Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023380 (lethargy)
 5,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

MDMA (3,4-methylenedioxymethamphetamine) or 'Ecstasy' was scheduled as an illegal drug in 1986, but since then its recreational use has increased dramatically. This review covers 15 years of research into patterns of use, its acute psychological and physiological effects, and the long-term consequences of repeated use. MDMA is an indirect monoaminergic agonist, stimulating the release and inhibiting the reuptake of serotonin (5-HT) and, to a lesser extent, other neurotransmitters. Single doses of MDMA have been administered to human volunteers in double-blind placebo-controlled trials, although most findings are based upon recreational MDMA users. The 'massive' boost in neurotransmitter activity can generate intense feelings of elation and pleasure, also hyperactivity and hyperthermia. This psychophysiological arousal may be exacerbated by high ambient temperatures, overcrowding, prolonged dancing and other stimulant drugs. Occasionally the 'serotonin syndrome' reactions may prove fatal. In the days after Ecstasy use, around 80% of users report rebound depression and lethargy, due probably to monoaminergic depletion. Dosage escalation and chronic pharmacodynamic tolerance typically occur in regular users. Repeated doses of MDMA cause serotonergic neurotoxicity in laboratory animals, and there is extensive evidence for long-term neuropsychopharmacological damage in humans. Abstinent regular Ecstasy users often display reduced levels of 5-HT, 5-HIAA, tryptophan hydroxylase and serotonin transporter density; functional deficits in learning/memory, higher cognitive processing, sleep, appetite and psychiatric well-being, and, most paradoxically, 'loss of sexual interest/pleasure'. These psychobiological deficits are greatest in heavy Ecstasy users and may reflect serotonergic axonal loss in the higher brain regions, especially the frontal lobes, temporal lobes and hippocampus. These problems seem to remain long after the recreational use of Ecstasy has ceased, suggesting that the neuropharmacological damage may be permament. Copyright 2001 John Wiley & Sons, Ltd.
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PMID:Human psychopharmacology of Ecstasy (MDMA): a review of 15 years of empirical research. 1240 36

Migraine is an episodic pain disorder whose pathophysiology is related to deficiency of serotonin signaling and abnormal function of the P/Q-type calcium channel, CACNA1A. Because the relationship of the CACNA1A channel to serotonin signaling is unknown and potentially of therapeutic interest we have used genetic analysis of the Caenorhabditis elegans ortholog of this calcium channel, UNC-2, to help identify candidate downstream effectors of the human channel. By genetic dissection of the lethargic mutant phenotype of unc-2, we have established an epistasis pathway showing that UNC-2 function antagonizes a transforming growth factor (TGF)-beta pathway influencing movement rate. This same UNC-2/TGF-beta pathway is required for accumulation of normal serotonin levels and stress-induced modulation of tryptophan hydroxylase (tph) expression in the serotonergic chemosensory ADF neurons, but not the NSM neurons. We also show that transgenic expression of the migraine-associated Ca2+ channel, CACNA1A, in unc-2 animals can functionally substitute for UNC-2 in stress-activated regulation of tph expression. The demonstration that these evolutionarily related channels share a conserved ability to modulate tph expression through their effects on TGF-beta signaling provides the first specific example of how CACNA1A function may influence levels of the critical migraine neurotransmitter serotonin.
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PMID:The voltage-gated calcium channel UNC-2 is involved in stress-mediated regulation of tryptophan hydroxylase. 1467 54

Migraine is a chronic episodic disorder that has been linked to abnormalities in serotonin signaling and abnormal function of a presynaptic voltage-gated calcium channel, CACNA1A. Although the importance of serotonin to migraine tendency suggests a link between serotonergic signaling and CACNA1A function, the nature of this connection remains unclear in vertebrate studies. This article reviews findings, based on an invertebrate model of CACNA1A dysfunction, which suggest a potential connection between serotonergic and calcium channel abnormalities in migraine. Neurons of the invertebrate species Caenorhabditis elegans express a voltage-gated calcium channel, UNC-2, which is the closest ortholog in C. elegans of human CACNA1A. Mutations in unc-2, the gene that encodes this invertebrate channel, cause the animals to be lethargic and uncoordinated. By identifying the genes that could be altered in such a way as to suppress the lethargic phenotype of unc-2, a signaling pathway has been identified through which UNC-2 calcium channel function antagonizes a transforming growth factor-beta (TGF-beta) pathway modulating locomotion. In C. elegans, serotonergic signaling can inhibit the rate of movement. The UNC-2/transforming growth factor-beta pathway identified regulates the expression of a gene encoding the rate-limiting enzyme for serotonin synthesis, tryptophan hydroxylase. The evolutionary and functional relationship between the UNC-2 channel and the migraine-associated CACNA1A channel was further confirmed through experiments showing that transgenic expression of human CACNA1A can suppress the lethargic and serotonin-deficient phenotypes of unc-2 mutant animals. The findings in this invertebrate model constitute the first direct demonstration of how CACNA1A function might affect the levels of serotonin, a neurotransmitter known to be important in migraine.
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PMID:Invertebrate modeling of a migraine channelopathy. 1692 61