;2- adrenergic/imidazoline receptor agonist moxonidine (10 nmol) into CeA reduced 0.3 M NaCl and water intake. Moreover, bilateral injections of muscimol (0.25 nmol) into CeA reduced sodium intake without change water intake. Oxytocin receptors activation or its blockade in the CeA, blockade of muscarinic cholinergic receptor or activation of 5HT2A/2C serotonergic receptor into the CeA did not change 0.3 M NaCl or water intake in sodium-depleted animals. Bilateral injections of opioid receptor antagonist naloxone (40 &#956;g) into the CeA did not significantly change 0.3 M NaCl and water intake in sodium-depleted animals. However, sodium and water intake induced by bilateral injections of muscimol (0.5 nmol) into the LPBN in satiated animals were completely abolished after bilateral injections of naloxone (40 &#956;g) into CeA. Furthermore, paradoxical sodium intake observed in rats that received oral gavage with 2 M NaCl (2 ml/rat) combined with bilateral injections of moxonidine (0.5 nmol) in LPBN was also blocked by bilateral naloxone (40 &#956;g) into the CeA. 0.3 M NaCl and water intake induced by bilateral muscimol injections (0.5 nmol) into LPBN in satiated animals were abolished by blocking AT1 angiotensin receptors (losartan - 20 &#956;g) in CeA. In sodium-depleted animals, bilateral injections of losartan (20 &#956;g) into the CeA significantly reduced water intake but did not affect sodium intake. Bilateral injections of the aldosterone antagonist RU 28318 (50 ng) did not change sodium and water intake induced by sodium depletion. Present results suggest that ocitocinergic, cholinergic muscarinic, 5-HT2A/2C serotonergic receptors and aldosterone receptors of the CeA do not participate in the control of 0.3 M NaCl intake induced by sodium depletion. Moreover, present results suggest that GABAergic and &#945;2-adrenergic receptors of the CeA have an inhibitory role for sodium appetite in this situation. Although opioids and angiotensinergic mechanisms of the CeA apparently do not contribute to sodium depletion-induced sodium intake, opioidergic and angiotensinergic mechanisms in CeA are essential for sodium intake when the LPBN inhibitory mechanisms are blockade by LPBN muscimol injection. In addition, opioidergic mechanisms in CeA are also essential for the paradoxical sodium intake by hyperosmotic animals when the inhibitory mechanisms are attenuated by LPBN moxonidine. Therefore, the activation of opioidergic and angiotensinergic receptors of the CeA is required for sodium intake observed after removal or attenuation of LPBN inhibitory mechanisms. / O núcleo central da amígdala (CeA) e o núcleo parabraquial lateral (NPBL) são regiões importantíssimas para o controle da ingestão sódio e água. A integridade funcional do CeA é fundamental para a ingestão de sódio e água quando ocorre redução da atividade dos mecanismos inibitórios do NPBL. Portanto, os objetivos do presente estudo foram investigar a participação de alguns neurotransmissores no CeA no controle da ingestão de sódio e água induzida a) por desidratação extracelular e b) após o bloqueio dos mecanismos inibitórios do NPBL. Para tanto foram utilizados ratos Holtzman com cânulas guia de aço inoxidável implantadas bilateralmente apenas no CeA ou bilateralmente no CeA e no NPBL. A ingestão de NaCl 1,8% foi avaliada em animais saciados, hiperosmóticos ou com depleção de sódio. Em animais depletados de sódio, a administração bilateral do agonista de receptores adrenérgicos &#945;2/imidazólicos moxonidina (10 nmol), assim como a de muscimol (0,25 nmol) no CeA reduziram a ingestão de NaCl 1,8%. A ativação ou bloqueio dos receptores de ocitocina, o bloqueio de receptores muscarínicos, ativação de receptores serotenérgicos 5-HT2A/2C, ou ainda o bloqueio de receptores de aldosterona no CeA não modificaram a ingestão de sódio e água. Contudo, injeções bilaterais de losartan (20 &#956;g) no CeA reduziram a ingestão de água, mas não modificaram a ingestão de sódio em animais depletados. Já a ingestão de sódio e água induzidas por muscimol (0,5 nmol) no NPBL em animais saciados foram abolidas após bloqueio de receptores AT1 de angiotensina com administração de losartan no CeA. Administração bilateral de naloxona (40 &#956;g) no CeA não modificou a ingestão de NaCl 1,8% e de água em animais desidratados. No entanto, a ingestão de sódio e água induzidas por injeções bilaterais de muscimol (0,5 nmol) no NPBL em animais saciados foram completamente bloqueadas após injeções bilaterais de naloxona no CeA. Além disso, a ingestão paradoxal de NaCl 0,3 M observada em ratos hiperosmóticos após o tratamento bilateral de moxonidina no NPBL também foi bloqueada pelas injeções de naloxona no CeA. Os presentes resultados sugerem que receptores ocitocinérgicos, colinérgicos muscarínicos, serotoninérgicos 5-HT2 e receptores de aldosterona no CeA não participam do controle da ingestão de NaCl 1,8% induzida por depleção de sódio. Por outro lado, os presentes resultados sugerem que receptores GABAérgicos e receptores adrenérgicos &#945;2 no CeA apresentam um papel inibitório para o apetite ao sódio nessa situação. Embora os mecanismos opióides e angiotensinérgicos no CeA aparentemente não contribuam para a ingestão de sódio induzida pela depleção de sódio, os mecanismos opióides e angiotensinérgicos no CeA são essenciais para a ingestão de sódio observada quando os mecanismos inibitórios do NPBL são desativados pela ação do muscimol nessa área. Além disso, os mecanismos opióides no CeA também são essenciais para a ingestão paradoxal de sódio em animais hiperosmóticos quando os mecanismos inibitórios são atenuados pela ação da moxonidina no NPBL. Portanto, a ativação de receptores opióides e de receptores angiotensinérgicos no CeA é necessária para a ingestão de sódio observada após a remoção ou atenuação dos mecanismos inibitórios NPBL.

