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Molecular and Cellular Mechanisms of MDMA-Induced Neurotoxicity: A review

nuke

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Hey everyone, this is a review of an overview presented as Molecular and Cellular Mechanisms of Ecstasy-Induced Neurotoxicity: An Overview in Molecular Neurobiology (DOI 10.1007/s12035-009-8064-1). Thanks goes to the authors for some of the content, of whom I did not ask permission but are encouraged write in this thread if they wish to have their content removed.

Induced Hyperthermia

Hyperthermia appears to play a big role in the neurotoxic effect of MDMA, in that it often fails to develop in the presence of non-elevated body temperatures.

DA/5HT Agonism
-Blocking SERT with a substrate: temperature will still elevate
-DA antagonism: dose-dependent attenuation of hyperthermia
-D1/D2 antagonism (Haloperidol): dose dependent attenuation
-D2 antagonism: no effect
-5HT2A/5HT2C antagonism: absence of hyperthermia (2A seems more important)
-D1 and 5HT2A suspected to be the main factors in hyperthermia

Adrenoreceptors
-alpha1 and beta3 receptor antagonism: abolished hyperthermia
-beta1 and beta2 receptor antagonism: no effect
-alpha1 and general beta receptor antagonism: abolished hyperthermia
-alpha1-a and alpha1-b appear heavily implicated

Endocrine
-Hypophysectomized and thryoparathyroidectomized rats: abolished hyperthermia
-UCP3 down-regulation: decreased thermogenesis (in skeletal muscle)

Ambient temperature
-Increases in ambient temperature by heating or crowding increase the neurotoxic effect as well as acute toxicity/lethality
-Animals given 5HT2A antagonists or NMDA antagonists (latter also usually neuroprotective) and artificially heated will still experience neurotoxicity

Species Dissimilarities
-Primates appear to experience hyperthermia at small doses while rats or mice may not



Other miscellaneous effects of/facts about MDMA

Neuroendocrine Effects of MDMA
-Increases: arginine, cortisol, prolactin, corticosterone, oxytocin, vasopressin and adrenocorticotropin

Immunological Effects of MDMA
-Suppression of lymphocyte proliferation
-Profound leukocyte reduction
-Impairs interleukin-1 beta and alpha-TNF secretion
-Reduces number of CD4 cells
-Decline in CD4:CD8 ratio

Cannabinoid System
-CB1 knockout rats will not self-administer MDMA

Effects on Tryptophan Hydroxylase
-Administration of MDMA results in irreversible inhibition of TPH, suspected time to replenish TPH is 1-3 months
-Not directly caused by MDMA but rather from redox/quinone metabolites
-MDMA increases ROS and nitric oxide, nitric oxide itself inhibits TPH

Role of Glutamate
-Reduction in GLU mediated by DA/5HT release
-Requires further research to establish a possible role in neurotoxicity



Monoamine Oxidase

Monoamine oxidase, particularly MAO-B, is believed to play a large role in the production of MDMA mediated neurotoxicity via the production of free radicals. The formula for the enzymatic degradation of amines by MAO is as follows:

R-CH2-NH2 + H2O + O2 → R-CHO + NH3 + H2O2,

Where hydrogen peroxide can dissociate into hydroxyl radicals and spur the generation of other reactive oxygen species (ROS) like superoxide and nitric oxide.

-MAO-A Inhibition: Extreme acute toxicity
-MAO-B Inhibition: Ablation of neurotoxicity

-Locations of MAO-A in the brain: Catecholaminergic neurons
-Locations of MAO-B in the brain: Serotonergic neurons, astrocytes, glia
-Location of MAOs in the cell: Outer membrane of mitochondria

-MAO-B preferentially breaks down catecholamines but will break down 5HT if MAO-A is not present

-Superoxide or metals can produce toxic redox cycling quinone metabolites of DA, NE, 5HT and MDMA which generate additional ROS

-Formation of hydrogen peroxide causes the formation of hydroxyl radicals which cause mitochondrial DNA deletions because the mitochondria does not guard its DNA with histones or DNA binding proteins

-5HT2A agonism results in dopamine release; 5HT2C agonism results in GABA release and inhibition of dopamine release

-6-OH-DA neurotoxin pretreatment causes ablation of serotonergic neurotoxicity
-levo-DOPA increases neurotoxicity
-DAT inhibition prevents neurotoxicity
-D2 antagonist has produced conflicting research about prevention of neurotoxicity
-GABA antagonists reduce neurotoxicity
-Pretreatment with levo-tyrosine enhances neurotoxicity
-N-Acetylcysteine and other antioxidants appear to reduce neurotoxicity



Effects of Tryptamine-4,5-dione
-Uncouples mitochondrial respiration
-Inhibits NADH-CoQ1 reductase, cytochrome c oxidase, PDHC and KGDHC (irreversible)
-Because of the above, results in mitochondrial damage
-Difficult to detect this metabolite due to extreme reactivity with proteins and therefore very short half-life

I would encourage those interested to pick a copy of the article as well, this is only a brief overview of the information presented. Please see attached images for metabolic routes and other detailed figures.
 

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Last edited:
Information about neurotoxic metabolites.
 

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also worth reading
doi:10.1016/j.neuropharm.2008.07.002

Psychostimulant-induced alterations in vesicular monoamine transporter-2 function: Neurotoxic and therapeutic implications

VMAT2 is a fascinating therapeutic and recreational target. Perhaps increasing extracellular dopamine and serotonin does not necessarily have to be neurotoxic paving the way for "Nextasy" ™
 
Cannabinoid System
-CB1 knockout rats will not self-administer MDMA

interesting.. the CB system is becoming more and more implicated these days, not surprising considering it is the most common gpcr


-5HT2A agonism results in dopamine release; 5HT2C agonism results in GABA release and inhibition of dopamine release

interesting also... how does the brain mediate such complex subtleties when the same neurotransmitter activates both of these receptors.. and they are supposedly antagonistic in nature
 
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