A key role for orexin in panic anxiety
Orexin, a neuropeptide best known for its role in arousal and its absence in people with narcolepsy, is also involved in the pathophysiology of panic anxiety disorder. Panic disorder is a severe anxiety disorder with recurrent, debilitating panic attacks. In individuals with panic disorder there is...
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Published in | Nature medicine Vol. 16; no. 1; pp. 111 - 115 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
New York
Nature Publishing Group US
01.01.2010
Nature Publishing Group |
Subjects | |
Online Access | Get full text |
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Abstract | Orexin, a neuropeptide best known for its role in arousal and its absence in people with narcolepsy, is also involved in the pathophysiology of panic anxiety disorder.
Panic disorder is a severe anxiety disorder with recurrent, debilitating panic attacks. In individuals with panic disorder there is evidence of decreased central γ-aminobutyric acid (GABA) activity as well as marked increases in autonomic and respiratory responses after intravenous infusions of hypertonic sodium lactate
1
,
2
,
3
. In a rat model of panic disorder, chronic inhibition of GABA synthesis in the dorsomedial-perifornical hypothalamus of rats produces anxiety-like states and a similar vulnerability to sodium lactate–induced cardioexcitatory responses
4
,
5
,
6
,
7
,
8
,
9
. The dorsomedial-perifornical hypothalamus is enriched in neurons containing orexin (ORX, also known as hypocretin)
10
, which have a crucial role in arousal
10
,
11
, vigilance
10
and central autonomic mobilization
12
, all of which are key components of panic. Here we show that activation of ORX-synthesizing neurons is necessary for developing a panic-prone state in the rat panic model, and either silencing of the hypothalamic gene encoding ORX (
Hcrt
) with RNAi or systemic ORX-1 receptor antagonists blocks the panic responses. Moreover, we show that human subjects with panic anxiety have elevated levels of ORX in the cerebrospinal fluid compared to subjects without panic anxiety. Taken together, our results suggest that the ORX system may be involved in the pathophysiology of panic anxiety and that ORX antagonists constitute a potential new treatment strategy for panic disorder. |
---|---|
AbstractList | Panic disorder is a severe anxiety disorder with recurrent, debilitating panic attacks. In individuals with panic disorder there is evidence of decreased central γ-aminobutyric acid (GABA) activity as well as marked increases in autonomic and respiratory responses after intravenous infusions of hypertonic sodium lactate (1-3). In a rat model of panic disorder, chronic inhibition of GABA synthesis in the dorsomedial-perifornical hypothalamus of rats produces anxiety-like states and a similar vulnerability to sodium lactate-induced card ioexcitatory responses (4-9). The dorsomedial-perifornical hypothalamus is enriched in neurons containing orexin (ORX, also known as hypocretin) (10), which have a crucial role in arousal (10,11), vigilance (10) and central autonomic mobilization (12), all of which are key components of panic. Here we show that activation of ORX-synthesizing neurons is necessary for developing a panic-prone state in the rat panic model, and either silencing of the hypothalamic gene encoding ORX (Hcrt) with RNAi or systemic ORX-1 receptor antagonists blocks the panic responses. Moreover, we show that human subjects with panic anxiety have elevated levels of ORX in the cerebrospinal fluid compared to subjects without panic anxiety. Taken together, our results suggest that the ORX system may be involved in the pathophysiology of panic anxiety and that ORX antagonists constitute a potential new treatment strategy for panic disorder. Panic disorder is a severe anxiety disorder with recurrent, debilitating panic attacks. In individuals with panic disorder there is evidence of decreased central gamma-aminobutyric acid (GABA) activity as well as marked increases in autonomic and respiratory responses after intravenous infusions of hypertonic sodium lactate(1-3). In a rat model of panic disorder, chronic inhibition of GABA synthesis in the dorsomedial-perifornical hypothalamus of rats produces anxiety-like states and a similar vulnerability to sodium lactate-induced cardioexcitatory responses(4-9). The dorsomedial-perifornical hypothalamus is enriched in neurons containing orexin (ORX, also known as hypocretin)(10), which have a crucial role in arousal(10,11), vigilance(10) and central autonomic mobilization(12), all of which are key components of panic. Here we show that activation of ORX-synthesizing neurons is necessary for developing a panic-prone state in the rat panic model, and either silencing of the hypothalamic gene encoding ORX (Hcrt) with RNAi or systemic ORX-1 receptor antagonists blocks the panic responses. Moreover, we show that human subjects with panic anxiety have elevated levels of ORX in the cerebrospinal fluid compared to subjects without panic anxiety. Taken together, our results suggest that the ORX system may be involved in the pathophysiology of panic anxiety and that ORX antagonists