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Inhibitors of Endocannabinoid Metabolizing Enzymes Reduce Precipitated Withdrawal Responses in THC Dependent Mice 1Department of Pharmacology and Toxicology, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA 23298 2The Skaggs Institute for Chemical Biology and Department of Chemical Physiology, The Scripps Research Institute, La Jolla, California 92037 Corresponding Author: Dr. Aron H. Lichtman, Ph.D., Department of Pharmacology and Toxicology, Virginia Commonwealth University, PO Box 980613, Richmond, VA 23298-0613, Tel: 804-828-8480 ; Fax: 804-828-2117, Email: alichtma/at/vcu.edu The publisher's final edited version of this article is available at AAPS J.Abstract Abstinence symptoms in cannabis-dependent individuals are believed to contribute to the maintenance of regular marijuana use. However, there are currently no medications approved by the FDA to treat cannabis related disorders. The only treatment currently shown consistently to alleviate cannabinoid withdrawal in both animals and humans is substitution therapy, using the psychoactive constituent of marijuana, Δ9-tetrahydrocannabinol (THC). However, new genetic and pharmacological tools are available to increase endocannabinoid levels by targeting fatty acid amide hydrolase (FAAH) or monoacylglycerol lipase (MAGL), the enzymes responsible for the degradation of the endogenous cannabinoid ligands anandamide (AEA) and 2-arachidonoylglycerol (2-AG), respectively. In the present study, we investigated whether increasing endogenous cannabinoids levels, through the use of FAAH (−/−) mice as well as the FAAH inhibitor URB597 or the MAGL inhibitor JZL184, would reduce the intensity of withdrawal signs precipitated by the CB1 receptor antagonist rimonabant in THC-dependent mice. Strikingly, acute administration of either URB597 or JZL184 significantly attenuated rimonabant-precipitated withdrawal signs in THC-dependent mice. In contrast, FAAH (−/−) mice showed identical withdrawal responses as wild-type mice under a variety of conditions, suggesting that the absence of this enzyme across the development of dependence and during rimonabant challenge does not affect withdrawal responses. Of importance, subchronic administration of URB597 did not lead to cannabinoid dependence, and neither URB597 nor JZL184 impaired rotarod motor coordination. These results support the concept of targeting endocannabinoid metabolizing enzymes as a promising treatment for cannabis withdrawal. Keywords: cannabis dependence, Fatty Acid Amide Hydrolase (FAAH), Monoacylglycerol Lipase (MAGL), anandamide, 2-arachindonoylglycerol (2-AG) Introduction Cannabis sativa is by far the most commonly used illicit drug in the United States, representing 73% of all illicit drug use and more than half of these individuals use marijuana exclusively. Of the over 14 million people who use marijuana in the United States, almost 4 million are classified as being dependent or abusing (1). While it is common public perception that marijuana poses reduced physical dependency risk compared to other drugs of abuse, repeated marijuana smoking has been demonstrated to produce a distinct abstinence syndrome in clinical settings (2,3). The symptoms of this syndrome include anxiety, irritability, stomach pains, disrupted sleep, and general physical discomfort. Marijuana withdrawal has been compared to that of tobacco, and is reported to increase craving and desire to resume use (4,5). A similar abstinence syndrome has also been shown upon cessation of repeated oral Δ9-tetrahydrocannbinol (THC), the primary psychoactive component of marijuana, in human studies (6). Any abstinence syndrome may increase the desire to continue drug use and represents a complication in treating dependence. Despite representing more than half of all classified drug abusers and an average 1 million people receiving treatment each year for marijuana dependence, there are currently no approved pharmacological treatments available for cannabis dependence. THC is also the most reliable and effective pharmacological agent identified that reduces cannabis withdrawal signs in both preclinical (7–9) and clinical (10,11) studies. In fact, many common treatments employed for tobacco cessation and other drugs of abuse actually worsened marijuana withdrawal symptoms (10,12). Thus, there is a need to examine marijuana withdrawal treatment as a unique and separate area of research. Rodent models of precipitated cannabinoid withdrawal have been well characterized since the introduction of the selective CB1 receptor antagonist, rimonabant (13,14). Mice exposed to either repeated marijuana smoke or injections of THC display similar physical withdrawal symptoms (8), with the most common signs being paw tremors and head twitches (15,16). These withdrawal behaviors have been correlated with increased adenylyl cyclase activity in cerebellum (17), in marked contrast to acute cannabinoid actions that inhibit adenylyl cyclase activity (18). In addition, repeated THC administration results in significant desensitization and downregulation of CB1 receptors, consistent with behavioral tolerance seen in vivo (19). The observations that nonhuman primates self-administer THC (20) and that THC elicits a discriminative cue in animals (21) increase our understanding of cannabinoid dependence. The endogenous cannabinoid system has become a rapidly developing area of research in recent years. This system consists of two receptor subtypes (CB1 and CB2), and several endogenous lipid-based signaling molecules that bind to these receptors (endocannabinoids). The two best characterized endogenous ligands, anandamide (AEA) and 2-arachindonoylglycerol (2-AG), are formed from membrane phospholipid precursors on-demand, and are then rapidly eliminated by enzymatic degradation (for review see ref. 22). The primary enzyme responsible for AEA degradation is fatty acid amid hydrolase (FAAH), which upon genetic or pharmacological inactivation leads to up to 10-fold increases in brain AEA levels (23,24). FAAH (−/−) mice display wild-type behavioral responses in most tests, with mild to moderate hypoalgesic and anxiolytic-like phenotypes (25,26). Inhibitors of FAAH, such as URB597, have been characterized in the literature (24,27), and show promising therapeutic efficacy in a variety of pathologies (for review see ref. 28), with little evidence of cannabimimetic effects or abuse liability (29–31). The enzymatic degradation of 2-AG is primarily due to the activity of monoacylglycerol lipase (MAGL), which accounts for approximately 85% of 2-AG degradation in brain. Other enzymes identified as responsible for 2-AG degradation include ABHD12 and ABHD6, which have yet to be fully characterized (32). JZL184 is the first selective inhibitor of MAGL and when administered systemically led to 8-fold increases in brain 2-AG levels, hypoalgesia, and a subset of other cannabinoid effects (33). In the present study, we employed FAAH (−/−) mice as well as URB597 (34) and JZL184 (33) to investigate whether increasing endogenous cannabinoid levels can ameliorate cannabinoid withdrawal responses. URB597 does not elicit rewarding effects in the conditioned place preference test and does not produce generalization to the discriminative effects of THC in rats (35), and is not self-administered by monkeys (29). These findings suggest that indirect cannabinoid agonists possess less dependence liability than THC. In the first series of experiments, we examined whether FAAH (−/−) mice would display a decrease in the severity of THC withdrawal responses. In the second set of experiments, we investigated whether acute administration of either URB597 or JZL184 would suppress the somatic signs of THC withdrawal. In the final experiments, the physical liability of URB597 and overall motor suppressant effects of both inhibitors were examined to determine any side-effects undesirable for therapeutic use. Methods Subjects The subjects were adult male C57BL/6J mice that were purchased from the Jackson Laboratory (Bar Harbor, ME). Also serving as subjects were adult, male and female FAAH (−/−) and (+/+) mice that were obtained from the Center Transgenic Colony at Virginia Commonwealth University (Richmond, VA) backcrossed onto a C57BL/6J (at least 13 generations) background. Mice were kept on a 12-hour light/dark cycle, with all experiments performed during the light cycle. Mice were housed 4–6 per cage in a temperature (20–22°C) controlled environment, with food and water available ad libitum except during testing. All experiments were performed with the approval of the Institutional Animal Care and Use Committee at Virginia Commonwealth University in accordance with the Guide for the Care and Use of Laboratory Animals. Drugs THC and rimonabant were obtained from the National Institute on Drug Abuse (Bethesda, MD), while URB597 was purchased from Cayman Chemical (Ann Arbor, MI). JZL184 was synthesized as described previously (33). All other chemical components for vehicles were obtained from Sigma-Aldrich (St. Louis, MO) unless otherwise stated. THC and rimonabant were dissolved in vehicle mixture of ethanol/alkamuls-620 (Rhone-Poulenc, Princeton, NJ)/saline in a ratio of 1:1:18. URB597 was dissolved in a vehicle containing Tween 80/DMSO/saline in a ratio of 1:2:7. JZL184 was dissolved in a vehicle of PEG 200/Tween 80 in a ratio of 4:1. THC, rimonabant, and URB597 were diluted to an injection volume of 10 µL/g body mass, while JZL184 was injected at a volume of 4 µL/g body mass to limit vehicle effects. URB597 was administered 1 h before testing to coincide with previous findings of peak anandamide elevations at this time point (24). Similarly, JZL184 was administered 2 h before testing to coincide with peak levels of 2-AG elevations following systemic administration (33). Rimonabant-Precipitated THC Withdrawal Mice were given subcutaneous injections of THC to induce dependence under either a high or low dosing regimen. In the high-dose regimen, mice were given two daily injections of THC (50 mg/kg, s.c.) for five and a half days, with each injection separated by approximately 12 h. In the low-dose regimen, each mouse was given a single, daily injection of THC (10 mg/kg, s.c.) for six days. In both conditions, the mice were given an i.p. injection of rimonabant 30 min after THC. All mice were then monitored and scored as described below for one hour following rimonabant injection. Behavioral Evaluation of Somatic Withdrawal Signs Animals were pretreated with test drugs at times described above, followed by the described doses