THE ABILITY OF TO MODULATE CHANGES IN MORPHINE’S

AVERS IVE PROPERTIES DURING CHRONIC MORPHINE EXPOSURE

by

Meredith A. Fox

submitted to the

Faculty of the College of Arts and Sciences

of American University

in Partial Fulfillment of

the Requirements for the Degree of

Doctor of Philosophy

in

Psychology

Chair: -- f t Anthony L. Riley

Laura

Dean df College of Arts and Sciences Scott Parker

C.j s 'ha, Date ^ Cora Lee Wetherington^

2003

American University

Washington, DC 20016

AMERICAN UNIVERSITY LIBRARY

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Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. THE ABILITY OF PROGLUMIDE TO MODULATE CHANGES IN MORPINE’S

AVERSIVE PROPERTIES DURING CHRONIC MORPHINE EXPOSURE

by

Meredith A. Fox

ABSTRACT

Just as chronic exposure to morphine alters its antinociceptive properties, chronic

exposure to morphine has been shown to alter the strength of its aversive effects. As

(CCK) antagonists have been shown to prevent or reverse tolerance to

morphine’s analgesic effects, such compounds could potentially modulate morphine’s

aversive properties. The current experiment assessed the ability of the CCK antagonist

proglumide to block the development of tolerance to the aversive properties of morphine

in rats utilizing a conditioned taste aversion (CTA) design. Specifically, animals were

preexposed to vehicle, morphine (5 mg/kg), proglumide (5 mg/kg) or a combination of

proglumide administered either immediately or 15 min before morphine. On subsequent

conditioning days, saccharin was presented followed immediately by administration of

either morphine (10 mg/kg) or vehicle. Over conditioning, control animals increased

saccharin consumption, regardless of preexposure condition. Animals preexposed to

vehicle or proglumide and injected with morphine during conditioning acquired a

morphine-induced saccharin aversion. Animals preexposed to morphine and conditioned

with morphine acquired an attenuated morphine-induced saccharin aversion. Animals ii

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. preexposed to the combination of proglumide and morphine and injected with morphine

during conditioning also acquired an attenuated morphine-induced saccharin aversion.

Importantly, saccharin consumption in animals preexposed to either proglumide-

morphine combination was not different from animals preexposed to morphine,

indicating that proglumide had no effect on the development of tolerance to the aversive

properties of morphine in a CTA design. In order to assess whether the inability of

proglumide to block the development of tolerance was due to the specific parameters of

Experiment 1, Experiment 2 examined the effects of 5 mg/kg proglumide administered

either immediately, 5 or 15 min before CCK (3 or 10 ptg/kg) on CCK-induced

suppression of feeding. When proglumide was administered immediately before 3 pg/kg

CCK, it attenuated the CCK-induced suppression of feeding. The findings from the

current study suggest that CCK may not be involved in the aversive properties of

morphine.

iii

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. TABLE OF CONTENTS

ABSTRACT...... ii

LIST OF ILLUSTRATIONS...... vi

Chapter

1. INTRODUCTION...... 1

2. PROCEDURE: EXPERIM ENT!...... 12

Subjects

Drugs and Solutions

Phase 1: Habituation

Phase 2: Preexposure

Phase 3: Conditioning

Test for Saccharin Aversion

Statistical Analysis

3. RESULTS: EXPERIMENT 1...... 16

Preexposure

Conditioning

4. DISCUSSION: EXPERIMENT 1...... 22

5. PROCEDURE: EXPERIMENT 2 ...... 27

Subjects

iv

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Drugs

Phase 1: Habituation

Phase 2: Drug Effects on Feeding

Statistical Analysis

6. RESULTS: EXPERIMENT 2 ...... 29

7. DISCUSSION...... 33

BIBLIOGRAPHY...... 46

v

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. LIST OF ILLUSTRATIONS

1. Mean (± S.E.M.) consumption of water over repeated preexposure days for subjects in Preexposure Groups PM, PiM, PV, VM and VV. Water was available 5 h before injections...... 16

2. Mean (± S.E.M.) consumption of saccharin over repeated conditioning trials for control subjects and subjects in Groups VM-M and VV-M. * Significantly different from baseline...... 18

3. Mean (± S.E.M.) consumption of saccharin over repeated conditioning trials for control subjects and subjects in Groups PM-M and PV-M. * Significantly different from baseline...... 19

4. Mean (± S.E.M.) consumption of saccharin over repeated conditioning trials for control subjects and subjects in Groups PiM-M and PV-M. * Significantly different from baseline...... 20

5. Mean (± S.E.M.) consumption of food for food-deprived subjects over repeated 60-min experimental sessions following saline, 10 pg/kg CCK, 3 pg/kg CCK or 5 mg/kg proglumide. * Significantly different from baseline (saline)...... 29

6. Mean (± S.E.M.) consumption of food for food-deprived subjects over repeated 60-min experimental sessions following saline, 10 pg/kg CCK or 5 mg/kg proglumide (P) followed either 15 or 5 min later by 10 pg/kg CCK. * Significantly different from baseline (saline)...... 30

7. Mean (± S.E.M.) consumption of food for food-deprived subjects over repeated 60-min experimental sessions following saline, 3 pg/kg CCK or 5 mg/kg proglumide (P) followed either 15 min later or immediately by 3 pg/kg CCK. * Significantly different from baseline (saline). **Significantly different from 3 pg/kg CCK alone. ***Significantly different from proglumide followed 15 min later by 3 pg/kg CCK...... 32

vi

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. CHAPTER 1

INTRODUCTION

Cholecystokinin (CCK) is a gastrointestinal hormone and one of the most widely

distributed in the brain (Fink, Rex, Voits & Voigt, 1998), where it acts as a

neurotransmitter (Mutt, 1994). CCK has been shown to be involved in many biological

processes, including the reduction of food intake, the induction of anxiety-related

behavior, and may be involved in learning and memory processes (for a review, see

Crawley & Corwin, 1994; de Tullio, Delarge & Pirotte, 2000; Fink et al., 1998;

Lindefors, Linden, Brene, Sedvall & Persson, 1993). CCK has also been shown to be

involved in pain and antinociception/analgesia (for a review, see Wiesenfeld-Hallin &

Xu, 1996), where it acts as an anti-opioid (Wiesenfeld-Hallin, de Arauja, Alster,

Xu & Hokfelt, 1999).

In relation to its involvement in antinociception, the exogenous administration of

CCK produces a physiological antagonism of morphine-induced antinociception (Faris,

Komisaruk, Watkins & Mayer, 1983). For example, Faris et al. (1983) reported that rats

injected with CCK 20 min prior to morphine displayed significantly attenuated morphine-

induced analgesia, as assessed on the tail-flick test. CCK has also been found to reduce

analgesia induced by endogenous opiates. Specifically, CCK administered 30 min before

the delivery of foot shock to the front paws, which results in opiate-induced analgesia,

reduced foot-shock induced analgesia (Faris et al., 1983). Nonopiate hind paw foot- 1

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shock analgesia was not reduced by CCK, suggesting that CCK specifically inhibits

opiate analgesia (Faris et al., 1983). Thus, on an acute basis, CCK attenuates analgesia

induced by both morphine and endogenous opiates, suggesting that CCK, as an

endogenous opiate antagonist (Faris et al., 1983), may be released in response to opiate

administration, returning the organism to its basal level of pain sensitivity (Watkins,

Kinscheck & Mayer, 1985).

Chronic morphine administration results in the development of tolerance to its

antinociceptive effects (Zhou, Sun, Zhang & Han, 1992), and CCK is involved in this

development. For example, Dourish et al. (1990) induced tolerance to morphine

analgesia by a 6-day schedule of twice daily injections of increasing doses of morphine.

Animals were then challenged with morphine, and analgesia was assessed with the tail-

flick test. Animals treated chronically with morphine became tolerant and exhibited

only a small analgesic response when challenged with morphine (Dourish et al., 1990).

CCK antiserum has been reported to reverse this tolerance to morphine analgesia by

approximately 50% (Ding, Fan, Zhou & Han, 1986).

It has been suggested that chronic opiate administration might induce a

compensatory increase in the synthesis or release of CCK, which could result in a

progressive antagonism of opiate analgesia (Watkins, Kinscheck & Mayer, 1984). For

example, Zhou et al. (1992) found a marked increase in preproCCK mRNA in the

brains of rats receiving chronic morphine treatment for 1, 3 and 6 days, with morphine-

treated rats showing an increase of 52%, 62% and 92%, respectively, over control

levels. This increase paralleled the time course of the development of morphine

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tolerance. These findings suggest that an acceleration of CCK gene expression during

chronic morphine treatment might comprise one of the mechanisms for morphine

tolerance, i.e., the CCK system might be activated during chronic morphine treatment,

producing a negative feedback mechanism that leads to the development of tolerance to

opioids (Zhou et al., 1992).

