Neurological and
psychiatric disorders have been prevalent all through human history, but never
more poignant in this present day and age of fast paced civilization and
globalism. People with these conditions not only have to endure the ordeal of
the physical and psychological manifestations of these various debilitating
disorders, but also have to deal with the indirect impact on their familial and
workplace relationships along with consequences with regard to their
socioeconomic status. In many countries around the world and especially
pronounced in developed nations, mental illnesses leave a trail of suffering
and disability that have significant implications measures of wellness,
productivity, and economics. Some of these disorders include major depressive
disorder, anxiety disorders like obsessive-compulsive disorder and
post-traumatic stress disorder, as well as schizophrenia and addictions.
Optogenetics is described
as one of the great breakthroughs in the field of neuroscience in recent
history. The promise that it holds in treating a variety of medical conditions
especially neurological and psychiatric disorders brings hope to an area of
medicine that still has difficulty in effectively treating many of the
afflicted as well as a better understanding of the brain and how it works. This
is crucial because of the way that the field of psychiatry viewed mental illness
which is limited by gaps in knowledge of how the brain works. Optogenetics is a
unique approach that utilizes existing techniques and technology in a new way
of conducting experiments involving live tissue in living organisms, in
particular animals such as lab mice. This new approach or technique was the
product of long years of hard work and dedication by Karl Deisseroth, a
psychiatrist and neuroscientist at Stanford University, building on earlier
work and theories put forth by Luigi Galvani, an Italian physician from the
late 1700’s, who first observed that static electricity can cause movement in
the leg of a dead frog; Walter R. Hess who in the 1920’s demonstrated that
behavior and emotion came from electrical impulses in the brain by stimulating
cat brains via implanted wires; and Jose Manuel Rodriguez Delgado, a Spanish
physiologist from Yale who in the 1950’s used a device called a stimoceiver to
implant electrodes into subject brains to ultimately evoke an array of
responses including motor/emotional responses. Electrodes, however are
imprecise in the specificity of the neurons they target however. Deisseroth was
frustrated by the difficulty in explaining away a disorder like depression to a
patient which can be the result of many things going awry within the brain
further complicated by the wide variety of ways to treat it. Compare that
scenario with the relative ease that a cardiologist can explain away damaged
heart tissue and it is easy to see why the field of psychiatry can be so
challenging (Colapinto, 2015).
How exactly does
optogenetics work? First, lets fast forward to the 1970’s with the major
discovery by German biochemist Dieter Oesterhelt who observed the very first
opsin (a type of protein) in a single-celled bacterium originating from highly
saline lakes Egypt and Kenya which prompted significant research into the
phenomena worldwide. Despite the high salt content of these lakes, these
particular bacteria are capable of surviving and thriving in these conditions
and it just so happened they were also capable of converting absorbed light
into energy. One of the difficulties inherent in neuroscience before the
maturation of optogenetics was trouble working with a brain that operated at
the millisecond level speed while being able to target specific neurons in
specific areas in the brain. Then in 2003, a new opsin was discovered in a
particular kind of green algae that can be found in freshwater ponds. In an
experiment conducted by inserting these opsins into human embryonic kidney
cells, it was found that the opsins render the kidney cells responses to
flashes of blue light. This opsin is now referred to as channelrhodopsin-2
(ChR2) and is capable of turning light into electricity, allowing it to match
the speed at which electrical impulses work in the brain. Despite this exciting
new finding, the main issue that remained was getting these opsins into neurons
in the brain which is much more complicated than getting them into kidney
cells. It wasn’t until mid-2004 that Deisseroth found his answer. A graduate
student of Deisseroth’s named Feng Zhang figured out a way to migrate the opsin
into the cell by way of injecting it with a virus (a process called viral
transfection) and proved the concept by performing this technique on a rat
neuron in a petri dish and flashing blue light over it. The light generated
electrical activity via action potentials which is how neurons can communicate
with one another (Colapinto, 2015).
