PKC SIGNALING AND THE TREATMENT OF BIPOLAR DISORDER
Project Number1R01MH057743-01A1
Contact PI/Project LeaderMANJI, HUSSEINI K
Awardee OrganizationWAYNE STATE UNIVERSITY
Description
Abstract Text
DESCRIPTION (Adapted from applicant's abstract): BD, manic-depressive
illness is a severe, chronic and disabling disorder with a life-time
prevalence of 1.2 percent. The discovery of lithium's efficacy as a
mood-stabilizing agent revolutionized the treatment of patients with BD,
but, despite its role as one of psychiatry's most important treatments the
biochemical basis for lithium's antimanic and mood-stabilizing actions
remains to be fully elucidated. Elucidation of the mechanism(s) by which
lithium stabilizes an underlying dysregulation of limbic and
limbic-associated function also offers the potential to delineate the
underlying etiology/pathophysiology of BD. A major problem inherent in
neuropharmacologic research, however, is the difficulty in attributing
therapeutic relevance to any observed biochemical finding. One potential
approach to ascribe therapeutic relevance to any biochemical findings is to
identify common biochemical targets which are modified by drugs belonging to
the same therapeutic class but possessing distinct chemical structures
(e.g., lithium and valproic acid (VPA)). A large body of data has shown
that lithium exerts major effects on the PKC signaling pathway. Most of the
data, however, has been derived from preclinical rodent studies, thereby
precluding an adequate understanding of the therapeutic relevance of these
biochemical findings. These studies indicate two important and highly
clinically relevant directions for future research: first, it is important
to determine if similar modulation of the PKC signaling pathway is also
brought about by other pharmacological agents with proven efficacy in the
treatment of BD such as VPA; and second, it is critical to ultimately
elucidate the relationship between these biochemical changes and clinical
response, which may lead to the identification of biochemical and/or genetic
predictors of outcome. Thus, in this proposal, the investigator's specific
aims are to: 1) Characterize the effects of VPA on the PKC signaling
pathway in the brain. In order to ascribe potential therapeutic relevance
to the biochemical findings, they will be investigated in parallel with
lithium: a) in specific brain regions, and b) in a clinically meaningful
temporal profile, namely acutely, chronically, following medication
withdrawal, and medication re-administration. 2) Determine the relationship
between the lithium or VPA-induced changes in the PKC signaling system in
rat brain and in rat peripheral cells; ultimately the investigator wishes to
determine the relationship between treatment-induced changes in the PKC
signaling system and treatment response in BD patients. The demonstration
of a relationship between the changes in the CNS and the periphery in
rodents will allow for a subsequent investigation in BD patients. This is
imperative because, in order to establish therapeutic relevance for any
biochemical findings, it is necessary to demonstrate: a) that these
biochemical effects do, in fact, occur in patients administered the
pharmacological agents in a clinically relevant paradigm; and b) that there
is a relationship between the biochemical changes and treatment response.
Ultimately, elucidating the mechanisms by which lithium and VPA stabilize
mood should improve the prospects for the development of more effective
long-term treatments, and for the identification of biochemical predictors
of treatment response.
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