Although much of the research described has focused on CCK and its effect on

behavior, other research in this area has focused on the mechanism of CCK’s effects. In

so doing, two subtypes of CCK receptors have been revealed, specifically the CCKA

receptor, located in both peripheral tissues and in some brain areas, and the CCKB

receptor, located throughout the central nervous system (for a review, see de Tullio et

al., 2000). While mediating the effects of CCK, these receptors also have affinity for a

variety of compounds with no intrinsic activity, but which block the effects of CCK (for

a review, see Lindefors et al., 1993). These CCK antagonists differ in their relative

affinity for each of the receptor subtypes (for a review, see Woodruff & Hughes,

1991; Dunlop, 1998). There are nonspecific CCK antagonists, including proglumide,

lorglumide and benzotript, which have affinity for both CCKA and CCKB receptors,

CCKA-selective antagonists including L-365,071, PD 140548 and (also

known as L-364,718 and MK-329) and CCKB-selective antagonists including CI-988

and L-365,260. CCK antagonists have been shown to block CCK-induced

suppression of feeding as well as the anxiogenic effects of CCK (for a review, see

Woodruff & Hughes, 1991). As mentioned above, administration of exogenous CCK

produces a physiological antagonism of morphine-induced antinociception (Faris et

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al., 1983), and this antagonism of morphine's antinociceptive effects is blocked by the

nonselective CCK antagonist proglumide (Tang, Chou, Iadarola, Yang & Costa, 1984).

In addition to their ability to block various effects of CCK, CCK antagonists

have been shown to induce effects on their own. For example, on an acute basis,

CCK antagonists potentiate morphine's analgesic effects on a variety of analgesia

assays (Dourish, Hawley & Iverson, 1988; Dourish et al., 1990; Kellstein & Mayer,

1991; Ossipov, Kovelowski, Vanderah & Porreca, 1994; Singh et al., 1996; Tang et

al., 1984; Watkins, Kinscheck & Mayer, 1985). This effect has been shown with

nonspecific CCK antagonists such as proglumide (Kellstein & Mayer, 1990; Tang et

al., 1984; Watkins, Kinscheck & Mayer, 1994; 1995), as well as the CCKA-selective

antagonists L-365,718 (Dourish et al., 1988) and L-365,031 (Dourish et al, 1990) and

the CCKB-selective antagonists L-365,260 (Dourish et al., 1990; Ossipov et al., 1994)

and CI-988 (Singh et al., 1996). However, it has also been reported that the CCKB-

selective antagonist CI-988 fails to potentiate the antinociceptive effects of morphine

in morphine-naive animals (Hoffman & Wiesenfeld-Hallin, 1994).

CCK antagonists have also been shown to potentiate analgesia induced by

endogenous opiates. For example, proglumide produces a marked potentiation of

front paw foot-shock induced analgesia, analgesia mediated by the release of

endogenous opiates (Watkins, Kinscheck, Kaufman et al., 1985). Further, this effect is

specific to opiate systems, as proglumide attenuates or has no effect on various forms of

non-opiate analgesia (Watkins, Kinscheck, Kaufman et al., 1985). This potentiation of

morphine analgesia by CCK antagonists appears to be mediated by an interaction

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between CCK and opiate systems, as naltrindole, an opioid 5 , has

been shown to block the enhancement of the antinociceptive actions of morphine

induced by CCK antagonists (Ossipov et al., 1994).

Interestingly, when administered alone CCK antagonists do not alter baseline

pain thresholds in several assessments of analgesia, including the hot-plate (Dourish et

al., 1990; Hoffmann & Wiesenfeld-Hallin, 1994), tail-flick (Dourish et al., 1990;

Kellstein & Mayer, 1991; Ossipov et al., 1994; Singh et al., 1996; Watkins, Kinscheck

& Mayer, 1985) and rat paw formalin (Dourish et al., 1990) tests. This lack of effect of

CCK antagonists on baseline pain thresholds has been shown with nonspecific CCK

antagonists such as proglumide (Kellstein & Mayer, 1991; Panerai, Rovati, Cocco,

Sacerdote & Mantegazza, 1987; Watkins Kinscheck & Mayer, 1985; Watkins et al,

1984), lorglumide (Kellstein & Mayer, 1991) and benzotript (Panerai et al., 1987), the

CCKA-selective antagonists L-365,071 (Dourish et al., 1990) and PD 140548 (Singh et

al., 1996) and the CCKB-selective antagonists L-365,260 (Dourish et al., 1990; Ossipov

et al., 1994) and CI-988 (Hoffmann & Wiesenfeld-Hallin, 1984; Singh et al., 1996).

Given that CCK antagonists exert no analgesic effects on their own and potentiate the

analgesic effects of opiates on an acute basis, they appear to exert their analgesic

effects via their interactions with the opiate system (Watkins, Kinscheck & Mayer,

1985). These findings may suggest that CCK systems are not tonically active, but

rather are activated in response to either the administration or release of opiates

(Watkins et al., 1984).

As mentioned above, chronic exposure to morphine results in the development

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of tolerance to its analgesic effect (Zhou et al., 1992). Interestingly, CCK antagonists

have been shown to affect opiate tolerance in morphine-tolerant animals. For

example, the nonselective CCK antagonist proglumide (Watkins et al., 1984; Tang et

al., 1984) and the CCKB-selective antagonist CI-988 reverse tolerance to morphine

on the hot-plate test (Hoffman & Wiesenfeld-Hallin, 1994). CCK antagonists have

also been shown to block or reduce the development of tolerance to morphine-induced

analgesia in several assessments of analgesia, including the hot-plate (Xu,

Wiesenfeld-Hallin, Hughes, Horwell & Hokfelt, 1992; Hoffman & Wiesenfeld-Hallin,

1994) and tail-flick (Dourish et al., 1988; Kellstein & Mayer, 1991) tests. This effect

has been shown with nonspecific CCK antagonists such as proglumide (Panerai et al.,

1987; Kellstein & Mayer, 1991; Tang et al., 1984), lorglumide (Kellstein & Mayer,

1991) and benzotript (Panerai et al., 1987), as well as the CCKA-selective antagonists

devazepide (Dourish et al., 1988) and L-365,031 (Dourish et al., 1990) and the

CCKB-selective antagonists L-365,260 (Dourish et al., 1990) and CI-988 (Singh et

al., 1996; Xu et al., 1992).

Thus, CCK antagonists potentiate morphine analgesia (acute) and block or

reverse tolerance to morphine’s analgesic effects (chronic). These findings suggest

that endogenous CCK systems affect the action of opiates (Watkins et al., 1984;

Wiesenfeld-Hallin et al., 1999), possibly as a physiological opiate antagonist (Panerai

et al., 1987; Watkins, Kinscheck & Mayer, 1985). Acutely, CCK’s effects on opiate

analgesia can be blocked by CCK antagonists. Tolerance to the exogenous opioids

may be associated with an up-regulation of endogenous CCK, which induces greater

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blockade of opiate analgesia, resulting in tolerance (Wiesenfeld-Hallin & Xu, 1996).

CCK antagonists block the action of this up-regulated CCK system, which restores some

of the analgesic effect of the opioid, resulting in the reversal of morphine tolerance

(Wiesenfeld-Hallin & Xu, 1996). Further, upregulation of the CCK system may require

chronic stimulation of CCK receptors by repeated opiate administration, as CCK

antagonists also prevent the development of morphine tolerance (Wiesenfeld-Hallin &

Xu, 1996).

Although most of the research to date on the interactions of CCK and the opiates

has focused on morphine-induced analgesia, a few studies have investigated the role of

CCK and CCK antagonists in the rewarding motivational properties of morphine. Drugs

with abuse potential, such as morphine, possess opposing motivational properties in that

they concurrently produce both rewarding and aversive effects (Wise, Yokel & de Witt,

1976; Bechara & van der Kooy, 1985). Specifically, animals will self-administer a

compound as well as avoid tastes paired with that same compound, indicating that the

compound is rewarding and aversive, respectively (Wise et al., 1976). For example,

White, Sklar and Amit (1977) trained rats to run towards a goal box to obtain food.

