In a comprehensive series of studies that span immediate effects on HTR, changes in synaptic protein levels 3 and 11 days after treatment administration and changes in metabolic parameters at 11 days, we compared the effects of PSIL and PME at the equivalent psilocybin dose. Our findings show no difference in acute effects on HTR. However, we found an effect of PME on synaptic protein levels in 4 brain areas that is significantly more pronounced overall than the effect of PSIL. At the same time point (11 days after treatment administration), the effect of PME on metabolic parameters in the frontal cortex is clearly defined from that of PSIL suggesting a discernibly different or quantitatively stronger therapeutic mechanism.
Our HTR findings contrast with those of Zhuk et al 12 who compared the effect of psilocin, the active metabolite of psilocybin, on HTR to those of two different psilocin-containing mushroom extracts, Ph. cyanopus and P. semilanceata. Zhuk et al 12 found that the two mushroom extracts induced a similar number of HTR compared to pure psilocin, despite the fact that the amount of psilocin present in the extracts was much lower. Zhuk et al 12 speculated that this phenomenon could be related to the synergistic effect of the other indole alkaloids in the extracts. An important difference between the two studies is that our comparison was based on psilocybin and not psilocin content and the PME and PSIL that we injected were held constant in terms of psilocybin content. Thus, the two studies are not directly comparable.
Our second key focus was on comparing effects of PME and PSIL on key synaptic proteins, that we studied as markers of neuroplasticity. Neuroplasticity refers to the lifelong capacity of the brain to respond to experiences, learning and the environment and to reorganize structure, function and connections in response to such stimuli. Neuroplastic effects may be defined and measured in structural and functional terms. With regard to the effect of psychedelics, a key focus in the domain of neuroplastic effects has been on structural changes in the synapse with emphasis on growth of new dendrites and proliferation of dendritic spines 1, 23, 24, 36. It is widely suggested that synaptic plasticity is the central mechanism whereby psychedelics achieve their therapeutic effects 21, 22, 37–39.
Synaptic proteins are pivotally involved in synaptic plasticity by regulating synaptic transmission and because of their role in structural changes that occur during plasticity 40. Synaptic proteins such as GAP43, PSD95, synaptophysin and SV2A play vital roles in the development, functioning, and plasticity of the nervous system 29. GAP-43 plays a crucial role in axonal outgrowth, guidance, and pathfinding during development 41, 42. It has been implicated in the remodeling of synaptic connections, the stabilization of newly formed synapses, and the modulation of neurotransmitter release. Studies have shown that changes in the expression and localization of GAP-43 are associated with synaptic plasticity and learning processes 43, 44. PSD-95 interacts with various binding partners, such as associated synaptic proteins, ion channels, and cytoskeletal elements, to form a complex network that stabilizes and regulates synaptic function, transmission and formation and maintenance of dendritic spines, receptor trafficking, and synaptic signaling and plasticity mechanisms 45–48. Synaptophysin is involved in synaptic plasticity 49, and in synaptic vesicle exocytosis 50, 51. It is an integral component of the synaptic vesicle membrane and interacts with other proteins to regulate vesicle fusion with the presynaptic membrane, thereby facilitating the release of neurotransmitters into the synapse 52–54. SV2A is involved in multiple aspects of synaptic vesicle function and neurotransmitter release 55. It plays a crucial role in regulating the trafficking and exocytosis of synaptic vesicles 46, 56. The absence of SV2A leads to a decrease in neurotransmission mediated by action potentials, while neurotransmission independent of action potentials remains unaffected 56, 57.
