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Karahalil B, Elkama A, Ak M, Nemutlu E. Metabolomics mapping changed after olanzapine therapy in drug-naive schizophrenia patients—the significant impact of gene polymorphisms. Toxicol Res (Camb) 2022; 11:547-556. [DOI: 10.1093/toxres/tfac034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/26/2022] [Accepted: 03/26/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Oxidative stress may contribute to the development of schizophrenia and antipsychotics used in schizophrenia treatment may also cause oxidative stress. Gene polymorphisms on antioxidant and repair enzymes are responsible for individual variations and may change the efficacy of olanzapine treatment among schizophrenia patients. In our study, we assessed oxidative stress-related metabolite changes due to genetic polymorphisms on first diagnosed-schizophrenia patients treated with olanzapine. Blood samples (n = 30 patients) were taken before treatment (T1), after 10 ± 1 days (T2), and after 3 ± 1 months (T3). T1 served as control for T2 and T3, since it is advantageous to perform on same patient to evaluate the impact of olanzapine only. GSTs (GSTM1, GSTT1, and GSTP1) and OGG1 gene polymorphisms were analyzed by polymerase chain reaction. Changes in metabolites were detected with metabolomics profiling by gas chromatography–mass spectrometry according to each genotype before and after treatment. Multivariate analysis showed that metabolomics profiles differed after olanzapine treatment regardless gene polymorphisms. Tryptophan could be a biomarker in response to olanzapine treatment since its levels were increased after treatment. GSTM1 gene polymorphism caused significant changes in some metabolites after treatment. Urea, palmitic acid, and caprylic acid levels increased and alanine levels decreased in patients with GSTM1 null genotypes after olanzapine. In future, targeted metabolomics with these prominent metabolites and assessing gene expressions of GSTs will be beneficial to understand the mechanism of action.
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Affiliation(s)
- Bensu Karahalil
- Department of Toxicology , Faculty of Pharmacy, Gazi University, Ankara 06330 , Turkey
| | - Aylin Elkama
- Department of Toxicology , Faculty of Pharmacy, Gazi University, Ankara 06330 , Turkey
| | - Mehmet Ak
- Department of Psychiatry , Meram Faculty of Medicine, Necmettin Erbakan University, Konya 42080 , Turkey
| | - Emirhan Nemutlu
- Department of Analytical Chemistry , Faculty of Pharmacy, Hacettepe University, Ankara 06230 , Turkey
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2
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Kim S, Okazaki S, Otsuka I, Shinko Y, Horai T, Shimmyo N, Hirata T, Yamaki N, Tanifuji T, Boku S, Sora I, Hishimoto A. Searching for biomarkers in schizophrenia and psychosis: Case-control study using capillary electrophoresis and liquid chromatography time-of-flight mass spectrometry and systematic review for biofluid metabolites. Neuropsychopharmacol Rep 2022; 42:42-51. [PMID: 34889082 PMCID: PMC8919119 DOI: 10.1002/npr2.12223] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/20/2021] [Accepted: 11/27/2021] [Indexed: 11/10/2022] Open
Abstract
Metabolomics has been attracting attention in recent years as an objective method for diagnosing schizophrenia. In this study, we analyzed 378 metabolites in the serum of schizophrenia patients using capillary electrophoresis- and liquid chromatography-time-of-flight mass spectrometry. Using multivariate analysis with the orthogonal partial least squares method, we observed significantly higher levels of alanine, glutamate, lactic acid, ornithine, and serine and significantly lower levels of urea, in patients with chronic schizophrenia compared to healthy controls. Additionally, levels of fatty acids (15:0), (17:0), and (19:1), cis-11-eicosenoic acid, and thyroxine were significantly higher in patients with acute psychosis than in those in remission. Moreover, we conducted a systematic review of comprehensive metabolomics studies on schizophrenia over the last 20 years and observed consistent trends of increase in some metabolites such as glutamate and glucose, and decrease in citrate in schizophrenia patients across several studies. Hence, we provide substantial evidence for metabolic biomarkers in schizophrenia patients through our metabolomics study.
