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Liu L, Li Z, Kong D, Huang Y, Wu D, Zhao H, Gao X, Zhang X, Yang M. Neuroimaging markers of aberrant brain activity and treatment response in schizophrenia patients based on brain complexity. Transl Psychiatry 2024; 14:365. [PMID: 39251595 PMCID: PMC11384759 DOI: 10.1038/s41398-024-03067-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 08/21/2024] [Accepted: 08/23/2024] [Indexed: 09/11/2024] Open
Abstract
The complexity of brain activity reflects its ability to process information, adapt to environmental changes, and transition between states. However, it remains unclear how schizophrenia (SZ) affects brain activity complexity, particularly its dynamic changes. This study aimed to investigate the abnormal patterns of brain activity complexity in SZ, their relationship with cognitive deficits, and the impact of antipsychotic medication. Forty-four drug-naive first-episode (DNFE) SZ patients and thirty demographically matched healthy controls (HC) were included. Functional MRI-based sliding window analysis was utilized for the first time to calculate weighted permutation entropy to characterize complex patterns of brain activity in SZ patients before and after 12 weeks of risperidone treatment. Results revealed reduced complexity in the caudate, putamen, and pallidum at baseline in SZ patients compared to HC, with reduced complexity in the left caudate positively correlated with Continuous Performance Test (CPT) and Category Fluency Test scores. After treatment, the complexity of the left caudate increased. Regions with abnormal complexity showed decreased functional connectivity, with complexity positively correlated with connectivity strength. We observed that the dynamic complexity of the brain exhibited the characteristic of spontaneous, recurring "complexity drop", potentially reflecting transient state transitions in the resting brain. Compared to HC, patients exhibited reduced scope, intensity, and duration of complexity drop, all of which improved after treatment. Reduced duration was negatively correlated with CPT scores and positively with clinical symptoms. The results suggest that abnormalities in brain activity complexity and its dynamic changes may underlie cognitive deficits and clinical symptoms in SZ patients. Antipsychotic treatment partially restores these abnormalities, highlighting their potential as indicators of treatment efficacy and biomarkers for personalized therapy.
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Affiliation(s)
- Liju Liu
- The Fourth People's Hospital of Chengdu, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, PR China
| | - Zezhi Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Di Kong
- The Fourth People's Hospital of Chengdu, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, PR China
| | - Yanqing Huang
- The Fourth People's Hospital of Chengdu, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, PR China
| | - Diwei Wu
- The Fourth People's Hospital of Chengdu, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, PR China
| | - Huachang Zhao
- The Fourth People's Hospital of Chengdu, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, PR China
| | - Xin Gao
- The Fourth People's Hospital of Chengdu, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, PR China
| | - Xiangyang Zhang
- Affiliated Mental Health Center of Anhui Medical University; Hefei Fourth People's Hospital; Anhui Mental Health Center, Hefei, PR China.
| | - Mi Yang
- The Fourth People's Hospital of Chengdu, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, PR China.
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Liang CW, Cheng HY, Tseng MCM. Effects of sodium benzoate on cognitive function in neuropsychiatric disorders: a systematic review and meta-analysis. Front Psychiatry 2024; 15:1370431. [PMID: 39315325 PMCID: PMC11416944 DOI: 10.3389/fpsyt.2024.1370431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 08/19/2024] [Indexed: 09/25/2024] Open
Abstract
We performed a systematic review and meta-analysis on sodium benzoate's effects on cognitive function and other psychiatric symptoms in individuals with neuropsychiatric disorders. We searched PubMed, Embase, Cochrane Library, and PsychInfo databases until September 2023. A random-effects meta-analysis was performed within a frequentist framework. To investigate the potential sources of heterogeneity, we performed subgroup analyses based on sex, dose, diagnosis, and risk of bias of the included studies. Trial sequential analyses were performed to investigate the statistical power of the synthesized studies. The certainty in evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach. A total of 10 studies were included in the analysis. Sodium benzoate demonstrated a small-to-moderate positive effect on global cognitive function compared with placebo (standardized mean difference 0.40, 95% confidence interval 0.20 to 0.60, high certainty). Subgroup analyses suggested more pronounced effects in women; individuals receiving doses >500 mg/day; and individuals with early-phase Alzheimer's disease, chronic schizophrenia, or major depressive disorder. Sodium benzoate also demonstrated potential efficacy in enhancing the speed of processing, working memory, verbal learning and memory, visual learning and memory, and reasoning and problem solving. Furthermore, sodium benzoate was effective for positive psychotic symptoms but not for negative psychotic and depressive symptoms with moderate certainty. The current evidence strongly supports the positive effects of sodium benzoate on cognitive function in neuropsychiatric disorders. Further research is required to confirm its efficacy across different subtypes or stages of neurocognitive disorders and within specific cognitive domains. Systematic Review Registration PROSPERO, identifier CRD42023457462.
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Affiliation(s)
- Chun-Wei Liang
- Department of Primary Care Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hsiao-Yi Cheng
- Department of Primary Care Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Mei-Chih Meg Tseng
- Department of Psychiatry, Taipei Medical University Shuang Ho Hospital, New Taipei City, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University College of Medicine, Taipei, Taiwan
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Khan MM, Khan ZA, Khan MA. Metabolic complications of psychotropic medications in psychiatric disorders: Emerging role of de novo lipogenesis and therapeutic consideration. World J Psychiatry 2024; 14:767-783. [PMID: 38984346 PMCID: PMC11230099 DOI: 10.5498/wjp.v14.i6.767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 05/05/2024] [Accepted: 05/23/2024] [Indexed: 06/19/2024] Open
Abstract
Although significant advances have been made in understanding the patho-physiology of psychiatric disorders (PDs), therapeutic advances have not been very convincing. While psychotropic medications can reduce classical symptoms in patients with PDs, their long-term use has been reported to induce or exaggerate various pre-existing metabolic abnormalities including diabetes, obesity and non-alcoholic fatty liver disease (NAFLD). The mechanism(s) underlying these metabolic abnormalities is not clear; however, lipid/fatty acid accumulation due to enhanced de novo lipogenesis (DNL) has been shown to reduce membrane fluidity, increase oxidative stress and inflammation leading to the development of the aforementioned metabolic abnormalities. Intriguingly, emerging evidence suggest that DNL dysregulation and fatty acid accumulation could be the major mechanisms associated with the development of obesity, diabetes and NAFLD after long-term treatment with psychotropic medications in patients with PDs. In support of this, several adjunctive drugs comprising of anti-oxidants and anti-inflammatory agents, that are used in treating PDs in combination with psychotropic medications, have been shown to reduce insulin resistance and development of NAFLD. In conclusion, the above evidence suggests that DNL could be a potential pathological factor associated with various metabolic abnormalities, and a new avenue for translational research and therapeutic drug designing in PDs.
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Affiliation(s)
- Mohammad M Khan
- Laboratory of Translational Neurology and Molecular Psychiatry, Department of Biotechnology, Era’s Lucknow Medical College and Hospital, and Faculty of Science, Era University, Lucknow 226003, India
| | - Zaw Ali Khan
- Era’s Lucknow Medical College and Hospital, Era University, Lucknow 226003, India
| | - Mohsin Ali Khan
- Era’s Lucknow Medical College and Hospital, Era University, Lucknow 226003, India
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Jiang Q, Li T, Zhao L, Sun Y, Mao Z, Xing Y, Wang C, Bo Q. Treatment of antipsychotic-induced hyperprolactinemia: an umbrella review of systematic reviews and meta-analyses. Front Psychiatry 2024; 15:1337274. [PMID: 38505795 PMCID: PMC10948402 DOI: 10.3389/fpsyt.2024.1337274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 02/21/2024] [Indexed: 03/21/2024] Open
Abstract
Background Hyperprolactinemia is a common antipsychotic-induced adverse event in psychiatric patients, and the quality of clinical studies investigating the best treatments has varied. Thus, to better summarize the clinical evidence, we performed an umbrella review of overlapping systematic reviews and meta-analyses for the treatment of antipsychotic-induced hyperprolactinemia. Methods The PubMed, Cochrane Library, PsycINFO, Scopus and EMBASE were searched, and reviews and meta-analyses meeting our inclusion criteria were selected. Relevant data were extracted, and an umbrella review was conducted of all included meta-analyses. The quality of included meta-analyses was assessed by using PRISMA scores and AMSTAR 2 quality evaluation. Finally, the clinical evidence for appropriate treatments was summarized and discussed. Results Five meta-analyses published between 2013 and 2020 met the requirements for inclusion in this umbrella review. The PRISMA scores of the included meta-analyses ranged from 19.5-26. AMSTAR 2 quality evaluation showed that 2 of the 5 included meta-analyses were of low quality and 3 were of very low quality. The included meta-analyses provide clinical evidence that adding aripiprazole or a dopamine agonist can effectively and safely improve antipsychotic-induced hyperprolactinemia. Two meta-analyses also showed that adjunctive metformin can reduce serum prolactin level, but more clinical trials are needed to confirm this finding. Conclusion Adjunctive dopamine agonists have been proven to be effective and safe for the treatment of antipsychotic-induced hyperprolactinemia. Among the researched treatments, adding aripiprazole may be the most appropriate.
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Affiliation(s)
- Qitong Jiang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Tian Li
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Lei Zhao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yue Sun
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zhen Mao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yujie Xing
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Chuanyue Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Qijing Bo
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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He K, Hua Q, Li Q, Zhang Y, Yao X, Yang Y, Xu W, Sun J, Wang L, Wang A, Ji GJ, Wang K. Abnormal interhemispheric functional cooperation in schizophrenia follows the neurotransmitter profiles. J Psychiatry Neurosci 2023; 48:E452-E460. [PMID: 38123242 PMCID: PMC10743641 DOI: 10.1503/jpn.230037] [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: 03/02/2023] [Revised: 06/26/2023] [Accepted: 09/05/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Interhemispheric cooperation is one of the most prominent functional architectures of the human brain. In patients with schizophrenia, interhemispheric cooperation deficits have been reported using increasingly powerful neurobehavioural and neuroimaging measures. However, these methods rely in part on the assumption of anatomic symmetry between hemispheres. In the present study, we explored interhemispheric cooperation deficits in schizophrenia using a newly developed index, connectivity between functionally homotopic voxels (CFH), which is unbiased by hemispheric asymmetry. METHODS Patients with schizophrenia and age- and sexmatched healthy controls underwent multimodal MRI, and whole-brain CFH maps were constructed for comparison between groups. We examined the correlations of differing CFH values between the schizophrenia and control groups using various neurotransmitter receptor and transporter densities. RESULTS We included 86 patients with schizophrenia and 86 matched controls in our analysis. Patients with schizophrenia showed significantly lower CFH values in the frontal lobes, left postcentral gyrus and right inferior temporal gyrus, and significantly greater CFH values in the right caudate nucleus than healthy controls. Moreover, the differing CFH values in patients with schizophrenia were significantly correlated with positive symptom score and illness duration. Functional connectivity within frontal lobes was significantly reduced at the voxel cluster level compared with healthy controls. Finally, the abnormal CFH map of patients with schizophrenia was spatially associated with the densities of the dopamine D1 and D2 receptors, fluorodopa, dopamine transporter, serotonin transporter and acetylcholine transporter. CONCLUSION Regional abnormalities in interhemispheric cooperation may contribute to the clinical symptoms of schizophrenia. These CFH abnormalities may be associated with dysfunction in neurotransmitter systems strongly implicated in schizophrenia.
