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Mukai Y, Lupinacci R, Marder S, Snow-Adami L, Voss T, Smith SM, Egan MF. Effects of PDE10A inhibitor MK-8189 in people with an acute episode of schizophrenia: A randomized proof-of-concept clinical trial. Schizophr Res 2024; 270:37-43. [PMID: 38851166 DOI: 10.1016/j.schres.2024.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 05/07/2024] [Accepted: 05/26/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND PDE10A inhibition represents a potential mechanism for treating schizophrenia. PDE10A inhibitors increase cyclic nucleotides in striatal neurons, thereby mimicking the effects of dopamine receptor D2 antagonists and D1 agonists. We evaluated the PDE10A inhibitor MK-8189 for treating schizophrenia. METHODS Randomized, double-blind, placebo and active-controlled, phase 2a, multicenter, inpatient trial in adults experiencing an acute episode of schizophrenia. Participants were randomized 2:2:1 to once-daily MK-8189 12 mg, placebo, or risperidone 6 mg (active control) for 4-weeks. The primary outcome was change-from-baseline in total score on the Positive and Negative Syndrome Scale (PANSS) at 4 weeks. RESULTS The number of treated participants was 90 for MK-8189, 89 for placebo, and 45 for risperidone. MK-8189 demonstrated a trend towards improvement versus placebo for change-from-baseline in PANSS total score after 4 weeks (difference = -4.7 [95 % CI: -9.8,0.5], P = 0.074). The active control risperidone was superior to placebo on PANNS total score (difference = -7.3 [95 % CI: -14.0,-0.6], P = 0.033), demonstrating assay sensitivity, while MK-8189 and risperidone did not significantly differ (difference = 2.6 [95 % CI: -4.0,9.2], P = 0.440). MK-8189 had a nominally significant effect on PANSS positive subscale score compared to placebo (difference = -2.2 [95 % CI: -3.8,-0.5], P = 0.011). Discontinuation of MK-8189 treatment due to an adverse event was low (<10 %). Extrapyramidal symptoms occurred with MK-8189 but were mostly mild and transient. Compared with placebo, MK-8189 reduced body weight while risperidone increased weight. CONCLUSIONS These findings suggest that PDE10A inhibition may produce antipsychotic effects and associated weight loss and that further trials with PDE10A inhibitors are warranted. TRIAL REGISTRATION Clinicaltrials.gov identifier: NCT03055338.
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Affiliation(s)
| | | | - Stephen Marder
- Semel Institute for Neuroscience at UCLA, Los Angeles, CA, USA
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Yang P, Huang S, Luo Z, Zhou S, Zhang C, Zhu Y, Yang J, Li L. Radix Bupleuri aqueous extract attenuates MK801-induced schizophrenia-like symptoms in mice: Participation of intestinal flora. Biomed Pharmacother 2024; 172:116267. [PMID: 38364739 DOI: 10.1016/j.biopha.2024.116267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 02/18/2024] Open
Abstract
Schizophrenia (SCZ) is a psychotic mental disorder characterized by cognitive, behavioral, and social impairments. However, current pharmacological treatment regimens are subpar in terms of effectiveness. This study aimed to investigate the function of Radix Bupleuri aqueous extract in SCZ in mouse models. The SCZ mouse model was established by MK-801 injection and feeding of Radix Bupleuri aqueous extract or combined antibiotics. Radix Bupleuri aqueous extract significantly improved the aberrant behaviors and neuronal damage in SCZ mice, upregulated SYP and PSD-95 expression and BDNF levels in hippocampal homogenates, down-regulated DA and 5-HT levels, and suppressed microglial activation in SCZ mice. Moreover, Radix Bupleuri aqueous extract improved the integrity of the intestinal tract barrier. The 16 S rRNA sequencing of feces showed that Radix Bupleuri extract modulated the composition of gut flora. Lactobacillus abundance was decreased in SCZ mice and reversed by Radix Bupleuri aqueous extract administration which exhibited a significant negative correlation with IL-6, IL-1β, DA, and 5-HT, and a significant positive correlation with BDNF levels in hippocampal tissues. The abundance of Parabacteroides and Alloprevotella was increased in SCZ mice. It was reversed by Radix Bupleuri aqueous extract administration, which exhibited a positive correlation with IL-6, IL-1β, and 5-HT and a negative correlation with BDNF. In conclusion, Radix Bupleuri aqueous extract attenuates the inflammatory response in hippocampal tissues and modulates neurotransmitter levels, exerting its neuroprotective effect in SCZ. Meanwhile, the alteration of intestinal flora may be involved in this process, which is expected to be an underlying therapeutic option in treating SCZ.
