Elevation of 2-AG by monoacylglycerol lipase inhibition in the visceral insular cortex interferes with anticipatory nausea in a rat model.

Anticipatory nausea (AN) is a conditioned nausea reaction experienced by chemotherapy patients upon returning to the clinic. Currently, there are no specific treatments for this phenomenon, with the classic antiemetic treatments (e.g., ondansetron) providing no relief. The rat model of AN, contextually elicited conditioned gaping reactions in rats, provides a tool for assessing potential treatments for this difficult to treat disorder. Systemically administered drugs which elevate the endocannabinoids, anandamide (AEA) and 2-arachidonoyl glycerol (2-AG), by interfering with their respective degrading enzymes, fatty acid amide hydrolase (FAAH) and monoacyl glycerol lipase (MAGL) interfere with AN in the rat model. We have shown that MAGL inhibition within the visceral insular cortex (VIC) interferes with acute nausea in the gaping model (Sticht et al., 2015). Here we report that bilateral infusion of the MAGL inhibitor, MJN110 (but neither the FAAH inhibitor, PF3845, nor ondansetron) into the VIC suppressed contextually elicited conditioned gaping, and this effect was reversed by coadministration of the CB1 antagonist, AM251. These findings suggest that 2-AG within the VIC plays a critical role in the regulation of both acute nausea and AN. Because there are currently no specific therapeutics for chemotherapy patients that develop anticipatory nausea, MAGL inhibition by MJN110 may be a candidate treatment. (PsycINFO Database Record

[1]  M. Tejani,et al.  Current pharmacotherapy for chemotherapy-induced nausea and vomiting in cancer patients , 2013, Expert opinion on pharmacotherapy.

[2]  J. Foubert,et al.  Nausea: the neglected symptom? , 2004, European journal of oncology nursing : the official journal of European Oncology Nursing Society.

[3]  C. Limebeer,et al.  Inverse agonism of cannabinoid CB1 receptors potentiates LiCl‐induced nausea in the conditioned gaping model in rats , 2010, British journal of pharmacology.

[4]  C. Limebeer,et al.  The antiemetic drug ondansetron interferes with lithium-induced conditioned rejection reactions, but not lithium-induced taste avoidance in rats. , 2000, Journal of experimental psychology. Animal behavior processes.

[5]  L. Parsons,et al.  Evaluation of NHS carbamates as a potent and selective class of endocannabinoid hydrolase inhibitors. , 2013, ACS Chemical Neuroscience.

[6]  T. Freund,et al.  Brain monoglyceride lipase participating in endocannabinoid inactivation , 2002, Proceedings of the National Academy of Sciences of the United States of America.

[7]  R. Nesse,et al.  Pretreatment Nausea in Cancer Chemotherapy: A Conditioned Response?* , 1980, Psychosomatic medicine.

[8]  C. Hudis,et al.  An experimental analysis of classically conditioned nausea during cancer chemotherapy. , 1992, Psychosomatic medicine.

[9]  M. Qazilbash,et al.  Clinical Efficacy of Lorazepam in Prophylaxis of Anticipatory, Acute, and Delayed Nausea and Vomiting Induced by High Doses of Cisplatin: A Prospective Randomized Trial , 1995, American journal of clinical oncology.

[10]  S. Kiefer,et al.  Taste avoidance, but not aversion, learning in rats lacking gustatory cortex. , 1992, Behavioral neuroscience.

[11]  B. Cravatt,et al.  Interference with acute nausea and anticipatory nausea in rats by fatty acid amide hydrolase (FAAH) inhibition through a PPARα and CB1 receptor mechanism, respectively: a double dissociation , 2015, Psychopharmacology.

[12]  Stephen P. Mayfield,et al.  Molecular characterization of an enzyme that degrades neuromodulatory fatty-acid amides , 1996, Nature.

[13]  Raymond C Stevens,et al.  Discovery and characterization of a highly selective FAAH inhibitor that reduces inflammatory pain. , 2009, Chemistry & biology.