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Affiliation(s)
- Saehyeon Kim
- Department of PsychiatryKobe University Graduate School of MedicineKobeJapan
| | - Satoshi Okazaki
- Department of PsychiatryKobe University Graduate School of MedicineKobeJapan
| | - Ikuo Otsuka
- Department of PsychiatryKobe University Graduate School of MedicineKobeJapan
| | - Yutaka Shinko
- Department of PsychiatryKobe University Graduate School of MedicineKobeJapan
| | - Tadasu Horai
- Department of PsychiatryKobe University Graduate School of MedicineKobeJapan
| | - Naofumi Shimmyo
- Department of PsychiatryKobe University Graduate School of MedicineKobeJapan
| | - Takashi Hirata
- Department of PsychiatryKobe University Graduate School of MedicineKobeJapan
| | - Naruhisa Yamaki
- Department of PsychiatryKobe University Graduate School of MedicineKobeJapan
| | - Takaki Tanifuji
- Department of PsychiatryKobe University Graduate School of MedicineKobeJapan
| | - Shuken Boku
- Department of PsychiatryKobe University Graduate School of MedicineKobeJapan
- Department of NeuropsychiatryFaculty of Life SciencesKumamoto UniversityKumamotoJapan
| | - Ichiro Sora
- Department of PsychiatryKobe University Graduate School of MedicineKobeJapan
| | - Akitoyo Hishimoto
- Department of PsychiatryKobe University Graduate School of MedicineKobeJapan
- Department of PsychiatryYokohama City University Graduate School of MedicineYokohamaJapan
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3
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Takase M, Kimura H, Kanahara N, Nakata Y, Iyo M. Plasma monoamines change under dopamine supersensitivity psychosis in patients with schizophrenia: A comparison with first-episode psychosis. J Psychopharmacol 2020; 34:540-547. [PMID: 31961236 DOI: 10.1177/0269881119900982] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Patients with first-episode psychosis respond well to initial antipsychotic treatment, but among patients experiencing a relapse of psychosis, the response rate falls to approximately 30%. The mechanism of this discrepancy has not been clarified, but the development of dopamine supersensitivity psychosis with the underlying up-regulation of post-synaptic dopamine D2 receptors could be involved in this lesser response. It is uncertain whether elevated dopamine synthesis and release occurs in patients with dopamine supersensitivity psychosis, in contrast to those with first-episode psychosis. PATIENTS AND METHODS We examined a first-episode psychosis group (n=6) and a chronic schizophrenia group, i.e. patients experiencing relapse (n=23) including those who relapsed due to dopamine supersensitivity psychosis (n=18). Following the initiation of treatment, we measured the patients' blood concentrations of homovanillic acid and 3-methoxy-4-hydroxyphenylglycol at two weeks and four weeks after the baseline measurements. RESULTS The first-episode psychosis group tended to show decreased homovanillic acid, accompanied by an improvement of symptoms. The chronic schizophrenia group showed no alteration of homovanillic acid or 3-methoxy-4-hydroxyphenylglycol over the treatment period. These results were the same in the dopamine supersensitivity psychosis patients alone. CONCLUSIONS Our findings suggest that unlike first-episode psychosis, the release of dopamine from presynaptic neurons did not increase in relapse episodes in the patients with dopamine supersensitivity psychosis. This indirectly indicates that the development of supersensitivity of post-synapse dopamine D2 receptor is involved in relapse in dopamine supersensitivity psychosis patients.
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Affiliation(s)
- Masayuki Takase
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hisoshi Kimura
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan.,Department of Psychiatry, Gakuji-kai Kimura Hospital, Chiba, Japan
| | - Nobuhisa Kanahara
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan.,Center for Forensic Mental Health, Chiba University, Chiba, Japan
| | - Yusuke Nakata
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Masaomi Iyo
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
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Shiga T, Horikoshi S, Kanno K, Kanno-Nozaki K, Hikita M, Itagaki S, Miura I, Yabe H. Plasma levels of dopamine metabolite correlate with mismatch negativity in patients with schizophrenia. Psychiatry Clin Neurosci 2020; 74:289-293. [PMID: 31994282 DOI: 10.1111/pcn.12984] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 12/20/2019] [Accepted: 01/17/2020] [Indexed: 01/10/2023]
Abstract
AIM Mismatch negativity (MMN) deficit is one of the most robust and replicable findings in schizophrenia, and primarily reflects deficient functioning of the N-methyl-D-aspartate (NMDA) receptor system. Although the dopamine receptor is known not to modulate MMN over the short term, it is unclear whether the dopamine system affects MMN in the long term. METHODS We explored correlations between MMN and levels of plasma dopamine and serotonin metabolites in 18 patients with schizophrenia psychiatrically evaluated with the Positive and Negative Syndrome Scale (PANSS). RESULTS A significant negative correlation exists between MMN amplitude and plasma levels of dopamine metabolites. Plasma serotonin metabolite levels were not correlated with MMN. The PANSS total score and Negative score also showed negative correlations with MMN amplitude. CONCLUSION The usual strong therapeutic blockade of dopamine receptors applied in cases of schizophrenia may reduce MMN over the long term.
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Affiliation(s)
- Tetsuya Shiga
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Sho Horikoshi
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Kazuko Kanno
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Keiko Kanno-Nozaki
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Masayuki Hikita
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Shuntaro Itagaki
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Itaru Miura
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Hirooki Yabe
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
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5
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A snapshot of plasma metabolites in first-episode schizophrenia: a capillary electrophoresis time-of-flight mass spectrometry study. Transl Psychiatry 2014; 4:e379. [PMID: 24713860 PMCID: PMC4012283 DOI: 10.1038/tp.2014.19] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 01/20/2014] [Accepted: 02/23/2014] [Indexed: 02/04/2023] Open
Abstract
Few biomarkers have been known that can easily measure clinical conditions in mental illnesses such as schizophrenia. Capillary electrophoresis time-of-flight mass spectrometry (CE-TOFMS) is a new method that can measure ionized and low-molecular-weight metabolites. To explore global metabolomic alterations that characterize the onset of schizophrenia and identify biomarkers, we profiled the relative and absolute concentrations of the plasma metabolites from 30 patients with first-episode schizophrenia (FESZ, four drug-naïve samples), 38 healthy controls and 15 individuals with autism spectrum disorders using CE-TOFMS. Five metabolites had robust changes (increased creatine and decreased betaine, nonanoic acid, benzoic acid and perillic acid) in two independent sample sets. Altered levels of these metabolites are consistent with well-known hypotheses regarding abnormalities of the homocysteine metabolism, creatine kinase-emia and oxidative stress. Although it should be considered that most patients with FESZ received medication, these metabolites are candidate biomarkers to improve the determination of diagnosis, severity and clinical stages, especially for FESZ.
