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 inNature medicine Vol. 16; no. 1; pp. 111 - 115
Main Authors Johnson, Philip L, Truitt, William, Fitz, Stephanie D, Minick, Pamela E, Dietrich, Amy, Sanghani, Sonal, Träskman-Bendz, Lil, Goddard, Andrew W, Brundin, Lena, Shekhar, Anantha
Format Journal Article
LanguageEnglish
Published New York Nature Publishing Group US 01.01.2010
Nature Publishing Group
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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
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– 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
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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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Institutionen för kliniska vetenskaper, Lund
MultiPark: Multidisciplinary research focused on Parkinson's disease
Psychiatry (Lund)
Lunds universitet
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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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SSID ssj0003059
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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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pubmedcentral
proquest
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pubmed
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springer
SourceType Open Access Repository
Aggregation Database
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Enrichment Source
Publisher
StartPage 111
SubjectTerms Adult
Alprazolam - pharmacology
Analysis
Animals
Anxiety
Anxiety - drug therapy
Anxiety - physiopathology
Biomedical and Life Sciences
Biomedicine
Cancer Research
Clinical Medicine
Disease Models, Animal
Female
GABA
Genetic aspects
Hormones
Humans
Hypothalamus - physiology
Infectious Diseases
Intracellular Signaling Peptides and Proteins - antagonists & inhibitors
Intracellular Signaling Peptides and Proteins - cerebrospinal fluid
Intracellular Signaling Peptides and Proteins - physiology
Klinisk medicin
letter
Male
Medical and Health Sciences
Medicin och hälsovetenskap
Metabolic Diseases
Middle Aged
Molecular Medicine
Neurons
Neurons - drug effects
Neurons - physiology
Neuropeptides - antagonists & inhibitors
Neuropeptides - cerebrospinal fluid
Neuropeptides - physiology
Neurosciences
Neurotransmitter Agents - physiology
Neurotransmitters
Orexin Receptors
Orexins
Panic attacks
Panic Disorder - cerebrospinal fluid
Panic Disorder - drug therapy
Panic Disorder - physiopathology
Physiological aspects
Psychiatry
Psykiatri
Rats
Receptors, G-Protein-Coupled - drug effects
Receptors, G-Protein-Coupled - physiology
Receptors, Neuropeptide - drug effects
Receptors, Neuropeptide - physiology
Risk factors
Rodents
Sodium
Sodium Lactate - pharmacology
Title A key role for orexin in panic anxiety
URI https://link.springer.com/article/10.1038/nm.2075
https://www.ncbi.nlm.nih.gov/pubmed/20037593
https://www.proquest.com/docview/223110278
https://www.proquest.com/docview/21372081
https://www.proquest.com/docview/733633926
https://pubmed.ncbi.nlm.nih.gov/PMC2832844
https://lup.lub.lu.se/record/1547781
oai:portal.research.lu.se:publications/06350819-ae00-4d5e-aac9-7d4b7db4c564
Volume 16
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