of THC just prior to placement in observation chambers. All animals were placed into white (for contrast) acrylic chambers (20 cm × 20 cm × 20 cm), with a clear acrylic front panel and a mirrored back panel, for a 30 min period for acclimation to the test chamber. The chambers were enclosed in sound-attenuating cabinets, designed and custom built at Virginia Commonwealth University, that contained an indirect filtered LED light source and fans for air circulation and white noise. At the 30 min time point, the animals were briefly removed from the chambers, were given an i.p. injection of rimonabant, and were immediately returned to the chambers for a 1 h observation period. The chambers were wiped clean with water just before the mice were returned for the observation period. Behavior was recorded through the clear front panel using a series of Fire-i™ digital cameras (Unibrain, San Ramon, CA) and the videos were processed and saved using ANY-maze™ video tracking software (Stoelting Co., Wood Dale, IL). Chambers were fully sanitized at the end of each testing day using ammonia-based cleansers and soap, then left to air dry at least two days to dissipate any odors. The videos were subsequently placed in randomized order in a separate ANY-maze™ protocol for a trained observer to score using a keyboard-based behavioral tracking system, blinded to treatment group. ANY-maze™ software was used to track key presses assigned to somatic withdrawal behaviors for both time pressed and/or number of occurrences. Videos were scored using time sampling, examining periods of 5 min intervals, and then moving 5 min ahead on the video starting at minute 5 post-rimonabant injection (i.e. 5–10 min, 15–20 min, etc). At the end of the hour video, each animal had a similar sampled 30 min period observed and scored from their recordings. While a number of behavioral endpoints were observed that have been previously described in the literature as common in mice going through cannabinoid withdrawal (i.e. ptosis, retropulsion, piloerection, etc.), behaviors scored and presented are the most common, quantifiable, and with the highest inter-rater reliability (15). The primary behavior observed was front paw tremors that included a range of behavior from single-paw twitches to full fluttering/shaking of both paw simultaneously. These motions of the paws are not typical of normal behavior. Also recorded were head twitches, which generally manifest as rotational shakes of the head, similar to what is described as “wet dog shakes” in rats. The third behavior that was quantified was hind leg scratching that involved any repetitive scratching motion of the head or torso by either hind leg. All behaviors were counted as new incidences if either separated by at least 1 s, and/or interceded by another distinct behavior (i.e. crawling, climbing, grooming). Extraction & Quantification of Endocannabinoids by LC/MS To quantify AEA and 2-AG levels in brain, both FAAH (+/+) and (−/−) mice were treated with the high THC dosing regimen and challenged with rimonabant (10 mg/kg, i.p.), as described above. Thirty min into the withdrawal period, the subjects were decapitated and their brains were removed. The cerebellum and forebrain/midbrain regions were dissected. These global regions were selected based on studies showing that the cerebellum may contribute to precipitated cannabinoid somatic withdrawal signs in mice (17), while midbrain and cortical regions show a great deal of CB1 receptor down-regulation and desensitization following subchronic THC administration (19,36). Both sections were snap frozen in liquid nitrogen, and stored at −80°C. On the day of processing, tissues were weighed and homogenized with 1.4 ml chloroform: methanol(2:1 v/v containing 0.0348 mg PMFS/ml) after the addition of internal standards to each sample (2 pmol AEA –d8 and 1 nmol 2-AG-d8). Homogenates were then mixed with 0.3 ml of 0.73% w/v NaCl, vortexed, and then centrifuged for 10 min at 4000 rpm (4° C). The aqueous phase plus debris were collected and extracted two more times with 0.8 ml chloroform. The organic phases from the three extractions were pooled and the organic solvents were evaporated under nitrogen gas. Dried samples were reconstituted with 0.1 ml chloroform and mixed with 1 ml ice cold acetone. The mixtures were then centrifuged for 5 min at 3000 rpm and 4°C to precipitate the proteins. The upper layer of each sample was collected and evaporated under nitrogen. Dried samples were reconstituted with 0.1 ml methanol and placed in autosample vials for analysis. LC/MS/MS was used to quantify AEA and 2-AG. The mobile phase consisted of (10:90) water: methanol with 0.1% ammonium acetate and 0.1% formic acid. The column used was a Discovery HS C18, 4.6* 15 cm, 3 micron (Supelco, USA). The mass spectrometer was run in Electrospray Ionization, in positive mode. Ions were analyzed in multiple reaction monitoring mode, and the following transitions were monitored: (348>62) and (348>91) for AEA; (356>62) for AEA-d8; (379>287) and (279>269) for 2-AG; and (387>96) for 2AG-d8. A calibration curve was constructed for each assay based on linear regression using the peak area ratios of the calibrators. The extracted standard curves ranged from 0.03 pmol to 40 pmol for AEA and from 0.05nmol to 64 nmol for 