Chlorpromazine increases the turnover of metabolically active phosphoinositides and elevates the steady-state level of phosphatidylinositol-4-phosphate in human platelets

The first- and second-generation antipsychotic drugs affect ADP-induced platelet aggregation

OBJECTIVE

Blood platelets play an important role in haemostasis and their hyperaggregability may lead to thrombosis and cardiovascular diseases. Increased incidence of mortality, caused by cardiovascular disease, and the increased risk of thrombotic complication in schizophrenic patients treated with antipsychotics have been reported. The effects of antipsychotic drugs on blood platelet function are not fully explained, therefore the purpose of the present study was to examine and compare the effects of the second-generation antipsychotic drugs used in schizophrenia (clozapine, risperidone and olanzapine), with the effects of the first generation antipsychotic, haloperidol, on the platelet aggregation induced by ADP in vitro.

METHODS

Blood obtained from healthy volunteers (n=25) collected into sodium citrate was centrifuged (250xg, 10 min) at room temperature to obtain platelet-rich plasma. Aggregation of blood platelets (10 microM ADP) was recorded (Chrono-log aggregometer) in platelet-rich plasma preincubated with antipsychotic drugs (final concentration: clozapine 420 ng/ml, risperidone 65 ng/ml, olanzapine 40 ng/ml, haloperidol 20 ng/ml) for 30 min.

RESULTS

Our results showed that all tested drugs inhibit platelet aggregation induced by ADP in vitro. Among studied antipsychotic drugs clozapine and olanzapine significantly reduced platelet aggregability in vitro. In comparison with control platelets (without the drug), clozapine inhibited ADP-induced platelet aggregation by 21% (P=3.7x10(-6)) and olanzapine by 18% (P=2.8x10(-4)), respectively.

CONCLUSION

The obtained results indicate that antipsychotic drugs, especially clozapine and olanzapine, contrary to haloperidol, reduced response of blood platelets to ADP measured as platelet aggregation. This suggests that therapy with such antipsychotics, particularly with second-generation antipsychotics, may partly reduce prothrombotic events associated with the increased platelet activation observed in schizophrenic patients. The mechanism of antiaggregatory influence of antipsychotics requires further studies.

The changes of aggregability of blood platelets in schizophrenia

OBJECTIVE

Oxidative stress in schizophrenia may be responsible for the changes of platelet function and reactivity. Therefore, the aim of our present study was to evaluate the response of platelets from patients with schizophrenia to platelet agonists such as ADP and collagen.

RESULTS

Platelet aggregation of schizophrenic patients and healthy subjects stimulated by collagen or ADP showed significant differences. Aggregation of platelets stimulated by collagen was significantly lower in schizophrenic patients (about 86%) than in healthy subjects (P=0.022), but when this process was induced by ADP, aggregation of platelets was significantly higher in schizophrenic patients (increase to about 112%) than in healthy subjects (P=0.018). We also observed that antipsychotic drugs (clozapine, risperidone, olanzapine, haloperidol) reduce aggregation of platelets of schizophrenic patients and healthy group in vitro.

CONCLUSION

The obtained results indicate that the response of platelets from schizophrenic patients to ADP and collagen is different than in healthy subjects.

Glycerophospholipid molecular species in platelets and brain tissues – are platelets a good model for neurons?

The molecular classes of phosphatidylcholine (PC), phosphatidylethanolamine (PE) and phosphatidylserine (PS) from the basal ganglia, cerebellum, cortex, erythrocytes and blood platelets of female rats were separated by an isocratic HPLC method using a silica column and ultraviolet detection. Each glycerophospholipid class were thereafter derivatized to dimethylphosphatidic acid (PA) molecular species, separated by reverse phase HPLC and detected by an evaporative laser scatter to quantify the different glycerophospholipid species. The distribution of molecular species in each class of the glycerophospholipids in the three brain areas was very similar with a predominance of the 18:0/22:6 species and very little of the 18:0/20:4 species. In contrast, the 18:0/20:4 species predominated in the blood cells which had a very low proportion of 18:0/22:6. These results are discussed on the background that platelets have been extensively used as a model for neurons and our previous physicochemical observation that phenothiazines appear to interact specifically with the 18:0/22:6 species of PS.