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Affiliation(s)
- Kongliang He
- From the Affiliated Psychological Hospital of Anhui Medical University, Hefei, China (He, A. Wang); the Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China (He, Hua, Yao, Sun, L. Wang, Ji, K. Wang); the School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China (He, Zhang, Yang, Xu, A. Wang, Ji, K. Wang); the Hefei Fourth People's Hospital, Hefei, China (He, A. Wang); the Anhui Mental Health Center, Hefei, China (He, A. Wang); the Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China (Li); the Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China (Hua, Li, Zhang, Yang, Xu, Sun, L. Wang, Ji, K. Wang); the Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China (Hua, Li, Zhang, Yang, Xu, Sun, L. Wang, Ji, K. Wang); the Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China (K. Wang); and the Anhui Institute of Translational Medicine, Hefei, China (K. Wang)
| | - Qiang Hua
- From the Affiliated Psychological Hospital of Anhui Medical University, Hefei, China (He, A. Wang); the Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China (He, Hua, Yao, Sun, L. Wang, Ji, K. Wang); the School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China (He, Zhang, Yang, Xu, A. Wang, Ji, K. Wang); the Hefei Fourth People's Hospital, Hefei, China (He, A. Wang); the Anhui Mental Health Center, Hefei, China (He, A. Wang); the Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China (Li); the Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China (Hua, Li, Zhang, Yang, Xu, Sun, L. Wang, Ji, K. Wang); the Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China (Hua, Li, Zhang, Yang, Xu, Sun, L. Wang, Ji, K. Wang); the Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China (K. Wang); and the Anhui Institute of Translational Medicine, Hefei, China (K. Wang)
| | - Qianqian Li
- From the Affiliated Psychological Hospital of Anhui Medical University, Hefei, China (He, A. Wang); the Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China (He, Hua, Yao, Sun, L. Wang, Ji, K. Wang); the School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China (He, Zhang, Yang, Xu, A. Wang, Ji, K. Wang); the Hefei Fourth People's Hospital, Hefei, China (He, A. Wang); the Anhui Mental Health Center, Hefei, China (He, A. Wang); the Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China (Li); the Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China (Hua, Li, Zhang, Yang, Xu, Sun, L. Wang, Ji, K. Wang); the Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China (Hua, Li, Zhang, Yang, Xu, Sun, L. Wang, Ji, K. Wang); the Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China (K. Wang); and the Anhui Institute of Translational Medicine, Hefei, China (K. Wang)
| | - Yan Zhang
- From the Affiliated Psychological Hospital of Anhui Medical University, Hefei, China (He, A. Wang); the Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China (He, Hua, Yao, Sun, L. Wang, Ji, K. Wang); the School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China (He, Zhang, Yang, Xu, A. Wang, Ji, K. Wang); the Hefei Fourth People's Hospital, Hefei, China (He, A. Wang); the Anhui Mental Health Center, Hefei, China (He, A. Wang); the Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China (Li); the Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China (Hua, Li, Zhang, Yang, Xu, Sun, L. Wang, Ji, K. Wang); the Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China (Hua, Li, Zhang, Yang, Xu, Sun, L. Wang, Ji, K. Wang); the Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China (K. Wang); and the Anhui Institute of Translational Medicine, Hefei, China (K. Wang)
| | - Xiaoqing Yao
- From the Affiliated Psychological Hospital of Anhui Medical University, Hefei, China (He, A. Wang); the Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China (He, Hua, Yao, Sun, L. Wang, Ji, K. Wang); the School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China (He, Zhang, Yang, Xu, A. Wang, Ji, K. Wang); the Hefei Fourth People's Hospital, Hefei, China (He, A. Wang); the Anhui Mental Health Center, Hefei, China (He, A. Wang); the Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China (Li); the Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China (Hua, Li, Zhang, Yang, Xu, Sun, L. Wang, Ji, K. Wang); the Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China (Hua, Li, Zhang, Yang, Xu, Sun, L. Wang, Ji, K. Wang); the Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China (K. Wang); and the Anhui Institute of Translational Medicine, Hefei, China (K. Wang)
| | - Yinian Yang
- From the Affiliated Psychological Hospital of Anhui Medical University, Hefei, China (He, A. Wang); the Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China (He, Hua, Yao, Sun, L. Wang, Ji, K. Wang); the School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China (He, Zhang, Yang, Xu, A. Wang, Ji, K. Wang); the Hefei Fourth People's Hospital, Hefei, China (He, A. Wang); the Anhui Mental Health Center, Hefei, China (He, A. Wang); the Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China (Li); the Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China (Hua, Li, Zhang, Yang, Xu, Sun, L. Wang, Ji, K. Wang); the Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China (Hua, Li, Zhang, Yang, Xu, Sun, L. Wang, Ji, K. Wang); the Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China (K. Wang); and the Anhui Institute of Translational Medicine, Hefei, China (K. Wang)
| | - Wenqiang Xu
- From the Affiliated Psychological Hospital of Anhui Medical University, Hefei, China (He, A. Wang); the Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China (He, Hua, Yao, Sun, L. Wang, Ji, K. Wang); the School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China (He, Zhang, Yang, Xu, A. Wang, Ji, K. Wang); the Hefei Fourth People's Hospital, Hefei, China (He, A. Wang); the Anhui Mental Health Center, Hefei, China (He, A. Wang); the Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China (Li); the Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China (Hua, Li, Zhang, Yang, Xu, Sun, L. Wang, Ji, K. Wang); the Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China (Hua, Li, Zhang, Yang, Xu, Sun, L. Wang, Ji, K. Wang); the Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China (K. Wang); and the Anhui Institute of Translational Medicine, Hefei, China (K. Wang)
| | - Jinmei Sun
- From the Affiliated Psychological Hospital of Anhui Medical University, Hefei, China (He, A. Wang); the Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China (He, Hua, Yao, Sun, L. Wang, Ji, K. Wang); the School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China (He, Zhang, Yang, Xu, A. Wang, Ji, K. Wang); the Hefei Fourth People's Hospital, Hefei, China (He, A. Wang); the Anhui Mental Health Center, Hefei, China (He, A. Wang); the Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China (Li); the Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China (Hua, Li, Zhang, Yang, Xu, Sun, L. Wang, Ji, K. Wang); the Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China (Hua, Li, Zhang, Yang, Xu, Sun, L. Wang, Ji, K. Wang); the Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China (K. Wang); and the Anhui Institute of Translational Medicine, Hefei, China (K. Wang)
| | - Lu Wang
- From the Affiliated Psychological Hospital of Anhui Medical University, Hefei, China (He, A. Wang); the Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China (He, Hua, Yao, Sun, L. Wang, Ji, K. Wang); the School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China (He, Zhang, Yang, Xu, A. Wang, Ji, K. Wang); the Hefei Fourth People's Hospital, Hefei, China (He, A. Wang); the Anhui Mental Health Center, Hefei, China (He, A. Wang); the Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China (Li); the Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China (Hua, Li, Zhang, Yang, Xu, Sun, L. Wang, Ji, K. Wang); the Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China (Hua, Li, Zhang, Yang, Xu, Sun, L. Wang, Ji, K. Wang); the Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China (K. Wang); and the Anhui Institute of Translational Medicine, Hefei, China (K. Wang)
| | - Anzhen Wang
- From the Affiliated Psychological Hospital of Anhui Medical University, Hefei, China (He, A. Wang); the Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China (He, Hua, Yao, Sun, L. Wang, Ji, K. Wang); the School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China (He, Zhang, Yang, Xu, A. Wang, Ji, K. Wang); the Hefei Fourth People's Hospital, Hefei, China (He, A. Wang); the Anhui Mental Health Center, Hefei, China (He, A. Wang); the Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China (Li); the Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China (Hua, Li, Zhang, Yang, Xu, Sun, L. Wang, Ji, K. Wang); the Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China (Hua, Li, Zhang, Yang, Xu, Sun, L. Wang, Ji, K. Wang); the Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China (K. Wang); and the Anhui Institute of Translational Medicine, Hefei, China (K. Wang)
| | - Gong-Jun Ji
- From the Affiliated Psychological Hospital of Anhui Medical University, Hefei, China (He, A. Wang); the Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China (He, Hua, Yao, Sun, L. Wang, Ji, K. Wang); the School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China (He, Zhang, Yang, Xu, A. Wang, Ji, K. Wang); the Hefei Fourth People's Hospital, Hefei, China (He, A. Wang); the Anhui Mental Health Center, Hefei, China (He, A. Wang); the Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China (Li); the Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China (Hua, Li, Zhang, Yang, Xu, Sun, L. Wang, Ji, K. Wang); the Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China (Hua, Li, Zhang, Yang, Xu, Sun, L. Wang, Ji, K. Wang); the Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China (K. Wang); and the Anhui Institute of Translational Medicine, Hefei, China (K. Wang)
| | - Kai Wang
- From the Affiliated Psychological Hospital of Anhui Medical University, Hefei, China (He, A. Wang); the Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China (He, Hua, Yao, Sun, L. Wang, Ji, K. Wang); the School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China (He, Zhang, Yang, Xu, A. Wang, Ji, K. Wang); the Hefei Fourth People's Hospital, Hefei, China (He, A. Wang); the Anhui Mental Health Center, Hefei, China (He, A. Wang); the Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China (Li); the Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China (Hua, Li, Zhang, Yang, Xu, Sun, L. Wang, Ji, K. Wang); the Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China (Hua, Li, Zhang, Yang, Xu, Sun, L. Wang, Ji, K. Wang); the Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China (K. Wang); and the Anhui Institute of Translational Medicine, Hefei, China (K. Wang)
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Anand R, Turolla A, Chinellato G, Roy A, Hartman RD. Phase 2 Results Indicate Evenamide, A Selective Modulator of Glutamate Release, Is Associated With Clinically Important Long-Term Efficacy When Added to an Antipsychotic in Patients With Treatment-Resistant Schizophrenia. Int J Neuropsychopharmacol 2023; 26:523-528. [PMID: 37349110 PMCID: PMC10464926 DOI: 10.1093/ijnp/pyad035] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/21/2023] [Indexed: 06/24/2023] Open
Abstract
Results from a pilot, 6-week, randomized, open-label, rater-blinded study, with 46-week extension, indicate very good tolerability with exceptional, clinically important, increasing efficacy of evenamide (7.5, 15, and 30 mg bid), a glutamate modulator, as add-on treatment to antipsychotics in 161 treatment-resistant, schizophrenia patients. Ninety-five percent of patients completed 6 weeks (1 discontinued for adverse event), and 89% continued in the extension. Results from the first 100 patients enrolled showed very low attrition over 1 year (77 completers); data pooled from all dose groups showed the Positive and Negative Syndrome Scale total score improved significantly (P < .001; paired t test; last observation carried forward [LOCF]) from baseline at 6 weeks (-9.4), 6 months (-12.7), and 1 year (-14.7); similarly, the proportion of responders (≥20% improvement) increased over time from 6 weeks (16.5%) to 6 months (39%) to 1 year (47.4%). Noteworthy improvement was also observed at each timepoint on the Clinical Global Impression - Severity scale and Clinical Global Impression of Change, indicating progressively increasing efficacy of evenamide up to 1 year.
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Affiliation(s)
| | | | | | - Arjun Roy
- CliniRx Research Pvt Ltd, New Delhi, India
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7
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Tabrisi R, Harun-Rashid MD, Montero J, Venizelos N, Msghina M. Clozapine but not lithium reverses aberrant tyrosine uptake in patients with bipolar disorder. Psychopharmacology (Berl) 2023; 240:1667-1676. [PMID: 37318540 PMCID: PMC10349740 DOI: 10.1007/s00213-023-06397-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/31/2023] [Indexed: 06/16/2023]
Abstract
RATIONALE Availability of the dopamine and noradrenaline precursor tyrosine is critical for normal functioning, and deficit in tyrosine transport across cell membrane and the blood-brain barrier has been reported in bipolar disorder and schizophrenia. Clozapine and lithium are two psychoactive agents used to treat psychosis, mood disorders and suicidal behavior, but their mechanism of action remains largely unknown. OBJECTIVE To characterize immediate and delayed differences in tyrosine uptake between healthy controls (HC) and bipolar patients (BP) and see if these differences could be normalized by either clozapine, lithium or both. A second objective was to see if clozapine and lithium have additive, antagonistic or synergistic effects in this. METHOD Fibroblasts from five HC and five BP were incubated for 5 min or 6 h with clozapine, lithium, or combination of both. Radioactive labelled tyrosine was used to quantify tyrosine membrane transport. RESULTS There was significantly reduced tyrosine uptake at baseline in BP compared to HC, a deficit that grew with increasing incubation time. Clozapine selectively increased tyrosine uptake in BP and abolished the deficit seen under baseline conditions, while lithium had no such effect. Combination treatment with clozapine and lithium was less effective than when clozapine was used alone. CONCLUSIONS There was significant deficit in tyrosine transport in BP compared to HC that was reversed by clozapine but not lithium. Clozapine was more effective when used alone than when added together with lithium. Potential clinical implications of this will be discussed.
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Affiliation(s)
- R Tabrisi
- Department of Plastic Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - M D Harun-Rashid
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - J Montero
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - N Venizelos
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - M Msghina
- Department of Psychiatry, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
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8
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Saha S, González-Maeso J. The crosstalk between 5-HT 2AR and mGluR2 in schizophrenia. Neuropharmacology 2023; 230:109489. [PMID: 36889432 PMCID: PMC10103009 DOI: 10.1016/j.neuropharm.2023.109489] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/26/2023] [Accepted: 03/05/2023] [Indexed: 03/08/2023]
Abstract
Schizophrenia is a severe brain disorder that usually produces a lifetime of disability. First generation or typical antipsychotics such as haloperidol and second generation or atypical antipsychotics such as clozapine and risperidone remain the current standard for schizophrenia treatment. In some patients with schizophrenia, antipsychotics produce complete remission of positive symptoms, such as hallucinations and delusions. However, antipsychotic drugs are ineffective against cognitive deficits and indeed treated schizophrenia patients have small improvements or even deterioration in several cognitive domains. This underlines the need for novel and more efficient therapeutic targets for schizophrenia treatment. Serotonin and glutamate have been identified as key parts of two neurotransmitter systems involved in fundamental brain processes. Serotonin (or 5-hydroxytryptamine) 5-HT2A receptor (5-HT2AR) and metabotropic glutamate 2 receptor (mGluR2) are G protein-coupled receptors (GPCRs) that interact at epigenetic and functional levels. These two receptors can form GPCR heteromeric complexes through which their pharmacology, function and trafficking becomes affected. Here we review past and current research on the 5-HT2AR-mGluR2 heterocomplex and its potential implication in schizophrenia and antipsychotic drug action. This article is part of the Special Issue on "The receptor-receptor interaction as a new target for therapy".
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Affiliation(s)
- Somdatta Saha
- Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Javier González-Maeso
- Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA.
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Fukuyama K, Motomura E, Okada M. Enhanced L-β-Aminoisobutyric Acid Is Involved in the Pathophysiology of Effectiveness for Treatment-Resistant Schizophrenia and Adverse Reactions of Clozapine. Biomolecules 2023; 13:biom13050862. [PMID: 37238731 DOI: 10.3390/biom13050862] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/14/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
Clozapine is an effective antipsychotic for the treatment of antipsychotic-resistant schizophrenia; however, specific types of A/B adverse effects and clozapine-discontinuation syndromes are also well known. To date, both the critical mechanisms of clinical actions (effective for antipsychotic-resistant schizophrenia) and the adverse effects of clozapine remain to be elucidated. Recently, we demonstrated that clozapine increased the synthesis of L-β-aminoisobutyric acid (L-BAIBA) in the hypothalamus. L-BAIBA is an activator of the adenosine monophosphate-activated protein kinase (AMPK), glycine receptor, GABAA receptor, and GABAB receptor (GABAB-R). These targets of L-BAIBA overlap as potential targets other than the monoamine receptors of clozapine. However, the direct binding of clozapine to these aminoacidic transmitter/modulator receptors remains to be clarified. Therefore, to explore the contribution of increased L-BAIBA on the clinical action of clozapine, this study determined the effects of clozapine and L-BAIBA on tripartite synaptic transmission, including GABAB-R and the group-III metabotropic glutamate receptor (III-mGluR) using cultured astrocytes, as well as on the thalamocortical hyper-glutamatergic transmission induced by impaired glutamate/NMDA receptors using microdialysis. Clozapine increased astroglial L-BAIBA synthesis in time/concentration-dependent manners. Increased L-BAIBA synthesis was observed until 3 days after clozapine discontinuation. Clozapine did not directly bind III-mGluR or GABAB-R, whereas L-BAIBA activated these receptors in the astrocytes. Local administration of MK801 into the reticular thalamic nucleus (RTN) increased L-glutamate release in the medial frontal cortex (mPFC) (MK801-evoked L-glutamate release). Local administration of L-BAIBA into the mPFC suppressed MK801-evoked L-glutamate release. These actions of L-BAIBA were inhibited by antagonists of III-mGluR and GABAB-R, similar to clozapine. These in vitro and in vivo analyses suggest that increased frontal L-BAIBA signaling likely plays an important role in the pharmacological actions of clozapine, such as improving the effectiveness of treating treatment-resistant schizophrenia and several clozapine discontinuation syndromes via the activation of III-mGluR and GABAB-R in the mPFC.