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Leibowitz A, Boyko M, Shapira Y, Zlotnik A. Blood glutamate scavenging: insight into neuroprotection. Int J Mol Sci 2012; 13:10041-10066. [PMID: 22949847 PMCID: PMC3431845 DOI: 10.3390/ijms130810041] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/18/2012] [Accepted: 07/30/2012] [Indexed: 11/16/2022] Open
Abstract
Brain insults are characterized by a multitude of complex processes, of which glutamate release plays a major role. Deleterious excess of glutamate in the brain's extracellular fluids stimulates glutamate receptors, which in turn lead to cell swelling, apoptosis, and neuronal death. These exacerbate neurological outcome. Approaches aimed at antagonizing the astrocytic and glial glutamate receptors have failed to demonstrate clinical benefit. Alternatively, eliminating excess glutamate from brain interstitial fluids by making use of the naturally occurring brain-to-blood glutamate efflux has been shown to be effective in various animal studies. This is facilitated by gradient driven transport across brain capillary endothelial glutamate transporters. Blood glutamate scavengers enhance this naturally occurring mechanism by reducing the blood glutamate concentration, thus increasing the rate at which excess glutamate is cleared. Blood glutamate scavenging is achieved by several mechanisms including: catalyzation of the enzymatic process involved in glutamate metabolism, redistribution of glutamate into tissue, and acute stress response. Regardless of the mechanism involved, decreased blood glutamate concentration is associated with improved neurological outcome. This review focuses on the physiological, mechanistic and clinical roles of blood glutamate scavenging, particularly in the context of acute and chronic CNS injury. We discuss the details of brain-to-blood glutamate efflux, auto-regulation mechanisms of blood glutamate, natural and exogenous blood glutamate scavenging systems, and redistribution of glutamate. We then propose different applied methodologies to reduce blood and brain glutamate concentrations and discuss the neuroprotective role of blood glutamate scavenging.
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Affiliation(s)
- Akiva Leibowitz
- Author to whom correspondence should be addressed; E-Mail: ; Tel: +972-8-6400262; Fax: +972-8-6403795
| | | | - Yoram Shapira
- Department of Anesthesiology and Critical Care, Soroka Medical Center, Ben-Gurion University, Beer Sheva 84894, Israel; E-Mails: (M.B.); (Y.S.); (A.Z.)
| | - Alexander Zlotnik
- Department of Anesthesiology and Critical Care, Soroka Medical Center, Ben-Gurion University, Beer Sheva 84894, Israel; E-Mails: (M.B.); (Y.S.); (A.Z.)
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Xuan J, Pan G, Qiu Y, Yang L, Su M, Liu Y, Chen J, Feng G, Fang Y, Jia W, Xing Q, He L. Metabolomic profiling to identify potential serum biomarkers for schizophrenia and risperidone action. J Proteome Res 2011; 10:5433-43. [PMID: 22007635 DOI: 10.1021/pr2006796] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Despite recent advances in understanding the pathophysiology of schizophrenia and the mechanisms of antipsychotic drug action, the development of biomarkers for diagnosis and therapeutic monitoring in schizophrenia remains challenging. Metabolomics provides a powerful approach to discover diagnostic and therapeutic biomarkers by analyzing global changes in an individual's metabolic profile in response to pathophysiological stimuli or drug intervention. In this study, we performed gas chromatography-mass spectrometry based metabolomic profiling in serum of unmedicated schizophrenic patients before and after an 8-week risperidone monotherapy, to detect potential biomarkers associated with schizophrenia and risperidone treatment. Twenty-two marker metabolites contributing to the complete separation of schizophrenic patients from matched healthy controls were identified, with citrate, palmitic acid, myo-inositol, and allantoin exhibiting the best combined classification performance. Twenty marker metabolites contributing to the complete separation between posttreatment and pretreatment patients were identified, with myo-inositol, uric acid, and tryptophan showing the maximum combined classification performance. Metabolic pathways including energy metabolism, antioxidant defense systems, neurotransmitter metabolism, fatty acid biosynthesis, and phospholipid metabolism were found to be disturbed in schizophrenic patients and partially normalized following risperidone therapy. Further study of these metabolites may facilitate the development of noninvasive biomarkers and more efficient therapeutic strategies for schizophrenia.
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Affiliation(s)
- Jiekun Xuan
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiao Tong University, Shanghai 200030, China
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Gysin R, Kraftsik R, Boulat O, Bovet P, Conus P, Comte-Krieger E, Polari A, Steullet P, Preisig M, Teichmann T, Cuénod M, Do KQ. Genetic dysregulation of glutathione synthesis predicts alteration of plasma thiol redox status in schizophrenia. Antioxid Redox Signal 2011; 15:2003-10. [PMID: 20673128 DOI: 10.1089/ars.2010.3463] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Genetic studies have shown an association between schizophrenia and a GAG trinucleotide repeat (TNR) polymorphism in the catalytic subunit (GCLC) of the glutamate cysteine ligase (GCL), the key enzyme for glutathione (GSH) synthesis. The present study was aimed at analyzing the influence of a GSH dysregulation of genetic origin on plasma thiols (total cysteine, homocysteine, and cysteine-glycine) and other free amino acid levels as well as fibroblast cultures GSH levels. Plasma thiols levels were also compared between patients and controls. As compared with patients with a low-risk GCLC GAG TNR genotype, patients with a high-risk genotype, having an impaired GSH synthesis, displayed a decrease of fibroblast GSH and plasma total cysteine levels, and an increase of the oxidized form of cysteine (cystine) content. Increased levels of plasma free serine, glutamine, citrulline, and arginine were also observed in the high-risk genotype. Taken together, the high-risk genotypes were associated with a subgroup of schizophrenia characterized by altered plasma thiols and free amino acid levels that reflect a dysregulation of redox control and an increased susceptibility to oxidative stress. This altered pattern potentially contributes to the development of a biomarker profile useful for early diagnosis and monitoring the effectiveness of novel drugs targeting redox dysregulation in schizophrenia.