FundaÃÃo de Amparo à Pesquisa do Estado do Cearà / Maytenus rigida Mart. (Celastraceae) pupularly known as âbom-homemâ, âbom-nomeâ, âCabelo de Negroâ, âCasca-grossaâ, ChapÃu de couroâ or âpau-de-colherâ is a native species in the northeast region of Brazil, used in folk medicine in the tratament of inflammatory diseases, gastrointestinal disorders such diarrhea, dysentery and ulcers, kidney problems, hypertension, impotence and rheumatism. The aim of this work was to demonstrate the possible mechanism (s) of action underlying the gastroprotective effect of aqueous extract (AE) of Maytenus rigida in Swiss mice, in the gastric injury model induced by absolute ethanol. Fasted mice received AE (100, 200 or 400 mg/Kg, p.o.) 1h prior to oral administration of absolute ethanol (0,2 mL/animal). Groups treated with saline and ranitidine were used as controls. The stomachs were macroscopically and microscopically examined. Additionally, different pharmacologixal tools (naloxone, morphine, misoprostol, indomethacin, L-NAME, L-arginine, clonidine or yohimbine) were used in different tests, trying to clarify the possible mechanism (s) of action of AE. The macro and microscopic gastroprotective effect of AE was compared to that showed by ranitidine, on ethanol-induced model (p<0.05); the use of pharmacological tools revealed that the protective effect of AE involves the activation of &#945;-2-adrenergic receptors, opioid receptor and nitric oxide, but do not depends on prostaglandins. The EA has a gastroprotective effects, supporting its traditional use. Its effect is multifactorial, involving the participation of &#945;-2-adrenergic receptors, nitric oxide release and activation of opioids receptors. / Maytenus rigida Mart., (Celastraceae) popularmente conhecida como âbom-homemâ, âbom-nomeâ, âcabelo de negroâ, âcasca-grossaâ, âchapÃu de couroâ ou âpau-de-colherâ à uma espÃcie nativa do nordeste brasileiro, utilizada na medicina popular no tratamento das doenÃas inflamatÃrias, desordens gastrointestinais como diarreia, disenteria e Ãlceras, problemas renais, hipertensÃo, impotÃncia sexual e reumatismo. O objetivo deste trabalho foi evidenciar o(s) possÃvel(is) mecanismo(s) de aÃÃo subjaentes ao efeito gastroprotetor do extrato aquoso (EA) de Maytenus rigida em camundongos suÃÃos, no modelo de lesÃo gÃstrica induzida por etanol absoluto. Camundongos em jejum receberam EA (100, 200 ou 400 mg/Kg, p.o.) 1 h antes da administraÃÃo oral de etanol absoluto (0,2ml/animal). Grupos tratados com salina e ranitidina foram utilizados como controles. Os estÃmagos foram analisados macro e microscopicamente. Adicionalmente, foram utilizadas diferentes ferramentas farmacolÃgicas (naloxona, morfina, misoprostol, indometacina, L-NAME, L-arginina, clonidina ou ioimbina) em diferentes ensaios, para tentar esclarecer o(s) possÃvel(is) mecanismo(s) de aÃÃo do EA. O efeito gastroprotetor macro e microscÃpico do EA foi comparado ao exercido pela ranitidina no modelo etanol-induzido (p < 0,05); a utilizaÃÃo de ferramentas farmacolÃgicas revelou que o efeito protetor do EA envolve a ativaÃÃo de receptores &#945;2-adrenÃrgicos, receptores opioides, Ãxido nÃtrico, mas nÃo depende de prostaglandinas. O EA possui efeito gastroprotetor, corroborando com seu uso tradicional. Seu efeito à multifatorial, envolvendo a participaÃÃo de receptores &#945;2-adrenÃrgicos, liberaÃÃo de Ãxido nÃtrico, e ativaÃÃo de receptores opioides.