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Affiliation(s)
- Kouji Fukuyama
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan
| | - Eishi Motomura
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan
| | - Motohiro Okada
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan
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10
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Cong L, Wan Z, Li P, Liu D, He J, An Z, Liu L. Metabolic, genetic, and pharmacokinetic parameters for the prediction of olanzapine efficacy. Eur J Pharm Sci 2022; 177:106277. [PMID: 35981664 DOI: 10.1016/j.ejps.2022.106277] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 05/31/2022] [Accepted: 08/14/2022] [Indexed: 11/17/2022]
Abstract
Clinical use of the a olanzapine has significantly different individual-to-individual outcomes. Accordingly, this study aimed to develop a means of predicting response to olanzapine using a combined approach based on pharmacokinetics, pharmacometabonomics, and genetic polymorphism. The olanzapine pharmacokinetics of 19 healthy volunteers treated with orally disintegrating tablets were determined using high-performance liquid chromatography-tandem mass spectrometry. Metabolic profiling and phenotyping were performed on the blood samples that remained after pharmacokinetic analysis using ultrahigh-performance liquid chromatography coupled with high-resolution mass spectrometry. Uridine diphosphate-glucuronosyltransferase (UGT), tyrosine hydroxylase (TH), γ-aminobutyric acid transaminase (GABA-T), and succinic semialdehyde dehydrogenase (SSADH) were identified as key genes. The single nucleotide polymorphism genotypes most related to drug metabolism were investigated by polymerase chain reaction and Sanger sequencing. Forty-one metabolites (p < 0.05) are increased or decreased after treatment with olanzapine. Tryptophan metabolism, norepinephrine metabolism, and γ-aminobutyric acid metabolism were identified as being related to the effects of olanzapine. Subjects carrying rs1641031 AC and CC exhibited a 59.2% increase in the mean peak concentration (Cmax) value and a 25.33% decrease in the mean oral clearance rate (CL/F) value, compared to that in subjects with the GABA-T rs1641031 AA genotype (p < 0.05). Moreover, polymorphism of the GABA-T gene has an impact on the metabolism of 5-hydroxytryptamine. Lysophosphatidylethanolamine (0:0/18:3), lysophosphatidylethanolamine (0:0/22:5), and octadecatrienoic acid distinguish subjects with high and low olanzapine drug oral clearance and are thus identified as biomarkers for predicting its efficacy.
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Affiliation(s)
- Ling Cong
- Pharmacy Department of Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, PR China
| | - Zirui Wan
- Pharmacy Department of Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, PR China
| | - Pengfei Li
- Pharmacy Department of Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, PR China
| | - Dan Liu
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100050, PR China
| | - Jiuming He
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100050, PR China.
| | - Zhuoling An
- Pharmacy Department of Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, PR China.
| | - Lihong Liu
- Pharmacy Department of Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, PR China
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11
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Waldman L, Richardson B, Hamilton J, Thanos P. Chronic Oral Olanzapine Treatment but not Haloperidol Decreases [ 3H] MK-801 Binding in the Rat Brain Independent of Dietary Conditions. Neurosci Lett 2022; 781:136657. [PMID: 35483503 DOI: 10.1016/j.neulet.2022.136657] [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: 01/26/2022] [Revised: 03/27/2022] [Accepted: 04/21/2022] [Indexed: 11/19/2022]
Abstract
Haloperidol and olanzapine are first and second-generation antipsychotic (neuroleptic) medications approved to treat schizophrenia. Glutamate signaling is known to play an important role in the manifestation of schizophrenia symptoms, as phencyclidine, a non-competitive N-methyl-D-aspartate receptor (NMDAR) antagonist, replicates and exasperates these symptoms. While initial reports show that neuroleptic treatments can impact aspects of NMDAR expression, there is little attention on the interaction between neuroleptics and dietary conditions. Thus, we examined the impact of chronic haloperidol and olanzapine treatment under both normal and high-fat dietary conditions on NMDAR expression. Adult male rats were treated for 28-days with either oral vehicle, haloperidol (1.5mg/kg), or olanzapine (10mg/kg), and fed either a standard control diet or a high-fat diet. In-vitro receptor autoradiography binding was performed using [3H] MK-801 as a measure of NMDAR expression. Results showed that olanzapine, irrespective of the diet, significantly decreased [3H] MK-801 binding within the cingulate cortex, substantia nigra, insular cortex, piriform cortex, ectorhinal cortex and perirhinal cortex, the forelimb region of the somatosensory cortex, and all quadrants of the caudate-putamen. In contrast, haloperidol treatment did not impact [3H] MK-801 binding, and we also report no effect of diet on [3H] MK-801 binding. These data suggest that the effects seen in olanzapine treatment are not mediated by diet, nor does a 28-day chronic high-fat diet alter [3H] MK-801 binding. Furthermore, these data also importantly support that combined consumption of a high-fat diet and pharmacological treatments are not immediately detrimental to NMDARs and contribute to the expansive literature of precision medicine.
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Affiliation(s)
- Leah Waldman
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Clinical and Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biosciences, University at Buffalo, Buffalo, NY, USA
| | - Brittany Richardson
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Clinical and Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biosciences, University at Buffalo, Buffalo, NY, USA; Department of Psychology, University at Buffalo, Buffalo, NY, USA
| | - John Hamilton
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Clinical and Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biosciences, University at Buffalo, Buffalo, NY, USA
| | - Panayotis Thanos
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Clinical and Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biosciences, University at Buffalo, Buffalo, NY, USA; Department of Psychology, University at Buffalo, Buffalo, NY, USA.
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12
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Liu D, Huang J, Gao S, Jin H, He J. A temporo-spatial pharmacometabolomics method to characterize pharmacokinetics and pharmacodynamics in the brain microregions by using ambient mass spectrometry imaging. Acta Pharm Sin B 2022; 12:3341-3353. [PMID: 35967273 PMCID: PMC9366215 DOI: 10.1016/j.apsb.2022.03.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/10/2022] [Accepted: 03/20/2022] [Indexed: 11/01/2022] Open
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13
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Rogóż Z, Kamińska K, Lech MA, Lorenc-Koci E. N-Acetylcysteine and Aripiprazole Improve Social Behavior and Cognition and Modulate Brain BDNF Levels in a Rat Model of Schizophrenia. Int J Mol Sci 2022; 23:ijms23042125. [PMID: 35216241 PMCID: PMC8877560 DOI: 10.3390/ijms23042125] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/18/2022] [Accepted: 02/11/2022] [Indexed: 02/01/2023] Open
Abstract
Treatment of negative symptoms and cognitive disorders in patients with schizophrenia is still a serious clinical problem. The aim of our study was to compare the efficacy of chronic administration of the atypical antipsychotic drug aripiprazole (7-{4-[4-(2,3-dichlorophenyl)-1-piperazinyl] butoxy}-3,4-dihydro-2(1H)-quinolinone; ARI) and the well-known antioxidant N-acetylcysteine (NAC) both in alleviating schizophrenia-like social and cognitive deficits and in reducing the decreases in the levels of the brain-derived neurotrophic factor (BDNF) in the prefrontal cortex (PFC) and hippocampus (HIP) of adult Sprague-Dawley rats, that have been induced by chronic administration of the model compound L-buthionine-(S, R)-sulfoximine (BSO) during the early postnatal development (p5–p16). ARI was administered at doses of 0.1 and 0.3 mg/kg while NAC at doses of 10 and 30 mg/kg, alone or in combination. Administration of higher doses of ARI or NAC alone, or co-treatment with lower, ineffective doses of these drugs significantly improved social and cognitive performance as assessed in behavioral tests. Both doses of NAC and 0.3 mg/kg of ARI increased the expression of BDNF mRNA in the PFC, while all doses of these drugs and their combinations enhanced the levels of BDNF protein in this brain structure. In the HIP, only 0,3 mg/kg ARI increased the levels of both BDNF mRNA and its protein. These data show that in the rat BSO-induced neurodevelopmental model of schizophrenia, ARI and NAC differently modulated BDNF levels in the PFC and HIP.
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Affiliation(s)
- Zofia Rogóż
- Department of Pharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, 12 Smętna Street, 31-343 Kraków, Poland; (Z.R.); (K.K.); (M.A.L.)
| | - Kinga Kamińska
- Department of Pharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, 12 Smętna Street, 31-343 Kraków, Poland; (Z.R.); (K.K.); (M.A.L.)
| | - Marta Anna Lech
- Department of Pharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, 12 Smętna Street, 31-343 Kraków, Poland; (Z.R.); (K.K.); (M.A.L.)
| | - Elżbieta Lorenc-Koci
- Department of Neuro-Psychopharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, 12 Smętna Street, 31-343 Kraków, Poland
- Correspondence: ; Tel.: +48-126-623-272
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14
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Overview of the Neuroprotective Effects of the MAO-Inhibiting Antidepressant Phenelzine. Cell Mol Neurobiol 2021; 42:225-242. [PMID: 33839994 PMCID: PMC8732914 DOI: 10.1007/s10571-021-01078-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/10/2021] [Indexed: 12/18/2022]
Abstract
Phenelzine (PLZ) is a monoamine oxidase (MAO)-inhibiting antidepressant with anxiolytic properties. This multifaceted drug has a number of pharmacological and neurochemical effects in addition to inhibition of MAO, and findings on these effects have contributed to a body of evidence indicating that PLZ also has neuroprotective/neurorescue properties. These attributes are reviewed in this paper and include catabolism to the active metabolite β-phenylethylidenehydrazine (PEH) and effects of PLZ and PEH on the GABA-glutamate balance in brain, sequestration of reactive aldehydes, and inhibition of primary amine oxidase. Also discussed are the encouraging findings of the effects of PLZ in animal models of stroke, spinal cord injury, traumatic brain injury, and multiple sclerosis, as well other actions such as reduction of nitrative stress, reduction of the effects of a toxin on dopaminergic neurons, potential anticonvulsant actions, and effects on brain-derived neurotrophic factor, neural cell adhesion molecules, an anti-apoptotic factor, and brain levels of ornithine and N-acetylamino acids.
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15
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De Berardis D, De Filippis S, Masi G, Vicari S, Zuddas A. A Neurodevelopment Approach for a Transitional Model of Early Onset Schizophrenia. Brain Sci 2021; 11:brainsci11020275. [PMID: 33672396 PMCID: PMC7926620 DOI: 10.3390/brainsci11020275] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 12/16/2022] Open
Abstract
In the last decades, the conceptualization of schizophrenia has dramatically changed, moving from a neurodegenerative process occurring in early adult life to a neurodevelopmental disorder starting be-fore birth, showing a variety of premorbid and prodromal symptoms and, in relatively few cases, evolving in the full-blown psychotic syndrome. High rates of co-occurring different neurodevelopmental disorders such as Autism spectrum disorder and ADHD, predating the onset of SCZ, and neurobio-logical underpinning with significant similarities, support the notion of a pan-developmental disturbance consisting of impairments in neuromotor, receptive language, social and cognitive development. Con-sidering that many SCZ risk factors may be similar to symptoms of other neurodevelopmental psychi-atric disorders, transition processes from child & adolescent to adult systems of care should include both high risk people as well as subject with other neurodevelopmental psychiatric disorders with different levels of severity. This descriptive mini-review discuss the need of innovative clinical approaches, re-considering specific diagnostic categories, stimulating a careful analysis of risk factors and promoting the appropriate use of new and safer medications.
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Affiliation(s)
- Domenico De Berardis
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital “G. Mazzini,” National Health Service (NHS), 64100 ASL 4 Teramo, Italy
- Department of Neurosciences and Imaging, University “G. D’Annunzio”, 66100 Chieti, Italy
- Correspondence:
| | - Sergio De Filippis
- Department of Neuropsychiatry, Villa von Siebenthal Neuropsychiatric Hospital and Clinic, Genzano di Roma, 100045 Rome, Italy;
| | - Gabriele Masi
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56128 Pisa, Italy;
| | - Stefano Vicari
- Department of Life Sciences and Publich Health, Catholic University, 00135 Rome, Italy;
- Child & Adolescent Psychiatry, Bambino Gesù Children’s Hospital, 00168 Rome, Italy
| | - Alessandro Zuddas
- Child and Adolescent Neuropsychiatry Unit, Department of Biomedical Sciences, University of Cagliari and “A Cao” Paediatric Hospital, “G Brotzu” Hospital Trust, 109134 Cagliari, Italy;
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16
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Chestnykh DA, Amato D, Kornhuber J, Müller CP. Pharmacotherapy of schizophrenia: Mechanisms of antipsychotic accumulation, therapeutic action and failure. Behav Brain Res 2021; 403:113144. [PMID: 33515642 DOI: 10.1016/j.bbr.2021.113144] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 12/13/2022]
Abstract
Schizophrenia is a multi-dimensional disorder with a complex and mostly unknown etiology, leading to a severe decline in life quality. Antipsychotic drugs (APDs) remain beneficial interventions in the treatment of the disorder, but vary significantly in binding profile, clinical effects and adverse reactions. The present review summarizes the main principles of APD mechanisms of action with a particular focus on recent findings in APD accumulation and its role in the therapeutic efficacy and treatment failure. High and low doses of APDs were shown to be effective in different dimensions of antipsychotic-like behaviour in rodent models. Efficacy of the APDs correlates with high dopamine D2 receptor occupancy, which occurs quickly after drug administration. However, onset and peak of action are delayed up to several days or weeks. APD accumulation via acidic trapping in synaptic vesicles is considered to underlie the time course of APD action. Use-dependent exocytosis, co-release with dopamine and serotonin and inhibition of ion channels impact on the neuronal transmission and determine effects of APDs. Disruption in accumulating properties leads to diminished APD effects. In addition, long-term APD administration at therapeutic doses leads to treatment failure both in animal models and in humans. APD failure was associated with treatment induced neuroadaptations, including a decline in extracellular dopamine levels, dopamine transporter upregulation, and altered neuronal firing. However, enhanced synaptic vesicle release has also been reported. APD loss of efficacy may be reversed through inhibition of the dopamine transporter or switching the administration regimen from continuous to intermittent. Thus, manipulating the accumulation properties of APDs, changes in the administration regimen and doses, or co-administration with dopamine transporter inhibitors may be considered to yield benefits in the development of new effective strategies in the treatment of schizophrenia.