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Affiliation(s)
- René Gysin
- Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Site de Cery, Prilly, Lausanne, Switzerland
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9
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Cai HL, Fang PF, Li HD, Zhang XH, Hu L, Yang W, Ye HS. Abnormal plasma monoamine metabolism in schizophrenia and its correlation with clinical responses to risperidone treatment. Psychiatry Res 2011; 188:197-202. [PMID: 21146875 DOI: 10.1016/j.psychres.2010.11.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2010] [Revised: 10/29/2010] [Accepted: 11/01/2010] [Indexed: 11/26/2022]
Abstract
Abnormalities in plasma monoamine metabolism reflect partly the illness of schizophrenia and sometimes the symptoms. Such studies have been repeatedly reported but have rarely taken both metabolites and parent amines or inter-amine activity ratios into account. In this study, the monoamines, their metabolites, turnovers and between-metabolite ratios in plasma were measured longitudinally in 32 schizophrenic patients treated with risperidone for 6 weeks, to examine possible biochemical alterations in schizophrenia, and to examine the association between treatment responses and psychopathology assessed according to the Positive and Negative Syndrome Scale (PANSS). The results showed lower level of plasma 3,4-dihydroxyphenylacetic acid (DOPAC) in relapsed versus first-episode schizophrenic patients, higher norepinephrine (NE) turnover rate (TR) in undifferentiated in comparison to paranoid schizophrenic patients and relatively higher metabolic activity of dopamine (DA) to serotonin (5-HT) in first-episode versus relapsed schizophrenic patients. Risperidone treatment induced a decrement of plasma DA levels and increments of plasma DOPAC and DA TR in the total group of schizophrenic patients. The turnover rate of 5-HT was was reduced in undifferentiated and relapsed subgroups of schizophrenic patients. The linkages between 5-HT TR, DA/NE relative activity and clinical symptomatology were also identified. These findings are consistent with an involvement of these systems in the pathogenesis of schizophrenia as well as in the responses to treatment, and the usefulness of certain biochemical indices as markers for subgrouping.
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Affiliation(s)
- Hua-Lin Cai
- Clinical Pharmacy and Pharmacology Research Institute, Second Xiangya Hospital, Central South University, Changsha, China
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10
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Ohnuma T, Arai H. Significance of NMDA receptor-related glutamatergic amino acid levels in peripheral blood of patients with schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35:29-39. [PMID: 20828596 DOI: 10.1016/j.pnpbp.2010.08.027] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2010] [Revised: 08/20/2010] [Accepted: 08/27/2010] [Indexed: 11/18/2022]
Abstract
Hypo-function of N-methyl d-aspartate (NMDA) receptors is strongly involved in the brain pathophysiology of schizophrenia. Several excitatory amino acids, such as endogenous glutamate, glycine, serine and alanine, which are involved in glutamate neurotransmission via NMDA receptors, were studied to further understand the pathophysiology of schizophrenia and to find a biological marker for this disease, particularly in peripheral blood. In this literature review, we connect several earlier clinical studies and several studies of excitatory amino acid levels in peripheral blood in a historical context. Finally, we join these results and our previous studies, the Juntendo University Schizophrenia Projects (JUSP), which investigated plasma glutamatergic amino acid levels in detail, and considered whether these amino acid levels may be diagnostic, therapeutic, or symptomatic biological markers. This review concludes that peripheral blood levels of endogenous glycine and alanine could be a symptomatic marker in schizophrenia, while peripheral blood levels of exogenous glycine and alanine in augmentation therapies could be therapeutic markers. Noteworthy peripheral blood levels of endogenous d-serine could reflect its brain levels, and may prove to be a useful diagnostic and therapeutic marker in schizophrenia. In addition, measurements of new endogenous molecules, such as glutathione, are promising. Finally, for future therapies with glutamatergic agents still being examined in animal studies, the results of these biological marker studies may lay the foundation for the development of next-generation antipsychotics.
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Affiliation(s)
- Tohru Ohnuma
- Department of Psychiatry, Juntendo University Schizophrenia Projects, Juntendo University, School of Medicine, Tokyo, Japan.
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Stone JM, Raffin M, Morrison P, McGuire PK. Review: The biological basis of antipsychotic response in schizophrenia. J Psychopharmacol 2010; 24:953-64. [PMID: 19939865 DOI: 10.1177/0269881109106959] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Schizophrenia is a severe mental illness affecting approximately 1% of the population worldwide. Antipsychotic drugs are effective in symptom control in up to two-thirds of patients, but in at least one-third of patients the response is poor. The reason for this is not clear, but one possibility is that good and poor responders have different neurochemical pathologies, and may therefore benefit from different treatment approaches. In this selective review we summarise research findings investigating the biological differences between patients with schizophrenia who show a good or a poor response to treatment with antipsychotic drugs.
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Affiliation(s)
- James M Stone
- Institute of Psychiatry, King's College London, London SE5 8AF, UK.
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12
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De Luca V, Viggiano E, Messina G, Viggiano A, Borlido C, Viggiano A, Monda M. Peripheral amino Acid levels in schizophrenia and antipsychotic treatment. Psychiatry Investig 2008; 5:203-8. [PMID: 20046338 PMCID: PMC2796006 DOI: 10.4306/pi.2008.5.4.203] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Abnormal levels of amino acids have been reported in patients with schizophrenia and have also been investigated as a biomarker to monitor antipsychotic treatment, however results have been inconsistent. The purpose of the present review is to summarize the evidence in the literature of whether amino acid levels can be a biomarker and predict the treatment outcome in schizophrenia. The current review does not support amino acid concentration as a useful biomarker for monitoring antipsychotic response in patients with schizophrenia, although there is evidence that high levels of serum homocysteine and glutamate might be considered as a trait marker for schizophrenia. This review has also highlighted a considerable dearth of studies, specifically of studies evaluating antipsychotic side-effects.