constitute a potential new treatment strategy for panic disorder. (C) 2010 Nature America, Inc. All rights reserved. Panic disorder is a severe anxiety disorder with recurrent, debilitating panic attacks. In individuals with panic disorder there is evidence of decreased central gamma-aminobutyric acid (GABA) activity as well as marked increases in autonomic and respiratory responses after intravenous infusions of hypertonic sodium lactate. In a rat model of panic disorder, chronic inhibition of GABA synthesis in the dorsomedial-perifornical hypothalamus of rats produces anxiety-like states and a similar vulnerability to sodium lactate-induced cardioexcitatory responses. The dorsomedial-perifornical hypothalamus is enriched in neurons containing orexin (ORX, also known as hypocretin), which have a crucial role in arousal, vigilance and central autonomic mobilization, all of which are key components of panic. Here we show that activation of ORX-synthesizing neurons is necessary for developing a panic-prone state in the rat panic model, and either silencing of the hypothalamic gene encoding ORX (Hcrt) with RNAi or systemic ORX-1 receptor antagonists blocks the panic responses. Moreover, we show that human subjects with panic anxiety have elevated levels of ORX in the cerebrospinal fluid compared to subjects without panic anxiety. Taken together, our results suggest that the ORX system may be involved in the pathophysiology of panic anxiety and that ORX antagonists constitute a potential new treatment strategy for panic disorder.Panic disorder is a severe anxiety disorder with recurrent, debilitating panic attacks. In individuals with panic disorder there is evidence of decreased central gamma-aminobutyric acid (GABA) activity as well as marked increases in autonomic and respiratory responses after intravenous infusions of hypertonic sodium lactate. In a rat model of panic disorder, chronic inhibition of GABA synthesis in the dorsomedial-perifornical hypothalamus of rats produces anxiety-like states and a similar vulnerability to sodium lactate-induced cardioexcitatory responses. The dorsomedial-perifornical hypothalamus is enriched in neurons containing orexin (ORX, also known as hypocretin), which have a crucial role in arousal, vigilance and central autonomic mobilization, all of which are key components of panic. Here we show that activation of ORX-synthesizing neurons is necessary for developing a panic-prone state in the rat panic model, and either silencing of the hypothalamic gene encoding ORX (Hcrt) with RNAi or systemic ORX-1 receptor antagonists blocks the panic responses. Moreover, we show that human subjects with panic anxiety have elevated levels of ORX in the cerebrospinal fluid compared to subjects without panic anxiety. Taken together, our results suggest that the ORX system may be involved in the pathophysiology of panic anxiety and that ORX antagonists constitute a potential new treatment strategy for panic disorder. Panic disorder is a severe anxiety disorder with recurrent, debilitating panic attacks. In subjects with panic disorder there is evidence of decreased central GABAergic activity as well as marked increases in autonomic and respiratory responses following intravenous infusions of 0.5M sodium lactate 1 – 3 . In an animal model of panic disorder, chronic inhibition of GABA synthesis in the dorsomedial/perifornical hypothalamus of rats produces anxiety-like states and a similar vulnerability to sodium lactate-induced cardioexcitatory responses 4 – 9 . The dorsomedial/perifornical hypothalamus is enriched in orexin (ORX, also known as hypocretin)-containing neurons 10 that play a critical role in arousal 10 , 11 , vigilance 10 and central autonomic mobilization 12 , all of which are key components of panic. Here, we demonstrate that activation of the ORX neurons is necessary for developing a panic-prone state in the animal model, and either silencing the hypothalamic ORX gene ( Hcrt ) product with RNA interference or systemic ORX1 antagonists blocks the panic responses. Moreover, we show that subjects with panic anxiety have elevated levels of ORX in the cerebrospinal fluid compared to subjects without panic anxiety. Taken together our results suggest that the ORX system may be involved in the pathophysiology of panic anxiety, and that ORX antagonists constitute a potential novel treatment strategy for panic disorder. Panic disorder is a severe anxiety disorder with recurrent, debilitating panic attacks. In individuals with panic disorder there is evidence of decreased central gamma-aminobutyric acid (GABA) activity as well as marked increases in autonomic and respiratory responses after intravenous infusions of hypertonic sodium lactate. In a rat model of panic disorder, chronic inhibition of GABA synthesis in the dorsomedial-perifornical hypothalamus of rats produces anxiety-like states and a similar vulnerability to sodium lactate-induced cardioexcitatory responses. The dorsomedial-perifornical hypothalamus is enriched in neurons containing orexin (ORX, also known as hypocretin), which have a crucial role in arousal, vigilance and central autonomic mobilization, all of which are key components of panic. Here we