# Targeting Cav1.2 to treat Ketamine-Induced Pathology

> **NIH NIH U18** · BETH ISRAEL DEACONESS MEDICAL CENTER · 2020 · $262,500

## Abstract

Abstract:
Ketamine is a schedule III controlled substance used clinically as an anesthetic and antidepressant. The
drug’s hallucinogenic effects have led over the last 20 years to its unregulated consumption by abusers world-
wide. At least 2.3 million Americans above age 12 have abused ketamine (NIDA). Ketamine toxicity has been
reported in treated patients as well as in ketamine abusers. Indeed, ~30% of ketamine abusers develop
ketamine cystitis, a new urological disorder first defined in 2007. Ketamine cystitis is characterized by bladder
pain with urinary urgency, frequency, dysuria, and hematuria. Urodynamic and ultrasonic studies indicate a
small bladder, and 50% of cases are accompanied by vesicoureteric reflex and hydronephrosis. As the
molecular mechanism of ketamine cystitis is unknown, the mainstays of treatment remain abstinence from
ketamine and supportive therapies, with cystectomy and bladder reconstruction as a last resort. The overall
goals of this application are to define the underlying molecular target of ketamine cystitis and to develop novel
effective therapeutic approaches to the disorder. We present compelling evidence that ketamine induces
voiding dysfunction by dose-dependent inhibition of bladder smooth muscle (BSM) contraction. We have
shown that ketamine inhibits BSM contraction by acting as an inhibitor of the novel ketamine target, the L-type
voltage-gated calcium channel, Cav1.2. We have further shown that ketamine inhibits recombinant Cav1.2
activity expressed in Xenopus oocytes. We have also demonstrated that the Cav1.2 agonist Bay k8644 can
fully reverse the ketamine-induced voiding abnormality in vivo. In this proposal, we will further examine our
hypothesis through the following two aims: (1) we will examine the in-depth mechanism by which ketamine
inhibits the Cav1.2 channel as expressed endogenously in bladder smooth muscle cells and as recombinant
polypeptides in Xenopus oocytes. (2) We will then examine the hypothesis that Cav1.2 agonists are novel
drugs or lead compounds for treatment of ketamine-induced smooth muscle pathology. To achieve our aims,
we will use patch clamp techniques to study the mechanism of ketamine inhibition of Cav1.2 channels in both
Xenopus oocytes and freshly isolated bladder smooth muscle cells. We will then generate a chronic ketamine
cystitis mouse model, and treat these animals with systemic BayK8644 to test the ability of Cav1.2 agonists
to reverse or ameliorate ketamine cystitis. The therapeutic effect of BayK8644 will be evaluated by in vivo
urodynamic assays (voiding spot assay, cystometrograms), myography, and molecular/cellular approaches.
Our findings from this study will characterize Cav1.2 as a novel molecular target for the treatment of ketamine
cystitis, and will test candidate preclinical small molecule therapeutics for treatment of ketamine cystitis. We
are confident that our preliminary findings and proposed experiments will expedite development of novel
Cav1.2 ag...

## Key facts

- **NIH application ID:** 10104141
- **Project number:** 1U18DA052346-01
- **Recipient organization:** BETH ISRAEL DEACONESS MEDICAL CENTER
- **Principal Investigator:** weiqun yu
- **Activity code:** U18 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $262,500
- **Award type:** 1
- **Project period:** 2020-09-15 → 2022-09-14

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10104141

## Citation

> US National Institutes of Health, RePORTER application 10104141, Targeting Cav1.2 to treat Ketamine-Induced Pathology (1U18DA052346-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10104141. Licensed CC0.

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