[14]  J. Atkins,et al.  Nausea and emesis remain significant problems of chemotherapy despite prophylaxis with 5‐hydroxytryptamine‐3 antiemetics , 2003, Cancer.

[15]  H. Grill,et al.  The taste reactivity test. I. Mimetic responses to gustatory stimuli in neurologically normal rats , 1978, Brain Research.

[16]  M. Piccart,et al.  Prevention of adjustment disorders and anticipatory nausea secondary to adjuvant chemotherapy: a double-blind, placebo-controlled study assessing the usefulness of alprazolam. , 1993, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[17]  G. Hall,et al.  Exposure to a lithium-paired context elicits gaping in rats: A model of anticipatory nausea , 2006, Physiology & Behavior.

[18]  C. Limebeer,et al.  Cannabinoids suppress acute and anticipatory nausea in preclinical rat models of conditioned gaping , 2015, Clinical pharmacology and therapeutics.

[19]  C. Limebeer,et al.  The anti‐nausea effects of CB1 agonists are mediated by an action at the visceral insular cortex , 2012, British journal of pharmacology.

[20]  L. Parker Conditioned flavor avoidance and conditioned gaping: rat models of conditioned nausea. , 2014, European journal of pharmacology.

[21]  R. Mulhern,et al.  Anticipatory Nausea and Vomiting in Pediatric Cancer Patients: An Analysis of Conditioning and Coping Variables , 1997, Journal of developmental and behavioral pediatrics : JDBP.

[22]  M. Mehlsen,et al.  Anticipatory nausea: the role of individual differences related to sensory perception and autonomic reactivity. , 2007, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[23]  C. Limebeer,et al.  Intra-visceral insular cortex 2-arachidonoylglycerol, but not N-arachidonoylethanolamide, suppresses acute nausea-induced conditioned gaping in rats , 2015, Neuroscience.

[24]  K. Ossenkopp,et al.  Exposure to a context previously associated with nausea elicits conditioned gaping in rats: A model of anticipatory nausea , 2008, Behavioural Brain Research.

[25]  B. Cravatt,et al.  Endocannabinoid regulation of nausea is mediated by 2-arachidonoylglycerol (2-AG) in the rat visceral insular cortex , 2016, Neuropharmacology.

[26]  P. Fletcher,et al.  Double Dissociation between Regulation of Conditioned Disgust and Taste Avoidance by Serotonin Availability at the 5-HT3 Receptor in the Posterior and Anterior Insular Cortex , 2012, The Journal of Neuroscience.

[27]  C. Limebeer,et al.  A comparison of cannabidiolic acid with other treatments for anticipatory nausea using a rat model of contextually elicited conditioned gaping , 2014, Psychopharmacology.

[28]  Jill Keane,et al.  Disgust sensitivity predicts the insula and pallidal response to pictures of disgusting foods , 2007, The European journal of neuroscience.

[29]  G. Morrow,et al.  The role of patients' expectations in the development of anticipatory nausea related to chemotherapy for cancer. , 2001, Journal of pain and symptom management.

[30]  Kyle S. Smith,et al.  The Ventral Pallidum and Hedonic Reward: Neurochemical Maps of Sucrose “Liking” and Food Intake , 2005, The Journal of Neuroscience.

[31]  A. Molassiotis,et al.  Anticipatory nausea and vomiting , 2004, Supportive Care in Cancer.

[32]  R. Ueda,et al.  Anticipatory nausea among ambulatory cancer patients undergoing chemotherapy: Prevalence, associated factors, and impact on quality of life , 2010, Cancer science.

[33]  D. Piomelli,et al.  The effect of cannabidiol and URB597 on conditioned gaping (a model of nausea) elicited by a lithium-paired context in the rat , 2008, Psychopharmacology.

[34]  G. Morrow,et al.  Anticipatory nausea and vomiting in the era of 5-HT3 antiemetics , 1998, Supportive Care in Cancer.

[35]  M. Law,et al.  Anticipatory nausea and emesis, and psychological morbidity: assessment of prevalence among out-patients on mild to moderate chemotherapy regimens. , 1992, British Journal of Cancer.