2-AG. Rotarod Motor Coordination Testing Mice were trained for at least three days before testing to remain on a rotating 1¼” rotarod (IITC Life Sciences, Woodland Hills, CA) until able to stay on a rotarod maintained at 16 RPM. On drug test days, the rotarod was set to accelerate from 1 RPM to 16 RPM over the course of 60 s. The data shown reflect the RPM speed at which the animal fell off, 16 RPM representing animals that remained on the rotarod during testing. On test days, a baseline test was given prior to drug administration. THC (40 mg/kg) was administered at a dose that demonstrated significant motor impairment in preliminary testing, and then was tested for CB1 receptor specificity by treating animals with rimonabant (3 mg/kg) 10 min before THC administration. For the enzyme inhibitor tests, URB597 (10 mg/kg) and JZL184 (16 mg/kg) were given at the same doses as those used in withdrawal experiments. All drugs were tested at time points before, during, and after times observed during the withdrawal tests. Data Presentation & Analysis All data are reported as mean ± SEM. The somatic withdrawal behaviors were the scored observations of a 30 min sample observation period from the 1 h recording. Noncontinuous behaviors, such as head twitches and paw tremors, are presented as number of incidences observed. The continuous behavior of hind leg scratching is presented as total time observed scratching. All endocannabinoid levels are reported as mole per gram tissue. Rotarod data are expressed as the average RPM value at which the animal fell off the apparatus. Experiments with only two treatment groups were analyzed for statistical significance using the Student’s t test. Experiments with more than two groups were analyzed using two-way analysis of variance (ANOVA), rotarod testing analyzed using repeated measures ANOVA. Significant ANOVAs were followed by Tukey’s post-hoc test, while Dunnett’s post hoc test was used for the rimonabant dose-response experiment. Resulting p values of less than 0.05 were considered significant. ED50 values (with 95% confidence intervals) were calculated using the least-squares linear regression method. Results Rimonabant precipitates similar somatic withdrawal signs in FAAH (−/−) and (+/+) given repeated injections of THC The purpose of this series of experiments was to determine whether THC dependence would be reduced in FAAH (−/−) mice compared to FAAH (+/+) mice. In the first experiment, FAAH (−/−) and (+/+) mice were treated in the high THC dosing regimen or given vehicle for 5.5 days. On the sixth day, the vehicle-treated mice were given an acute injection of vehicle or rimonabant (10 mg/kg), while all the THC-treated mice were given an acute injection of rimonabant (10 mg/kg). Previous research from our laboratory indicated that mice treated repeatedly with THC and challenged with vehicle do not exhibit any withdrawal symptoms (7,8). Front paw tremors/fluttering were the primary somatic sign observed. As seen in Figure 1A
Although FAAH (−/−) mice did not display significant decreases in withdrawal behavior, it is possible that ceiling effects caused by the high THC dosing regimen obscured subtle genotype differences. Thus, a follow-up experiment was conducted using a mild THC dosing regimen to examine whether severity of rimonabant precipitated withdrawal is altered in FAAH (−/−) mice. Rimonabant precipitated paw tremors [F(2, 26) = 97.5, p < 0.001; Figure 2a
In the next experiment, we examined whether rimonabant would be more potent in precipitating withdrawal in FAAH (−/−) mice than in FAAH (+/+) mice. Both genotypes were subjected to the high THC dosing regimen (i.e., 50 mg/kg twice a day for 5.5 days) and the dose-response relationship of rimonabant in precipitating paw tremors and head shakes was determined. Rimonabant elicited a significant dose-responsive effect on paw tremors [F(3, 37) = 38.4, p < 0.001; Figure 3A
Quantification AEA and 2-AG Brain Levels in THC-dependent FAAH (+/+) and (−/−) mice Undergoing Withdrawal To examine whether rimonabant (10 mg/kg) altered endogenous cannabinoid levels in vFAAH (+/+) or (−/−) mice treated with repeated injections of either vehicle or THC (50 mg/kg), cerebellum and combined forebrain/midbrain were obtained from these. As summarized in Table 1, equivalent AEA levels were found in cerebellum in THC-dependent and non-dependent mice, though AEA levels were approximately 10-fold higher in FAAH (−/−) mice than in FAAH (+/+) mice [F(1, 28) = 242.4, p < 0.001]. Similarly, 2-AG levels did not differ between THC-dependent and non-dependent mice. However, FAAH (−/−) mice showed significant decreases in cerebellar 2-AG content regardless of subchronic treatment [F(1, 28) = 5.5, p < 0.05]. In the forebrain/midbrain, FAAH (−/−) mice also displayed significant increases in AEA, regardless of subchronic treatment [F(1, 29) = 313.9, p < 0.001]. However, a significant interaction was found between genotype and subchronic treatment [F(1, 29) = 5.6, p < 0.05]. A small, but significant reduction of AEA levels was found in the forebrain/midbrain of THC-treated FAAH (−/−) mice compared to vehicle-treated FAAH (−/−) mice (Tukey’s post-hoc; p < 0.05). Finally, there were no differences in 2-AG levels in forebrain/midbrain tissues based on genotype or subchronic THC treatment.