The psychotropic drug olanzapine (Zyprexa) increases the area of acid glycerophospholipid monolayers

The typical antipsychotics chlorpromazine (CPZ) and trifluoperazine (TFP) increase the mean molecular area (mma) of acidic, but not neutral, glycerophospholipids in monolayers at pH 7.36 measured by the Langmuir technique. The atypical antipsychotic olanzapine (OLP(1)) is structurally similar to TFP. We have therefore studied the effects of OLP on glycerophospholipid monolayers and in comparison with CPZ. Olanzapine (10 microM, in subphase, pH 7.36) influenced the isotherms (surface pressure versus mma) in monolayers of the neutral dipalmitoyl phosphatidylcholine (DPPC) and the acidic dipalmitoyl phosphatidylserine (DPPS) or 1-palmitoyl-2-oleoylphosphatidylserine (POPS) in the increasing order of mma: DPPS<DPPC<POPS at both lower and higher temperature. Thus, presence of an unsaturated acyl in PS increased the drug-induced effect on mma. The mma in the absence of drugs was lower at lower temperatures than at higher temperatures. OLP affected mma to a greater extent than CPZ, and caused the greatest interaction at surface pressure of 30 mN/m at higher temperatures. In contrast, CPZ gave the largest effect in the monolayers at surface pressure 30 mN/m at lower temperatures. CPZ did not alter the isotherms of DPPC, at lower or higher temperature, and only affected the packing of the DPPS and POPS monolayers. In contrast, OLP altered the isotherms of DPPC. It is suggested that the drugs affect the monolayer packing by intercalating between the glycerophospholipid molecules. Since CPZ has major side effects, while OLP has few, this may indicate that there is poor correlation between side effects and effects of the drugs on phospholipid monolayers.

Membrane stress is coupled to a rapid translational control of gene expression in chlorpromazine-treated cells

Chlorpromazine (CPZ) is a small permeable cationic amphiphilic molecule that inserts into membrane bilayers and binds to anionic lipids such as poly-phosphoinositides (PIs). Since PIs play important roles in many cellular processes, including signaling and membrane trafficking pathways, it has been proposed that CPZ affects cellular growth functions by preventing the recruitment of proteins with specific PI-binding domains. In this study, we have investigated the biological effects of CPZ in the yeast Saccharomyces cerevisiae. We screened a collection of approximately 4,800 gene knockout mutants, and found that mutants defective in membrane trafficking between the late-Golgi and endosomal compartments are highly sensitive to CPZ. Microscopy and transport analyses revealed that CPZ affects membrane structure of organelles, blocks membrane transport and activates the unfolded protein response (UPR). In addition, CPZ-treatment induces phosphorylation of the translation initiation factor (eIF2alpha), which reduces the general rate of protein synthesis and stimulates the production of Gcn4p, a major transcription factor that is activated in response to environmental stresses. Altogether, our results reveal that membrane stress within the cells rapidly activates an important gene expression program, which is followed by a general inhibition of protein synthesis. Remarkably, the increase of phosphorylated eIF2alpha and protein synthesis inhibition were also detected in CPZ-treated NIH-3T3 fibroblasts, suggesting the existence of a conserved mechanism of translational regulation that operates during a membrane stress.

Trifluoperazine causes a disturbance in glycerophospholipid monolayers containing phosphatidylserine (PS): effects of pH, acyl unsaturation, and proportion of PS

We have studied the interaction of trifluoperazine (TFP) with monolayers of various glycerophospholipids at 37 degrees C. TFP (1-10 microM) had little effect on surface pressure/molecular area isotherms in monolayers (on pure water) of dipalmitoylphosphatidylcholine (DPPC) and dipalmitoylphosphatidylethanolamine but greatly increased the mean molecular area (mma) of dipalmitoylphosphatidylserine; the increment was greatest between 0 and 1 microM, and a further increase to 10 microM TFP gave only a slight increase in mma. With phosphatidylserine (PS)-containing stearoyl and varying acyls in the sn-1 and -2 positions, respectively, TFP increased the mma in a manner that depended on the number of double bonds and chain length. In mixtures of DPPC with two of these PS species the TFP-induced mma of the monolayers (on buffer, pH 7.4) increased linearly with the proportion of PS. Both PS and TFP have ionizable groups, and the TFP-induced mma increase had optima at pH 5.0 and 7.0. We conclude that the TFP-PS interaction is mainly, but not entirely, driven by electrostatic interactions between the TFP cation and PS headgroup anion, with an insertion of the phenothiazine moiety among the acyls in the monolayer that depends on the packing of the acyls.

