ABSTRACT
Tobacco use remains a major public health and economic concern, particularly in women who are more
susceptible to the long-term consequences of nicotine exposure. Clinical evidence has revealed that stress
produced by nicotine withdrawal can be intensified by fluctuations in gonadal hormones in women, although the
underlying mechanisms remain obscure. Thus, there is a critical need to determine the mechanisms by which
stress systems enhance withdrawal severity in females versus males, and the influence of ovarian hormones on
these measures in adult females. If this knowledge gap is not filled, then the challenges of reducing nicotine use
and developing specialized medications for females will remain largely insurmountable. The long-term goal of
our research program is to identify the mechanisms that mediate nicotine use among different clinical populations
that are uniquely susceptible to this problem. The objective of this application is to determine the mechanisms
that promote withdrawal from chronic nicotine vapor inhalation. Recent work in male rodents has revealed that
nicotine withdrawal is modulated in the medial habenula-interpeduncular nucleus (MHb-IPN) pathway. Our
central hypothesis is that sex differences in withdrawal are modulated in the local circuits of the IPN, where
stress and ovarian hormones modulate withdrawal severity in females. Specifically, our mechanistic
hypothesis is that females experience greater inhibitory tone in the IPN via local interneurons that release the
inhibitory neurotransmitter gamma-aminobutyric acid (GABA). These GABA interneurons express type 1
receptors for the stress peptide, corticotropin-releasing factor (CRFR1). We posit that chronic nicotine produces
a greater enhancement of CRF production and CRFR1 receptor expression which further promotes GABAergic
inhibitory tone in the IPN of females. The rationale for the proposed research is that its successful completion is
likely to contribute to a mechanistic framework for the development of new cessation strategies, particularly for
women. Guided by strong preliminary data, the following specific aims were designed to: 1) identify the
mechanisms by which the IPN controls nicotine withdrawal in females and males and 2) determine the effects of
ovarian hormones on IPN-modulated nicotine withdrawal in females. The proposed studies constitute a multi-
disciplinary approach involving tract tracing, behavior, immunocytochemistry, neurochemistry, and gene-transfer
technology to compare sex differences (Aim 1) and the influence of ovarian hormones (Aim 2) on withdrawal
severity and inhibitory tone in the IPN. The proposed work is innovative because it combines state-of-the-art
methods to unveil the mechanisms by which inhibitory tone in the IPN modulates withdrawal in a sex- and
hormone-dependent manner. The proposed research is significant because the results are expected to inform
the development of future interventions that will selectively target the underlying mechanisms of withdrawal.
Ultimately, the results of our research continuum are expected to contribute meaningfully to the design of
precision therapeutics that will reduce health disparities produced by chronic nicotine use, particularly in women.