Prior evidence that psilocybin or any other psychedelic drugs influence brain levels of the synaptic proteins that we studied, is limited to one report. Raval et al. 58 examined the density of SV2A in pig brain one day and 7 days after a 0.08mg/kg of psilocybin. SV2A protein density was determined by [3H]UCB-J autoradiography in the hippocampus and the prefrontal cortex. Compared to the saline-treated group, psilocybin treatment was associated with 4.42% higher SV2A in the hippocampus (p < 0.0001), one day after psilocybin injection and 9.24% higher SV2A in the hippocampus (p = 0.024), seven days after psilocybin. Our results partially overlap with those of Raval et al. 58. We found that in mice, a dose of PME containing a similar psilocybin dose (adjusted for species differences), increased SV2A in the hippocampus 11 days after administration and a similar dose of PSIL increased SV2A in the striatum, an area that Raval et al. 58 did not examine.
Taking into account both PME and PSIL, it is noteworthy that we found an overall increase in all 4 synaptic proteins examined (GAP43, PSD95, synaptophysin and SV2A) over all 4 brain areas (frontal cortex, hippocampus, amygdala, striatum). The stronger effect of PME was highlighted by the fact the extract increased all four synaptic proteins, while PSIL increased only two of them. These findings suggest that synaptic protein levels can serve as an informative marker for the effect of psychedelic compounds on synaptic plasticity. Further studies are required to understand regional differences in the effect of PME and PSIL on the synaptic proteins that we studied. It will also be of considerable interest to compare the effect of PME and PSIL on brain derived neurotrophic factor (BDNF) levels. Given the cardinal role of BDNF in supporting growth, survival, and differentiation of both developing and mature neurons and inducing synaptic plasticity, its relationship to psychedelic compounds has been extensively tested in the past years. Animal models have established that BDNF expression is elevated after a single administration of psychedelics 59, resulting in changed neuroplasticity including dendritic complexity, which outlasted the acute effects of the psychedelic. Moreover, chronic psychedelic administrations increased BDNF mRNA and protein levels up to a month after treatment 60–62. Human studies have usually assessed peripheral plasma BDNF protein levels as a biomarker for neuroplastic modulation, although results are mixed 22. Most recently, psychedelics have been found to directly bind to the BDNF receptor TrKB, but the therapeutic implications of this interaction are not fully understood 63.
In our metabolomics analyses, principal components analysis revealed complete separation between PME and VEH groups, whereas PSIL components corresponded to a shared area associated with both groups. This initial finding is expected given the natural complexity of biological specimens, as compared to a single chemical molecule, when compared to VEH and may explain the progressive differences in specific metabolite expression. In this context we propose a “purine hypothesis” where “free” purines in their unphosphorylated form show a progressive decline from VEH, to PSIL, to PME while the phosphorylated (bioactive) forms are progressively up-regulated in the counter direction. This may in part explain the energy-dependent biological processes that are attributed to the potentially therapeutic effects of PSIL and PME (anti-inflammatory, neurite outgrowth, neurogenesis, neuroprotection and more) 64. This system level observation may further demonstrate key longitudinal biotransformation changes (PEP associated ATP and neurotransmitter synthesis, synaptic vesicle formation etc.) that may underlie additional energy supply that enables positive neuroplastic modulations 65. Furthermore, signaling pathway analysis supported this hypothesis, where the purine metabolism pathway was found to be the most significantly differentiated between PME and VEH. Other metabolic pathways that were found to be significantly different were the pyrimidine metabolism pathway associated with nucleic acid synthesis, and the arginine and proline metabolism pathway associated with metabolism of several amino acids including arginine, ornithine, proline, citrulline, and glutamate in mammals.
In conclusion, we have shown, in a mouse model, clear synaptic protein pattern differences following the administration of PME and PSI and have demonstrated for the first-time, alterations in cortical metabolic expression patterns between PME and vehicle treated mice and have suggested possible pathway-related mechanisms to explain these differences. While our data do not provide conclusive evidence for the therapeutic superiority of naturally-derived psychedelic mushroom extract over chemical psilocybin, they open the door to serious consideration of the potential of combinations of molecules found in psychedelic mushrooms, especially those related to the psilocybin biosynthetic pathway, with psilocybin. Such combinations may not only have enhanced or more prolonged therapeutic effects but may result in even more effective combinations by increasing the amount of the additional neuroactive compounds that are only present in extremely small amounts naturally.