Chlorpromazine interaction with phosphatidylserines: A 13C and 31P solid-state NMR study

Chlorpromazine (CPZ), a cationic, amphiphilic phenothiazine derivative is widely used as an antipsychotic drug because it antagonizes dopaminergic receptors. (13)C and (31)P solid-state NMR techniques were employed on phospholipid bilayers with and without CPZ. Phosphatidylserine from pig brain (PBPS), 1-palmitoyl-2-oleoyl phosphatidylserine (POPS), synthetic 1,2-dipalmitoyl phosphatidylcholine (DPPC) and chlorpromazineHCl were used to make phospholipid bilayers containing two types of phospholipids: DPPC (60%)/PBPS (40%) as well as POPS and PBPS bilayers without and with 10% CPZ. CPZ is found to prefer binding to the phosphate of phosphatidylserine, but also binding to the carboxyl of the serine head group in the DPPC/PBPS/CPZ bilayer is present. (31)P-NMR spectra indicate an effect of acyl chain unsaturation on the anisotropic motion of the charged serine head group. This implies that the serine head group anisotropic motion is restricted by intermolecular rather than intramolecular effects. The degree of phospholipid acyl chain unsaturation determines part of the CPZ bilayer interaction. The PBPS bilayer has the 22:6 acyl chain at 34 mol% and the C(4)?C(5) group of this acyl appears to be a determinant for CPZ bilayer interdigitation.

Phospholipase C activation by anesthetics decreases membrane-cytoskeleton adhesion

Many different amphiphilic compounds cause an increase in the fluid-phase endocytosis rates of cells in parallel with a decrease in membrane-cytoskeleton adhesion. These compounds, however, do not share a common chemical structure, which leaves the mechanism and even site of action unknown. One possible mechanism of action is through an alteration of inositol lipid metabolism by modifying the cytoplasmic surface of the plasma membrane bilayer. By comparing permeable amphiphilic amines used as local anesthetics with their impermeable analogs, we find that access to the cytoplasmic surface is necessary to increase endocytosis rate and decrease membrane-cytoskeleton adhesion. In parallel, we find that the level of phosphatidylinositol 4,5-bisphosphate (PIP2) in the plasma membrane is decreased and cytoplasmic Ca2+ is increased only by permeable amines. The time course of both the decrease in plasma membrane PIP2 and the rise in Ca2+ parallels the decrease in cytoskeleton-membrane adhesion. Inositol labeling shows that phosphatidylinositol-4-phosphate levels are increased by the permeable anesthetics, indicating that lipid turnover is increased. Consistent with previous observations, phospholipase C (PLC) inhibitors block anesthetic effects on the PIP2 and cytoplasmic Ca2+ levels, as well as the drop in adhesion. Therefore, we suggest that PLC activity is increased by amine anesthetics at the cytoplasmic surface of the plasma membrane, which results in a decrease in membrane-cytoskeleton adhesion.

Chlorpromazine-induced increase in dipalmitoylphosphatidylserine surface area in monolayers at room temperature

The Langmuir technique revealed that the surface area of acidic glycerophospholipids (dipalmitoylphosphatidylserine, -glycerol, and dipalmitoylphosphatidic acid) in monolayers increased dramatically when micromolar concentrations of the antipsychotic drug chlorpromazine (CPZ) were present in the subphase. Monolayers of neutral glycerophospholipids (dipalmitoylphosphatidylcholine and -ethanolamine) did not show such a large effect with CPZ. Compared to CPZ, millimolar concentrations of the monovalent cations Li+, K+, Na+, Rb+, and Cs+ did not appear to influence the dipalmitoylphosphatidylserine monolayer, suggesting that the effect of CPZ, a monovalent cationic amphophile, was due to an interaction with the acyl chains of the lipids. In addition, the effect of CPZ was reduced by 150 mM Na+, suggesting that the sodium cations might screen the negatively charged headgroups from an electrostatic interaction with the positively charged drug molecule. Two CPZ analogs, chlorpromazine sulfoxide and CPZ with 2 carbons in the side chain, were also studied. These observations suggest that part of the biological effects of CPZ, being antipsychotic and/or side effects, may be due to CPZ's action on the acidic glycerophospholipids in nerve cell membranes.