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Affiliation(s)
- Daria A Chestnykh
- Department of Psychiatry and Psychotherapy, University Clinic, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Davide Amato
- Department of Psychiatry and Psychotherapy, University Clinic, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany; Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University Clinic, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Christian P Müller
- Department of Psychiatry and Psychotherapy, University Clinic, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany.
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17
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Cosi C, Martel JC, Auclair AL, Collo G, Cavalleri L, Heusler P, Leriche L, Gaudoux F, Sokoloff P, Moser PC, Gatti-McArthur S. Pharmacology profile of F17464, a dopamine D 3 receptor preferential antagonist. Eur J Pharmacol 2021; 890:173635. [PMID: 33065094 DOI: 10.1016/j.ejphar.2020.173635] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 10/01/2020] [Accepted: 10/05/2020] [Indexed: 12/19/2022]
Abstract
F17464 (N-(3-{4-[4-(8-Oxo-8H-[1,3]-dioxolo-[4,5-g]-chromen-7-yl)-butyl]-piperazin-1-yl}-phenyl)-methanesulfonamide, hydrochloride) is a new potential antipsychotic with a unique profile. The compound exhibits high affinity for the human dopamine receptor subtype 3 (hD3) (Ki = 0.17 nM) and the serotonin receptor subtype 1a (5-HT1a) (Ki = 0.16 nM) and a >50 fold lower affinity for the human dopamine receptor subtype 2 short and long form (hD2s/l) (Ki = 8.9 and 12.1 nM, respectively). [14C]F17464 dynamic studies show a slower dissociation rate from hD3 receptor (t1/2 = 110 min) than from hD2s receptor (t1/2 = 1.4 min) and functional studies demonstrate that F17464 is a D3 receptor antagonist, 5-HT1a receptor partial agonist. In human dopaminergic neurons F17464 blocks ketamine induced morphological changes, an effect D3 receptor mediated. In vivo F17464 target engagement of both D2 and 5-HT1a receptors is demonstrated in displacement studies in the mouse brain. F17464 increases dopamine release in the rat prefrontal cortex and mouse lateral forebrain - dorsal striatum and seems to reduce the effect of MK801 on % c-fos mRNA medium expressing neurons in cortical and subcortical regions. F17464 also rescues valproate induced impairment in a rat social interaction model of autism. All the neurochemistry and behavioural effects of F17464 are observed in the dose range 0.32-2.5 mg/kg i.p. in both rats and mice. The in vitro - in vivo pharmacology profile of F17464 in preclinical models is discussed in support of a therapeutic use of the compound in schizophrenia and autism.
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Affiliation(s)
- Cristina Cosi
- Innovation Unit CNS, CEPC Pierre Fabre Laboratories, Bel Air de Campans, 81106, Castres, France
| | - Jean-Claude Martel
- Innovation Unit CNS, CEPC Pierre Fabre Laboratories, Bel Air de Campans, 81106, Castres, France
| | - Agnès L Auclair
- Innovation Unit CNS, CEPC Pierre Fabre Laboratories, Bel Air de Campans, 81106, Castres, France
| | - Ginetta Collo
- Dept of Molecular and Translational Medicine University of Brescia, Viale Europa 11, Brescia, Italy
| | - Laura Cavalleri
- Dept of Molecular and Translational Medicine University of Brescia, Viale Europa 11, Brescia, Italy
| | - Peter Heusler
- Innovation Unit CNS, CEPC Pierre Fabre Laboratories, Bel Air de Campans, 81106, Castres, France
| | - Ludovic Leriche
- Innovation Unit CNS, CEPC Pierre Fabre Laboratories, Bel Air de Campans, 81106, Castres, France
| | - Florence Gaudoux
- Innovation Unit CNS, CEPC Pierre Fabre Laboratories, Bel Air de Campans, 81106, Castres, France
| | - Pierre Sokoloff
- Innovation Unit CNS, CEPC Pierre Fabre Laboratories, Bel Air de Campans, 81106, Castres, France
| | - Paul C Moser
- Innovation Unit CNS, CEPC Pierre Fabre Laboratories, Bel Air de Campans, 81106, Castres, France
| | - Silvia Gatti-McArthur
- Innovation Unit CNS, CEPC Pierre Fabre Laboratories, Bel Air de Campans, 81106, Castres, France.
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18
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Kraguljac NV, Lahti AC. Neuroimaging as a Window Into the Pathophysiological Mechanisms of Schizophrenia. Front Psychiatry 2021; 12:613764. [PMID: 33776813 PMCID: PMC7991588 DOI: 10.3389/fpsyt.2021.613764] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 02/15/2021] [Indexed: 12/16/2022] Open
Abstract
Schizophrenia is a complex neuropsychiatric disorder with a diverse clinical phenotype that has a substantial personal and public health burden. To advance the mechanistic understanding of the illness, neuroimaging can be utilized to capture different aspects of brain pathology in vivo, including brain structural integrity deficits, functional dysconnectivity, and altered neurotransmitter systems. In this review, we consider a number of key scientific questions relevant in the context of neuroimaging studies aimed at unraveling the pathophysiology of schizophrenia and take the opportunity to reflect on our progress toward advancing the mechanistic understanding of the illness. Our data is congruent with the idea that the brain is fundamentally affected in the illness, where widespread structural gray and white matter involvement, functionally abnormal cortical and subcortical information processing, and neurometabolic dysregulation are present in patients. Importantly, certain brain circuits appear preferentially affected and subtle abnormalities are already evident in first episode psychosis patients. We also demonstrated that brain circuitry alterations are clinically relevant by showing that these pathological signatures can be leveraged for predicting subsequent response to antipsychotic treatment. Interestingly, dopamine D2 receptor blockers alleviate neural abnormalities to some extent. Taken together, it is highly unlikely that the pathogenesis of schizophrenia is uniform, it is more plausible that there may be multiple different etiologies that converge to the behavioral phenotype of schizophrenia. Our data underscore that mechanistically oriented neuroimaging studies must take non-specific factors such as antipsychotic drug exposure or illness chronicity into consideration when interpreting disease signatures, as a clear characterization of primary pathophysiological processes is an imperative prerequisite for rational drug development and for alleviating disease burden in our patients.
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Affiliation(s)
- Nina Vanessa Kraguljac
- Neuroimaging and Translational Research Laboratory, Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Adrienne Carol Lahti
- Neuroimaging and Translational Research Laboratory, Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United States
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19
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Chen LY, Qi J, Xu HL, Lin XY, Sun YJ, Ju SQ. The Value of Serum Cell-Free DNA Levels in Patients With Schizophrenia. Front Psychiatry 2021; 12:637789. [PMID: 33859582 PMCID: PMC8042127 DOI: 10.3389/fpsyt.2021.637789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/08/2021] [Indexed: 01/05/2023] Open
Abstract
Background: Schizophrenia is a severe mental disorder, which has a major impact on the quality of life and imposes a huge burden on the family. However, the pathogenesis of schizophrenia remains unclear and there are no specific biomarkers. Therefore, we intend to explore whether cf-DNA levels are related to the occurrence and development of schizophrenia. Methods: We analyzed and compared the concentration of cf-DNA in 174 SZ patients and 100 matched healthy controls by using quantitative real-time PCR by amplifying the Alu repeats. Results: We found that cf-DNA levels in peripheral blood reliably distinguished SZ patients from healthy controls (P < 0.05). The ROC analysis also supports the above conclusion. By tracking the absolute concentration of serum cf-DNA in primary cases, we found a distinct increase before treatment with antipsychotics, which decreased progressively after treatment. Conclusions: The present work indicates that cf-DNA may improve the efficiency of disease diagnosis, and the level of cf-DNA plays a predictive role in the development of schizophrenia. By evaluating the level of cf-DNA, we might play a certain role in a more reasonable and standardized clinical treatment of schizophrenia.
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Affiliation(s)
- Ling-Yun Chen
- Center of Laboratory Medicine, Nantong Mental Health Center, Nantong, China
| | - Jing Qi
- Reaserch Center of Clinical Medicine, Affiliated Hospital of Nantong University, Nantong, China
| | - Hong-Lei Xu
- Neurology Laboratory, Affiliated Hospital of Nantong University, Nantong, China
| | - Xiang-Yun Lin
- School of Public Health, Nantong University, Nantong, China
| | - Ya-Jun Sun
- Center of Laboratory Medicine, Nantong Mental Health Center, Nantong, China
| | - Shao-Qing Ju
- Center of Laboratory Medicine, Affiliated Hospital of Nantong University, Nantong, China
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20
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Gurler D, White DM, Kraguljac NV, Ver Hoef L, Martin C, Tennant B, Lahti AC. Neural Signatures of Memory Encoding in Schizophrenia Are Modulated by Antipsychotic Treatment. Neuropsychobiology 2021; 80:12-24. [PMID: 32316023 PMCID: PMC7874518 DOI: 10.1159/000506402] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 02/07/2020] [Indexed: 12/17/2022]
Abstract
There is no pharmacological treatment to remediate cognitive impairment in schizophrenia (SZ). It is imperative to characterize underlying pathologies of memory processing in order to effectively develop new treatments. In this longitudinal study, we combined functional magnetic resonance imaging during a memory encoding task with proton MR spectroscopy to measure hippocampal glutamate + glutamine (Glx). Seventeen SZ were scanned while unmedicated and after 6 weeks of treatment with risperidone and compared to a group of matched healthy controls (HC) scanned 6 weeks apart. Unmedicated patients showed reduced blood oxygen level dependent (BOLD) response in several regions, including the hippocampus, and greater BOLD response in regions of the default mode network (DMN) during correct memory encoding. Post hoc contrasts from significant group by time interactions indicated reduced hippocampal BOLD response at baseline with subsequent increase following treatment. Hippocampal Glx was not different between groups at baseline, but at week 6, hippocampal Glx was significantly lower in SZ compared to HC. Finally, in unmedicated SZ, higher hippocampal Glx predicted less deactivation of the BOLD response in regions of the DMN. Using 2 brain imaging modalities allowed us to concurrently investigate different mechanisms involved in memory encoding dysfunction in SZ. Hippocampal pathology during memory encoding stems from decreased hippocampal recruitment and faulty deactivation of the DMN, and hippocampal recruitment during encoding can be modulated by antipsychotic treatment. High Glx in unmedicated patients predicted less deactivation of the DMN; these results suggest a mechanism by which faulty DMN deactivation, a hallmark of pathological findings in SZ, is achieved.
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Affiliation(s)
- Demet Gurler
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham
| | - David Matthew White
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham
| | - Nina Vanessa Kraguljac
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham
| | | | - Clinton Martin
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham
| | - Blake Tennant
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham
| | - Adrienne Carol Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama, USA,
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21
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Park SC, Kim GM, Kato TA, Chong MY, Lin SK, Yang SY, Avasthi A, Grover S, Kallivayalil RA, Xiang YT, Chee KY, Tanra AJ, Tan CH, Sim K, Sartorius N, Shinfuku N, Park YC, Inada T. Dyskinesia is most centrally situated in an estimated network of extrapyramidal syndrome in Asian patients with schizophrenia: findings from research on Asian psychotropic prescription patterns for antipsychotics. Nord J Psychiatry 2021; 75:9-17. [PMID: 32580668 DOI: 10.1080/08039488.2020.1777462] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Network analysis provides a new viewpoint that explicates intertwined and interrelated symptoms into dynamic causal architectures of symptom clusters. This is a process called 'symptomics' and is concurrently applied to various areas of symptomatology. AIMS Using the data from Research on Asian Psychotropic Prescription Patterns for Antipsychotics (REAP-AP), we aimed to estimate a network model of extrapyramidal syndrome in patients with schizophrenia. METHODS Using data from REAP-AP, extrapyramidal symptoms of 1046 Asian patients with schizophrenia were evaluated using the nine items of the Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS). The estimated network of the ordered-categorical DIEPSS items consisted of nodes (symptoms) and edges (interconnections). A community detection algorithm was also used to identify distinctive symptom clusters, and correlation stability coefficients were used to evaluate the centrality stability. RESULTS An interpretable level of node strength centrality was ensured with a correlation coefficient. An estimated network of extrapyramidal syndrome showed that 26 (72.2%) of all possible 35 edges were estimated to be greater than zero. Dyskinesia was most centrally situated within the estimated network. In addition, earlier antipsychotic-induced extrapyramidal symptoms were divided into three distinctive clusters - extrapyramidal syndrome without parkinsonism, postural instability and gait difficulty-dominant parkinsonism, and tremor-dominant parkinsonism. CONCLUSIONS Our findings showed that dyskinesia is the most central domain in an estimated network structure of extrapyramidal syndrome in Asian patients with schizophrenia. These findings are consistent with the speculation that acute dystonia, akathisia, and parkinsonism could be the risk factors of tardive dyskinesia.