Bases: A antinocicepção induzida por substâncias doces tem sido largamente estudada. Contudo, a investigação dos neurotransmissores envolvidos nesse processo antinociceptivo ainda carece de mais estudos, pois é de extrema importância entender o envolvimento desses neurotransmissores no sistema neural que controla este tipo de antinocicepção. Objetivo: O objetivo deste estudo é clarificar o envolvimento dos sistemas opióide e serotoninérgico na antinocicepção induzida por substância doce. Método: O presente trabalho foi realizado em modelo animal (Rattus norvegicus, Rodentia, Muridae), objetivando investigar se a ingestão crônica de solução de sacarose é seguida de antinocicepção. A latência de retirada de cauda após a aplicação de estímulo nocivo térmico foi medida antes e após esse tratamento no teste de retirada de cauda (provavelmente um reflexo espinal). Não houve diferenças estatisticamente significantes entre os valores de linha basal dos diferentes grupos e foi calculado um índice de analgesia da latência de retirada de cauda antes e depois do tratamento. O envolvimento de opióides endógenos e de serotonina neste processo antinociceptivo foi pesquisado com fármacos antagonistas específicos e não-específicos dos receptores opióides e serotoninérgicos. Resultados: O efeito analgésico da ingestão de sacarose depende da concentração da solução de sacarose e do tempo de duração do consumo da mesma. Naltrexona e metisergida diminuíram a antinocicepção induzida por substâncias doce (após 14 dias de ingestão da sacarose). Estes efeitos foram corroborados pela administração periférica de naloxonazina e cetanserina. Conclusões: Os resultados sugerem o envolvimento de opióides endógenos e serotonina no processo antinociceptivo atualmente estudado. Tudo apontando para a participação de receptores opióides µ1 e serotoninérgicos 5-HT2 na regulação central da antinocicepção induzida por substâncias doces. / Rationale: Sweet substance-induced antinociception has been widely studied, and the investigation of the neurotransmitters involved in the antinociceptive process is an important way for understanding the involvement of neural system controlling this kind of antinociception. Objective: The aim of this study is to investigate the involvement of opioid and serotonergic system in the sweet substance-induces antinociception. Methods: the present work was made in animal model (Rattus norvegicus, Rodentia, Muridae); with the aim of investigating if the chronic intake of sweet substance, such as sucrose, is followed by antinociception. Their tail withdrawal latencies in the tail-flick test (probably a spinal reflex) were measured before and immediately after this treatment. As there was not statistic significant differences between baseline values of different groups, an analgesia index was calculated from the withdrawal latencies before and after treatment. The involvement of endogenous opioid and serotonin in the antinociceptive process was investigated with specific and non-specific pharmacological antagonism on opioid and serotonergic receptors. Results: The analgesic effect of sucrose intake depends on the concentration of sucrose solution and on the time during which the solution is consumed. Naltrexone and methysergide decreased the sweet substance-induced antinociception (post 14 days of sucrose intake). These effects were corroborated by peripheral administration of naloxonazina and ketanserin. Conclusions: The present results suggest the involvement of endogenous opioids and serotonin in the antinociceptive process presently studied. µ1-opioid and 5-HT2 serotonergic receptors may be involved in the central regulation of the sweet substance-produced antinociception.

The thesis is focused on perioperative use of opioids during caesarean section. The general part is concerned with pharmacology of opioids due to their practical use during general and regional anaesthesia and postoperative analgesia with particular focus on remifentanil. Emphasis is put on the placental transfer of opioids into breast milk which has the possible influence on postnatal adaptation of the newborns and breastfeeding/lactation. The first part of the research describes current anaesthetic practice and opioid use in obstetrics in the Czech Republic according to the OBAAMA-CZ study in 2011. The second study on a unique group of 151 parturients showed that bolus application of remifentanil at a dose of 1 μg/kg at the time of 30 seconds before induction of general anaesthesia for caesarean section significantly stabilizes maternal hemodynamic parameters (blood pressure, heart rate) and reduces the stress response to tracheal intubation and skin incision. On the contrary, no influence on depth of anaesthesia (monitored by BIS) was found. But we demonstrated a slight effect of remifentanil on the assessment of postnatal adaptation of newborns at first minute after delivery. However, this attenuation was very short and in the fifth minute the results were already fully comparable to the control...