The stimulatory effects of cationic amphiphilic drugs on human platelets treated with thrombin

The actions of eight cationic amphiphilic drugs on human platelets displayed three different effects according to drug concentration ranges. At lower concentrations (below approximately 25 microM), the drugs stimulated secretory responses induced by 0.2 U/mL of thrombin, while at concentrations in the 25-50 microM range they inhibited these responses. Above 50-100 microM, the drugs caused permeabilization of the platelet plasma membrane as measured by leakage of cytoplasmic adenine nucleotides. The effects of these agents on phosphoinositide metabolism were monitored in platelets prelabeled with (32)P-inorganic phosphate, such that phosphatidic acid (PA), phosphatidylinositol 4-phosphate (PIP), and phosphatidylinositol 4,5-bisphosphate (PIP(2)), but not phosphatidylinositol (PI), were labeled to equilibrium. In unstimulated platelets, the level of labeled PA decreased slightly (about 25%), with corresponding increases in PIP(2) labeling up to drug concentrations of about 50 microM. In contrast to the relatively small changes in PI and PIP(2), the levels of labeled PIP, precursor to PIP(2), increased 2- to 4-fold in both resting and thrombin-treated platelets from 5 microM up to about 50-100 microM of drugs and remained elevated throughout the permeabilization concentrations. [(32)P]PA increased 20-fold over control upon thrombin activation and 5-30 microM of drugs caused [(32)P]PA to increase 30-37 times over that seen in control, resting platelets; the concentration of drugs that potentiated thrombin-induced [(32)P]PA elevation corresponded to that causing the potentiation of platelet secretion. Higher drug concentrations decreased [(32)P]PA elevation. [(32)P]PIP(2) levels increased about 25% in response to thrombin treatment alone; low concentrations of drugs led to another 25% elevation. A significant decrease in [(32)P]PIP(2) was seen above 30 microM, corresponding to inhibition of platelet secretion. Concentrations of 5-30 microM of several psychoactive agents, both neuroleptics and antidepressants, potentiated the thrombin-induced activation of platelets as measured by dense granule secretion and increased turnover of phosphoinositides. Remarkably, all of the drugs increased the levels of PIP even in resting platelets, indicating that they have common effects apart from the specific receptor interactions currently attributed to them. These common effects, e.g. an increase in membrane fluidity such as is known to be caused by amphipathic agents, may be in part responsible for the observed overlapping psychotropic effects of tricyclic antidepressants and phenothiazines.

Lipid metabolism as a target for potassium channel effectors

K(+) channel effectors are widely used in the treatment of various diseases, including diabetes mellitus type II, hypertension, and cardiac arrhythmia. In addition, a constantly growing body of literature reveals that some of these substances, despite their direct effect on K(+) channels, may influence cellular lipid metabolism. As a result, membrane lipid content and cellular concentrations of lipid messengers are changed. Due to the dependence of K(+) channel activity on membrane lipids, these observations seem to be of particular importance not only to characterize secondary effects of K(+) channel effectors but also to understand the long-term effects of these agents on K(+) channel activity.

Chlorpromazine interaction with glycerophospholipid liposomes studied by magic angle spinning solid state (13)C-NMR and differential scanning calorimetry