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Affiliation(s)
- Seon-Cheol Park
- Department of Psychiatry, Inje University Haeundae Paik Hospital, Busan, Republic of Korea
| | - Gyung-Mee Kim
- Department of Psychiatry, Inje University Haeundae Paik Hospital, Busan, Republic of Korea
| | - Takahiro A Kato
- Department of Neuropsychiatry, Graduate School of Medicine, Kyushu University, Fukuoka, Japan
| | - Mian-Yoon Chong
- Chang Gung Memorial Hospital, Chiayi, Taiwan.,School of Medicine, Chang Gung University, Kwei-Shan, Taiwan
| | - Shih-Ku Lin
- Department of Psychiatry, Taipei City Hospital, Songde Branch, Taipei, Taiwan
| | - Shu-Yu Yang
- Department of Pharmacy, Tapei City Hospital, Songde Branch, Tapei, Taiwan
| | - Ajit Avasthi
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | | | - Yu-Tao Xiang
- Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China
| | - Kok Yoon Chee
- Tunku Abdul Rahman Institute of Neuroscience, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | | | - Chay Hoon Tan
- Department of Pharmacology, National University Hospital, Singapore, Singapore
| | - Kang Sim
- West Region, Institute of Mental Health and Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
| | - Naotaka Shinfuku
- Department of Social Welfare, School of Human Sciences, Seinan Gakuin University, Fukuoka, Japan
| | - Yong Chon Park
- Department of Neuropsychiatry, Hanyang University Guri Hospital, Guri, Republic of Korea
| | - Toshiya Inada
- Department of Psychiatry and Psychobiology, Nagoya University, Graduate School of Medicine, Nagoya, Japan
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22
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Dietrich-Muszalska A, Kolodziejczyk-Czepas J, Nowak P. Comparative Study of the Effects of Atypical Antipsychotic Drugs on Plasma and Urine Biomarkers of Oxidative Stress in Schizophrenic Patients. Neuropsychiatr Dis Treat 2021; 17:555-565. [PMID: 33628026 PMCID: PMC7898201 DOI: 10.2147/ndt.s283395] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/20/2021] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Evidence that antipsychotic drugs (ADs) can affect oxidative stress estimated with various biomarkers in schizophrenic patients is controversial and limited. Therefore, in the present study, we assessed the ability of six atypical ADs (clozapine, olanzapine, quetiapine, risperidone, aripiprazole, and ziprasidone) used in schizophrenia treatment to modulate oxidative damage to different biomolecules such as lipids and proteins. PATIENTS AND METHODS We measured the levels of oxidative stress markers in plasma and urine: total antioxidant capacity by FRAP (according to a modified method of Benzie & Strain), thiobarbituric acid reactive species - TBARS (spectrophotometric method), 4-hydroxy-2-nonenal (4-HNE) (OxiSelect™ HNE Adduct Competitive ELISA Kit), 3-nitrotyrosine (3-NT) (OxiSelect™ Nitrotyrosine ELISA Kit) in plasma, and F2-isoprostanes (BIOXYTECH® Urinary 8-epi-Prostaglandin F2α) in the urine of 60 schizophrenic patients (before and after treatment) and in 30 healthy subjects. RESULTS Our results showed that in schizophrenic patients levels of lipid peroxidation markers (TBARS, F2-isoprostanes) were higher than in healthy subjects but FRAP in schizophrenic patients was lower than in healthy controls and increased after 4-week treatment with tested ADs. A 4-week treatment with ADs caused the improvement of psychopathology symptoms estimated by Positive and Negative Syndrome Scale (PANSS) that was accompanied by decreased lipid peroxidation (F2-isoprostanes, TBARS; p=2.9x10-6, p=7.6x10-5, respectively) and an increase in total antioxidative capacity (FRAP) (p=5.16x10-16). CONCLUSION Atypical antipsychotics especially clozapine, olanzapine and quetiapine demonstrate the effective outcome of antipsychotic treatment, beneficial antioxidative action by reducing lipid peroxidation and increased total plasma antioxidant activity.
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Affiliation(s)
- Anna Dietrich-Muszalska
- Medical University of Lodz, Department of Biological Psychiatry and Neurophysiology, Lodz, Poland
| | | | - Pawel Nowak
- University of Lodz, Department of General Biochemistry, Lodz, Poland
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23
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Toneatti R, Shin JM, Shah UH, Mayer CR, Saunders JM, Fribourg M, Arsenovic PT, Janssen WG, Sealfon SC, López-Giménez JF, Benson DL, Conway DE, González-Maeso J. Interclass GPCR heteromerization affects localization and trafficking. Sci Signal 2020; 13:eaaw3122. [PMID: 33082287 PMCID: PMC7717648 DOI: 10.1126/scisignal.aaw3122] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Membrane trafficking processes regulate G protein-coupled receptor (GPCR) activity. Although class A GPCRs are capable of activating G proteins in a monomeric form, they can also potentially assemble into functional GPCR heteromers. Here, we showed that the class A serotonin 5-HT2A receptors (5-HT2ARs) affected the localization and trafficking of class C metabotropic glutamate receptor 2 (mGluR2) through a mechanism that required their assembly as heteromers in mammalian cells. In the absence of agonists, 5-HT2AR was primarily localized within intracellular compartments, and coexpression of 5-HT2AR with mGluR2 increased the intracellular distribution of the otherwise plasma membrane-localized mGluR2. Agonists for either 5-HT2AR or mGluR2 differentially affected trafficking through Rab5-positive endosomes in cells expressing each component of the 5-HT2AR-mGluR2 heterocomplex alone, or together. In addition, overnight pharmacological 5-HT2AR blockade with clozapine, but not with M100907, decreased mGluR2 density through a mechanism that involved heteromerization between 5-HT2AR and mGluR2. Using TAT-tagged peptides and chimeric constructs that are unable to form the interclass 5-HT2AR-mGluR2 complex, we demonstrated that heteromerization was necessary for the 5-HT2AR-dependent effects on mGluR2 subcellular distribution. The expression of 5-HT2AR also augmented intracellular localization of mGluR2 in mouse frontal cortex pyramidal neurons. Together, our data suggest that GPCR heteromerization may itself represent a mechanism of receptor trafficking and sorting.
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MESH Headings
- Amino Acids/pharmacology
- Animals
- Bridged Bicyclo Compounds, Heterocyclic/pharmacology
- Cell Membrane/metabolism
- Clozapine/pharmacology
- Endosomes/metabolism
- HEK293 Cells
- Humans
- Mice, 129 Strain
- Mice, Knockout
- Microscopy, Confocal
- Multiprotein Complexes/chemistry
- Multiprotein Complexes/metabolism
- Protein Multimerization
- Protein Transport/drug effects
- Receptor, Serotonin, 5-HT2A/chemistry
- Receptor, Serotonin, 5-HT2A/genetics
- Receptor, Serotonin, 5-HT2A/metabolism
- Receptors, Metabotropic Glutamate/chemistry
- Receptors, Metabotropic Glutamate/genetics
- Receptors, Metabotropic Glutamate/metabolism
- Serotonin Antagonists/pharmacology
- Signal Transduction
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Affiliation(s)
- Rudy Toneatti
- Department of Physiology and Biophysics, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Jong M Shin
- Department of Physiology and Biophysics, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Urjita H Shah
- Department of Physiology and Biophysics, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Carl R Mayer
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA 23220, USA
| | - Justin M Saunders
- Department of Physiology and Biophysics, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Miguel Fribourg
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Translational Transplant Research Center, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Paul T Arsenovic
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA 23220, USA
| | - William G Janssen
- Department Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Stuart C Sealfon
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Juan F López-Giménez
- Department of Physiology and Biophysics, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA
- Instituto de Parasitología y Biomedicina "López-Neyra", CSIC, E-18016 Granada, Spain
| | - Deanna L Benson
- Department Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Daniel E Conway
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA 23220, USA
| | - Javier González-Maeso
- Department of Physiology and Biophysics, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA.
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24
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Nelson EA, Kraguljac NV, White DM, Jindal RD, Shin AL, Lahti AC. A Prospective Longitudinal Investigation of Cortical Thickness and Gyrification in Schizophrenia. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2020; 65:381-391. [PMID: 32022594 PMCID: PMC7265602 DOI: 10.1177/0706743720904598] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Cortical thickness (CT) and gyrification are complementary indices that assess different aspects of gray matter structural integrity. Both neurodevelopment insults and acute tissue response to antipsychotic medication could underlie the known heterogeneity of treatment response and are well-suited for interrogation into the relationship between gray matter morphometry and clinical outcomes in schizophrenia (SZ). METHODS Using a prospective design, we enrolled 34 unmedicated patients with SZ and 23 healthy controls. Patients were scanned at baseline and after a 6-week trial with risperidone. CT and local gyrification index (LGI) values were quantified from structural MRI scans using FreeSurfer 5.3. RESULTS We found reduced CT and LGI in patients compared to controls. Vertex-wise analyses demonstrated that hypogyrification was most prominent in the inferior frontal cortex, temporal cortex, insula, pre/postcentral gyri, temporoparietal junction, and the supramarginal gyrus. Baseline CT was predictive of subsequent response to antipsychotic treatment, and increase in CT after 6 weeks was correlated with greater symptom reductions. CONCLUSIONS In summary, we report evidence of reduced CT and LGI in unmedicated patients compared to controls, suggesting involvement of different aspects of gray matter morphometry in the pathophysiology of SZ. Importantly, we found that lower CT at baseline and greater increase of CT following 6 weeks of treatment with risperidone were associated with better clinical response. Our results suggest that cortical thinning may normalize as a result of a good response to antipsychotic medication, possibly by alleviating potential neurotoxic processes underlying gray matter deterioration.
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Affiliation(s)
- Eric A. Nelson
- Department of Psychology, University of Alabama at Birmingham, AL, USA
| | - Nina V. Kraguljac
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, AL, USA
| | - David M. White
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, AL, USA
| | - Ripu D. Jindal
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, AL, USA
- Birmingham Veteran Affairs Medical Center, AL, USA
| | - Ah L. Shin
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, AL, USA
| | - Adrienne C. Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, AL, USA
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25
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Chang CH, Lin CH, Liu CY, Chen SJ, Lane HY. Efficacy and cognitive effect of sarcosine (N-methylglycine) in patients with schizophrenia: A systematic review and meta-analysis of double-blind randomised controlled trials. J Psychopharmacol 2020; 34:495-505. [PMID: 32122256 DOI: 10.1177/0269881120908016] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Sarcosine (N-methylglycine), a type 1 glycine transporter inhibitor (GlyT1), has shown therapeutic potential for treating schizophrenia; however, studies have reported conflicting results. This meta-analysis aimed to explore the efficacy and cognitive effect of sarcosine for schizophrenia. METHODS In this study, PubMed, Cochrane Systematic Reviews, and Cochrane Collaboration Central Register of Controlled Clinical Trials were searched electronically for double-blinded randomised controlled trials that used sarcosine for treating schizophrenia. We used the published trials up to November 2019 to investigate the efficacy of sarcosine in schizophrenia. We pooled studies by using a random-effect model for comparing sarcosine treatment effects. Patients who were diagnosed with schizophrenia according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition were recruited. Clinical improvement and cognitive function scores between baseline and after sarcosine use were compared using the standardised mean difference (SMD) with 95% confidence intervals (CIs). The heterogeneity of the included trials was evaluated through visual inspection of funnel plots and through the I2 statistic. RESULTS We identified seven trials with 326 participants with schizophrenia meeting the inclusion criteria. All these studies evaluated the overall clinical symptoms, and four of them evaluated overall cognitive functions. Sarcosine use achieved more significant effects than the use of its comparators in relieving overall clinical symptoms (SMD = 0.51, CI = 0.26-0.76, p < 0.01). Moreover, studies with the low Positive and Negative Syndrome Scale range of 70-79 showed significant effect size (ES)s of 0.67 (95% CI: 0.03-1.31, p = 0.04). In addition, trials enrolling patients with stable clinical symptoms had significant ESs: 0.53 (95% CI: 0.21-0.85, p < 0.01). Add-on sarcosine combined with first- and second-generation antipsychotics, except clozapine, had a positive effect. For overall cognitive functions, sarcosine showed a positive but insignificant effect compared with its comparators (SMD = 0.27, CI = -0.06 to 0.60, p = 0.10). The effects were correlated with increased female proportions and decreased illness duration, albeit nonsignificantly. CONCLUSIONS The meta-analysis suggests that sarcosine may be associated with treatment effect on overall clinical symptoms in patients with schizophrenia but not cognitive functions.
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Affiliation(s)
- Chun-Hung Chang
- Institute of Clinical Medical Science, China Medical University, Taichung.,Department of Psychiatry & Brain Disease Research Center, China Medical University Hospital, Taichung.,An Nan Hospital, China Medical University, Tainan
| | - Chieh-Hsin Lin
- Institute of Clinical Medical Science, China Medical University, Taichung.,Graduate Institute of Biomedical Sciences, China Medical University, Taichung.,Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung
| | - Chieh-Yu Liu
- Department of Speech Language Pathology and Audiology, Biostatistical Consulting Lab, National Taipei University of Nursing and Health Sciences, Taipei
| | - Shaw-Ji Chen
- Department of Psychiatry, Mackay Memorial Hospital Taitung Branch, Taitung.,Department of Medicine, Mackay Medical College, New Taipei
| | - Hsien-Yuan Lane
- Institute of Clinical Medical Science, China Medical University, Taichung.,Department of Psychiatry & Brain Disease Research Center, China Medical University Hospital, Taichung.,Graduate Institute of Biomedical Sciences, China Medical University, Taichung.,Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung
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26
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Les antipsychotiques. ACTUALITES PHARMACEUTIQUES 2020. [DOI: 10.1016/j.actpha.2019.12.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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27
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Activation of Astroglial Connexin is Involved in Concentration-Dependent Double-Edged Sword Clinical Action of Clozapine. Cells 2020; 9:cells9020414. [PMID: 32054069 PMCID: PMC7072131 DOI: 10.3390/cells9020414] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 02/08/2020] [Accepted: 02/10/2020] [Indexed: 01/07/2023] Open
Abstract
Clozapine (CLZ) is a gold-standard antipsychotic against treatment-refractory schizophrenia, but is one of the most toxic antipsychotic agents. Pharmacological mechanisms of the double-edged sword clinical action of CLZ remain to be clarified. To explore the mechanisms of CLZ, the present study determined the astroglial transmission associated with connexin43 (Cx43), which is the most principal expression in astrocytes and myocardial cells, and expression of Cx43 in primary cultured astrocytes. Both acute and subchronic administrations of CLZ concentration-dependently increased Cx43-associated astroglial release of l-glutamate and d-serine, whereas therapeutic-relevant concentration of CLZ acutely did not affect but subchronically increased astroglial release. In contrast, after the subchronic administration of therapeutic-relevant concentration of valproate (VPA), acute administration of therapeutic-relevant concentration of CLZ drastically increased Cx43-associated astroglial releases. VPA increased Cx43 expression in cytosol fraction without affecting plasma membrane fraction, whereas CLZ increased Cx43 expression in both fractions. Acute administration of therapeutic-relevant concentration of CLZ drastically increased Cx43 expression in the plasma membrane fraction of astrocytes subchronically treated with VPA. The present findings suggest that CLZ-induced the activation of Cx43-associated channel activity and transported Cx43 to plasma membrane, probably contribute to the double-edged sword clinical action of CLZ, such as improvement of cognitive dysfunction and CLZ-induced myocarditis.