Acute administration of the FAAH inhibitor, URB597, reduces the severity of rimonabant-precipitated withdrawal in THC-dependent mice FAAH (−/−) mice possess constitutively elevated levels of AEA that would have occurred presumably across the development of dependence and during rimonabant challenge. Thus, in the next experiment we investigated whether acute blockade of FAAH using the irreversible FAAH inhibitor, URB597, would reduce the severity of rimonabant-precipitated withdrawal responses in mice subjected to the high THC dosing regimen. The experiment was conducted in both FAAH (+/+) and (−/−) mice to determine the specificity of any URB597 effects to its actions on FAAH activity. As seen in Figure 4A
Acute administration of the MAGL inhibitor, JZL184, reduces the severity of rimonabant-precipitated withdrawal in THC-dependent mice There are currently no available MAGL knockout mice to examine the impact of deleting this enzyme and concomitant elevations in 2-AG levels on THC withdrawal. However, the first selective MAGL inhibitor reported, JZL184, shows a partial set of CB1 receptor mediated behavioral effects in the cannabimimetic tetrad test (hypomotility, hypothermia, and analgesia) (33). To examine if acute elevation of 2-AG levels can reduce somatic signs of rimonabant precipitated-withdrawal in THC-dependent mice, vehicle or JZL184 (16 mg/kg) was administered 2 h before rimonabant injection. The high THC dosing regimen was used. Testing was performed in both FAAH (+/+) and (−/-) mice to examine the specificity of drug effects to FAAH, and to ascertain whether simultaneous elevation of AEA and 2-AG levels causes differential responses. As seen in Figure 5A
Rimonabant Precipitated Withdrawal of Repeated URB597 The purpose of this experiment was to examine whether repeated administration of FAAH inhibitors produces a cannabimimetic physical dependence. Mice were treated with URB597 (10 mg/kg) or vehicle twice daily for 5.5 days and were challenged with rimonabant 1 h after their final injection. No irregular behaviors were observed or noted during the recording or scoring of the videos, and all the same somatic signs tracked during THC withdrawal were quantified. Rimonabant produced no significant differences between mice that were given repeated injections of URB597 and vehicle on paw tremors [t(14) = 0.8, p = 0.44] as well as head twitching [t(14) = 0.4, p = 0.68]. These results are summarized in Table 2.
Rotarod Motor Coordination Tests While URB597 does not appear to affect locomotor activity (28), JZL184 has been reported to suppress spontaneous activity (33); however, neither compound has been examined in the rotarod test, an assay used to assess motor coordination. In order to evaluate whether URB597 or JZL184 elicits motor deficits that may interfere with the expression of somatic withdrawal signs, both endocannabinoid modulators were evaluated in this assay. In an initial experiment, we examined the effects of THC (40 mg/kg) vs. rimonabant (3 mg/kg) on performance in the rotarod test. As shown in Figure 6A
The final experiment examined whether URB597 (10 mg/kg) or JZL184 (16 mg/kg) would impair performance in the rotarod test (Figure 6B Discussion In the present study, we investigated the role of endocannabinoid degradative enzymes in THC dependence. Specifically, we examined the impact of increasing AEA or 2-AG levels on somatic withdrawal signs precipitated by the CB1 receptor antagonist rimonabant in THC dependent mice. Despite persistent elevation of AEA above that of wild-type mice, FAAH (−/−) mice showed no alterations in rimonabant precipitated withdrawal responses across a variety of experimental conditions. Thus, the constitutive absence of this enzyme across ontogeny does not affect the development of physical dependence to THC. Strikingly, the FAAH inhibitor URB597 and the MAGL inhibitor JZL184 ameliorated withdrawal responses in THC-dependent mice when administered acutely. In FAAH (−/−) mice, URB597 no longer reduced precipitated paw tremors, while JZL184 maintained its efficacy. This pattern of findings is consistent with the notion that these drugs produce their effects through the inhibition of distinct enzymes. Unlike direct-acting cannabinoid agonists that possess dependence liability, repeated administration of URB597 alone did not lead to physical dependence. These findings indicate that increasing endogenous cannabinoid signaling may represent a novel strategy to treat cannabis dependence. The characteristic pattern of behavior associated with rimonabant-precipitated somatic withdrawal signs in THC-dependent mice reported here is similar to that previously characterized in the literature (7,15). Tremors in the front paws continue to be the most consistent, quantifiable, and consistently dose-responsive. Paw tremors was dose-responsive to both the dose