Sometime afterward
Deisseroth and his team futher refined optogenetics as a technique by attaching
some DNA to the opsins which when injected into the target brain regions, will
only be expressed on the desired neurons. Then the Deisseroth team developed a
method of reaching the deep brain tissue injected with the opsins utilizing
fiber-optic wires attached to a laser diode attached to the top of the mouse
head. The ultimate culmination of these endeavors was first demonstrated when
Zhang stimulated the motor cortex region with of a mouse with blue light
causing it to run in circles and promptly stopping followed by sniffing
behavior when the light was turned off. This finding was later expounded by
further discoveries such as the utilization of optogenetics by another student
of Deisseroth’s (Viviana Gradinaru) establishing correlations in Parkinson’s
disease and Zhang’s findings on the role of certain dopaminergic neurons that
play a role in reward response and by extension drug addiction (which is similar
to the findings as indicated by Dr. Stephen Steidl in regards to the
dopaminergic system during his presentation at Loyola University Chicago on
September 5, 2017). Another disciple of Deisseroth’s, Edward Boyden conducted
his own research at M.I.T. using an opsin that is responsive to yellow light
which results in a shutting down of neural activity. All of these experiments
combined to demonstrate the strong selectivity of the neuronal populations that
were the foci of opsin expression and stimulation (Colapinto, 2015).
How does optogenetics
compare to how clinical psychiatry is currently conducted? Optogenetics still
has a long way to go before it or something along a similar vein can be applied
to human beings, despite the relative similarity between optogenetic test
subjects(mice) and human brains in terms of function especially with regard to
emotional responses such as fear, anxiety, and reward. One major issue is all
of the unknowns regarding injecting living people with viruses and their
potential long-term effects. In the practice of psychiatry, quite often the
approach to treating various disorders such as major depression involves
prescribing medications that affect different systems in the brain such as the
antidepressant Prozac. It was presumed for a long time that the issue in many
mental disorders was a chemical imbalance (Colapinto, 2015). A big issue
involving the use of drugs is the potential for undesirable side effects. Many
drugs are metabolized in the liver where in some cases they are inactivated by
the cytochrome P-450 family of enzymes, but in others metabolism creates active
metabolites that may have an even stronger effect the drug in its original form
(also known as a prodrug). If you’ve heard the adage to beware of drinking
grapefruit juice when taking certain medications, then you’ll know what I’m
talking about. Grapefruit juice acts an inhibitor of the CYP3A4 enzyme which is
one of the major enzymes that metabolizes drugs. For example, this induction
could potentially elevate levels of prescription drugs that someone might be
taking which would generate toxicity and potential harm. Some of the popular
drugs used to treat depression, anxiety, schizophrenia, and pain (opioids) are
either inducers (which can lower levels of other drugs) or inhibitors of these
CYP enzymes which creates problematic situations especially when people are on
multiple drugs (Le, 2016).
Optogenetics has now
had a very large impact on the field of neuroscience giving scientific
researchers the ability to work with the detailed networks that constitute the
makeup of the brain and have uncovered new information regarding a number of
its functions such as learning, memory, metabolism, hunger, sleep, reward
response, motivation, and fear. As time passes, more and more researchers in
the field of neuroscience are seeing that the brain and disorders that involve
it involve complex networks of circuitry with diseases resulting something
resembling a short-circuit in the vast and extensive wiring within its frame
(Colapinto, 2015). It is my belief that optogenetics, if the issues regarding
usage in humans can be worked out perhaps through further refinement or optimization
of the technique can play an important role in potentially solving the issue of
side effects from medications (especially multiple medication regimes). Being
able to target only the specific population of neurons in specific parts of the
brain would be a big advantage over conventional trial and error prescription
which not only may cause side effects, but may also be a waste of time and
money. This may prove to be beneficial not only to the patient’s physical and
psychological wellbeing, but also their professional and private lives. In the
grand scheme of things, the work performed by Karl Deisseroth and his peers
exemplifies and demonstrates the height of human ingenuity and creativity.
References
Colapinto, John. “Lighting the Brain: Karl Deisseroth
and the Optogenetics Breakthrough.” The
New Yorker, 18 May 2015, https://www.newyorker.com/magazine/2015/05/18/lighting-the-brain. Accessed 12 October
2017.
“Drug Metabolism.” YouTube, uploaded by Kim T, 12 September 2008. https://www.youtube.com/watch?v=2uehdqZzKEM. Accessed 17 October
2017.
“Karl Deisseroth (Stanford/HHMI): Development
of Optogenetics.” YouTube, uploaded
by iBioMagazine, 20 September 2016. https://www.youtube.com/watch?v=MUGky_QaaV0&t=415s. Accessed 15 October
2017.
Le, Jennifer. “Drug Metabolism.” Merck Manuals: Professional Version.
April 2016, http://www.merckmanuals.com/professional/clinical-pharmacology/pharmacokinetics/drug-metabolism. Accessed 17 October
2017.
Steidl, Stephen. “Mesopontine tegmental inputs to the dopamine system contribute to
appetitively motivated behaviors in rats and mice.” 5 September 2017. Loyola
University Chicago, Chicago, IL. Speaker Presentation.