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A dopaminergic mechanism of antipsychotic drug efficacy, failure, and failure reversal: the role of the dopamine transporter. Mol Psychiatry 2020; 25:2101-2118. [PMID: 30038229 PMCID: PMC7473845 DOI: 10.1038/s41380-018-0114-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 04/30/2018] [Accepted: 05/25/2018] [Indexed: 12/21/2022]
Abstract
Antipsychotic drugs are effective interventions in schizophrenia. However, the efficacy of these agents often decreases over time, which leads to treatment failure and symptom recurrence. We report that antipsychotic efficacy in rat models declines in concert with extracellular striatal dopamine levels rather than insufficient dopamine D2 receptor occupancy. Antipsychotic efficacy was associated with a suppression of dopamine transporter activity, which was reversed during failure. Antipsychotic failure coincided with reduced dopamine neuron firing, which was not observed during antipsychotic efficacy. Synaptic field responses in dopamine target areas declined during antipsychotic efficacy and showed potentiation during failure. Antipsychotics blocked synaptic vesicle release during efficacy but enhanced this release during failure. We found that the pharmacological inhibition of the dopamine transporter rescued antipsychotic drug treatment outcomes, supporting the hypothesis that the dopamine transporter is a main target of antipsychotic drugs and predicting that dopamine transporter blockers may be an adjunct treatment to reverse antipsychotic treatment failure.
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Liu D, An Z, Li P, Chen Y, Zhang R, Liu L, He J, Abliz Z. A targeted neurotransmitter quantification and nontargeted metabolic profiling method for pharmacometabolomics analysis of olanzapine by using UPLC-HRMS. RSC Adv 2020; 10:18305-18314. [PMID: 35517196 PMCID: PMC9053711 DOI: 10.1039/d0ra02406f] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 04/21/2020] [Indexed: 12/22/2022] Open
Abstract
Neurotransmitters (NTs) are specific endogenous metabolites that act as “messengers” in synaptic transmission and are widely distributed in the central nervous system. Olanzapine (OLZ), a first-line antipsychotic drug, plays a key role in sedation and hypnosis, but, it presents clinical problems with a narrow therapeutic window, large individual differences and serious adverse effects, as well as an unclear mechanism in vivo. Herein, a simultaneous targeted NT quantification and nontargeted metabolomics method was developed and validated for pharmacometabolomics analysis of OLZ by using ultra-high-performance liquid chromatography coupled with high-resolution mass spectrometry (UPLC-HRMS). Considering the low physiological concentrations of NTs, a full MS scan and target selective ion monitoring (tSIM) scan were combined for nontargeted metabolomics and targeted NT quantification, respectively. By using this strategy, NTs at a very low physiological concentration can be accurately detected and quantified in biological samples by tSIM scans. Moreover, simultaneously nontargeted profiling was also achieved by the full MS scan. The newly established UPLC-HRMS method was further used for the pharmacometabolomics study of OLZ. Statistical analysis revealed that tryptophan, 5-hydroxytryptophan, 5-hydroxytryptamine, γ-aminobutyric acid etc. were significantly downregulated, while tyrosine was significantly upregulated, which suggested that OLZ could promote the downstream phase II reaction of 5-hydroxytryptamine, inhibit tyrosine hydroxylase activity, and increase the activity of γ-aminobutyric acid transaminase. In conclusion, this method could provide novel insights for revealing the pharmacodynamic effect and mechanism of antipsychotic drugs. We developed a method that would provide novel insights for revealing the pharmacodynamic effect and mechanism of antipsychotic drugs (olanzapine).![]()
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Affiliation(s)
- Dan Liu
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines
- Institute of Materia Medica
- Chinese Academy of Medical Sciences
- Peking Union Medical College
- Beijing 100050
| | - Zhuoling An
- Pharmacy Department of Beijing Chao-Yang Hospital
- Capital Medical University
- Beijing 100020
- P. R. China
| | - Pengfei Li
- Pharmacy Department of Beijing Chao-Yang Hospital
- Capital Medical University
- Beijing 100020
- P. R. China
| | - Yanhua Chen
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines
- Institute of Materia Medica
- Chinese Academy of Medical Sciences
- Peking Union Medical College
- Beijing 100050
| | - Ruiping Zhang
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines
- Institute of Materia Medica
- Chinese Academy of Medical Sciences
- Peking Union Medical College
- Beijing 100050
| | - Lihong Liu
- Pharmacy Department of Beijing Chao-Yang Hospital
- Capital Medical University
- Beijing 100020
- P. R. China
| | - Jiuming He
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines
- Institute of Materia Medica
- Chinese Academy of Medical Sciences
- Peking Union Medical College
- Beijing 100050
| | - Zeper Abliz
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines
- Institute of Materia Medica
- Chinese Academy of Medical Sciences
- Peking Union Medical College
- Beijing 100050
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Suzuki M, Niidome K, Maeda K, Kikuchi T, Usami T, Futamura T. [Preclinical pharmacological profiles and clinical efficacy of the novel antipsychotic drug brexpiprazole (REXULTI ® Tablets 1 mg, 2 mg)]. Nihon Yakurigaku Zasshi 2019; 154:275-287. [PMID: 31735758 DOI: 10.1254/fpj.154.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Brexpiprazole (Rexulti®) is the second antipsychotic agent in the world with dopamine D2 receptor partial agonist which was developed by Otsuka Pharmaceutical Co. Ltd. It is categorized as 〝Serotonin- dopamine Activity Modulator (SDAM)〟 that regulates both serotoninergic and dopaminergic systems by acting as a partial agonist for serotonin 5-HT1A receptors and D2 receptors and as an antagonist for 5-HT2A receptors. In preclinical pharmacological studies, brexpiprazole showed the equivalent antipsychotic-like effects to those of other atypical antipsychotics. And it was suggested that brexpiprazole has the low potentials to induce extrapyramidal symptoms, hyperprolactinemia and tardive dyskinesia, with improvement effects on cognitive dysfunction. Furthermore, brexpiprazole has the weak effects on histamine H1 receptors which are associated with sedation and weight gain in clinical. In the clinical trials in patients with schizophrenia in both acute and maintenance phase, brexpiprazole showed improvement of antipsychotic effects against placebo, and low incidence of adverse events, e.g., extrapyramidal symptoms, hyperprolactinemia, and weight gain, as suggested in preclinical studies. Furthermore, brexpiprazole showed low incidence of metabolic abnormalities. In particular, brexpiprazole showed relatively low incidences of akathisia, insomnia and agitation which has been commonly reported with aripiprazole. This would be based on the pharmacological features of brexpiprazole that is more potent antagonism at 5-HT2A receptors and D2 receptors partial agonism with lower intrinsic activity compared to those of aripiprazole. In conclusion, brexpiprazole could be one of the antipsychotics with the most rational mechanism of action, and the better efficacy and safety/tolerability profiles would contribute to the treatment of patients with schizophrenia.
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Affiliation(s)
- Mikio Suzuki
- Department of CNS Research, Otsuka Pharmaceutical Co. Ltd
| | | | - Kenji Maeda
- Department of Lead Discovery Research, Otsuka Pharmaceutical Co. Ltd
| | - Tetsuro Kikuchi
- Pharmaceutical Business Division, Otsuka Pharmaceutical Co. Ltd
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Okada M, Fukuyama K, Okubo R, Shiroyama T, Ueda Y. Lurasidone Sub-Chronically Activates Serotonergic Transmission via Desensitization of 5-HT1A and 5-HT7 Receptors in Dorsal Raphe Nucleus. Pharmaceuticals (Basel) 2019; 12:ph12040149. [PMID: 31590422 PMCID: PMC6958501 DOI: 10.3390/ph12040149] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 09/20/2019] [Accepted: 10/04/2019] [Indexed: 02/06/2023] Open
Abstract
Lurasidone is an atypical mood-stabilizing antipsychotic agent with unique receptor-binding profile, including 5-HT7 receptor (5-HT7R) antagonism. Effects of 5-HT7R antagonism on transmitter systems of schizophrenia and mood disorders, however, have not been well clarified. Thus, this study examined the mechanisms underlying the clinical effects of lurasidone by measuring mesocortical serotonergic transmission. Following systemic and local administrations of lurasidone, MK801 and 5-HT receptor modulators, we determined releases of 5-HT in dorsal raphe nucleus (DRN), mediodorsal thalamic nucleus (MDTN) and medial prefrontal cortex (mPFC) and γ-aminobutyric acid (GABA) in DRN using multiprobe microdialysis with ultra-high-performance liquid chromatography (UHPLC). Serotonergic and GABAergic neurons in the DRN are predominantly regulated by inhibitory 5-HT1A receptor (5-HT1AR) and excitatory 5-HT7R, respectively. Lurasidone acutely generates GABAergic disinhibition by 5-HT7R antagonism, but concomitant its 5-HT1AR agonism prevents serotonergic hyperactivation induced by 5-HT7R inhibition. During treatments with 5-HT1AR antagonist in DRN, lurasidone dose-dependently increased 5-HT release in the DRN, MDTN and mPFC. Contrary, lurasidone chronically enhanced serotonergic transmission and GABAergic disinhibition in the DRN by desensitizing both 5-HT1AR and 5-HT7R. These effects of lurasidone acutely prevented MK801-evoked 5-HT release by GABAergic disinhibition via N-methyl-D-aspartate (NMDA)/glutamate receptor (NMDA-R)-mediated inhibition of 5-HT1AR function, but enhanced MK801-induced 5-HT release by desensitizing 5-HT1AR and 5-HT7R. These results indicate that acutely lurasidone fails to affect 5-HT release, but chronically enhances serotonergic transmission by desensitizing both 5-HT1AR and 5-HT7R. These unique properties of lurasidone ameliorate the dysfunctions of NMDA-R and augment antidepressive effects.
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Affiliation(s)
- Motohiro Okada
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan.
| | - Kouji Fukuyama
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan.
| | - Ruri Okubo
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan.
| | - Takashi Shiroyama
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan.
| | - Yuto Ueda
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan.
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Okada M, Fukuyama K, Ueda Y. Lurasidone inhibits NMDA receptor antagonist-induced functional abnormality of thalamocortical glutamatergic transmission via 5-HT 7 receptor blockade. Br J Pharmacol 2019; 176:4002-4018. [PMID: 31347694 PMCID: PMC6811777 DOI: 10.1111/bph.14804] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 05/22/2019] [Accepted: 07/09/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND AND PURPOSE Lurasidone is an atypical mood-stabilizing antipsychotic with a unique receptor-binding profile, including 5-HT7 receptor antagonism; however, the detailed effects of 5-HT7 receptor antagonism on various transmitter systems relevant to schizophrenia, particularly the thalamo-insular glutamatergic system and the underlying mechanisms, are yet to be clarified. EXPERIMENTAL APPROACH We examined the mechanisms underlying the clinical effects of lurasidone by measuring the release of l-glutamate, GABA, dopamine, and noradrenaline in the reticular thalamic nucleus (RTN), mediodorsal thalamic nucleus (MDTN) and insula of freely moving rats in response to systemic injection or local infusion of lurasidone or MK-801 using multiprobe microdialysis with ultra-HPLC. KEY RESULTS Systemic MK-801 (0.5 mg·kg-1 ) administration increased insular release of l-glutamate, dopamine, and noradrenaline but decreased GABA release. Systemic lurasidone (1 mg·kg-1 ) administration also increased insular release of l-glutamate, dopamine, and noradrenaline but without affecting GABA. Local lurasidone administration into the insula (3 μM) did not affect MK-801-induced insular release of l-glutamate or catecholamine, whereas local lurasidone administration into the MDTN (1 μM) inhibited MK-801-induced insular release of l-glutamate and catecholamine, similar to the 5-HT7 receptor antagonist SB269970. CONCLUSIONS AND IMPLICATIONS The present results indicate that MK-801-induced insular l-glutamate release is generated by activation of thalamo-insular glutamatergic transmission via MDTN GABAergic disinhibition resulting from NMDA receptor inhibition in the MDTN and RTN. Lurasidone inhibited this MK-801-evoked insular l-glutamate release through inhibition of excitatory 5-HT7 receptor in the MDTN. These effects on thalamo-insular glutamatergic transmission may contribute to the antipsychotic and mood-stabilizing actions of lurasidone.
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Affiliation(s)
- Motohiro Okada
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of MedicineMie UniversityTsuJapan
| | - Kouji Fukuyama
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of MedicineMie UniversityTsuJapan
| | - Yuto Ueda
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of MedicineMie UniversityTsuJapan
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Fukuyama K, Kato R, Murata M, Shiroyama T, Okada M. Clozapine Normalizes a Glutamatergic Transmission Abnormality Induced by an Impaired NMDA Receptor in the Thalamocortical Pathway via the Activation of a Group III Metabotropic Glutamate Receptor. Biomolecules 2019; 9:biom9060234. [PMID: 31213006 PMCID: PMC6628267 DOI: 10.3390/biom9060234] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 06/12/2019] [Accepted: 06/12/2019] [Indexed: 12/14/2022] Open
Abstract
Pharmacological mechanisms of gold-standard antipsychotics against treatment-refractory schizophrenia, such as clozapine (CLZ), remain unclear. We aimed to explore the mechanisms of CLZ by investigating the effects of MK801 and CLZ on tripartite synaptic transmission in the thalamocortical glutamatergic pathway using multi-probe microdialysis and primary cultured astrocytes. l-glutamate release in the medial prefrontal cortex (mPFC) was unaffected by local MK801 administration into mPFC but was enhanced in the mediodorsal thalamic nucleus (MDTN) and reticular thalamic nucleus (RTN) via GABAergic disinhibition in the RTN–MDTN pathway. The local administration of therapeutically relevant concentrations of CLZ into mPFC and MDTN increased and did not affect mPFC l-glutamate release. The local administration of the therapeutically relevant concentration of CLZ into mPFC reduced MK801-induced mPFC l-glutamate release via presynaptic group III metabotropic glutamate receptor (III-mGluR) activation. However, toxic concentrations of CLZ activated l-glutamate release associated with hemichannels. This study demonstrated that RTN is a candidate generator region in which impaired N-methyl-d-aspartate (NMDA)/glutamate receptors likely produce thalamocortical hyperglutamatergic transmission. Additionally, we identified several mechanisms of CLZ relating to its superiority in treatment-resistant schizophrenia and its severe adverse effects: (1) the prevention of thalamocortical hyperglutamatergic transmission via activation of mPFC presynaptic III-mGluR and (2) activation of astroglial l-glutamate release associated with hemichannels. These actions may contribute to the unique clinical profile of CLZ.