Lifetime prevalence estimates of psychotropic medicine use as well as prevalence of DSM-IV prescription drug use disorders from the baseline investigation of the Early Developmental Stages of Psychopathology (EDSP) Study are presented. Use of prescription medication at some time in their life was reported by 27.4% of the respondents. Illicit use of prescription drugs, which means an intake without medical legitimation, was reported by 4.5% of the sample. The findings suggest that abuse of and dependence on prescription drugs, with most cases reporting polysubstance use, is quite rare in the 14- to 24-year-olds. DSM-IV abuse was more prevalent than dependence (0.5 vs. 0.3%). In general, women reported higher prevalence rates of prescription drug use, whereas men reported higher prevalence rates of prescription drug disorders. This result suggests that men have a higher risk to develop a substance-use-related disorder.

Introduction : La tolérance induite par l’utilisation prolongée des opiacés peut se traduire par un syndrome de sevrage aux opiacés (SDSO). Il n’existe aucun consensus sur la méthode idéale de sevrage des opiacés pour prévenir le SDSO chez la clientèle des soins intensifs pédiatriques (SIP). L’objectif de cette étude était de comparer l’efficacité de deux stratégies de sevrage des opiacés, à savoir la méthadone et la morphine administrées par voie entérale, à prévenir le SDSO. Devis : Essai clinique randomisé à double aveugle chez les enfants sous ventilation mécanique hospitalisés aux SIP. Méthode : Nous avons comparé la durée totale de sevrage, l’incidence et la sévérité du SDSO chez les enfants à risque au moins modéré de SDSO sevrés avec la méthadone et la morphine entérales. Les enfants inclus étaient ceux hospitalisés au Centre Hospitalier Universitaire Sainte-Justine ou au Centre Mère-Enfant Soleil de Québec entre le 1er novembre 2003 et le 31 mai 2009. Résultats : Quarante-huit patients (22 groupe méthadone et 26 groupe morphine) ont été inclus et 30 patients ont complété le protocole de sevrage (16 groupe méthadone et 14 groupe morphine). La durée médiane de sevrage était de 5.4 jours dans le groupe méthadone comparativement à 5.8 jours pour le groupe morphine (p=0.49). Il n’y avait pas de différence dans l’incidence du SDSO (62.5% versus 42.9%; p=0.46), et dans sa sévérité (12.5% versus 14.3% de SDSO sévère; p=0.62). Conclusion : L’efficacité d’un sevrage standardisé des opiacés par la méthadone était comparable à celle de la morphine. / Background : The prolonged use of opioids has been associated with opioid tolerance and weaning is necessary to prevent opioid withdrawal symptoms (OWS). Little research exist for an ideal effective opioid taper to reduce the prevalence of OWS. This study aim to compare the effectiveness of two opioid taper strategies, enteral’s methadone and morphine, in preventing the occurrence of OWS among pediatric intensive care patients. Design: Double-blinded randomized controlled trial in mechanically ventilated children (MVCs) hospitalized in 2 pediatric intensive care units (PICU). Methods: Eligible patients were MVCs at moderate risk of OWS admitted in PICU of the Centre Hospitalier Universitaire Sainte-Justine or the Centre Mère-Enfant Soleil de Québec between November 1, 2003 and May 31, 2009. We assessed the total weaning duration, the OWS’s incidence and the OWS’s severity in a methadone’s and a morphine’s taper schedule. Results: Forty-eight patients were included, 22 in the methadone group and 26 in the morphine group and 30 patients completed the weaning protocol (16 methadone and 14 morphine). The median duration of weaning was 5.4 days among methadone’s patients as opposed to 5.8 days among morphine’s group (p=0.49). There was no statistical difference between groups for OWS’s incidence (62.5% vs 42.9%; p=0.46), nor for its severity (12.5% vs 14.3% of severe OWS; p=0.62). Conclusion: The use of a standardized opioid weaning protocol with enteral methadone was as effective as the enteral morphine one’s to prevent OWS. Further studies are needed to determine an ideal opioid taper to reduce OWS.

The thesis is focused on perioperative use of opioids during caesarean section. The general part is concerned with pharmacology of opioids due to their practical use during general and regional anaesthesia and postoperative analgesia with particular focus on remifentanil. Emphasis is put on the placental transfer of opioids into breast milk which has the possible influence on postnatal adaptation of the newborns and breastfeeding/lactation. The first part of the research describes current anaesthetic practice and opioid use in obstetrics in the Czech Republic according to the OBAAMA-CZ study in 2011. The second study on a unique group of 151 parturients showed that bolus application of remifentanil at a dose of 1 μg/kg at the time of 30 seconds before induction of general anaesthesia for caesarean section significantly stabilizes maternal hemodynamic parameters (blood pressure, heart rate) and reduces the stress response to tracheal intubation and skin incision. On the contrary, no influence on depth of anaesthesia (monitored by BIS) was found. But we demonstrated a slight effect of remifentanil on the assessment of postnatal adaptation of newborns at first minute after delivery. However, this attenuation was very short and in the fifth minute the results were already fully comparable to the control...