Immediately upon eating the food, animals were injected with either saline or morphine

and were then returned to the goal box for 50 min. Over five conditioning trials, rats

injected with morphine increased their running speed to the goal box by approximately

400%, indicating that the drug has rewarding effects, while at the same time decreasing

the amount of food consumed in the goal box to approximately 70% of baseline

consumption, indicating that the drug also has aversive effects. Animals injected with

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saline showed no change in either running speed or food consumption. It has been

suggested that it is the relative strength of each of these motivational properties that

affects whether or not a drug will be taken (Ettenberg, Sgro & White, 1982; Rademacher,

Anders, Thompson & Steinpreis, 2000; Riley & Simpson, 2000; Stolerman, 1989). For

example, a drug high in aversive properties and low in rewarding properties is less likely

to be used than a drag that is low in aversive properties and high in rewarding properties

(Stolerman, 1989).

Although no research has directly examined CCK antagonists and the aversive

properties of morphine, results from research investigating CCK antagonists and the

rewarding properties of morphine have been variable. For example, the CCKA-selective

antagonists PD 140548 (Singh et al., 1996) and devazepide (Higgins, Nguyen & Sellers,

1992) have been shown to dose-dependently antagonize or attenuate the development of a

conditioned place preference (CPP) to morphine, indicating that CCK antagonists may

affect the rewarding properties of morphine. However, these same effects were not seen

with the CCKB-selective antagonists CI-988 (Singh et al., 1996) nor L-365,260 (Higgins

et al, 1992). Conversely, Lu and colleagues (Lu, Huang, Liu & Ma, 2000; Lu, Huang,

Ma & Li, 2001) found that morphine CPP was significantly attenuated by the CCKB-

selective antagonist L-365,260, whereas this effect was not observed with the CCKA-

selective antagonist MK-329. In this same study, following a 28-day extinction period,

the morphine CPP disappeared and was reactivated by a single morphine injection.

However, pretreatment with the CCKB-selective antagonist L-365,260 blocked the

reactivation of the morphine CPP, whereas the CCKA-selective antagonist MK-329

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failed to produce these same results (Lu et al., 2001).

In other studies, CCKB-selective antagonists have been shown to potentiate

morphine place preferences. For example, in animals pretreated with L-365,260, a

subthreshold dose of morphine induced a significant CPP (Higgins et al., 1992),

indicating that CCK antagonists may increase the rewarding motivational properties of

morphine. Further, although the CCKB-selective antagonist PD-134,308 elicited neither

a place preference nor a place aversion, when given with a subthreshold dose of

morphine, a CPP was observed (Valverde, Foumie-Zaluski, Roques & Maldonado,

1996). This same effect was also seen when this CCKB-selective antagonist was

administered with a subthreshold dose of RB 101, a complete inhibitor of enkephalin

catabolism (Valverde et al., 1996).

Just as chronic morphine exposure results in tolerance to its analgesic effects,

chronic exposure to morphine has also been shown to alter the strength of its aversive

effects. Specifically, tolerance to the aversive properties of morphine develops following

chronic morphine exposure (e.g., see Dacanay & Riley, 1982; Domjan & Siegel, 1983;

Riley, Dacanay & Mastropaolo, 1984; Stewart & Eikelboom, 1978). As CCK antagonists

prevent the development of tolerance to morphine's analgesic effects, CCK antagonists

could potentially modulate the aversive motivational properties of morphine. Of interest

to the current research is whether or not CCK antagonists are also effective in blocking

tolerance to the aversive properties of morphine. To this end, the current research

investigated the effects of the nonselective CCK antagonist proglumide on changes in the

strength of the aversive motivational properties of morphine during chronic morphine

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exposure.

One way that the aversive properties of morphine can be assessed is by the

conditioned taste aversion (CTA) design (e.g., see Hutchinson et al., 2000; Mucha &

Herz, 1985; Riley, Jacobs & LoLordo, 1978, Switzman, Hunt & Amit, 1981; for an

alternate interpretation, see Grigson, 1997), a behavioral index of toxicity (Riley & Tuck,

1985). Specifically, in this design water-deprived animals are given access to a novel

solution, such as saccharin, which is subsequently followed by administration of a drug,

such as morphine (e.g., see Hutchinson et al., 2000). Saccharin consumption is measured

over conditioning trials, and animals administered drug typically decrease saccharin

consumption, whereas control animals administered vehicle typically increase saccharin

consumption over conditioning trials. For example, Switzman et al. (1981) paired saccharin

and either 4, 8 or 12 mg/kg morphine. Following only one such pairing, there were

significant decreases in saccharin consumption in the groups of animals exposed to either 8

or 12 mg/kg morphine, whereas there was an increase in saccharin consumption in animals

administered vehicle on the conditioning day. There was no significant change in the

animals administered 4 mg/kg morphine. Thus, at the two higher doses tested, morphine

induced a CTA evidenced by a significant decrease in saccharin consumption on the test day.

This effect has been seen with other opioids (Gaiardi, Gubellini & Bartoletti, 1998; Grigson,

Twinning & Carelli, 2000; Hutchinson et al., 2000), in other rat strains (Lancelotti, Bayer,

Glowa, Houghtling & Riley, 2000), in both females (Jacobs, Zellner, LoLordo & Riley,

1981) and males (Bardo & Valone, 1994) and with different routes of administration

(Bechara, Martin, Pridgar & van der Kooy, 1993; Hutchinson et al., 2000).

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Although morphine is effective in inducing a CTA, it is less effective in doing so

following preexposure to morphine (e.g., Cappell & Le Blanc, 1977). For example, Capped

& Le Blanc (1977) found that after six morphine-saccharin pairings animals displayed a

significant aversion to saccharin, i.e., a significant decrease in saccharin consumption.

However, animals exposed to morphine prior to the pairing of saccharin and morphine

showed an attenuated aversion to saccharin. Thus, chronic exposure to morphine attenuates

subsequent morphine-induced taste aversions, presumably due to the development of

tolerance to its aversive properties over repeated exposure (Capped & Le Blanc, 1977;

Randich & LoLordo, 1979; Riley & Simpson, 2001). This change in the relative strengths of

the aversive motivational properties of morphine may lead to an increase in future use and/or

abuse of the drug (for a discussion, see Riley & Simpson, 2001).

The current research assessed the ability of the CCK antagonist proglumide to

block the development of tolerance to the aversive properties of morphine in rats

utilizing a CTA design. Specifically, animals were preexposed to either vehicle alone,

morphine alone or a combination of either proglumide and morphine or proglumide and

vehicle. Subsequently, saccharin consumption was measured within a CTA design,

where saccharin was paired with either morphine or vehicle. If the effects of morphine

preexposure, which generally result in an attenuation of morphine-induced taste

aversions, are blocked by this CCK antagonist, it may suggest that CCK antagonists

block tolerance to the aversive properties of morphine, further implicating the role of

CCK in morphine tolerance.

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. CHAPTER 2

PROCEDURE: EXPERIMENT 1

Subjects

Subjects were 84 experimentally-naive male Sprague Dawley rats, approximately

60-90 days in age and approximately 300-450g in weight at the beginning of the

experiment. Animals were housed individually in stainless-steel, wire-mesh cages and

maintained on a 12 light: 12 dark cycle (lights on at 0800h) and at an ambient temperature

of 23° C for the duration of the experiments. Standard rat chow and water (except where

noted) were availablead libitum. Animals were housed for approximately two weeks

prior to the commencement of the experiments to allow for habituation to their new

environment.

Druss and Solutions

Morphine sulfate was generously provided by the National Institute on Drug

Abuse (NIDA) and was dissolved in distilled water. Proglumide was obtained from

Panos Therapeutics and was suspended in a solution of 1.2% DMSO and 98.8% 7.0 pH

buffer solution. All drugs were administered by intraperitoneal (i.p.) injection. For

vehicle injections (see below), the solution in which the drug was dissolved is defined as

that drug’s vehicle. Saccharin (0.1% sodium saccharin, Sigma Chemical Company) was

prepared as a 1 g/1 solution in tap water.

12

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Phase 1: Habituation

Following 23-h water deprivation, animals were given 20-min access to water.

This procedure was repeated each day until all subjects drank within 2 s of water

presentation.

Phase 2: Preexposure

On Day 1 of this phase, animals received their regular 20-min access to water. At

the outset of this phase, animals were assigned to a drug preexposure group based on the

average amount of water consumed over the last three days of water habituation.

