Effects of Smoking on Opioid Receptor Binding: A PET Study



Status:Completed
Conditions:Smoking Cessation
Therapuetic Areas:Pulmonary / Respiratory Diseases
Healthy:No
Age Range:21 - 50
Updated:4/17/2018
Start Date:January 17, 2008
End Date:January 8, 2015

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Effects of Smoking on Opioid Receptor Binding Using [(11)C]Carfentanil: An Imaging PET Study

Background:

- Tobacco smoking is one of the most preventable causes of morbidity and mortality in the
world, but the addictive property of nicotine is such that fewer than 10 percent of
people who attempt to quit smoking remain tobacco-free after 1 year. Researchers are
studying the addictive properties of nicotine in an attempt to develop more successful
medication therapies for smoking cessation.

- Nicotine acts on chemical receptors in the brain, including opioid receptors that affect
the perception of pain. Repeated nicotine administration can cause adaptations in the
brain s opioid receptors, which heightens the addictive properties of nicotine and
increases the likelihood and severity of withdrawal symptoms associated with smoking
cessation. Researchers are interested in using positron emission tomography (PET)
scanning to study brain chemical responses to nicotine in current smokers and
nonsmokers.

Objectives:

- To study brain chemical activity related to cigarette smoking and nicotine
administration.

- To compare the brain chemical activity of current daily smokers with that of nonsmokers.

Eligibility:

- Individuals 21 to 50 years of age who are either current smokers (10 to 25 cigarettes daily
for at least 2 years) or have had some exposure to tobacco but have never smoked regularly
(may have had a maximum of 20 cigarettes in their lifetime and none in past year).

Design:

- Eligible participants will undergo initial medical and psychological screening and
neuropsychological testing before beginning the main phase of the study. Participants
will be required to abstain from alcohol and drugs (except caffeine, nicotine, and
prescription drugs) for 24 hours before each session, and smokers will refrain from
smoking after midnight on the night before each session.

- Session 1: Participants will answer questions about nicotine craving and withdrawal
symptoms, followed by a magnetic resonance imaging (MRI) scan to provide baseline
information about brain activity.

- Session 2 and 3: Participants will answer questions about nicotine craving and
withdrawal symptoms, and then will smoke one cigarette (either active nicotine or
placebo). Researchers will document participants consumption of the cigarette. After the
cigarette is smoked, participants will have a PET scan. Blood samples will be drawn
during the PET session.

Objective: To determine whether nicotine, at the dose delivered through a cigarette (1-2 mg),
will increase the release of endogenous opioids, measured by the displacement of the
mu-opioid PET receptor radioligand [(11)C]carfentanil and to determine whether smokers have
adaptations in the opioid system compared with nonsmokers.

Study Population: 20 current, daily smoikers and 20 never-smokers who have smoked between 1
and 20 cigarettes in their lifetime.

Design: Double-blind, placebo-controlled, parallel groups design.

Outcome Measures: 1) displacement [(11)C]carfentanil binding, secondary to the release of
endorphins by nicotine; 2) upregulation of [(11)C]carfentanil specific binding in smokers
compared with nonsmokers; 3) [(11)C]carfentanil specific binding as a function of the
mu-opioid receptor A118G polymorphism; and 4) correlation between self-report measures of
nicotine effect and [(11)C]carfentanil binding profile.

- INCLUSION CRITERIA FOR SMOKERS:

1. 21-50 year old males and females

2. smoke 10 cigarettes per day on average for at least 2 years

3. urine cotinine level greater than or equal to 200 ng/ml (NicAlert reading greater
than or equal to 4)

4. estimated IQ score greater than or equal to 85 (competent to give informed
consent)

5. medically and psychologically healthy as determined by screening criteria.

EXCLUSION CRITERIA FOR SMOKERS:

1. interest in reducing or quitting tobacco use

2. treatment for nicotine dependence in the past 3 months

3. current drug or alcohol abuse or dependence

4. consumption of more than 15 alcoholic drinks per week during the past month

5. any opiate use in the past 6 months

6. marijuana use greater than one time per week on an average during the past month

7. other drug use greater than 2 time per month on average during the past 3 months.

8. current use of any medication that would interfere with the protocol

9. under the influence of a drug or alcohol at experimental sessions

10. HIV positive

11. history of psychotropic medications

12. history of head injury with unconscious longer than 5 minutes

13. implantable device or foreign body that would make an MRI examination unobtainable

14. MRI abnormality judged clinically significant by the PI

15. use of any investigational medication or device within the previous 30 days

16. donation at least 450 ml of blood or equivalent levels of plasma within the previous
30 days

17. exposure to ionizing radiation that, in combination with the study tracer, would
result in a cumulative exposure exceeding 5 rem in one calendar year

18. any subject judged by the PI to be inappropriate for the study.

19. chronic pulmonary disease, including COPD, bronchitis, asthma, and emphysema

20. pregnant, nursing, or become pregnant during the study

INCLUSION CRITERIA FOR NONSMOKERS:

1. 21-50 year old males and females

2. smoked 1-20 cigarettes in their life and none in past year

3. urine cotinine level less than 30 ng/ml (NicAlert reading less than or equal to 1)

4. estimated IQ score greater than or equal to 85 (competent to give informed consent)

5. medically and psychologically healthy as determined by screening criteria.

EXCLUSION CRITERIA FOR NONSMOKERS:

1. use of any tobacco products in the past year

2. current drug or alcohol abuse or dependence

3. consumption of more than 15 alcoholic drinks per week during the past month

4. any opiate use in the past 6 months

5. marijuana use greater than one time per week on average during past month

6. other drug use greater than two times per month on average during past three months.

7. current use of any medication that would interfere with the protocol

8. under the influence of a drug or alcohol at experimental sessions

9. HIV positive

10. history of psychotropic medications

11. history of head injury with unconscious longer than 5 minutes

12. implantable device or foreign body that would make an MRI examination unobtainable

13. MRI abnormality judged clinically significant by the PI

14. use of any investigational medication or device within the previous 30 days

15. donation of at least 450 ml of blood or equivalent levels of plasma within the
previous 30 days

16. exposure to ionizing radiation that, in combination with the study tracer, would
result in a cumulative exposure exceeding 5 rem in one calendar year

17. any subject judged by the PI to be inappropriate for the study.

18. chronic pulmonary disease, including COPD, bronchitis, asthma, and emphysema

19. pregnant, nursing, or become pregnant during the study
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