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Affiliation(s)
- Kouji Fukuyama
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan.
| | - Ryo Kato
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan.
| | - Masahiko Murata
- National Hospital Organization Sakakibara Hospital, 777 Sakakibara, Tsu, Mie 514-1292, Japan.
| | - Takashi Shiroyama
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan.
| | - Motohiro Okada
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan.
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Aripiprazole and haloperidol protect neurite lesions via reducing excessive D2R-DISC1 complex formation. Prog Neuropsychopharmacol Biol Psychiatry 2019; 92:59-69. [PMID: 30597182 DOI: 10.1016/j.pnpbp.2018.12.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 12/11/2018] [Accepted: 12/14/2018] [Indexed: 12/15/2022]
Abstract
Dopamine D2 receptor (D2R) hyperactivity causes altered brain development and later produces onset of symptoms mimicking schizophrenia. It is known that D2R interacts with disrupted in schizophrenia 1 (DISC1); however, the effect of D2R-DISC1 interaction in intracellular signalling and neurite growth has not been studied. This study investigated the effect of D2R over-activation on Akt-GSK3β signalling and neurite morphology in cortical neurons. Over-activation of D2Rs caused neurite lesions, which were associated with decreased protein kinase B (Akt) and glycogen synthase kinase 3 beta (GSK3β) phosphorylation in cortical neurons. The antipsychotic drug aripiprazole was more effective in the prevention of neurite lesions than haloperidol. Unlike haloperidol, aripiprazole prevented downregulation of phospho (p) Akt-pGSK3β induced by D2R hyperactivity, indicating involvement of different pathways. D2Rs were hyperactive in cortical neurons of mice with DISC1 mutation, which caused more severe neurite lesions in cortical neurons treated with quinpirole. Immunofluorescent staining for Ca2+/calmodulin-dependent protein kinase II (CaMKII) confirmed that cortical pyramidal neurons were involved in the D2R hyperactivity-induced neurite lesions. Using the fluorescence resonance energy transfer (FRET) technique, we provide direct evidence that D2R hyperactivity led to D2R-DISC1 complex formation, which altered pGSK3β signalling. This study showed that D2R hyperactivity-induced D2R-DISC1 complex formation is associated with decreased pAkt-pGSK3β signalling and in turn, caused neurite impairment. Aripiprazole and haloperidol prevented the impairment of neurite growth but appeared to do so via different intracellular signalling pathways.
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Schizophrenia and Parkinson’s disease: Selected therapeutic advances beyond the dopaminergic etiologies. ALEXANDRIA JOURNAL OF MEDICINE 2019. [DOI: 10.1016/j.ajme.2013.03.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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Okada M, Fukuyama K, Kawano Y, Shiroyama T, Ueda Y. Memantine protects thalamocortical hyper-glutamatergic transmission induced by NMDA receptor antagonism via activation of system xc<sup/>. Pharmacol Res Perspect 2019; 7:e00457. [PMID: 30631447 PMCID: PMC6323135 DOI: 10.1002/prp2.457] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 12/14/2018] [Indexed: 12/26/2022] Open
Abstract
Deficiencies in N-methyl-d-aspartate (NMDA)/glutamate receptor (NMDAR) signaling have been considered central to the cognitive impairments of schizophrenia; however, an NMDAR antagonist memantine (MEM) improves cognitive impairments of Alzheimer's disease and schizophrenia. These mechanisms of paradoxical clinical effects of NMDAR antagonists remain unclear. To explore the mechanisms by which MK801 and MEM affect thalamocortical transmission, we determined interactions between local administrations of MK801, MEM, system xc- (Sxc), and metabotropic glutamate receptors (mGluRs) on extracellular glutamate and GABA levels in the mediodorsal thalamic nucleus (MDTN) and medial prefrontal cortex (mPFC) using dual-probe microdialysis with ultra-high-pressure liquid chromatography. Effects of MK801 and MEM on Sxc activity were also determined using primary cultured astrocytes. Sxc activity was enhanced by MEM, but was unaffected by MK801. MK801 enhanced thalamocortical glutamatergic transmission by GABAergic disinhibition in the MDTN. In the MDTN and the mPFC, MEM weakly increased glutamate release by activating Sxc, whereas MEM inhibited thalamocortical glutamatergic transmission. Paradoxical effects of MEM were induced following secondary activation of inhibitory II-mGluR and III-mGluR by exporting glutamate from astroglial Sxc. The present results suggest that the effects of therapeutically relevant concentrations of MEM on thalamocortical glutamatergic transmission are predominantly caused by activation of Sxc rather than inhibition of NMDAR. These demonstrations suggest that the combination between reduced NMDAR and activated Sxc contribute to the neuroprotective effects of MEM. Furthermore, activation of Sxc may compensate for the cognitive impairments that are induced by hyperactivation of thalamocortical glutamatergic transmission following activation of Sxc/II-mGluR in the MDTN and Sxc/II-mGluR/III-mGluR in the mPFC.
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Affiliation(s)
- Motohiro Okada
- Department of NeuropsychiatryDivision of NeuroscienceGraduate School of MedicineMie UniversityTsuMieJapan
| | - Kouji Fukuyama
- Department of NeuropsychiatryDivision of NeuroscienceGraduate School of MedicineMie UniversityTsuMieJapan
| | - Yasuhiro Kawano
- Department of NeuropsychiatryDivision of NeuroscienceGraduate School of MedicineMie UniversityTsuMieJapan
| | - Takashi Shiroyama
- Department of NeuropsychiatryDivision of NeuroscienceGraduate School of MedicineMie UniversityTsuMieJapan
| | - Yuto Ueda
- Department of NeuropsychiatryDivision of NeuroscienceGraduate School of MedicineMie UniversityTsuMieJapan
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Chang CH, Lane HY, Tseng PT, Chen SJ, Liu CY, Lin CH. Effect of N-methyl-D-aspartate-receptor-enhancing agents on cognition in patients with schizophrenia: A systematic review and meta-analysis of double-blind randomised controlled trials. J Psychopharmacol 2019; 33:436-448. [PMID: 30730250 DOI: 10.1177/0269881118822157] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Multiple N-methyl-d-aspartate (NMDA)-receptor-enhancing agents have demonstrated promising effects for cognition in schizophrenia. However, the results of studies have been conflicting. This updated meta-analysis explored the effect of NMDA-receptor-enhancing agents on cognitive function. METHODS We searched PubMed, the Cochrane Collaboration Central Register of Controlled Clinical Trials and Cochrane Systematic Reviews for studies on the effect of NMDA-receptor-enhancing agents on cognitive function in patients with schizophrenia up to September 2018. Double-blind randomised placebo trials with cognition rating scales were included. We pooled studies by using a random-effect model for comparisons with add-on NMDA-receptor-enhancing agents. Cognitive function scores were compared between baseline and subsequent levels, and NMDA-receptor-positive modulators were assessed using the standardised mean difference (SMD) with 95% confidence intervals (CIs). We evaluated statistical heterogeneity through visual inspection of funnel plots and by using the I2 statistic. RESULTS We identified 25 trials with 1951 participants meeting the inclusion criteria. NMDA-receptor-enhancing agents had a small but nonsignificant effect compared with the placebo on overall cognitive function (SMD = 0.068, CI = -0.056 to 0.193, P = 0.283). We identified trials enrolling patients aged between 30 and 39 years old, which reported significant positive effects (SMD: 0.163, 95% CI: 0.016-0.310, P = 0.030). Men were associated with a smaller effect of NMDA-receptor-positive modulators on overall cognitive function. Moreover, subgroup meta-analysis of cognitive domains revealed that N-acetyl cysteine (NAC) had a significant effect on working memory ( P-value for interaction = 0.038; SMD = 0.679, CI = 0.397-0.961, P < 0.001). CONCLUSIONS Our meta-analysis revealed no significant effect of NMDA-enhancing agents on overall cognition. However, subgroup analysis suggested that NMDAR-enhancing agents may benefit young patients with schizophrenia, and NAC may have an effect on working memory. Additional trials with larger samples are suggested to evaluate these cognitive domains and ascertain the possible mechanisms.
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Affiliation(s)
- Chun-Hung Chang
- 1 Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.,2 Department of Psychiatry & Brain Disease Research Center, China Medical University Hospital, Taichung, Taiwan
| | - Hsien-Yuan Lane
- 1 Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.,2 Department of Psychiatry & Brain Disease Research Center, China Medical University Hospital, Taichung, Taiwan.,3 Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan.,4 Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
| | - Ping-Tao Tseng
- 5 Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai's Home, Kaohsiung, Taiwan.,6 WinShine Clinics in Specialty of Psychiatry, Kaohsiung, Taiwan
| | - Shaw-Ji Chen
- 7 Department of Psychiatry, Mackay Memorial Hospital Taitung Branch, Taitung, Taiwan.,8 Department of Medicine, Mackay Medical College, New Taipei, Taiwan
| | - Chieh-Yu Liu
- 9 Biostatistical Consulting Lab, Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Chieh-Hsin Lin
- 1 Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.,3 Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan.,10 Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Zhao QL, Ito H, Kondo T, Uehara T, Ikeda M, Abe H, Saitoh JI, Noguchi K, Suzuki M, Kurachi M. Antipsychotic drugs scavenge radiation-induced hydroxyl radicals and intracellular ROS formation, and protect apoptosis in human lymphoma U937 cells. Free Radic Res 2019; 53:304-312. [DOI: 10.1080/10715762.2019.1572889] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Qing-Li Zhao
- Department of Radiology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Hiroko Ito
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Takashi Kondo
- Department of Radiology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Takashi Uehara
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| | - Masayuki Ikeda
- Department of Biology, Graduate School of Science and Engineering, University of Toyama, Toyama, Japan
| | - Hitoshi Abe
- Department of Biology, Graduate School of Science and Engineering, University of Toyama, Toyama, Japan
| | - Jun-Ichi Saitoh
- Department of Radiology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Masayoshi Kurachi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
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Porter JH, Webster KA, Prus AJ. Translational Value of Drug Discrimination with Typical and Atypical Antipsychotic Drugs. Curr Top Behav Neurosci 2019; 39:193-212. [PMID: 28341945 DOI: 10.1007/7854_2017_4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This chapter focuses on the translational value of drug discrimination as a preclinical assay for drug development. In particular, the importance of two factors, i.e., training dose and species, for drug discrimination studies with the atypical antipsychotic clozapine is examined. Serotonin receptors appear to be an important pharmacological mechanism mediating clozapine's discriminative cue in both rats and mice, although differences are clearly evident as antagonism of cholinergic muscarinic receptors is important in rats at a higher training dose (5.0 mg/kg) of clozapine, but not at a lower training dose (1.25 mg/kg). Antagonism of α1 adrenoceptors is a sufficient mechanism in C57BL/6 and 129S2 mice to mimic clozapine's cue, but not in DBA/2 and B6129S mice, and only produces partial substitution in low-dose clozapine discrimination in rats. Dopamine antagonism produces partial substitution for clozapine in DBA/2, 129S2, and B6129S mice, but not in C57BL/6 mice, and partial substitution is seen with D4 antagonism in low-dose clozapine drug discrimination in rats. Thus, it is evident that clozapine has a complex mixture of receptor contributions towards its discriminative cue based on the data from the four mouse strains that have been tested that is similar to the results from rat studies. A further examination of antipsychotic stimulus properties in humans, particularly in patients with schizophrenia, would go far in evaluating the translational value of the drug discrimination paradigm for antipsychotic drugs.
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Affiliation(s)
- Joseph H Porter
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, 23284, USA.
| | - Kevin A Webster
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, 23284, USA
| | - Adam J Prus
- Department of Psychology, Northern Michigan University, Marquette, MI, USA
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Matrisciano F, Dong E, Nicoletti F, Guidotti A. Epigenetic Alterations in Prenatal Stress Mice as an Endophenotype Model for Schizophrenia: Role of Metabotropic Glutamate 2/3 Receptors. Front Mol Neurosci 2018; 11:423. [PMID: 30564095 PMCID: PMC6289213 DOI: 10.3389/fnmol.2018.00423] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 10/30/2018] [Indexed: 01/13/2023] Open
Abstract
Mice subjected to prenatal restraint stress (PRS mice) showed biochemical and behavioral abnormalities consistent with a schizophrenia-like phenotype (Matrisciano et al., 2016). PRS mice are characterized by increased DNA-methyltransferase 1 (DNMT1) and ten-eleven methylcytosine dioxygenase 1 (TET1) expression levels and exhibit an enrichment of 5-methylcytosine (5MC) and 5-hydroxymethylcytosine (5HMC) at neocortical GABAergic and glutamatergic gene promoters. Activation of group II metabotropic glutamate receptors (mGlu2 and−3 receptors) showed a potential epigenetically-induced antipsychotic activity by reversing the molecular and behavioral changes observed in PRS mice. This effect was most likely caused by the increase in the expression of growth arrest and DNA damage 45-β (Gadd45-β) protein, a molecular player of DNA demethylation, induced by the activation of mGlu2/3 receptors. This effect was mimicked by clozapine and valproate but not by haloperidol. Treatment with the selective mGlu2/3 receptors agonist LY379268 also increased the amount of Gadd45-β bound to specific promoter regions of reelin, BDNF, and GAD67. A meta-analysis of several clinical trials showed that treatment with an orthosteric mGlu2/3 receptor agonist improved both positive and negative symptoms of schizophrenia, but only in patients who were early-in-disease and had not been treated with atypical antipsychotic drugs (Kinon et al., 2015). Our findings show that PRS mice are valuable model for the study of epigenetic mechanisms involved in the pathogenesis of schizophrenia and support the hypothesis that pharmacological modulation of mGlu2/3 receptors could impact the early phase of schizophrenia and related neurodevelopmental disorders by regulating epigenetic processes that lie at the core of the disorders.