Specifically, animals were rank ordered according to water consumption and were then

alternately assigned to one of five preexposure groups. Five hours later, subjects

received injections of their preexposure drug(s). Specifically, animals received i.p.

injections of either proglumide (5 mg/kg) or its vehicle (see above) followed 15 min later

by an i.p. injection of either morphine (5 mg/kg) or its vehicle. One group of animals

received an injection of proglumide followed immediately by morphine. This resulted in

five groups (PM, PV, VM, VV and PiM). The first letter refers to the first compound to

be administered [proglumide (P) or vehicle (V)], and the last letter refers to the second

compound to be administered [morphine (M) or vehicle (V)]. PiM refers to the group

that was injected with proglumide immediately followed by morphine. These

preexposure injections were administered every other day for a total of five preexposure

days. Animals received 20-min access to water on the recovery day between preexposure

injections, as well as on the day following the last drug preexposure day.

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Phase 3: Conditionins

On the second day after the last drug preexposure injections in Phase 2, all

animals received 20-min access to a novel saccharin solution. Immediately following

access to saccharin, each preexposure group was divided in half based on saccharin

consumption such that saccharin consumption was comparable between groups.

Specifically, animals in each Preexposure Group were ranked according to saccharin

consumption and were then alternately assigned to one of two groups. Each animal then

immediately received an i.p. injection of either morphine (10 mg/kg) or vehicle. This

resulted in a total often groups (PM-M, PM-V, PV-M, PV-V, VM-M, VM-V, VV-M,

VV-V, PiM-M and PiM-V). Names for these groups are the same as above, with the

letter after the hyphen representing whether that group was injected with morphine (M)

or vehicle (V) during this phase. For example, Group PM-M was preexposed to

proglumide and morphine and was injected with morphine during this phase. On the

following three water-recovery days, all animals received 20-min access to water. No

injections followed water access on those days. This alternating procedure of

conditioning followed by three water-recovery days was repeated for four cycles.

Test for Saccharin Aversion

On the day after the final water-recovery session of Phase 3, animals received 20-

min access to saccharin in a final test of the aversion to saccharin. No injections

followed saccharin access on the test day.

Statistical Analysis

A 5 x 5 repeated measures ANOVA with one within-group factor (Preexposure

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Day) and one between-group factor (Preexposure Drug) was performed on mean water

consumption during preexposure. Post-hoc analyses were conducted using Tukey HSD

pairwise comparisons. Significance was based on p < 0.05. Within-subject differences in

water consumption from baseline (Preexposure Day 1) were assessed using paired sample

t-tests with a Bonferroni correction (g = 0.0125).

A 5 x 2 x 5 repeated measures ANOVA with one within-group factor (Trial) and

two between-group factors (Preexposure Drug and Conditioning Drug) was performed to

study saccharin consumption during conditioning. Post-hoc analyses were conducted

using Tukey HSD pairwise comparisons. Significance was based on g < 0.05. Within-

subject differences in saccharin consumption from baseline (Trial 1) were assessed using

paired sample t-tests with a Bonferroni correction (g = 0.0125).

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. CHAPTER 3

RESULTS: EXPERIMENT I

Preexposure

Figure 1 illustrates the mean (± standard error of the mean (S.E.M.)) consumption

of water for subjects during preexposure. A 5 x 5 repeated-measures ANOVA revealed a

significant effect of Preexposure Day (F(4,268) = 9.075, p < 0.001) and of Preexposure

Drug (F(4,67) = 3.881, p = 0.007). There was no significant interaction for Preexposure

Day x Preexposure Drug (F(l6,268) = 1.283, p = 0.207), indicating that water

consumption was comparable among preexposure groups during preexposure. On the

initial drug preexposure day, animals consumed approximately 15 ml and this level was

maintained over multiple exposures.

PM PiM PV ■VM ■VV

03 ° £ 4-

2- 0-1

i------1------1------1------1— 12 3 4 5 Preexposure Day Figure 1 Mean (± S.E.M.) consumption o f water over repeated preexposure days for subjects in Preexposure Groups PM, PiM, PV, VM and VV. Water was available 5 h before injections. 16

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 17

Conditioning

A 5 x 5 (Group x Trial) repeated measures ANOVA was performed to assess

differences in saccharin consumption among control groups (groups not conditioned with

morphine) across conditioning trials. There was a significant main effect for Trial

(F(4,140) = 75.296, p < 0.001). However, there was no significant effect for Group

(F(4,35) = 1.491, p = 0.226), nor was there a significant Group x Trial interaction

(F(16,140) = 1.212, g = 0.266). Consequently, all control groups were combined for all

further analyses.

A 5 x 2 x 5 repeated measures ANOVA revealed significant main effects for

Preexposure Drug (F(4,73) = 5.439, g = 0.001), Conditioning Drug (F(l,73) = 138.573, g

< 0.001) and Trial (F(4,292) = 34.973, g < 0.001). There were also significant two-way

interactions for Trial x Preexposure Drug (F(16,292) = 7.365, g < 0.001), Trial x

Conditioning Drug (F(4,292) = 53.697, g < 0.001) and Preexposure Drug x Conditioning

Drug (F(4,73)= 10.353, g < 0.001), as well as a significant three-way interaction for

Preexposure Drug x Conditioning Drug x Trial (F(16,292) = 3.607, g <0.001).

Figure 2 illustrates the mean (± S.E.M.) consumption of saccharin over repeated

conditioning trials and on the test day for Controls and animals in Groups VM-M and

VV-M. Post-hoc Tukey HSD analyses revealed that there were no significant differences

among groups on the first trial (all g’s > 0.05), indicating that all groups drank similar

amounts of saccharin on this initial conditioning day (approximately 11.8 ml). Within-

group paired sample t-tests revealed significant differences between each trial and each

group’s respective baseline (Trial 1). Specifically, Controls significantly increased

saccharin consumption relative to baseline on all trials (all g’s < 0.0125). Group VV-M,

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 18

subjects preexposed to the vehicle and conditioned with morphine, decreased saccharin

consumption significantly from its baseline on all trials (all p’s < 0.0125). Group VM-M,

subjects preexposed to morphine and conditioned with morphine, increased consumption

significantly relative to its baseline on Trial 2 (p = 0.011). Saccharin consumption on

Trials 3 and 4 as well as on the Test Day did not differ from baseline (all p’s > 0.0125).

<=> 22 "i s, 20- 8 —*— Controls K. 16- •-■’•-VM-M | 14- C/2 4 § 12‘ O 10- 8

Test Conditioning Trial Figure 2 Mean (± S.E.M.) consumption of saccharin over repeated conditioning trials for control subjects and subjects in Groups VM-M and W -M . * Significantly different from baseline.

Post-hoc Tukey HSD analyses also revealed significant differences among

groups. Specifically, Group VV-M consumed significantly less saccharin than Controls

on Trials 2, 3 and 4 as well as on the Test Day (all p’s < 0.05). Consumption for Group

VM-M was also significantly less than that of Controls on Trials 2, 3, 4 and on the Test

Day (all p’s < 0.05), but it was significantly greater than that of nonpreexposed animals

in Group VV-M on Trials 2, 3 and 4 as well as on the Test Day (all p’s < 0.05), indicating

that preexposure to morphine significantly attenuated the aversion to morphine.

Figure 3 illustrates the mean (± S.E.M.) consumption of saccharin over repeated

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 19

conditioning trials and on the test day for Controls and animals in Groups PM-M and PV-

M. As previously described, Controls significantly increased saccharin consumption

relative to baseline on all trials. Group PV-M, subjects preexposed to proglumide and

vehicle and conditioned with morphine, decreased saccharin consumption significantly

from its baseline on Trials 3 and 4 as well as on the Test Day (all p’s < 0.0125). Group

PM-M, subjects preexposed to proglumide followed 15 min later by morphine and

conditioned with morphine, significantly increased saccharin consumption relative to its

baseline on Trial 2 only (p = 0.001).

C, 22-1 S 20- —•— Controls I 18_ 'S, 16- -o-PM-M | 14- § 12- PV-M O 10- 8

Test Conditioning Trial Figure 3 Mean (± S.E.M.) consumption of saccharin over repeated conditioning trials for control subjects and subjects in Groups PM-M and PV-M. * Significantly different from baseline.

Post-hoc Tukey HSD analyses revealed significant between-group differences.

Specifically, Group PV-M consumed significantly less saccharin than Controls on Trials

2, 3 and 4 as well as on the Test Day (all p’s < 0.05). Consumption for Group PM-M was

also significantly less than that of Controls on Trials 3 and 4 and on the Test Day (all p’s

< 0.05), but it was significantly greater than that of nonpreexposed animals in Group PV-

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 20

M on Trials 2, 3 and 4 as well as on the Test Day (all p’s < 0.05), indicating that

preexposure to morphine attenuated the aversion to morphine, even in subjects receiving

proglumide 15 min prior to morphine drug preexposure.

