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Auger F, Martin F, Pétrault O, Samaillie J, Hennebelle T, Trabelsi MS, Bailleul F, Staels B, Bordet R, Duriez P. Risperidone-induced metabolic dysfunction is attenuated by Curcuma longa extract administration in mice. Metab Brain Dis 2018; 33:63-77. [PMID: 29034440 DOI: 10.1007/s11011-017-0133-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 10/09/2017] [Indexed: 12/12/2022]
Abstract
Antipsychotics, such as risperidone, increase food intake and induce alteration in glucose and lipid metabolism concomitantly with overweight and body fat increase, these biological abnormalities belong to the metabolic syndrome definition (high visceral adiposity, hypertriglyceridemia, hyperglycemia, low HDL-cholesterol and high blood pressure). Curcumin is a major component of traditional turmeric (Curcuma longa) which has been reported to improve lipid and glucose metabolism and to decrease weight in obese mice. We questioned the potential capacity of curcumin, contained in Curcuma longa extract (Biocurcuma™), to attenuate the risperidone-induced metabolic dysfunction. Two groups of mice were treated once a week, for 22 weeks, with intraperitoneal injection of risperidone (Risperdal) at a dose 12.5 mpk. Two other groups received intraperitoneal injection of the vehicle of Risperdal following the same schedule. Mice of one risperidone-treated groups and of one of vehicle-treated groups were fed a diet with 0.05% Biocurcuma™ (curcumin), while mice of the two other groups received the standard diet. Curcumin limited the capacity of risperidone to reduce spontaneous motricity, but failed to impede risperidone-induced increase in food intake. Curcumin did not reduce the capacity of risperidone to induce weight gain, but decreased visceral adiposity and decreased the risperidone-induced hepatomegaly, but not steatosis. Furthermore, curcumin repressed the capacity of risperidone to induce the hepatic over expression of enzymes involved in lipid metabolism (LXRα, FAS, ACC1, LPL, PPARγ, ACO, SREBP2) and decreased risperidone-induced glucose intolerance and hypertriglyceridemia. Curcumin decreased risperidone-induced increases in serum markers of hepatotoxicity (ALAT, ASAT), as well as of one major hepatic pro-inflammatory transcription factor (NFκB: p105 mRNA and p65 protein). These findings support that nutritional doses of curcumin contained in Curcuma longa extract are able to partially counteract the risperidone-induced metabolic dysfunction in mice, suggesting that curcumin ought to be tested to reduce the capacity of risperidone to induce the metabolic syndrome in human.
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Affiliation(s)
- Florent Auger
- Joint Service of Life's Imaging Platform, University of Lille, UDSL, Lille, France
- Inserm, CHU Lille, U1171 - Degenerative & Vascular Cognitive Disorders, University of Lille, F-59000, Lille, France
| | - Françoise Martin
- Faculty of Pharmacy, University of Lille, UDSL, Lille, France
- INSERM U 1011, University of Lille, UDSL, Lille, France
- Pasteur Institute, Lille, France
- European Genomic Institute for Diabetes (E.G.I.D.), 3508, Lille, FR, France
| | - Olivier Pétrault
- Inserm, CHU Lille, U1171 - Degenerative & Vascular Cognitive Disorders, University of Lille, F-59000, Lille, France
- Laboratory of Blood Brain Barrier Physiopathology, University of Artois, Lens, France
| | - Jennifer Samaillie
- Faculty of Pharmacy, University of Lille, UDSL, Lille, France
- Interdisciplinary Group of Research in Therapeutic Innovation and Optimization, 4481, Lille, EA, France
| | - Thierry Hennebelle
- Faculty of Pharmacy, University of Lille, UDSL, Lille, France
- Interdisciplinary Group of Research in Therapeutic Innovation and Optimization, 4481, Lille, EA, France
| | - Mohamed-Sami Trabelsi
- INSERM U 1011, University of Lille, UDSL, Lille, France
- Pasteur Institute, Lille, France
- European Genomic Institute for Diabetes (E.G.I.D.), 3508, Lille, FR, France
| | - François Bailleul
- Faculty of Pharmacy, University of Lille, UDSL, Lille, France
- Interdisciplinary Group of Research in Therapeutic Innovation and Optimization, 4481, Lille, EA, France
| | - Bart Staels
- Faculty of Pharmacy, University of Lille, UDSL, Lille, France
- INSERM U 1011, University of Lille, UDSL, Lille, France
- Pasteur Institute, Lille, France
- European Genomic Institute for Diabetes (E.G.I.D.), 3508, Lille, FR, France
| | - Régis Bordet
- Inserm, CHU Lille, U1171 - Degenerative & Vascular Cognitive Disorders, University of Lille, F-59000, Lille, France
| | - Patrick Duriez
- Inserm, CHU Lille, U1171 - Degenerative & Vascular Cognitive Disorders, University of Lille, F-59000, Lille, France.
- Faculty of Pharmacy, University of Lille, UDSL, Lille, France.
- Faculté de Pharmacie, Université de Lille, 3 rue du Pr. Laguesse, 59000, Lille, France.
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Quality of care indicators for schizophrenia: determinants of observed variations among Italian Departments of Mental Health. Results from the ETAS DSM study. Epidemiol Psychiatr Sci 2017; 26:299-313. [PMID: 27019391 PMCID: PMC6998681 DOI: 10.1017/s204579601600010x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AIMS The primary aim of this study is to analyse the conformance of usual care patterns for persons with schizophrenia to treatment guidelines in three Italian Departments of Mental Health (DMHs). The secondary aim is to examine possible organisational and structural reasons accounting for variations among DMHs. METHODS Within the framework of the Evaluation of Treatment Appropriateness in Schizophrenia (ETAS) project, 20 consensus quality of care indicators were developed. Ten concerned pharmacological treatment and ten encompassed general care and psychosocial rehabilitation interventions. Indicators were calculated using data from a stratified random sample of 458 patients treated at three DMHs located in North-Eastern, North-Western and Southern Italy. Patients' data were collected by combining information from medical charts and from a survey carried out by the health care professionals in charge of the patients. Data on the structural and organisational characteristics of the DMHs were retrieved from administrative databases. For each indicator, the number and percentage of appropriate interventions with and without moderators were calculated. Appropriateness was defined as the percentage of eligible patients receiving an intervention conformant with guidelines. Moderators, i.e., reasons justifying a discrepancy between the interventions actually provided and that recommended by guidelines were recorded. Indicators based on a sufficient number of eligible patients were further explored in a statistical analysis to compare the performance of the DMHs. RESULTS In the overall sample, the percentage of inappropriate interventions ranged from 11.1 to 59.3% for non-pharmacological interventions and from 5.9 to 66.8% for pharmacological interventions. Comparisons among DMHs revealed significant variability in appropriateness for the indicators 'prevention and monitoring of metabolic effects', 'psychiatric visits', 'psychosocial rehabilitation', 'family involvement' and 'work'. After adjusting the patient's gender, age and functioning, only the indicators 'Prevention and monitoring of metabolic effects', 'psychiatric visits' and 'work' continued to differ significantly among DMHs. The percentage of patients receiving appropriate integrated care (at least one appropriate non-pharmacological intervention and one pharmacological intervention) was significantly different among the three DMHs and lower than expected. CONCLUSIONS Our results underscore discrepancies among Italian DMHs in indicators that explore key aspects of care of patients with schizophrenia. The use of quality indicators and improved guideline adherence can address suboptimal clinical outcomes, and has the potential to reduce practice variations and narrow the gap between optimal and routine care.
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