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Affiliation(s)
- Vincenzo De Luca
- Department of Psychiatry, University of Toronto, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Section of Human Physiology 'Filippo Bottazzi', Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Emanuela Viggiano
- Section of Human Physiology 'Filippo Bottazzi', Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Giovanni Messina
- Section of Human Physiology 'Filippo Bottazzi', Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Alessandro Viggiano
- Section of Human Physiology 'Filippo Bottazzi', Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Carol Borlido
- Department of Psychiatry, University of Toronto, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Andrea Viggiano
- Department of Study of Institutions and Territorial Systems, University of Naples "Parthenope", Naples, Italy
| | - Marcellino Monda
- Section of Human Physiology 'Filippo Bottazzi', Department of Experimental Medicine, Second University of Naples, Naples, Italy
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13
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Pani L, Villagrán JM, Kontaxakis VP, Alptekin K. Practical issues with amisulpride in the management of patients with schizophrenia. Clin Drug Investig 2008; 28:465-77. [PMID: 18598092 DOI: 10.2165/00044011-200828080-00001] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Amisulpride is an atypical antipsychotic with a significantly greater effect size than first-generation, typical antipsychotics, and efficacy at least similar to that of olanzapine and risperidone in large-scale clinical trials in schizophrenia. Amisulpride provides greater improvement in positive and negative symptoms of schizophrenia, a better long-term outcome than typical antipsychotics, and distinct tolerability advantages over typical antipsychotics, which are reported to cause extrapyramidal symptoms (EPS) in 20-50% of patients. In addition, amisulpride is associated with significantly less weight gain than olanzapine and risperidone, does not increase body mass index, and favourably influences lipid profiles. In many patients with schizophrenia, adverse events impair adherence to treatment, and switching from typical or atypical antipsychotic therapy to amisulpride may be clinically appropriate. Observational drug-utilization studies suggest that many physicians switch to amisulpride because of fewer EPS and/or less weight gain and improved patient adherence. Cross-tapering (over 4 weeks), rather than abrupt cessation of pre-switch treatment, is preferred. Amisulpride has a low risk of drug-drug interactions, and, during cross-tapering, patients can remain on concurrent treatments (e.g. anticholinergics and antiparkinsonian agents) until the effective dosage has been reached. An appropriate amisulpride starting dose is 800 mg/day for patients with acute psychotic exacerbations, 400-800 mg/day for patients with predominantly positive symptoms, and 100-300 mg/day for predominantly negative symptoms. Amisulpride may be particularly suitable for clozapine-augmentation therapy in patients with refractory schizophrenia. Indeed, amisulpride is more effective than quetiapine as augmentation therapy in patients partially responsive to clozapine, and several prospective open-label studies and case series have reported promising results for amisulpride/clozapine combination therapy. In three prospective studies, addition of amisulpride 200-800 mg/day to clozapine significantly reduced mean scores on the Brief Psychiatric Rating Scale (BPRS) total (-33% to -35%), Clinical Global Impression (CGI)-Severity scale (-31%), Positive and Negative Syndrome Scale total (-22%), and Scale for the Assessment of Negative Symptoms (-34%). The proportion of responders (CGI score > or =3 or BPRS improvement >20%) was 71-86%. Retrospective case-series analyses have also reported improved psychopathological state, reduced adverse events, and lower clozapine dosage requirement with use of this combination. The pharmacological and clinical profiles of amisulpride suggest that this agent is a viable clinical option when a change of antipsychotic therapy is required in patients with schizophrenia because of lack of efficacy, adverse events and poor adherence to treatment, or for augmentation of clozapine in treatment-resistant illness.
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Affiliation(s)
- Luca Pani
- Institute of Biomedical Technologies, National Research Council (CNR), Milan, ItalyPharmaNess Scarl, Sardegna Ricerche, Pula (Cagliari), Italy
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14
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Arranz B, Rosel P, San L, Ramírez N, Dueñas RM, Salavert J, Centeno M, del Moral E. Low baseline serotonin-2A receptors predict clinical response to olanzapine in first-episode schizophrenia patients. Psychiatry Res 2007; 153:103-9. [PMID: 17629952 DOI: 10.1016/j.psychres.2006.12.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2006] [Revised: 10/31/2006] [Accepted: 12/16/2006] [Indexed: 10/23/2022]
Abstract
The purpose of this study was to determine whether platelet serotonin-2A (5-HT2A) binding sites and inositol 1,4,5 trisphosphate (IP3) concentrations before treatment can identify olanzapine-responsive patients. The study included 21 never medicated, first-episode schizophrenia patients (antipsychotic-naïve) and 21 patients with a DSM-IV-TR diagnosis of paranoid schizophrenia who had not received depot antipsychotic treatment in the previous 6 months or oral antipsychotic or antidepressant treatment in the previous 2 months (antipsychotic-free). In the antipsychotic-naïve group, olanzapine responders had a significantly lower number of 5-HT2A receptors and lower IP3 concentrations at baseline than non-responders. The combination of baseline 5-HT2A and IP3 values significantly predicted an improvement in negative symptomatology after 6 weeks of treatment with olanzapine. In the antipsychotic-free group, responders had significantly higher positive and lower negative symptomatology at baseline, together with a reduced number of 5-HT2A receptors. However, basal 5-HT2A receptors or IP3 concentrations did not significantly predict positive, negative or general clinical response. The reported results suggest that platelet 5-HT2A binding might be a trait marker that could help to identify those patients likely to show greater improvement in negative symptomatology after olanzapine treatment.