Figure 4 illustrates the mean (± S.E.M.) consumption of saccharin over repeated

conditioning trials and on the test day for Controls and animals in Groups PiM-M and

PV-M. As described above, controls significantly increased saccharin consumption

relative to baseline on all trials and animals in Group PV-M decreased saccharin

consumption significantly from its baseline on Trials 3 and 4 as well as on the Test Day.

Group PiM-M, subjects preexposed to proglumide immediately prior to morphine and

conditioned with morphine, did not differ in saccharin consumption from its baseline on

any trials (all p ’s > 0.0125).

— Controls PiM-M pv-M

8 CO /- j s 6 I 4

2 3 4 Test Conditioning Trial Figure 4 Mean (± S.E.M.) consumption of saccharin over repeated conditioning trials for control subjects and subjects in Groups PiM-M and PV-M. * Significantly different from baseline.

Post-hoc Tukey FISD analyses revealed significant between-group differences.

As previously described, Group PV-M consumed significantly less saccharin than

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 21

Controls on Trials 2, 3 and 4 as well as on the Test Day. Group PiM-M consumed

significantly less saccharin than Controls on Trials 2, 3 and 4 as well as on the Test Day

(all p’s < 0.05), but consumed significantly more saccharin than Group PV-M on Trials 3

and 4 as well as on the Test Day, indicating that morphine preexposure significantly

attenuated the aversion to saccharin, even in subjects receiving proglumide immediately

prior to morphine drug preexposure.

There were no significant differences in saccharin consumption between Groups

PV-M and VV-M, subjects not preexposed to morphine and conditioned with morphine,

on any trial (all p’s > 0.05). Further, there were no differences in saccharin consumption

on any trial among Groups VM-M, PM-M and PiM-M, subjects preexposed to morphine

or a combination of proglumide and morphine and conditioned with morphine (all p’s >

0.05), indicating that proglumide had no effect on tolerance to the aversive properties of

morphine.

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. CHAPTER 4

DISCUSSION: EXPERIMENT 1

Chronic exposure to morphine results in tolerance to its analgesic effects, and

CCK antagonists block and/or reverse this development. Chronic exposure to morphine

has also been shown to alter the strength of its aversive effects (e.g., see Riley et al.,

1984), and, thus, of interest to the current research was whether or not CCK antagonists

would also be effective in affecting tolerance to these properties. Specifically, the

current research assessed the ability of the nonselective CCK antagonist proglumide to

block the development of tolerance to the aversive properties of morphine in rats

utilizing a UCS preexposure design. In such a design, exposure to a drug prior to taste

aversion conditioning with that drug results in an attenuated taste aversion (see Cappell

& Le Blanc, 1977), presumably due to the development of tolerance to its aversive

properties over repeated exposure (e.g., see Dacanay & Riley, 1982; Domjan & Siegel,

1983; Riley, Dacanay & Mastropaolo, 1984; Stewart & Eikelboom, 1978; for a review,

see Riley & Simpson, 2001). In the current study, animals were preexposed to either

vehicle alone, proglumide alone, morphine alone or a combination of proglumide and

morphine. Subsequently, saccharin was paired with either morphine or vehicle.

As reported, animals preexposed to either proglumide or vehicle and conditioned

with morphine significantly decreased saccharin consumption. This decrease presumably

reflects the association of saccharin with the aversive effects of morphine (Riley & Tuck, 22

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 23

1985) and not to the unconditioned suppressant effects of morphine, as chronic exposure

to morphine (e.g., 40 mg/kg; Riley, West, Sipel & Woods, 1983) results in an increase in

the size and duration of feeding and frequency of drinking. This aversion was

significantly attenuated when animals were preexposed to morphine and conditioned with

morphine, indicating that preexposure to morphine attenuated the aversion to morphine

(for other examples of UCS with morphine, see Cappell & Le Blanc, 1977; Martin,

Bechara & van der Kooy, 1988; Riley et al., 1984). In animals preexposed to proglumide

administered either immediately or 15 min prior to morphine and then conditioned with

morphine, the aversions were also attenuated. This attenuated aversion was similar to

that seen in animals preexposed to morphine (in the absence of proglumide), indicating

that proglumide had no effect on the development of tolerance to the aversive properties

of morphine.

Although proglumide has been shown to be effective in blocking the development

of tolerance to the analgesic effects of morphine and has also been shown to reverse such

tolerance, proglumide is ineffective in preventing the development of tolerance to the

aversive effects of morphine within the current preparation. Whether this is a function of

proglumide or the specific conditions under which proglumide was tested, however,

remains unknown. There are several parametric issues that might have affected the

ability of proglumide to block tolerance to morphine’s aversive effects, e.g., the dose of

proglumide (5 mg/kg) and the amount of time between the administration of proglumide

and morphine (immediate or 15 min).

In the current study, 5 mg/kg proglumide was administered prior to 5 mg/kg

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 24

morphine during drug preexposures. Although tolerance to morphine’s aversive effects

did develop, 5 mg/kg proglumide did not block this development. In other reports,

proglumide at lower doses does modulate morphine’s effects (Ben-Horin, Ben-Horin &

Frenk, 1984; Watkins, Kinscheck & Mayer, 1985). However, these lower doses

potentiate, rather than block, morphine’s effects, including morphine-induced analgesia

and hypokinesia. There is only one study assessing the ability of proglumide to block

morphine’s chronic effects (Tang et al., 1984). In this study, animals were administered

either 4 mg/kg morphine subcutaneously (s.c.) alone or morphine and 15 mg/kg

proglumide i.p. every 2 hours for a total of seven times, and the development of tolerance

to morphine’s analgesic effects was assessed over time. Under these conditions,

proglumide partially blocked the development of tolerance to morphine’s analgesic

effects (Tang et al., 1984). In other behavioral assessments, 50 mg/kg proglumide

reverses CCK-induced satiety (Willis, Hansky & Smith, 1986) and 150 mg/kg

proglumide blocks CCK’s suppression of food intake (Collins, Walker, Forsyth &

Belbeck, 1983). Lower doses of proglumide have also been shown to be effective in

blocking CCK’s effects. For example, 2 mg/kg s.c. blocks the effect of CCK-induced

suppression of locomotion scores (Katsuura, Hsiao & Itoh, 1984). Further, 5 mg/kg

proglumide blocks CCK-induced reduction of passive avoidance latency (Deupree &

Hsaio, 1984). Thus, although ineffective in the current study, 5 mg/kg proglumide has

been shown to be effective in blocking CCK’s effects within another behavioral paradigm

and is certainly within the range of effective doses.

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 25

Another possible reason that proglumide may not have blocked the development

of tolerance to the aversive effects of morphine is the timing between the injections of

proglumide and morphine. In the current study, proglumide was administered either

immediately or 15 min before the administration of morphine. A range in the amount of

time between injections has been shown to be effective in various behavioral

assessments. Although the single study investigating the ability of proglumide to block

the development of morphine tolerance did not describe the amount of time between

injections (Tang et al., 1984), proglumide administered immediately before morphine is

effective in blocking the effects of other drugs, such as CCK. For example, Deupree and

Hsaio (1984) found that 5 mg/kg proglumide, the dose used in the current study,

administered concurrently with CCK blocked CCK’s reduction of passive avoidance

latency. Proglumide followed immediately by CCK also blocks CCK-induced

suppression of feeding (Collins et al., 1983; Willis et al., 1986).

Thus, the dose and amount of time between injections used in the current study

have been shown to be within the range of doses and within the proglumide-morphine

interval that have been effective in other studies. In order to assess whether this dose and

these intervals between proglumide and morphine injections would be effective under the

conditions in the first experiment (e.g., strain of rats, gender, route of administration)

utilizing another behavioral assessment, Experiment 2 investigated the ability of 5 mg/kg

proglumide, administered either immediately, 5 or 15 min before CCK, to block or

attenuate CCK-induced suppression of feeding. Specifically, following 23 h of food

deprivation, animals were injected with either saline, proglumide, CCK or a combination

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 26

of proglumide followed either immediately, 5 or 15 min later by CCK. Animals were

then allowed access to food for 60 min. The amount of food eaten at the end of the 60-

min period was measured.

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. CHAPTER 5

PROCEDURE: EXPERIMENT 2

Subjects

Subjects were 16 male Sprague Dawley rats, approximately 350-500g in weight at

the beginning of the experiment. Animals were housed individually in stainless-steel,

wire-mesh cages and maintained on a 12 light: 12 dark cycle (lights on at 0800h) and at an

ambient temperature of 23° C for the duration of the experiment. Standard rat chow and

water (except where noted) were availablead libitum.

