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prenatal β2 agonists - may increase the risk of negative effects of MDMA?

Cotcha Yankinov

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1986775/ - "Developmental Exposure to Terbutaline and Chlorpyrifos, Separately or Sequentially, Elicits Presynaptic Serotonergic Hyperactivity in Juvenile and Adolescent Rats"

"Discussion: In our earlier studies with neonatal terbutaline treatment, we found overexpression of both the 5HT presynaptic transporter and 5HT receptors in adulthood [3]. Notably, however, the primary effects were seen in the regions containing 5HT cell bodies (midbrain, brainstem) and in one area with 5HT terminals, the hippocampus, whereas the cerebral cortex and striatum were largely spared. This pattern is consistent with damage to developing nerve terminals and consequent reactive sprouting [10,32,38] but the persistence of the upregulation of these static markers of 5HT synaptic integrity suggests that underlying functional abnormalities remain.

In the current study, we found initial overall reductions in 5HT content, consistent with nerve terminal damage. This was accompanied by presynaptic 5HT hyperactivity, as monitored by 5HT turnover, throughout juvenile and adolescent stages of development, with the most notable and persistent changes occurring in the cerebral cortex and striatum, the very same regions that appeared to be spared the upregulation of 5HT receptors in our earlier study [3]. The most likely explanation of this pattern is that 5HT synapses are “miswired,” namely that, consequent to the initial damage, sprouting reestablishes innervation but to inappropriate loci within the affected regions, so that presynaptic hyperactivity occurs as compensation for defective synaptic function. Confirmation of this interpretation will require anatomical evaluations; prior work has established that developmental exposures to terbutaline or related β-adrenergic receptor agonists do indeed cause structural alterations consistent with miswiring [33,59] but our findings point to the need to supplement these with specific histological markers to identify the locations and potential misconnections of 5HT projections and their target cells containing 5HT receptors."
 
So you're thinking that because the 5HT system is miswired, it's more fragile and susceptible to damage when exposed to a 5HT neurotoxin? It makes sense. I may be wrong but I recall you in previous posts talking about possible neurogenesis in the 5HT system after a toxic insult like an abusive MDMA regimen. If this is so, then could it possibly be that killing off these "miswired" neurons would allow them to rewire correctly once undergoing neurogenesis (kind of crazy idea)?

The paper doesn't discuss detailed mechanisms by which these changes are brought about. They are probably very complex. Could prenatal b2 antagonism (e.g propranolol) possibly cause the absolute reverse of this and cause more functional wiring of the 5HT system during development?
 
I'm willing to accept a scenario where serotonin nerve terminal toxicity might not be playing much of a role in MDMA related adverse effects - so in that case I might propose that an already dysfunctional serotonergic system is even more apt to dysregulation, with something akin to a result of excess of default mode network activity leading to increased rumination and such. But if there is an element of B2 agonists worsening nerve terminal loss, it could be due to a wide variety of effects (B2 does a lot in the developing brain) - increased uptake of harmful molecules (because of the increased pre-synaptic activity/5HT turnover found in the above study, this would lead to more uptake?), effects on cellular differentiation lead to miss-wiring leading to more natural neurotransmitter efflux from genuine action potentials which worsens serotonin depletion, and I suppose it's possible that if the reactive sprouting from B2 agonists resprouts inaccurately, this could compound with yet another inaccurate resprouting from MDMA (or could also result in a more functional re-sprouting, or just eliminate the dysfunctional sprouting entirely).

B2 stimulation could also result in excitotoxicity because it seems the homeostasis mechanisms of the developing brain specifically related to B2 are in their infancy, resulting in super sensitization

http://www.ncbi.nlm.nih.gov/pubmed/11718842
http://www.ncbi.nlm.nih.gov/pubmed/16487945
http://www.ncbi.nlm.nih.gov/pubmed/8848348

As far as what B2 antagonists in utero would do - it's hard to say. There is an increased risk of neuropsychiatric events/ASD in children exposed to B2 agonists in utero, but they do seem to still retain some intelligence as I recall, and concerning a case study of 2 adolescents exposed to terbutaline, they were above average intelligence if I recall correctly, but weren't without issues. There is probably some data on B2 antagonist use in pregnant mothers for either high blood pressure or panic attacks etc, but I imagine it would be hard to interpret that data. I.e. the pre-term babies like myself might have abnormal outcomes related to whatever caused us to be pre-term in the first place. Although the animal studies have found deleterious effects of terbutaline quite clearly it seems http://www.ncbi.nlm.nih.gov/pubmed/14610225
 
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