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Affiliation(s)
- Ping Yang
- School of Clinical Medicine, Hunan Brain Hospital, Hunan University of Chinese Medicine, Changsha, Hunan 410208, PR China; Key Laboratory of Biomedical Information Engineering of Ministry of Education, Biomedical Informatics & Genomics Center, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China
| | - Sheng Huang
- School of Clinical Medicine, Hunan Brain Hospital, Hunan University of Chinese Medicine, Changsha, Hunan 410208, PR China; Jiuzhitang Co., Ltd., Changsha, Hunan 410208, PR China
| | - Zhihong Luo
- School of Clinical Medicine, Hunan Brain Hospital, Hunan University of Chinese Medicine, Changsha, Hunan 410208, PR China
| | - Shaoming Zhou
- School of Clinical Medicine, Hunan Brain Hospital, Hunan University of Chinese Medicine, Changsha, Hunan 410208, PR China
| | - Changjuan Zhang
- School of Clinical Medicine, Hunan Brain Hospital, Hunan University of Chinese Medicine, Changsha, Hunan 410208, PR China
| | - Yong Zhu
- School of Clinical Medicine, Hunan Brain Hospital, Hunan University of Chinese Medicine, Changsha, Hunan 410208, PR China; Key Laboratory of Biomedical Information Engineering of Ministry of Education, Biomedical Informatics & Genomics Center, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China
| | - Jingjing Yang
- Community Health Service Center of Dongtang Street, Yuhua District, Changsha, Hunan 410004, China
| | - Liang Li
- School of Clinical Medicine, Hunan Brain Hospital, Hunan University of Chinese Medicine, Changsha, Hunan 410208, PR China; Provincial Key Laboratory of TCM Diagnostics, Hunan University of Chinese Medicine, Changsha, Hunan 410208, PR China.
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Thomson C, Boss K, Calhoun A, Fridrich C, Gardinier KM, Hall EC, Jendza K, Kirman L, Labbé-Giguere N, Laumen K, Qian M, Sanyal S, Shultz MD, Snajdrova R, Tan K, Wang KY, Yang F, Gao F, Hong T, Dale E, Kuzmiski B, Ortuno D, Palacios DS. Transaminases Provide Key Chiral Building Blocks for the Synthesis of Selective M1/M4 Agonists. ACS Med Chem Lett 2023; 14:1692-1699. [PMID: 38116445 PMCID: PMC10726473 DOI: 10.1021/acsmedchemlett.3c00331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 12/21/2023] Open
Abstract
We have developed a chiral route toward the synthesis of muscarinic M4 agonists that was enabled by the biocatalytic synthesis of the key spirocyclic diamine building blocks 10 and 12. Using these bifunctional compounds we were able to optimize a synthetic sequence toward a collection of advanced intermediates for further elaboration. These advanced intermediates were then used as starting points for early medicinal chemistry and the identification of selective M1/M4 agonists.
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Affiliation(s)
- Christopher
G. Thomson
- Global
Discovery Chemistry, Novartis Biomedical
Research, Cambridge, Massachusetts 02139, United States
| | - Kelly Boss
- Global
Discovery Chemistry, Novartis Biomedical
Research, Cambridge, Massachusetts 02139, United States
| | - Amy Calhoun
- Global
Discovery Chemistry, Novartis Biomedical
Research, Cambridge, Massachusetts 02139, United States
| | - Cary Fridrich
- Global
Discovery Chemistry, Novartis Biomedical
Research, Cambridge, Massachusetts 02139, United States
| | - Kevin M. Gardinier
- Global
Discovery Chemistry, Novartis Biomedical
Research, Cambridge, Massachusetts 02139, United States
| | - Edward C. Hall
- Global
Discovery Chemistry, Novartis Biomedical
Research, Cambridge, Massachusetts 02139, United States
| | - Keith Jendza
- Global
Discovery Chemistry, Novartis Biomedical
Research, Cambridge, Massachusetts 02139, United States
| | - Louise Kirman
- Global
Discovery Chemistry, Novartis Biomedical
Research, Cambridge, Massachusetts 02139, United States
| | - Nancy Labbé-Giguere
- Global
Discovery Chemistry, Novartis Biomedical
Research, Cambridge, Massachusetts 02139, United States
| | - Kurt Laumen
- Global
Discovery Chemistry, Novartis Biomedical
Research, Basel CH-4002, Switzerland
| | - Ming Qian
- Global
Discovery Chemistry, Novartis Biomedical
Research, Cambridge, Massachusetts 02139, United States
| | - Sanjit Sanyal
- Global
Discovery Chemistry, Novartis Biomedical
Research, Cambridge, Massachusetts 02139, United States
| | - Michael D. Shultz
- Global
Discovery Chemistry, Novartis Biomedical
Research, Cambridge, Massachusetts 02139, United States
| | - Radka Snajdrova
- Global
Discovery Chemistry, Novartis Biomedical
Research, Basel CH-4002, Switzerland
| | - Kian Tan
- Global
Discovery Chemistry, Novartis Biomedical
Research, Cambridge, Massachusetts 02139, United States
| | - Kate Yaping Wang