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Affiliation(s)
- Belén Arranz
- Department of Psychiatry, Hospital San Rafael, and Department of Clinical Chemistry, Ciutat Sanitaria i Universitaria de Bellvitge, Barcelona, Spain
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15
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Maeshima H, Ohnuma T, Sakai Y, Shibata N, Baba H, Ihara H, Higashi M, Ohkubo T, Nozawa E, Abe S, Ichikawa A, Nakano Y, Utsumi Y, Suzuki T, Arai H. Increased plasma glutamate by antipsychotic medication and its relationship to glutaminase 1 and 2 genotypes in schizophrenia -- Juntendo University Schizophrenia Projects (JUSP). Prog Neuropsychopharmacol Biol Psychiatry 2007; 31:1410-8. [PMID: 17669570 DOI: 10.1016/j.pnpbp.2007.06.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2007] [Revised: 06/14/2007] [Accepted: 06/15/2007] [Indexed: 11/29/2022]
Abstract
Disturbed glutamatergic neurotransmission has become recognized as a key component in the pathophysiology of schizophrenia. The change in serum/plasma glutamate with the use of antipsychotic medication has been studied and may be a possible clinical marker. In the present study, we examined plasma glutamate concentration, including a comprehensive investigation of its involvement with clinical course of schizophrenia and a genomic analysis. We performed a case-control genetic association analysis of the glutaminase 1 (GLS) and 2 (GLS2) genes. In addition, the difference in plasma glutamate concentration between the "acute stage" and "remission stage", and the effect of genotypes of SNPs within the two genes were assessed. The genetic association analysis of the GLS and GLS2 genes showed no association with schizophrenia. Plasma glutamate was increased with antipsychotic medication at "remission stage". Although GLS and GLS2 are not likely genetic risk factors for schizophrenia, changes in plasma glutamate concentration might be connected with clinical course of schizophrenia.
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Affiliation(s)
- Hitoshi Maeshima
- Department of Psychiatry, Juntendo University, School of Medicine, Tokyo, Japan
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16
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Heresco-Levy U. Glutamatergic neurotransmission modulation and the mechanisms of antipsychotic atypicality. Prog Neuropsychopharmacol Biol Psychiatry 2003; 27:1113-23. [PMID: 14642971 DOI: 10.1016/j.pnpbp.2003.09.007] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The neurotransmission mediated by the excitatory amino acids (EAA) glutamate (GLU) and aspartate is of interest to the pharmacotherapy of psychosis due to its role in neurodevelopment and neurotoxicity, its complex interactions with dopaminergic and other neurotransmitter systems and its pivotal importance in recent models of schizophrenia. Accumulating evidence indicates that modulation of glutamatergic neurotransmission may play an important role in the mechanisms of action of atypical antipsychotic drugs. The principles of the phencyclidine (PCP) model of schizophrenia suggest that conventional neuroleptics cannot counteract all aspects of schizophrenia symptomatology, while a more favorable outcome, including anti-negative and cognitive symptoms effects, would be expected with the use of treatment modalities targeting glutamatergic neurotransmission. Clozapine and other presently used atypical antipsychotics differ from conventional neuroleptics in the way they affect various aspects of glutamatergic receptors function. In this context, a specific hypothesis suggesting an agonistic role of clozapine at the N-methyl-D-aspartate (NMDA) subtype of GLU receptors has been postulated. Furthermore, the results of the first generation of clinical trials with glycine (GLY) site agonists of the NMDA receptor in schizophrenia suggest that this type of compounds (1) have efficacy and side effects profiles different than those of conventional neuroleptics and (2) differ in their synergic effects when used in addition to conventional neuroleptics versus clozapine and possibly additional atypical antipsychotics. These findings (1) bring further support to the hypothesis that glutamatergic effects may play an important role in the mechanism of action of atypical antipsychotics, (2) help explain the unique clinical profile of clozapine, and (3) suggest that GLY site agonists of the NMDA receptor may represent a new class of atypical antipsychotic medication. Future research in this area is bound to bring about a better understanding of the role of glutamatergic neurotransmission manipulation in the pharmacotherapy of psychosis and the development of novel pharmacological strategies targeting GLU brain systems.
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Affiliation(s)
- Uriel Heresco-Levy
- Department of Psychiatry, Ezrath Nashim-Sarah Herzog Memorial Hospital, Hadassah Medical School, Hebrew University, PO Box 35300, Jerusalem 91351, Israel.
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Oades RD, Klimke A, Henning U, Rao ML. Relations of clinical features, subgroups and medication to serum monoamines in schizophrenia. Hum Psychopharmacol 2002; 17:15-27. [PMID: 12404703 DOI: 10.1002/hup.368] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Plasma and serum indices of monoaminergic activity reflect partly the illness of schizophrenia (e.g. HVA/deficit syndrome) and sometimes the symptoms (e.g. HVA/anhedonia). But, such studies have rarely taken both metabolites and parent amines or inter-amine activity ratios into account. We hypothesized that comparing the major symptom dimensions to measures of transmitter activity (with and without control for antipsychotic drug treatment) would show differential patterns of activity useful for the design of pharmacological treatments. METHODS Dopamine (DA), noradrenaline (NA), serotonin (5-HT), their three major metabolites and prolactin were measured in the serum of 108 patients with schizophrenia and 63 matched controls: DA D2-receptor blocking-activity was estimated from a regression of butyrophenone displacement in striatum in vitro on to PET reports of drug-binding in vivo. Symptoms were factored into four dimensions (disorganized/thought disorder, nonparanoid/negative, ideas-of-reference and paranoid/positive symptoms). RESULTS (1). Patients' DA activity did not differ from controls: but their 5-HT and NA turnovers increased/decreased, respectively, and the DA/5HT-metabolite ratio was lower. Increased DA-D2-receptor occupancy was predicted by decreased DA-metabolism and its ratio to 5-HT-metabolism. (2). Patients had higher levels of NA, DA-metabolites and DA-/5-HT-metabolite ratios on atypical vs typical drugs. (3). Increased D2-occupancy was associated with lower DA metabolism in paranoid patients but was unrelated to relative increases of DA/5-HT- and NA-metabolism in nonparanoid patients. (4). Low DA-/5-HT-metabolite ratios, high prolactin and low DA-metabolism characterized thought-disordered patients. (5). High DA-/5-HT-metabolite ratios paralleled many ideas-of-reference. The metabolites were sensitive, respectively, to control for D2-occupancy and prolactin. CONCLUSIONS The role of DA in paranoid, and 5-HT in thought-disordered and ideas-of-reference dimensions point both to the mechanisms underlying the features typical of these subgroups and the type of medication appropriate.