Drugs

Proglumide was obtained from Panos Therapeutics and was suspended in a

solution of 1.2% DMSO and 98.8% 7.0 pH buffer solution. CCK octapeptide

(generously supplied by Bristol-Myers Squibb) was prepared in distilled water. All drugs

were administered by i.p. injection.

Phase 1: Habituation

Animals were deprived of food in their home cages for 23 h prior to each training

or experimental session. The rats received three habituation sessions in which they were

injected with distilled water and were then placed for 60 min in experimental cages that

contained a weighed amount of food. The amount of food eaten at the end of the 60-min

period was measured. 27

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 28

Phase 2: Drus Effects on Feedins

During these sessions, the rats were injected i.p. with either saline, proglumide (5

mg/kg), CCK (3 or 10 pg/kg) or a combination of proglumide followed either

immediately, 5 min or 15 min later by CCK. Five min after the animals were injected

with one of the drugs or drug combinations mentioned above, they were placed for 60

min into experimental cages that contained a weighed amount of food. The amount of

food eaten at the end of the 60-min period was measured. Animals were run in two

separate groups, and each group received the vehicle and each drug or drug combination

in a different order. There was at least one recovery day between sessions, during which

animals hadad-libitum access to food and water. Water was availablead libitum

throughout all sessions.

Statistical Analysis

A repeated measures ANOVA with one within-subjects factor (Drug) was

performed on the amount of food consumed during each 60-min period of Phase 2.

Significance was based on p < 0.05. Within-subject differences in food consumption

were assessed using planned paired sample t-tests with a Bonferroni correction (p =

0.0038).

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. CHAPTER 6

RESULTS: EXPERIMENT 2

Figure 5 illustrates the mean (± S.E.M.) consumption of food for subjects injected

with saline, 3 pg/kg CCK, 10 pg/kg CCK or 5 mg/kg proglumide. A repeated-measures

ANOVA revealed a significant effect for Drug (F(7,105) = 30.314, g < 0.001).

Following saline injections, mean consumption was approximately 8.1 g. Both 3 pg/kg

and 10 pg/kg CCK significantly decreased feeding relative to this saline baseline (g’s <

0.0038), with animals consuming approximately 3.7 g and 2.6 g, respectively.

Proglumide, alone, did not significantly alter feeding compared to baseline (g - 0.133),

with subjects eating approximately 7.2 g.

Kh w _o53 tx

os O T3o o P3

Saline 10 CCK 3 CCK Proglumide (P) Condition Figure 5 Mean (± S.E.M.) consumption of food for food-deprived subjects over repeated 60-min experimental sessions following saline, 10 pg/kg CCK, 3 pg/kg CCK or 5 mg/kg proglumide. * Significantly different from baseline (saline).

29

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 30

Figure 6 illustrates the mean (± S.E.M.) consumption of food for subjects injected

with saline, 10 pg/kg CCK or proglumide followed either 5 or 15 min later by 10 pg/kg

CCK. As described, animals consumed approximately 8.1 g of food following saline

injections and this consumption was decreased significantly by 10 pg/kg CCK (to 2.6 g).

Proglumide did not affect this CCK-induced suppression of feeding. Specifically, food

consumption was significantly suppressed relative to baseline following the combination

of proglumide and 10 pg/kg CCK, administered either 5 or 15 min apart (p’s < 0.001),

when animals consumed approximately 3.4 g and 2.6 g, respectively. The amount of

food consumed following either of the proglumide and 10 pg/kg CCK combinations was

not significantly different from the amount consumed following 10 pg/kg CCK alone,

indicating that proglumide did not block the decrease in feeding induced by this dose of

CCK (p’s > 0.0038). Further, food consumption following proglumide and 10 pg/kg

CCK administered 15 min apart did not differ from food consumption following this

proglumide and CCK combination administered 5 min apart (p = 0.217).

^ 10-i HD

.2 8 ' 4—»a, 6H cnI C o O 4 -a O O tu 2-

Saline 10 CCK P-15min-10 CCK P-5min-10 CCK Condition Figure 6 Mean (± S.E.M.) consumption of food for food-deprived subjects over repeated 60-min experimental sessions following saline, 10 pg/kg CCK or 5 mg/kg proglumide (P) followed either 1 5 or 5 min later by 1 0 pg/kg CCK. * Significantly different from baseline (saline).

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 31

Figure 7 illustrates the mean (± S.E.M.) consumption of food for subjects injected

with saline, 3 pg/kg CCK or proglumide followed either immediately or 15 min later by 3

pg/kg CCK. As described, animals consumed approximately 8.1 g of food following

saline injections, and this consumption was decreased significantly by 3 pg/kg CCK (to

3.7 g). Proglumide administered 15 min before 3 pg/kg CCK did not affect this CCK-

induced suppression of feeding. Specifically, consumption following proglumide

administered 15 min before 3 pg/kg was significantly decreased from baseline (p <

0.001) to approximately 4.0 g. Further, consumption following proglumide and 3 pg/kg

15 min later did not did not differ from feeding following 3 pg/kg alone (p = 0.615).

However, proglumide administered immediately before 3 pg/kg CCK did block its

suppression of feeding. Specifically, the amount of food consumed following

proglumide immediately before 3 pg/kg CCK, when consumption was approximately

6.2 g, did not differ relative to baseline consumption (p > 0.0038). Further, following

this proglumide and CCK combination, animals consumed significantly more food than

that consumed by animals administered 3 pg/kg alone (p < 0.001). Further, food

consumption following proglumide given immediately prior to 3 pg/kg CCK was

significantly higher than that consumed when proglumide was administered 15 min

before 3 pg/kg CCK (p = 0.003).

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Saline 3 CCK P-15min-3 CCK P-immediate-3 CCK Condition Figure 7 Mean (± S.E.M.) consumption of food for food-deprived subjects over repeated 60-min experimental sessions following saline, 3 pg/kg CCK or 5 mg/kg proglumide (P) followed either 15 min later or immediately by 3 pg/kg CCK. * Significantly different from baseline (saline). * * Significantly different from 3 pg/kg CCK alone. * * * Significantly different from proglumide followed 15 min later by 3 pg/kg CCK.

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. CHAPTER 7

DISCUSSION

Chronic exposure to morphine results in tolerance to its analgesic effects, and

CCK antagonists block and/or reverse this development. Chronic exposure to morphine

has also been shown to alter the strength of its aversive effects (e.g., see Cappell & Le

Blanc, 1977; Martin et al., 1988; Riley et al., 1984), and, thus, of interest to the current

research was whether or not CCK antagonists would also be effective in affecting

tolerance to these properties. Specifically, the current research assessed the ability of

the nonselective CCK antagonist proglumide to block the development of tolerance to

the aversive properties of morphine in rats utilizing a UCS preexposure design. In such

a design, exposure to a drug prior to taste aversion conditioning with that drug results in

an attenuated taste aversion (see Cappell & Le Blanc, 1977), presumably due to the

development of tolerance to its aversive properties over repeated exposure (e.g., see

Dacanay & Riley, 1982; Domjan & Siegel, 1983; Riley, Dacanay & Mastropaolo, 1984;

Stewart & Eikelboom, 1978; for a review, see Riley & Simpson, 2001). In the current

study, animals were preexposed to either vehicle alone, proglumide alone, morphine

alone or a combination of proglumide and morphine. Subsequently, saccharin was

paired with either morphine or vehicle.

As described, in Experiment 1 a significant morphine-induced taste aversion was

obtained in animals preexposed to either proglumide or vehicle and conditioned with 33

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 34

morphine. Further, this aversion was significantly attenuated when animals were

preexposed to, and conditioned with, morphine, indicating that preexposure to morphine

attenuated the morphine-induced taste aversion (for other examples of UCS with

morphine, see Cappell & Le Blanc, 1977; Martin et al., 1988; Riley et al., 1984). In

animals preexposed to proglumide administered either immediately or 15 min prior to

morphine and then conditioned with morphine, the aversions were also attenuated. This

attenuated aversion was similar to that seen in animals preexposed to morphine (in the

absence of proglumide), indicating that proglumide had no effect on the development of

tolerance to the aversive properties of morphine.