- Global
Discovery Chemistry, Novartis Biomedical
Research, Cambridge, Massachusetts 02139, United States
| | - Fan Yang
- Global
Discovery Chemistry, Novartis Biomedical
Research, Cambridge, Massachusetts 02139, United States
| | - Feng Gao
- Chemical
& Analytical Development, Suzhou, Novartis
Technical Development, Co., Ltd., Changshu, Jiangsu 215537, P. R. China
| | - Tao Hong
- Chemical
& Analytical Development, Suzhou, Novartis
Technical Development, Co., Ltd., Changshu, Jiangsu 215537, P. R. China
| | - Elena Dale
- Neuroscience
Disease Area, Novartis Biomedical Research, Cambridge, Massachusetts 02139, United States
| | - Brent Kuzmiski
- Neuroscience
Disease Area, Novartis Biomedical Research, Cambridge, Massachusetts 02139, United States
| | - Danny Ortuno
- Neuroscience
Disease Area, Novartis Biomedical Research, Cambridge, Massachusetts 02139, United States
| | - Daniel S. Palacios
- Global
Discovery Chemistry, Novartis Biomedical
Research, San Diego, California 92121, United States
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Morland C, Nordengen K. N-Acetyl-Aspartyl-Glutamate in Brain Health and Disease. Int J Mol Sci 2022; 23:ijms23031268. [PMID: 35163193 PMCID: PMC8836185 DOI: 10.3390/ijms23031268] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 02/04/2023] Open
Abstract
N-acetyl-aspartyl-glutamate (NAAG) is the most abundant dipeptide in the brain, where it acts as a neuromodulator of glutamatergic synapses by activating presynaptic metabotropic glutamate receptor 3 (mGluR3). Recent data suggest that NAAG is selectively localized to postsynaptic dendrites in glutamatergic synapses and that it works as a retrograde neurotransmitter. NAAG is released in response to glutamate and provides the postsynaptic neuron with a feedback mechanisms to inhibit excessive glutamate signaling. A key regulator of synaptically available NAAG is rapid degradation by the extracellular enzyme glutamate carboxypeptidase II (GCPII). Increasing endogenous NAAG—for instance by inhibiting GCPII—is a promising treatment option for many brain disorders where glutamatergic excitotoxicity plays a role. The main effect of NAAG occurs through increased mGluR3 activation and thereby reduced glutamate release. In the present review, we summarize the transmitter role of NAAG and discuss the involvement of NAAG in normal brain physiology. We further present the suggested roles of NAAG in various neurological and psychiatric diseases and discuss the therapeutic potential of strategies aiming to enhance NAAG levels.
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Affiliation(s)
- Cecilie Morland
- Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, The Faculty of Mathematics and Natural Sciences, University of Oslo, 1068 Oslo, Norway
- Correspondence: (C.M.); (K.N.); Tel.: +47-22844937; (C.M.); +47-23073580 (K.N.)
| | - Kaja Nordengen
- Department of Neurology, Oslo University Hospital, 0424 Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0318 Oslo, Norway
- Correspondence: (C.M.); (K.N.); Tel.: +47-22844937; (C.M.); +47-23073580 (K.N.)
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Taube M. Case Report: Severe Side Effects Following Treatment With First Generation Antipsychotics While Cariprazine Leads to Full Recovery. Front Psychiatry 2021; 12:804073. [PMID: 34970176 PMCID: PMC8713645 DOI: 10.3389/fpsyt.2021.804073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 11/24/2021] [Indexed: 12/16/2022] Open
Abstract
Schizophrenia is a psychiatric disorder characterized by positive, negative, cognitive and affective symptoms. Patient cooperation with health care professionals, compliance with the treatment regime, and regular use of medications are some of the preconditions that need to be met for a favorable disease course. A negative experience following the use of a first-generation antipsychotic to treat first-episode psychosis can negatively affect a patient's motivation for further medication use. In the clinical case reported here, cariprazine was able to restore one such patient's confidence in therapy and facilitated their cooperation with the physician, thereby ensuring effective control of negative and positive symptoms and good functioning for a period of 1 year. Cariprazine may be a good option for maintenance therapy following first-episode psychosis, especially in situations in which a patient has had a negative first experience associated with antipsychotic medication use.
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Affiliation(s)
- Maris Taube
- Department of Psychiatry and Narcology, Riga Stradinš University, Riga, Latvia
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