of THC that was subchronically administered and dose of rimonabant used to precipitate withdrawal, making it the most principal behavior in defining THC dependence in mice. Rimonabant elicited head twitches in non-dependent mice, but this effect was augmented in THC dependent mice. On the other hand, scratching behavior appears to be an intrinsic effect of rimonabant. Previous research has demonstrated that rimonabant induces scratching in a dose-responsive manner, and is blocked by cannabinoid agonists (38). In fact, our research has shown that the endocannabinoid system may play a modulatory role in scratching behavior (39). Given the observation that URB597 reduced rimonabant precipitated withdrawal signs in THC dependent mice, the lack of a FAAH (−/−) phenotype in this withdrawal model was somewhat surprising. Though one might expect that enhanced endocannabinoid signaling might provide a protective mechanism against cannabinoid withdrawal, especially as AEA is discretely produced on-demand under conditions of stress (40), it is also possible that elevated endocannabinoids during the development of dependence may have enhanced the severity of precipitated withdrawal. Despite having consistently elevated AEA levels nearly 10-fold above that of the wild-type animals, FAAH-deficient mice have previously been demonstrated to display similar responses to acute THC in a battery of cannabinoid sensitive behaviors as wild type animals (23). FAAH (−/−) and (+/+) mice also have identical levels of CB1 receptors in brain and possess similar binding affinities to [3H]CP-55,940, suggesting no abnormalities in receptor number or function (25). However, the possibility exists that other compensatory actions occurred due to genetic deletion of this gene across ontogeny. Follow-up studies into AEA and 2-AG content in the brains of FAAH (−/−) mice showed lower 2-AG content in the cerebellum compared to wild-type mice, which may be a compensatory mechanism for consistent AEA elevations. AEA content in midbrain/forebrain regions was reduced approximately 23% in THC-treated FAAH (−/−) mice compared to vehicle treated FAAH (−/−) mice, suggesting the possibility that THC dependence or withdrawal may elicit negative feedback on AEA biosynthesis. Reductions in AEA content of midbrain/forebrain regions have been previously reported in rats during THC withdrawal, and similarly no alterations were seen in cerebellum (36). Subchronic THC elicits less CB1 receptor desensitization and down-regulation in the cerebellum than in midbrain areas, such as thalamus and hippocampus (19). Although the reduced AEA levels detected in midbrain/forebrain region of the THC-dependent FAAH (−/−) mice might contribute to the normalized rimonabant-precipitated somatic withdrawal responses in the THC-dependent animals, it should be noted that AEA levels were still elevated approximately 8-fold in the FAAH (−/−) mice compared to the wild type mice. At any rate, genetic deletion of FAAH does not appear to influence rimonabant-precipitated withdrawal responses in THC dependent mice across a variety of different conditions. Because FAAH (−/−) mice possess constitutively elevated levels of AEA throughout the development of dependence, we examined the effect of acute FAAH inhibition through pharmacological means. The FAAH inhibitor, URB597, was administered just before rimonabant challenge in order to elevate AEA levels during the withdrawal period. The short-term elevation of AEA during this period significantly attenuated the severity of the withdrawal behavior, as seen primarily in the reduced amount of paw tremors (Figure 4A With recent advances allowing systemic examination of MAGL inhibition and consequential 2-AG elevations, we examined whether elevating 2-AG could similarly reduce somatic THC withdrawal symptoms. While less is known about the behavioral consequences of 2-AG inhibition, the concentration of this endocannabinoid is more than one hundred-fold greater than that of AEA in the brain. However, it is possible much of the 2-AG in the body does not play a role in cannabinoid signaling (42). Acute administration of the MAGL inhibitor, JZL184, significantly reduced paw tremor incidence. One might predict an increased efficacy of JZL184 in reducing withdrawal symptoms in FAAH (−/−) mice, since both major endogenous cannabinoids, AEA & 2-AG, are elevated above that of wild-type mice. However, this was not the case. The observation that JZL184 was equally efficacious in FAAH (+/+) and (−/−) mice, indicates that the mechanism of JZL184 was independent of FAAH activity. However, given the limits with knockout animals, full characterization of dual inhibition of both enzymes on cannabinoid withdrawal is warranted in future studies. The lack of rimonabant-precipitated cannabinoid withdrawal signs by repeated URB597 injection is an