Although proglumide has been shown to be effective in blocking the development

of tolerance to the analgesic effects of morphine and has been shown to reverse such

tolerance, proglumide is ineffective in preventing the development of tolerance to the

aversive effects of morphine within the current preparation. Whether this is a function of

parametric issues employed in the current study, or other nonparametric issues such as

the UCS preexposure design or the role of CCK antagonists in the motivational properties

of morphine, however, remains unknown. In relation to specific parameters used in the

current assessment, there are several issues that might have affected the ability of

proglumide to block tolerance to morphine’s aversive effects. For example, it is possible

that proglumide might have been effective had a different dose of morphine, rather than 5

mg/kg, been utilized during the preexposure phase of Experiment 1. However, the doses

used were known to produce the UCS preexposure effect, i.e., block the development of

tolerance to the aversive effects of morphine (Stevenson & Riley, 2002). Further, this

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 35

preexposure dose, in conjunction with a conditioning dose of 10 mg/kg morphine, results

in a moderate, but significant, attenuation of the morphine-induced taste aversion. This

was important, as proglumide could have altered the UCS preexposure effect in either

direction, i.e., potentiate or attenuate. Thus, these doses of morphine were necessary in

order to assess the effects of proglumide on the UCS preexposure effect. Other

parameters that may have affected the results of the current study include the dose of

proglumide (5 mg/kg) and the amount of time between the administration of proglumide

and morphine (immediate or 15 min). As reported in Experiment 2, however, this

combination of parameters was pharmacologically effective. As reported, CCK (3 and 10

pg/kg) significantly decreased feeding relative to baseline. Proglumide did not block the

suppression of feeding induced by 10 pg/kg when administered either 5 or 15 min before

CCK. Further, when proglumide was administered 15 min before 3 pg/kg, the

suppression of feeding induced by CCK was not affected. However, when 5 mg/kg

proglumide was administered immediately before 3 pg/kg CCK, proglumide attenuated

the CCK-induced suppression of feeding. Thus, although these injection parameters of

proglumide were ineffective in antagonizing the development of tolerance to the aversive

effects of morphine in Experiment 1, under similar conditions as in Experiment 1, e.g.,

strain of rats, gender, route of administration, these dose and injection parameters of

proglumide produced antagonism in another behavioral preparation. It remains possible,

however, that other doses or injection parameters might have been effective in blocking

the development of tolerance to the aversive effects of morphine, given that antagonism

has been parametric-dependent in previous studies (see also Experiment 2).

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 36

Another parametric issue concerns the role of CCKA versus CCKB receptors in

the motivational properties of morphine. Although the nonspecific CCK antagonist

proglumide used in the current study has a relatively low affinity for CCK receptor

subtypes (Wiesenfeld-Hallin & Xu, 1996), it does have activity at both CCKA and

CCKB receptors (Wiesenfeld-Hallin & Xu, 1996). Thus, if there were an interaction

between CCK antagonists and the development of tolerance to the aversive effects of

morphine, regardless of whether the this effect is mediated by CCKA versus CCKB

receptors, proglumide would have been effective. Thus, employing a CCKA- or CCKB-

selective antagonist may not have altered the results of the current study. However, it

remains possible that a CCK antagonist with a higher affinity for either CCKA or CCKB

receptors may have been effective in the current study.

There are also other issues related to the preparation utilized in Experiment 1 that

might account for the findings of the current study, including whether or not the UCS

preexposure design is susceptible to antagonism. The UCS preexposure effect in CTA

learning is well established (for a review, see Riley & Simpson, 2001). This effect has

been shown with many compounds, including drugs of abuse, and can be altered by a

variety of parametric conditions, e.g., the number of preexposures, the specific compound

used during preexposure and conditioning, the length of time separating drug preexposure

and conditioning, the dose of both the preexposure drug and the conditioning drug.

However, few studies have examined whether or not this effect can be blocked. Previous

research has found that various compounds have failed to block the development of

tolerance to a drug’s aversive effects within a UCS preexposure design when examining

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. 37

the effects of preexposure to a drug on an aversion to that same drug. For example,

Stevenson & Riley (2002) found that the NMDA receptor antagonist MK-801, which

inhibits the development of tolerance to analgesia induced by chronic morphine

administration, did not block the development of tolerance to the aversive properties of

morphine under similar conditions as in Experiment 1. Specifically, MK-801 was

administered with morphine prior to conditioning with morphine in a CTA design.

Animals preexposed to vehicle and conditioned with morphine consumed significantly

less saccharin than animals not conditioned with morphine, and animals preexposed to

morphine and conditioned with morphine displayed an attenuated morphine aversion.

MK-801 had no effect on this attenuation, indicating that MK-801 does not block the

development of tolerance to the aversive effects of morphine. This has also been seen

with ethanol. Specifically, June et al. (1992) administered the inverse benzodiazepine

agonist Rol5-4513 to animals immediately before each of five daily consecutive ethanol

exposures prior to conditioning with ethanol. Animals preexposed to saline and

conditioned with ethanol displayed a significant ethanol-induced saccharin aversion

compared to animals not conditioned with ethanol. Further, animals preexposed to

ethanol and conditioned with ethanol displayed an attenuated aversion, and drank at

levels similar to controls. However, administration of Ro 15-4513 with ethanol during

preexposure did not block the effects of ethanol preexposure on ethanol-induced

conditioned taste aversions.

Although in these studies the UCS preexposure effect was not blocked, two

studies examining cross-drug preexposure effects, where the effects of preexposure to

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drug A on conditioning with drug B in a taste aversion design are assessed, did block the

UCS preexposure effect. For example, Kunin and colleagues (Kunin, Bloch, Smith &

Amit, 2001) examined whether nicotine preexposure would attenuate a caffeine-induced

taste aversion and whether or not this attenuation could be blocked by concurrent

administration of mecamylamine, a nicotine receptor antagonist. The lowest dose (but

not higher doses) of nicotine attenuated the caffeine-induced CTA, and this effect was

reversed by mecamylamine. In another study, the opiate antagonist naloxazone injected

4.5 h before the preexposure drug, either morphine or ethanol, significantly attenuated the

preexposure effect of morphine on ethanol CTA as well as the effect of ethanol on

morphine CTA (Ng Cheong Ton & Amit, 1987). Given the results with cross-drug

preexposure, it appears that the UCS preexposure effect of a drug can be affected

pharmaco logical ly.

The current study was based on the premise that the UCS preexposure effect is

due to the development of tolerance to the aversive effects of the drug. Accordingly, the

design should allow an assessment of the ability of proglumide to affect this

development. It should be noted, however, that a variety of mechanisms have been

proposed to account for the attenuating effects of drug preexposure, of which tolerance is

only one. These mechanisms include other nonassociative processes, such as habituation

to the novelty of the drug, habituation to the drug-induced illness, creation of an

unnatural need state, sensitization to reward, activation of an opponent B process, as well

as associative processes such as learned helplessness and associative blocking, i.e., the

acquisition of stimulus associations during preexposure that interfere with taste aversion

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learning (for a review, see Randich & LoLordo, 1979; Riley & Simpson, 2001).

Importantly, it is not necessarily the case that there is a single mechanism underlying the

UCS preexposure effect for all drugs. Of interest to the current study is morphine, and

whether or not tolerance is the mechanism underlying the preexposure effect seen with

this drug of abuse. In one of the first studies to examine the UCS preexposure effect with

morphine, Dacanay and Riley (1982) preexposed rats to morphine or water in a novel

environment and later conditioned them with morphine in either the same novel

environment or the home cage. If an associative mechanism were responsible for any

effects of morphine preexposure, it would be expected that the preexposure effects would

only be evident when preexposure and conditioning occurred in the same environment.

Only under such conditions would stimuli associated with morphine during preexposure

affect aversion conditioning with morphine. On the other hand, if a nonassociative

mechanism mediated the effects of morphine preexposure, it would be expected that the

preexposure effect would occur independent of any similarity between the preexposure

and conditioning environments (though see Siegel & MacRae, 1984). In the Dacanay

and Riley (1982) report, animals preexposed to morphine displayed attenuated aversions,

independent of the similarity of the preexposure and conditioning environments,

supporting a nonassociative basis for the effects of morphine preexposure on morphine-

induced taste aversion learning (see also Domjan & Siegel, 1983; Riley, Dacanay &

Mastropaolo, 1984; Stewart & Eikelboom, 1978). This effect with morphine is in

contrast to that of LiCl. Specifically, animals administered LiCl preexposure and

conditioning in a distinct environment display significantly attenuated aversions, while

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animals preexposed to LiCl in the distinct environment and conditioned with LiCl in the

home cage do not. Such findings with LiCl are consistent with an associative (blocking)

explanation (see Dacanay & Riley, 1982; Willner, 1978).

