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PTSD Treatment: New Drug Targets Brain’s GABA Imbalance

Here’s a breakdown of the provided text, focusing on the key findings and implications:

The Problem:

Post-Traumatic Stress Disorder (PTSD) is tough to treat.
Current medications (targeting serotonin) offer limited relief for many.

The New Finding:

Brain Region of Interest: Medial Prefrontal Cortex (mPFC) – crucial for fear regulation.
Key Findings in PTSD patients:
Unusually high levels of GABA (a neurotransmitter that inhibits neural activity).
Reduced cerebral blood flow in the mPFC.
GABA’s Role in Recovery: GABA levels decreased in patients who showed clinical betterment, indicating its central role in recovery.
source of Excess GABA:
Not neurons, but astrocytes (a type of glial cell).
Astrocytes produce abnormal GABA via the enzyme monoamine oxidase B (MAOB). Mechanism of Dysfunction: This astrocyte-derived GABA impairs neural activity, specifically blocking the brain’s ability to forget traumatic memories (memory extinction).

The Potential Treatment:

Drug: KDS2010 – a selective, reversible MAOB inhibitor developed at IBS.
How it works:
Inhibits MAOB, reducing GABA production by astrocytes.
Reduces GABA levels.
Restores blood flow in the mPFC.
Re-enables memory extinction mechanisms.
Preclinical Evidence: KDS2010 showed normalized brain activity and allowed mice to extinguish fear responses.

Key Methodological Innovation:

Reverse Translational Strategy: the researchers started with clinical findings in humans (brain scans) and worked backward to identify the cellular source of dysfunction, then confirmed the mechanism and tested drugs in animal models. This approach helped link human symptoms to cellular mechanisms.

Importance and future Implications:

novel Understanding: Identifies astrocyte-derived GABA as a key pathological driver of fear extinction deficits in PTSD.
New Therapeutic Target: MAOB inhibition is a viable therapeutic path.
Broader Impact: Opens a new therapeutic paradigm not only for PTSD but potentially for other neuropsychiatric disorders like panic disorder,depression,and schizophrenia.
Current Status: KDS2010 is currently undergoing Phase 2 clinical trials, suggesting a potential for new treatment options for patients unresponsive to conventional therapies.
Glial Cell Role: Highlights the active role of glial cells in shaping psychiatric symptoms, challenging the previous view of them as merely passive support cells.

Quotes:

Dr.Woojin Won: Emphasizes the study’s novelty in identifying astrocyte-derived GABA as a driver of fear extinction deficit and the preclinical evidence for MAOB inhibitors.
Director C. Justin LEE: Highlights the success of reverse translational research and the potential for a new therapeutic paradigm for multiple neuropsychiatric disorders.

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