show that activation of ORX-synthesizing neurons is necessary for developing a panic-prone state in the rat panic model, and either silencing of the hypothalamic gene encoding ORX (Hcrt) with RNAi or systemic ORX-1 receptor antagonists blocks the panic responses. Moreover, we show that human subjects with panic anxiety have elevated levels of ORX in the cerebrospinal fluid compared to subjects without panic anxiety. Taken together, our results suggest that the ORX system may be involved in the pathophysiology of panic anxiety and that ORX antagonists constitute a potential new treatment strategy for panic disorder. Panic disorder is a severe anxiety disorder with recurrent, debilitating panic attacks. In individuals with panic disorder there is evidence of decreased central [gamma]-aminobutyric acid (GABA) activity as well as marked increases in autonomic and respiratory responses after intravenous infusions of hypertonic sodium lactate. In a rat model of panic disorder, chronic inhibition of GABA synthesis in the dorsomedial-perifornical hypothalamus of rats produces anxiety-like states and a similar vulnerability to sodium lactate-induced cardioexcitatory responses. The dorsomedial-perifornical hypothalamus is enriched in neurons containing orexin (ORX, also known as hypocretin), which have a crucial role in arousal, vigilance and central autonomic mobilization, all of which are key components of panic. Here we show that activation of ORX-synthesizing neurons is necessary for developing a panic-prone state in the rat panic model, and either silencing of the hypothalamic gene encoding ORX (Hcrt) with RNAi or systemic ORX-1 receptor antagonists blocks the panic responses. Moreover, we show that human subjects with panic anxiety have elevated levels of ORX in the cerebrospinal fluid compared to subjects without panic anxiety. Taken together, our results suggest that the ORX system may be involved in the pathophysiology of panic anxiety and that ORX antagonists constitute a potential new treatment strategy for panic disorder. [PUBLICATION ABSTRACT] Panic disorder is a severe anxiety disorder with recurrent, debilitating panic attacks. In individuals with panic disorder there is evidence of decreased central g-aminobutyric acid (GABA) activity as well as marked increases in autonomic and respiratory responses after intravenous infusions of hypertonic sodium lactate. In a rat model of panic disorder, chronic inhibition of GABA synthesis in the dorsomedial-perifornical hypothalamus of rats produces anxiety-like states and a similar vulnerability to sodium lactate-induced cardioexcitatory responses. The dorsomedial-perifornical hypothalamus is enriched in neurons containing orexin (ORX, also known as hypocretin), which have a crucial role in arousal, vigilance and central autonomic mobilization, all of which are key components of panic. Here we show that activation of ORX-synthesizing neurons is necessary for developing a panic-prone state in the rat panic model, and either silencing of the hypothalamic gene encoding ORX (Hcrt) with RNAi or systemic ORX-1 receptor antagonists blocks the panic responses. Moreover, we show that human subjects with panic anxiety have elevated levels of ORX in the cerebrospinal fluid compared to subjects without panic anxiety. Taken together, our results suggest that the ORX system may be involved in the pathophysiology of panic anxiety and that ORX antagonists constitute a potential new treatment strategy for panic disorder. Orexin, a neuropeptide best known for its role in arousal and its absence in people with narcolepsy, is also involved in the pathophysiology of panic anxiety disorder. Panic disorder is a severe anxiety disorder with recurrent, debilitating panic attacks. In individuals with panic disorder there is evidence of decreased central γ-aminobutyric acid (GABA) activity as well as marked increases in autonomic and respiratory responses after intravenous infusions of hypertonic sodium lactate 1 , 2 , 3 . In a rat model of panic disorder, chronic inhibition of GABA synthesis in the dorsomedial-perifornical hypothalamus of rats produces anxiety-like states and a similar vulnerability to sodium lactate–induced cardioexcitatory responses 4 , 5 , 6 , 7 , 8 , 9 . The dorsomedial-perifornical hypothalamus is enriched in neurons containing orexin (ORX, also known as hypocretin) 10 , which have a crucial role in arousal 10 , 11 , vigilance 10 and central autonomic mobilization 12 , all of which are key components of panic. Here we show that activation of ORX-synthesizing neurons is necessary for developing a panic-prone state in the rat panic model, and either silencing of the hypothalamic gene encoding ORX ( Hcrt ) with RNAi or systemic ORX-1 receptor antagonists blocks the panic responses. Moreover, we show that human subjects with panic anxiety have elevated levels of ORX in the cerebrospinal fluid compared to subjects without panic anxiety. Taken together, our results suggest that the ORX system may be involved in the pathophysiology of panic anxiety and that ORX antagonists constitute a potential new treatment strategy for panic disorder. |
Audience | Academic |