Although the effect of morphine preexposure appears nonassociative in nature,

the specific nonassociative mechanism underlying these effects remains unknown. As

described above, several nonassociative processes have been proposed as mechanisms

underlying the US preexposure effect. For drugs of abuse in general, it appears that

tolerance may be responsible. Support for this position comes from several sources,

indirectly, by investigating the development of tolerance to other drug effects occurring

along with attenuated aversions in the same animals, and, more directly, by varying the

parameters of drug preexposure known to affect the development of tolerance (for a

review, see Riley & Simpson, 2001) and assessing their effects on UCS preexposure in

aversion learning. In relation to studies examining the issue of tolerance indirectly,

Cannon, Baker and Berman (1977) assessed the effects of ethanol preexposure on

aversion learning with ethanol and on the ability of ethanol to affect motor activity. They

found that ethanol preexposure attenuated ethanol-induced taste aversions and reduced

the effects of ethanol on rotor-rod performance (indicating tolerance to ethanol’s effects

on motor behavior). The parallel between the development of tolerance to the motor

suppressant effects of ethanol and the development of the UCS preexposure effect with

ethanol provides indirect support for the role of tolerance in the UCS preexposure effect.

Other studies have examined tolerance to the aversive effects of a drug more directly by

examining the effects of variations in parameters known to affect tolerance, e.g., the

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number of preexposures, the time between preexposure and conditioning, etc. (for a

review, see Riley & Simpson, 2001) on the UCS preexposure effect. For example,

Cappell and Le Blanc (1975) examined the effects of varying the amount of time between

preexposure to and conditioning with amphetamine. Specifically, animals were

conditioned with amphetamine 0, 1, 7 or 14 days following amphetamine preexposure.

Animals conditioned either 0 or 1 day after preexposure displayed attenuated aversions.

Animals conditioned 7 or 14 days after preexposure also displayed attenuated aversions;

however, this attenuation was weaker than that seen in animals conditioned with the

shorter intervals, indicating that the degree of attenuation was affected by the amount of

time between preexposure and conditioning, an effect consistent with tolerance.

As with other drugs of abuse, research has examined the issue of tolerance with

morphine preexposure. For example, Cappell and Le Blanc (1977) examined the effects

of the spacing of morphine preexposures, a manipulation known to affect the

development of tolerance to behavioral effects of the opioids (see Goldstein, Aronov &

Kalman, 1974). Specifically, different groups of animals were given morphine exposures

every 24 (massed) or 120 (spaced) h for a total of 15 exposures prior to taste aversion

conditioning with morphine. Interestingly the massed preexposures to morphine were no

more effective in attenuating morphine-induced taste aversions than were the spaced

preexposures, an effect inconsistent with what might be expected if the preexposure

effect with morphine was a function of tolerance. Although apparently inconsistent, it is

possible that the intervals assessed by Cappell and LeBlanc were too long to see

differential effects on the development of tolerance. This suggestion is supported by

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earlier work by Goldstein et al. (1974) who reported that greater tolerance was evident

with shorter intervals between repeated drug injections (8 h). As the inter-injection

interval exceeded 24 h, there was little evidence of differential tolerance (or of tolerance

itself), suggesting a direct effect of such injection schedules on tolerance development. It

remains unknown if variations in the interval of morphine preexposure would affect

morphine-induced aversion learning if intervals less than 24 h were used. More direct

assessments of tolerance to morphine preexposure come from other work by Cappell &

Le Blanc (1977) who examined the effects of varying the amount of time between

preexposure to and conditioning with morphine, another parameter known to affect

tolerance. Specifically, animals were preexposed to morphine1,7, 14 or 28 days before

six conditioning trials with morphine. Although the preexposure effect was evident as

long as 28 days following morphine preexposure, on the third through the last

trials, the degree of aversion was ordered according to the number of days since the last

preexposure day, i.e., the degree of aversion following 28 days was less than the degree

of attenuation observed following fewer days, consistent with tolerance. It is interesting

to note in this context that morphine-induced taste aversions have been reported to

weaken with extended conditioning (Siegel, Parker & Morez, 1995). This weakening is

suggestive of the development of tolerance over conditioning and is consistent with the

reduction of the aversive effects of morphine with repeated administration. Although

limited, the work with morphine preexposure points to a nonassociative mechanism

underlying the effects of UCS preexposure. Further, manipulations assessing variations

in the parameters known to affect tolerance are consistent with tolerance as the specific

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nonassociative mechanism. Thus, the failure of proglumide to block the UCS

preexposure effect is not likely due to the fact that tolerance was not assayed in this

design, although more research is required before conclusively determining that tolerance

is responsible for the US preexposure effect with morphine.

The issues discussed to this point are parametric and procedural in nature.

However, the results of the current study might be due to the role of CCK in the

motivational properties of morphine. In other words, perhaps CCK is not involved in the

motivational effects of morphine. Only a few studies have examined the interaction

between CCK antagonists and the motivational properties of morphine. In relation to the

rewarding effects of morphine, the CCKA-selective antagonists PD140548 (Singh et al.,

1996) and devazepide (Higgins et al., 1992) and the CCKB-selective antagonist L-

365,260 (Lu et al., 2000; 2001) attenuate or block morphine-induced CPP. Further,

following extinction, the CCKB-selective antagonist L-365,260 blocks the reactivation

of morphine place preference by morphine (Lu et al., 2001). Other studies, however,

have found that CCK antagonists have the opposite effect, as the CCKB-selective

antagonists L-365,260 (Higgins et al., 1992) and PD-134,308 (Valverde et al., 1996)

potentiate morphine CPP. Although this would indicate that CCK has a role in the

rewarding effects of morphine, several studies have found that CCK antagonists have no

effect. For example, the CCKA-selective antagonist MK-329 (Lu et al., 2000; 2001) and

the CCKB-selective antagonist CI-988 (Singh et al., 1996), administered with morphine

during the development of morphine place preference, do not affect morphine-induced

place preferences. Further, following extinction of a morphine-induced place preference,

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the CCKA-selective antagonist MK-329 does not block the reactivation of morphine

place preference induced by the administration of morphine (Lu et al., 2001). Given the

current findings, it appears that CCK may play a limited role (if any) in the aversive

effects of morphine.

Drugs with abuse potential, such as morphine, possess opposing motivational

properties in that they concurrently produce both rewarding and aversive effects (Wise et

al., 1976; Bechara & van der Kooy, 1985). It has been suggested that the relative

strength of each of these motivational properties affects whether or not the drug will be

taken (Stolerman, 1989). For example, a drug that is both high in rewarding properties

and low in aversive properties is more likely to be used than a drug that is both low in

rewarding properties and high in aversive properties (Stolerman, 1989). Any

manipulation that could alter these properties may affect the drug’s abuse liability. One

such manipulation that may alter the relative strength of these properties, and, thus, drug

acceptability, is drug history. In relation to the aversive properties, decreases with

repeated exposure would result in an increased acceptability of the drug, which may lead

to increased use. If the effects of drug history on drug acceptability could be altered,

subsequent drug use might be affected. In other words, manipulating the changes in the

motivational properties of a drug of abuse with exposure could have therapeutic value.

The current study was the first to examine directly the effects of a CCK antagonist,

proglumide, on the development of tolerance to the aversive effects of morphine. The

interest in CCK antagonists lies in their potential therapeutic value to chronic pain

patients treated with morphine. Recent studies have investigated the utility of CCK

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antagonists for such patients, specifically assessing the ability of CCK antagonists to

increase the analgesic effects of morphine (e.g., see McCleane, 2002; 2003; Price, von

der Gruen, Miller, Rafii & Price, 1985). CCK antagonists could also be useful in

preventing the development of tolerance to the analgesic effects of morphine, thus,

decreasing the need for higher doses of morphine for continued effective pain relief

(Price et al., 1985). Had CCK antagonists also been effective in blocking the

development of tolerance to the aversive effects of morphine, it could have potentially

blocked any increase in drug acceptability following chronic exposure. Given that drug

history has also been reported to increase the rewarding properties of morphine, i.e.,

sensitization, resulting in an increase in drug acceptability (e.g., Gaiardi, Bartoletti,

Bacchi, Gubellini, Costa & Babbini, 1991), future research should further examine the

effects of proglumide and other CCK antagonists on these properties of morphine. This

is of similar interest to the effects of CCK antagonists on the aversive effects of

morphine, as CCK antagonists could prevent sensitization to the rewarding effects of

morphine following exposure, perhaps reducing the likelihood of increased use and abuse

following pain treatment.

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