important observation for the clinical development of this drug and has important implications for the development of other FAAH inhibitors. Cannabis withdrawal is not recognized in the current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), but is currently under debate for inclusion in the next edition (43). Without widespread medical consensus as to the severity (or even existence) of such a condition, possible treatment options must present minimal risk in contributing to any further dependence problems. The present findings examining endocannabinoid attenuation of withdrawal adds to a growing body of literature demonstrating that URB597 lacks the rewarding properties that is typical of exogenous cannabinoids. URB597 fails to elicit conditioned place preferences (35), and also fails to generalize in rats trained to discriminate the drug effects of THC (31,35). In addition, URB597 does not increase dopamine release in the shell of the nucleus accumbens (30), a common hallmark of almost all substances of abuse. Moreover, it has recently been shown that monkeys previously trained to administer other drugs of abuse, including THC, will not self-administer URB597. Finally, URB597 also lacks the ability to prime reinstatement, and fails to increase self-administration, in monkeys receiving either THC or cocaine (29). The aforementioned study suggests that not only do FAAH inhibitors lack rewarding properties, but also they do not enhance the dependence liability of common drugs of abuse. The lack of effects of URB597 in the rotarod test complement the results of other studies showing that genetic deletion or pharmacological inhibition of FAAH does not elicit any apparent untoward motor effects. In contrast, THC elicited motor incoordination that persisted for up to six hours. This impairment was reversed by rimonabant, demonstrating a CB1 receptor mechanism of action. While mice receiving JZL184 display a decrease in spontaneous activity, and exhibit a flattened posture reminiscent of mice receiving THC, these mice were able to perform normally in the rotarod test throughout the full time course of demonstrated 2-AG elevations (33). These findings suggest that endocannabinoid elevation, through blockade of enzymatic degradation, is not sufficient to cause dependence or motor incoordination typical of high doses of THC and other exogenous cannabinoid receptor agonists. Conclusion Acute administration of the selective FAAH inhibitor, URB597, or the selective MAGL inhibitor, JZL184, significantly reduced somatic withdrawal symptoms precipitated by the CB1 receptor antagonist rimonabant in THC-dependent mice. These findings suggest that inhibitors of endocannabinoid metabolizing enzymes may offer an effective pharmacotherapy to treat cannabis withdrawal. Neither FAAH nor MAGL inhibition impaired gross motor function, and repeated administration of URB597 did not lead to cannabinoid physical dependence. Collectively, these data suggest that endocannabinoid modulation represents a promising avenue of treatment for a challenging, yet still controversial syndrome. Acknowledgements The authors would like to acknowledge the technical assistance of Noor S. Shubar Ali, Deborah Karp, and Megan O’Brien with rotarod testing. The work was supported by National Institute on Drug Abuse grants P01DA017259, R01DA15197, R01DA03672, R01DA02396, R01DA015683, P50DA005274, and T32DA007027. Additional support was provided by Scholar Rescue Funds of The Institute of International Education, New York. Nonstandard Abbreviations
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J Abnorm Psychol. 2003 Aug; 112(3):393-402.
[J Abnorm Psychol. 2003]Psychopharmacology (Berl). 1999 Feb; 141(4):395-404.
[Psychopharmacology (Berl). 1999]J Subst Abuse Treat. 2008 Dec; 35(4):362-8.
[J Subst Abuse Treat. 2008]Drug Alcohol Depend. 2008 Jan 1; 92(1-3):48-54.
[Drug Alcohol Depend. 2008]Psychopharmacology (Berl). 1999 Feb; 141(4):385-94.
[Psychopharmacology (Berl). 1999]Pharmacol Biochem Behav. 2001 May-Jun; 69(1-2):181-8.
[Pharmacol Biochem Behav. 2001]J Pharmacol Exp Ther. 1986 Nov; 239(2):311-9.
[J Pharmacol Exp Ther. 1986]Neuropsychopharmacology. 2004 Jan; 29(1):158-70.
[Neuropsychopharmacology. 2004]Drug Alcohol Depend. 2007 Jan 5; 86(1):22-9.
[Drug Alcohol Depend. 2007]Psychopharmacology (Berl). 2001 May; 155(2):171-9.
[Psychopharmacology (Berl). 2001]Eur J Pharmacol. 1995 Aug 25; 282(1-3):R1-2.
[Eur J Pharmacol. 1995]Eur J Pharmacol. 1995 Jul 14; 280(3):R13-5.
[Eur J Pharmacol. 1995]Pharmacol Biochem Behav. 2006 Sep; 85(1):105-13.
[Pharmacol Biochem Behav. 2006]J Pharmacol Exp Ther. 1998 Jun; 285(3):1150-6.
[J Pharmacol Exp Ther. 1998]Br J Pharmacol. 1998 Dec; 125(7):1567-77.
[Br J Pharmacol. 1998]Neuropharmacology. 2009; 56 Suppl 1():235-43.
[Neuropharmacology. 2009]Proc Natl Acad Sci U S A. 2001 Jul 31; 98(16):9371-6.