Phosphatidylserine (PS) extracted from pig brain and synthetic dipalmitoylphosphatidylcholine (DPPC) and dimyristoylphosphatidylcholine (DMPC) were used to make DPPC/DMPC and DPPC/PS large unilamellar liposomes with a diameter of approximately 1 microm. Chlorpromazine-HCl (CPZ), an amphipathic cationic psychotropic drug of the phenothiazine group, is known to partition into lipid bilayer membranes of liposomes with partition coefficients depending on the acyl chain length and to alter the bilayer structure in a manner depending on the phospholipid headgroups. The effects of adding CPZ to these membranes were studied by differential scanning calorimetry and proton cross polarization solid state magic angle spinning (13)C-nuclear magnetic resonance spectroscopy (CP-MAS-(13)C-NMR). CP-MAS-(13)C-NMR spectra of the DPPC (60%)/DMPC (40%) and the DPPC (54%)/DMPC (36%)/CPZ (10%) liposomes, show that CPZ has low or no interaction with the phospholipids of this neutral and densely packed bilayer. Conversely, the DPPC (54%)/PS (36%)/CPZ (10%) bilayer at 25 degrees C demonstrates interaction of CPZ with the phospholipid headgroups (PS). This CPZ interaction causes about 30% of the acyl chains to enter the gauche conformation with low or no CPZ interdigitation among the acyl chains at this temperature (25 degrees C). The DPPC (54%)/PS (36%)/CPZ (10%) bilayer at a sample temperature of 37 degrees C (T(C)=31.2 degrees C), shows CPZ interdigitation among the phospholipids as deduced from the finding that approximately 30% of the phospholipid acyl chains carbon resonances shift low-field by 5-15 ppm.

Effect of chlorpromazine on the synthesis of neutral lipids and phospholipids from [3H]glycerol in the primordial human placenta

Addition of chlorpromazine (CPZ) of 100 microM final concentration to fragments of primordial human placenta incubated in vitro with [3H]glycerol results in the following changes in the labelling of various neutral lipids and phospholipids: (1) rapid accumulation of [3H]phosphatidic acid (PA) to a 2.31 +/- 0.12-fold (mean +/- s.d., P < 0.05) higher steady-state level within 5 min; (2) a dramatic, 5-6-fold (5.74 +/- 0.31, P < 0.01) increase in [3H]phosphatidylinositol (PI) synthesis within 5-10 min, followed by progressive PI accumulation; (3) gradual accumulation of [3H]1,2-diacylglycerol (DAG) reaching approximately 1.7-fold (1.72 +/- 0.14, P < 0.05) higher steady-state level at 30 min; and (4) an approximately 20 and 30% decrease in [3H]triacylglycerol (TG) and [3H]phosphatidylcholine (PC) formation, respectively, which begins to become evident between 10-30 min. As dose-response studies indicate, accumulations of PI and DAG are most susceptible to CPZ. They respond in the concentration range of 10-50 microM, while only higher drug concentrations (100-250 microM) affect the synthesis of PA, PC and TG significantly. Finally, dioctanoylethyleneglycol (DOEG), a structural analogue of the diacyl moiety of PA and DAG, selectively inhibits the basal synthesis (0.59 +/- 0.15, P < 0.05) as well as the CPZ-induced rise (0.49 +/- 0.11, P < 0.02) of PI. These results suggest that CPZ-induced increase in the concentrations of PI and 1,2-DAG may interfere with signal-transduction pathways in the placenta of pregnant patients treated with CPZ. Furthermore, DOEG is able to antagonize the CPZ effect which directs lipid biosynthesis towards the formation of PI.

Effects of perphenazine on the metabolism of inositol phospholipids in SK-N-BE(2) human neuroblastoma cells

Administration of myo-[3H]inositol to SK-N-BE(2) human neuroblastoma cells for 24 hr resulted in equilibrium labelling of phosphatidylinositol (PI), phosphatidylinositol 4-phosphate (PIP) and phosphatidylinositol 4,5-bisphosphate (PIP2), as well as in retention of a large intracellular pool of free myo-[3H]inositol. Equilibrium labelling was no longer observed when cells were treated for 2 hr with 20 microM perphenazine (PPZ) in label-free medium; under these conditions, myo-[3H]inositol from the retained intracellular pool was incorporated into PI and PIP but not into PIP2. Analysis of water-soluble myo-[3H]inositol derivatives and inositol 1,4,5-trisphosphate mass determination indicated that PPZ did not stimulate phosphoinositide hydrolysis by phospholipase C. These results indicate that PPZ raises PI and PIP levels, whereas it is ineffective in expanding the PIP2 pool. The latter effect is not due to a concomitant synthesis and hydrolysis of this lipid.