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Affiliation(s)
- Robert D Oades
- University of Essen Clinic for Child and Adolescent Psychiatry and Psychotherapy, Essen, Germany.
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18
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Goff D. Glutamate Receptors in Schizophrenia and Antipsychotic Drugs. NEUROTRANSMITTER RECEPTORS IN ACTIONS OF ANTIPSYCHOTIC MEDICATIONS 2000. [DOI: 10.1201/9781420041774.ch8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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Abstract
BACKGROUND The antipsychotic drug sulpiride was formulated over 20 years ago and was marked as having a low incidence of adverse effects and an effect on the negative symptoms of schizophrenia. This relatively inexpensive antipsychotic drug has a similar neuropharmacological profile to several novel atypical drugs. OBJECTIVES To estimate the clinical efficacy and tolerability of sulpiride. SEARCH STRATEGY Electronic searches of Biological Abstracts (1982-1997), CINAHL (1982-1998), Cochrane Schizophrenia Group's Register (March 1998), Cochrane Library (Issue 1, 1998), EMBASE (1980-1998), MEDLINE (1966-1998), PsycLIT (1974-1997), SIGLE (1994-1998), and Sociofile (1974-1997) were supplemented by reference searching, contacting authors and the manufacturers of sulpiride. SELECTION CRITERIA All randomised or quasi-randomised clinical trials focusing on the use of different doses of sulpiride or comparing sulpiride to (i) placebo; (ii) typical antipsychotic drugs; or (iii) atypical antipsychotic drugs, for those with schizophrenia or serious mental illness were selected. DATA COLLECTION AND ANALYSIS Trials were reliably selected and quality rated. Data were independently extracted, by two reviewers (BGOS, MF), and analysed on an intention-to-treat basis. It was assumed that people who did not complete the follow up had no improvement. Authors of trials were contacted for additional and missing data. Relative risk (RR) and 95% confidence intervals (CI) of dichotomous data were calculated with the random effects model and weighted mean difference (WMD) was calculated for continuous data. MAIN RESULTS The review currently includes 18 studies (30 citations). Studies are generally small and of poor quality. Limited evidence suggests that there is little difference between sulpiride and other drugs although the incidence of side effects may be less for sulpiride. There are no clear findings relating to negative symptoms. REVIEWER'S CONCLUSIONS Sulpiride may be an effective antipsychotic drug but evidence is limited and data relating to claims for its value against negative symptoms is not trial-based.
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Affiliation(s)
- B G Soares
- Evidence Based Medicine Center, Universidade Federal de Pelotas, Av. Duque de Caxias, 250, Pelotas, RS, Brazil, 96100.
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20
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Tsai G, van Kammen DP, Chen S, Kelley ME, Grier A, Coyle JT. Glutamatergic neurotransmission involves structural and clinical deficits of schizophrenia. Biol Psychiatry 1998; 44:667-74. [PMID: 9798069 DOI: 10.1016/s0006-3223(98)00151-6] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Phencyclidine and ketamine induce a syndrome closely resembling schizophrenia due to their blockade of N-methyl-D-aspartate (NMDA) receptor. These findings suggested that some aspects of schizophrenia are associated with decreased NMDA--glutamatergic function. We hypothesized that structural and symptomatic deficits in schizophrenia are related to glutamatergic neurotransmission. METHODS We studied the relationships among cerebrospinal fluid (CSF) glutamatergic markers, clinical presentation of schizophrenia, and CT parameters of brain structure in drug-free schizophrenics. RESULTS We found no significant differences between patients with schizophrenia and controls in CSF glutamatergic markers. When patients with schizophrenia were considered as a group, significant negative correlations between glutamatergic markers and brain structural measures as well as clinical measures were observed. Cluster analysis reveals a group of lower indices of glutamatergic neurotransmission, and more prominent thought disorder as well as ventricular enlargement, and a group with increased glutamate level. CONCLUSIONS The findings support the hypothesis that altered glutamatergic neurotransmission plays a role in the brain structure and the clinical symptoms of schizophrenia.
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Affiliation(s)
- G Tsai
- Laboratory of Molecular and Developmental Neuroscience, Harvard Medical School, Charlestown, Massachusetts, USA
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21
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Evins AE, Amico ET, Shih V, Goff DC. Clozapine treatment increases serum glutamate and aspartate compared to conventional neuroleptics. J Neural Transm (Vienna) 1998; 104:761-6. [PMID: 9444574 DOI: 10.1007/bf01291892] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
To examine whether serum excitatory amino acid concentrations change with clozapine treatment and whether these changes correlate with improvement in negative symptoms, serum excitatory amino acids were measured and clinical scales administered in seven subjects with schizophrenia before and after switching from conventional neuroleptics to clozapine. Clozapine treatment was associated with increased serum glutamate and aspartate concentrations. Clinical improvement was negatively correlated with baseline glycine concentrations. These results support the hypothesis that clozapine acts at least in part by increasing glutamatergic activity.