[Proc Natl Acad Sci U S A. 2001]J Pharmacol Exp Ther. 2005 Apr; 313(1):352-8.
[J Pharmacol Exp Ther. 2005]J Pharmacol Exp Ther. 2002 Jul; 302(1):73-9.
[J Pharmacol Exp Ther. 2002]Pain. 2004 Jun; 109(3):319-27.
[Pain. 2004]Nat Med. 2003 Jan; 9(1):76-81.
[Nat Med. 2003]Nat Chem Biol. 2009 Jan; 5(1):37-44.
[Nat Chem Biol. 2009]Proc Natl Acad Sci U S A. 2005 Dec 20; 102(51):18620-5.
[Proc Natl Acad Sci U S A. 2005]Biol Psychiatry. 2008 Dec 1; 64(11):930-7.
[Biol Psychiatry. 2008]Nat Chem Biol. 2009 Jan; 5(1):37-44.
[Nat Chem Biol. 2009]J Pharmacol Exp Ther. 2005 Apr; 313(1):352-8.
[J Pharmacol Exp Ther. 2005]J Pharmacol Exp Ther. 1998 Jun; 285(3):1150-6.
[J Pharmacol Exp Ther. 1998]Eur J Neurosci. 2000 Mar; 12(3):1038-46.
[Eur J Neurosci. 2000]J Pharmacol Exp Ther. 2002 Oct; 303(1):36-44.
[J Pharmacol Exp Ther. 2002]Drug Alcohol Depend. 2004 May 10; 74(2):159-70.
[Drug Alcohol Depend. 2004]Pharmacol Biochem Behav. 2001 May-Jun; 69(1-2):181-8.
[Pharmacol Biochem Behav. 2001]Pharmacol Biochem Behav. 2006 Sep; 85(1):105-13.
[Pharmacol Biochem Behav. 2006]Pharmacol Biochem Behav. 2006 Sep; 85(1):105-13.
[Pharmacol Biochem Behav. 2006]J Neural Transm. 2000; 107(8-9):931-45.
[J Neural Transm. 2000]Nat Chem Biol. 2009 Jan; 5(1):37-44.
[Nat Chem Biol. 2009]CNS Drug Rev. 2006 Spring; 12(1):21-38.
[CNS Drug Rev. 2006]Nat Chem Biol. 2009 Jan; 5(1):37-44.
[Nat Chem Biol. 2009]J Pharmacol Exp Ther. 2005 Apr; 313(1):352-8.
[J Pharmacol Exp Ther. 2005]Nat Chem Biol. 2009 Jan; 5(1):37-44.
[Nat Chem Biol. 2009]Pharmacol Biochem Behav. 2001 May-Jun; 69(1-2):181-8.
[Pharmacol Biochem Behav. 2001]J Pharmacol Exp Ther. 1998 Jun; 285(3):1150-6.
[J Pharmacol Exp Ther. 1998]Pharmacol Biochem Behav. 2002 Jan-Feb; 71(1-2):155-62.
[Pharmacol Biochem Behav. 2002]Nature. 2005 Jun 23; 435(7045):1108-12.
[Nature. 2005]Proc Natl Acad Sci U S A. 2001 Jul 31; 98(16):9371-6.
[Proc Natl Acad Sci U S A. 2001]J Pharmacol Exp Ther. 2002 Jul; 302(1):73-9.
[J Pharmacol Exp Ther. 2002]Drug Alcohol Depend. 2004 May 10; 74(2):159-70.
[Drug Alcohol Depend. 2004]J Pharmacol Exp Ther. 2002 Oct; 303(1):36-44.
[J Pharmacol Exp Ther. 2002]Proc Natl Acad Sci U S A. 2001 Jul 31; 98(16):9371-6.
[Proc Natl Acad Sci U S A. 2001]Biochemistry. 2006 Aug 1; 45(30):9007-15.
[Biochemistry. 2006]Biochem Biophys Res Commun. 1999 Mar 16; 256(2):377-80.
[Biochem Biophys Res Commun. 1999]Addiction. 2006 Sep; 101 Suppl 1():115-24.
[Addiction. 2006]Proc Natl Acad Sci U S A. 2005 Dec 20; 102(51):18620-5.
[Proc Natl Acad Sci U S A. 2005]J Pharmacol Exp Ther. 2007 Apr; 321(1):370-80.
[J Pharmacol Exp Ther. 2007]J Neurochem. 2006 Jul; 98(2):408-19.
[J Neurochem. 2006]Biol Psychiatry. 2008 Dec 1; 64(11):930-7.
[Biol Psychiatry. 2008]Nat Chem Biol. 2009 Jan; 5(1):37-44.
[Nat Chem Biol. 2009]