Author | Fitz, Stephanie D Träskman-Bendz, Lil Dietrich, Amy Shekhar, Anantha Brundin, Lena Minick, Pamela E Sanghani, Sonal Truitt, William Johnson, Philip L Goddard, Andrew W |
AuthorAffiliation | 2 Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN 46202, U.S.A 5 Indiana Clinical and Translational Sciences Institute Indianapolis, IN 46202, USA 3 Department of Biochemistry, Indiana University School of Medicine, Indianapolis, IN 46202, U.S.A 1 Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202, U.S.A 4 Section of Psychiatry, Department of Clinical Sciences, Lund University Hospital, 221 85 Lund, Sweden |
AuthorAffiliation_xml | – name: 2 Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN 46202, U.S.A – name: 3 Department of Biochemistry, Indiana University School of Medicine, Indianapolis, IN 46202, U.S.A – name: 5 Indiana Clinical and Translational Sciences Institute Indianapolis, IN 46202, USA – name: 4 Section of Psychiatry, Department of Clinical Sciences, Lund University Hospital, 221 85 Lund, Sweden – name: 1 Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202, U.S.A |
Author_xml | – sequence: 1 givenname: Philip L surname: Johnson fullname: Johnson, Philip L organization: Department of Psychiatry, Indiana University School of Medicine – sequence: 2 givenname: William surname: Truitt fullname: Truitt, William organization: Department of Psychiatry, Indiana University School of Medicine, Department of Anatomy and Cell Biology, Indiana University School of Medicine – sequence: 3 givenname: Stephanie D surname: Fitz fullname: Fitz, Stephanie D organization: Department of Psychiatry, Indiana University School of Medicine – sequence: 4 givenname: Pamela E surname: Minick fullname: Minick, Pamela E organization: Department of Psychiatry, Indiana University School of Medicine – sequence: 5 givenname: Amy surname: Dietrich fullname: Dietrich, Amy organization: Department of Psychiatry, Indiana University School of Medicine – sequence: 6 givenname: Sonal surname: Sanghani fullname: Sanghani, Sonal organization: Department of Biochemistry, Indiana University School of Medicine – sequence: 7 givenname: Lil surname: Träskman-Bendz fullname: Träskman-Bendz, Lil organization: Department of Clinical Sciences, Section of Psychiatry, Lund University Hospital – sequence: 8 givenname: Andrew W surname: Goddard fullname: Goddard, Andrew W organization: Department of Psychiatry, Indiana University School of Medicine – sequence: 9 givenname: Lena surname: Brundin fullname: Brundin, Lena organization: Department of Clinical Sciences, Section of Psychiatry, Lund University Hospital – sequence: 10 givenname: Anantha surname: Shekhar fullname: Shekhar, Anantha email: ashekhar@iupui.edu organization: Department of Psychiatry, Indiana University School of Medicine, Indiana Clinical and Translational Sciences Institute |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/20037593$$D View this record in MEDLINE/PubMed https://lup.lub.lu.se/record/1547781$$DView record from Swedish Publication Index oai:portal.research.lu.se:publications/06350819-ae00-4d5e-aac9-7d4b7db4c564$$DView record from Swedish Publication Index |
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CorporateAuthor | Psykiatri, Lund Institutionen för kliniska vetenskaper, Lund MultiPark: Multidisciplinary research focused on Parkinson's disease Psychiatry (Lund) Lunds universitet Profile areas and other strong research environments Lund University Department of Clinical Sciences, Lund Strategiska forskningsområden (SFO) Faculty of Medicine Strategic research areas (SRA) Section IV Medicinska fakulteten Sektion IV Profilområden och andra starka forskningsmiljöer |
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Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 both authors made equal contribution to this report AUTHOR CONTRIBUTIONS AS, PLJ, and WT formulated the hypotheses and designed the studies. SDF and PLJ performed telemetrical probe surgeries. SDF and PLJ scored all behavior and SDF performed all stereotaxic surgeries. PLJ performed the immunohistochemistry. PEM and AD performed all RT-PCR assays with technical expertise from WT and SS. PLJ and WT analyzed all animal data. LT-B and LB were responsible for the human subject study, the ORX assays of the CSF samples and the analysis of the human data. PLJ, WT and AS interpreted the data and collectively wrote the main draft of the article. PJ, WT, SDF, AD, PK, LB, LT-B, AG and AS contributed to the writing of the manuscript and have approved of the final version. |
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Snippet | Orexin, a neuropeptide best known for its role in arousal and its absence in people with narcolepsy, is also involved in the pathophysiology of panic anxiety... Panic disorder is a severe anxiety disorder with recurrent, debilitating panic attacks. In individuals with panic disorder there is evidence of decreased... Panic disorder is a severe anxiety disorder with recurrent, debilitating panic attacks. In subjects with panic disorder there is evidence of decreased central... |
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Title | A key role for orexin in panic anxiety |
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