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Affiliation(s)
- A E Evins
- Psychotic Disorders Program, Massachusetts General Hospital, Boston, USA
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22
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Nagaoka S, Iwamoto N, Arai H. First-episode neuroleptic-free schizophrenics: concentrations of monoamines and their metabolites in plasma and their correlations with clinical responses to haloperidol treatment. Biol Psychiatry 1997; 41:857-64. [PMID: 9099412 DOI: 10.1016/s0006-3223(96)00244-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Thirty-two first-episode neuroleptic-free schizophrenics were treated with neuroleptics for 8 weeks. The monoamines and their metabolites, dopamine, norepinephrine, serotonin, homovanillic acid (HVA), 3-methoxy-4-hydroxy-phenylglycol(MHPG), and 5-hydroxyindoleacetic acid (5-HIAA) in plasma were measured to examine the association with treatment responses and psychopathology assessed according to the brief psychiatry rating scale (BPRS). No differences were noted in the pretreatment concentrations of monoamines and their metabolites between patients and healthy controls; however, during treatment the concentrations of HVA and MHPG were significantly reduced only in the schizophrenics who responded to treatment. Moreover, the HVA and MHPG reductions correlated significantly with improvements in BPRS scores. Since their plasma levels reflect to some extent central dopaminergic and noradrenergic activities, respectively, the present findings suggest the involvement of these systems in the pathogenesis of schizophrenia as well as the usefulness of such measurements as predictors of responsiveness to neuroleptics.
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Affiliation(s)
- S Nagaoka
- Department of Psychiatry, Juntendo University School of Medicine, Tokyo, Japan
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23
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Miller R. Striatal dopamine in reward and attention: a system for understanding the symptomatology of acute schizophrenia and mania. INTERNATIONAL REVIEW OF NEUROBIOLOGY 1993; 35:161-278. [PMID: 8463061 DOI: 10.1016/s0074-7742(08)60571-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- R Miller
- Department of Anatomy and Structural Biology, University of Otago Medical School, Dunedin, New Zealand
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Wiesel FA. Neuroleptics and diagnostic heterogeneity in relation to drug evaluation. PSYCHOPHARMACOLOGY SERIES 1993; 10:124-30. [PMID: 8103221 DOI: 10.1007/978-3-642-78010-3_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- F A Wiesel
- Department of Psychiatry, Uppsala University, Sweden
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25
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Markianos M, Botsis A, Arvanitis Y. Biogenic amine metabolites in plasma of drug-naive schizophrenic patients: associations with symptomatology. Biol Psychiatry 1992; 32:288-92. [PMID: 1384728 DOI: 10.1016/0006-3223(92)90110-l] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The main metabolites of dopamine, noradrenaline, and serotonin, homovanillic acid, methoxyhydroxyphenylglycol (MHPG), and 5-hydroxyindoleacetic acid (5-HIAA), were estimated in plasma of 20 drug-naive young male schizophrenic patients and 21 healthy controls. Although there were no significant differences between the two groups, multiple regression analysis revealed strong associations of the patients' 5-HIAA and MHPG plasma levels to their scores in the Brief Psychiatric Rating Scale items. 5-HIAA levels were mainly related positively to hostility and negatively to somatic concern, and MHPG positively to disorientation and negatively to emotional withdrawal and uncooperativeness. The results suggest that levels of the neurotransmitter metabolites may be related to certain psychological dysfunctions of the patients rather than to disease entities.
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Affiliation(s)
- M Markianos
- Athens University Medical School, Psychiatric Clinic, Eginition Hospital, Greece
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26
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Skrinskaya JA, Nikulina EM, Popova NK. Role of genotype in brain dopamine metabolism and dopamine-dependent behavior of mice. Pharmacol Biochem Behav 1992; 42:261-7. [PMID: 1385878 DOI: 10.1016/0091-3057(92)90525-k] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
In mice of eight inbred strains--BALB/c, AKR/J, DBA/2, CBA, C57B1/6, DD, CC57Br, and C3H/He--brain dopamine and its metabolites, 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA), in striatum and nucleus accumbens with tuberculum olfactorium, the structures of two main dopaminergic systems--nigrostriatal and mesolimbic--were determined. In both dopaminergic regions, no strain effect on either dopamine or DOPAC levels was found, while for HVA content a highly significant hereditary determination was shown. Influences of selective D1 and D2 dopamine receptor agonists--SK&F 38393 and quinpirole, respectively--as well as that of a mixed D1/D2 agonist, apomorphine, on general locomotor activity and stereotypic climbing were studied. By that, marked genotypic differences in dopamine-dependent behavior and dopamine receptor sensitivity were observed. Although both SK&F 38393 (5 mg/kg) and apomorphine (0.25 mg/kg) decreased locomotion, the effect being genotype dependent, in all strains of mice quinpirole (2.5 mg/kg) proved more potent in locomotor inhibition. SK&F 38393 (10 mg/kg) induced climbing, but 2.5 mg/kg apomorphine in most strains was much more effective. At the same time, quinpirole (up to 8 mg/kg) failed to induce this behavior. This suggests the crucial role of D1 receptors in the generation of climbing, attracting, at the same time, attention to the importance of D1/D2 interaction. The observed drastic interstrain differences in dopamine receptor sensitivity demonstrate the essential role of genotype in the effects of dopaminergic drugs.
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Affiliation(s)
- J A Skrinskaya
- Behavioral Phenogenetics Laboratory, Siberian Branch of the Academy of Sciences of Russia, Novosibirsk, Russia
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