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Affiliation(s)
- Francesco Matrisciano
- Department of Psychiatry, Psychiatric Institute, College of Medicine, University of Illinois Chicago, Chicago, IL, United States
| | - Erbo Dong
- Department of Psychiatry, Center for Alcohol Research in Epigenetics College of Medicine, University of Illinois Chicago, Chicago, IL, United States
| | - Ferdinando Nicoletti
- Department of Physiology and Pharmacology, University of Rome "Sapienza", Rome, Italy.,IRCCS, Neuromed, Pozzilli, Italy
| | - Alessandro Guidotti
- Department of Psychiatry, Psychiatric Institute, College of Medicine, University of Illinois Chicago, Chicago, IL, United States.,Department of Psychiatry, Center for Alcohol Research in Epigenetics College of Medicine, University of Illinois Chicago, Chicago, IL, United States
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Fukuyama K, Hasegawa T, Okada M. Cystine/Glutamate Antiporter and Aripiprazole Compensate NMDA Antagonist-Induced Dysfunction of Thalamocortical L-Glutamatergic Transmission. Int J Mol Sci 2018; 19:ijms19113645. [PMID: 30463253 PMCID: PMC6274792 DOI: 10.3390/ijms19113645] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 11/14/2018] [Accepted: 11/15/2018] [Indexed: 01/03/2023] Open
Abstract
To explore pathophysiology of schizophrenia, this study analyzed the regulation mechanisms that are associated with cystine/glutamate antiporter (Sxc), group-II (II-mGluR), and group-III (III-mGluR) metabotropic glutamate-receptors in thalamo-cortical glutamatergic transmission of MK801-induced model using dual-probe microdialysis. L-glutamate release in medial pre-frontal cortex (mPFC) was increased by systemic- and local mediodorsal thalamic nucleus (MDTN) administrations of MK801, but was unaffected by local administration into mPFC. Perfusion into mPFC of activators of Sxc, II-mGluR, and III-mGluR, and into the MDTN of activators of Sxc, II-mGluR, and GABAA receptor inhibited MK801-evoked L-glutamate release in mPFC. Perfusion of aripiprazole (APZ) into MDTN and mPFC also inhibited systemic MK801-evoked L-glutamate release in mPFC. Inhibition of II-mGluR in mPFC and MDTN blocked inhibitory effects of Sxc-activator and APZ on MK801-evoked L-glutamate release; however, their inhibitory effects were blocked by the inhibition of III-mGluR in mPFC but not in MDTN. These results indicate that reduced activation of the glutamate/NMDA receptor (NMDAR) in MDTN enhanced L-glutamate release in mPFC possibly through GABAergic disinhibition in MDTN. Furthermore, MDTN-mPFC glutamatergic transmission receives inhibitory regulation of Sxc/II-mGluR/III-mGluR functional complex in mPFC and Sxc/II-mGluR complex in MDTN. Established antipsychotic, APZ inhibits MK801-evoked L-glutamate release through the activation of Sxc/mGluRs functional complexes in both MDTN and mPFC.
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Affiliation(s)
- Kouji Fukuyama
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan.
| | - Toshiki Hasegawa
- Department of Psychiatry, Mie University Hospital, Mie University, Tsu 514-8507, Japan.
| | - Motohiro Okada
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan.
- Department of Psychiatry, Mie University Hospital, Mie University, Tsu 514-8507, Japan.
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Hideshima KS, Hojati A, Saunders JM, On DM, de la Fuente Revenga M, Shin JM, Sánchez-González A, Dunn CM, Pais AB, Pais AC, Miles MF, Wolstenholme JT, González-Maeso J. Role of mGlu2 in the 5-HT 2A receptor-dependent antipsychotic activity of clozapine in mice. Psychopharmacology (Berl) 2018; 235:3149-3165. [PMID: 30209534 PMCID: PMC6408231 DOI: 10.1007/s00213-018-5015-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 08/29/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Serotonin 5-HT2A and metabotropic glutamate 2 (mGlu2) are neurotransmitter G protein-coupled receptors (GPCRs) involved in the signaling mechanisms underlying psychosis and schizophrenia treatment. Previous findings in mGlu2 knockout (KO) mice suggested that mGlu2 is necessary for head-twitch behavior, a rodent phenotype characteristic of hallucinogenic 5-HT2A receptor agonists. However, the role of mGlu2 in the behavioral effects induced by antipsychotic drugs remains poorly understood. Here, we tested antipsychotic-like behavioral phenotypes induced by the atypical antipsychotic clozapine in mGlu2-KO mice and wild-type control littermates. METHODS Locomotor activity was tested in mGlu2-KO mice and control littermates injected (i.p.) with clozapine (1.5 mg/kg) or vehicle followed by MK801 (0.5 mg/kg), PCP (7.5 mg/kg), amphetamine (6 mg/kg), scopolamine (2 mg/kg), or vehicle. Using a virally (HSV) mediated transgene expression approach, the role of frontal cortex mGlu2 in the modulation of MK801-induced locomotor activity by clozapine treatment was also evaluated. RESULTS The effect of clozapine on hyperlocomotor activity induced by the dissociative drugs MK801 and phencyclidine (PCP) was decreased in mGlu2-KO mice as compared to controls. Clozapine treatment, however, reduced hyperlocomotor activity induced by the stimulant drug amphetamine and the deliriant drug scopolamine in both wild-type and mGlu2-KO mice. Virally mediated over-expression of mGlu2 in the frontal cortex of mGlu2-KO mice rescued the ability of clozapine to reduce MK801-induced hyperlocomotion. CONCLUSION These findings further support the existence of a functionally relevant crosstalk between 5-HT2A and mGlu2 receptors in different preclinical models of antipsychotic activity.
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Affiliation(s)
- Kelsey S Hideshima
- Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Ashkhan Hojati
- Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Justin M Saunders
- Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Doan M On
- Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Mario de la Fuente Revenga
- Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Jong M Shin
- Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Ana Sánchez-González
- Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Cassandra M Dunn
- Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Alexander B Pais
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
- VCU Alcohol Research Center, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Anthony C Pais
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
- VCU Alcohol Research Center, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Michael F Miles
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
- VCU Alcohol Research Center, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Jennifer T Wolstenholme
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
- VCU Alcohol Research Center, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Javier González-Maeso
- Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA.
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Cao Y, Sun N, Zhang J, Liu Z, Tang YZ, Wu Z, Kim KM, Cheon SH. Design, synthesis, and evaluation of bitopic arylpiperazine-phthalimides as selective dopamine D 3 receptor agonists. MEDCHEMCOMM 2018; 9:1457-1465. [PMID: 30288220 PMCID: PMC6148523 DOI: 10.1039/c8md00237a] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 06/12/2018] [Indexed: 11/21/2022]
Abstract
The dopamine D3 receptor (D3R) is a proven therapeutic target for the treatment of neurological and neuropsychiatric disorders. In particular, D3R-selective ligands that can eliminate side effects associated with dopamine D2 receptor (D2R) therapeutics have been validated. However, the high homology in signaling pathways and the sequence similarity between D2R and D3R have rendered the development of D3R-selective ligands challenging. Herein, we designed and synthesized a series of piperazine-phthalimide bitopic ligands based on a fragment-based and molecular docking inspired design. Compound 9i was identified as the most selective D3R ligand among these bitopic ligands. Its selectivity was improved compared to reference compounds 1 and 2 by 9- and 2-fold, respectively, and it was 21-fold more potent than compound 2. Molecular docking demonstrated that the orientation of Leu2.64 and Phe7.39 and the packing at the junction of helices may affect the specificity for D3R over D2R. Functional evaluation revealed that D3R-selective ligand 9i displayed a subpicomolar agonist activity at D3R with a 199-fold increase in potency compared to quinpirole. These results may be useful for the fragment-based design of bitopic compounds as selective D3R ligands.
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Affiliation(s)
- Yongkai Cao
- Integrated Chinese and Western Medicine Postdoctoral Research Station , Jinan University , Guangzhou 510632 , China
- College of Pharmacy and Research Institute of Drug Development , Chonnam National University , Gwangju 500-757 , Republic of Korea . ; ; ; Fax: +82 625302911 ; Tel: +82 625302936 ; Tel: +82 625302929
- The Fist Affiliated Hospital of Shenzhen University , Shenzhen 518035 , China
| | - Ningning Sun
- College of Pharmacy and Research Institute of Drug Development , Chonnam National University , Gwangju 500-757 , Republic of Korea . ; ; ; Fax: +82 625302911 ; Tel: +82 625302936 ; Tel: +82 625302929
| | - Jiumei Zhang
- The Fist Affiliated Hospital of Shenzhen University , Shenzhen 518035 , China
| | - Zhiguo Liu
- Chemical Biology Research at School of Pharmaceutical sciences , Wenzhou Medical University , Wenzhou 325035 , China . ; ; Tel: +86 75525622938
| | - Yi-Zhe Tang
- The Fist Affiliated Hospital of Shenzhen University , Shenzhen 518035 , China
| | - Zhengzhi Wu
- The Fist Affiliated Hospital of Shenzhen University , Shenzhen 518035 , China
| | - Kyeong-Man Kim
- College of Pharmacy and Research Institute of Drug Development , Chonnam National University , Gwangju 500-757 , Republic of Korea . ; ; ; Fax: +82 625302911 ; Tel: +82 625302936 ; Tel: +82 625302929
| | - Seung Hoon Cheon
- College of Pharmacy and Research Institute of Drug Development , Chonnam National University , Gwangju 500-757 , Republic of Korea . ; ; ; Fax: +82 625302911 ; Tel: +82 625302936 ; Tel: +82 625302929
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Ahmed HI, Abdel-Sattar SA, Zaky HS. Vinpocetine halts ketamine-induced schizophrenia-like deficits in rats: impact on BDNF and GSK-3β/β-catenin pathway. Naunyn Schmiedebergs Arch Pharmacol 2018; 391:1327-1338. [PMID: 30083945 DOI: 10.1007/s00210-018-1552-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 07/31/2018] [Indexed: 01/03/2023]
Abstract
There are increasing evidences supporting the involvement of oxidative stress and neuroinflammation in schizophrenia. Vinpocetine, a nootropic phosphodiesterase-1 inhibitor, was proven to possess anti-oxidant and anti-inflammatory potentials. This research aimed to reveal the likely protective features of vinpocetine against ketamine-induced schizophrenia-like deficits in rats. Additionally, the probable mechanisms contributing to this neuroprotection were also elucidated. Vinpocetine was given (20 mg/kg, i.p.) once a day for 14 days commencing 7 days before administrating ketamine (25 mg/kg i.p.). Risperidone was applied as a reference antipsychotic. Vinpocetine pre-treatment revealed a marked amendment in the hyperlocomotion, anxiety, and short-term memory deficits induced by ketamine in rats. In rats' hippocampus, ketamine induced a drastic increase in tissue levels of dopamine, lipid peroxidation, and pro-inflammatory cytokines along with a significant decrease in glutamate, GABA, SOD, and total anti-oxidant capacity. Also, ketamine induced a reduced level of BDNF together with the potentiation of GSK-3β/β-catenin pathway that led to the destruction of β-catenin. Pre-treatment of ketamine-challenged animals with vinpocetine significantly attenuated oxidative stress, inflammation, and neurotransmitter alterations. Vinpocetine also elevated BDNF expression and prevented ketamine-induced stimulation of the GSK-3β/β-catenin signaling. This research presents enlightenments into the role of vinpocetine in schizophrenia. This role may be accomplished through its effect on oxidative stress, inflammation as well as modulating BDNF and the GSK-3β/β-catenin pathway.
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Affiliation(s)
- Hebatalla I Ahmed
- Department of Pharmacology and Toxicology, Faculty of Pharmacy (Girls), Al-Azhar University, Cairo, 11754, Egypt.
| | - Somaia A Abdel-Sattar
- Department of Pharmacology and Toxicology, Faculty of Pharmacy (Girls), Al-Azhar University, Cairo, 11754, Egypt
| | - Heba S Zaky
- Department of Pharmacology and Toxicology, Faculty of Pharmacy (Girls), Al-Azhar University, Cairo, 11754, Egypt
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de la Fuente Revenga M, Ibi D, Saunders JM, Cuddy T, Ijaz MK, Toneatti R, Kurita M, Holloway T, Shen L, Seto J, Dozmorov MG, González-Maeso J. HDAC2-dependent Antipsychotic-like Effects of Chronic Treatment with the HDAC Inhibitor SAHA in Mice. Neuroscience 2018; 388:102-117. [PMID: 30025863 DOI: 10.1016/j.neuroscience.2018.07.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 06/08/2018] [Accepted: 07/05/2018] [Indexed: 01/20/2023]
Abstract
Antipsychotic drugs, including both typical such as haloperidol and atypical such as clozapine, remain the current standard for schizophrenia treatment. These agents are relatively effective in treating hallucinations and delusions. However, cognitive deficits are at present essentially either persistent or exacerbated following chronic antipsychotic drug exposure. This underlines the need of new therapeutic approaches to improve cognition in treated schizophrenia patients. Our previous findings suggested that upregulation of histone deacetylase 2 (HDAC2) expression upon chronic antipsychotic treatment may lead to negative effects on cognition and cortical synaptic structure. Here we tested different phenotypes of psychosis, synaptic plasticity, cognition and antipsychotic drug action in HDAC2 conditional knockout (HDAC2-cKO) mice and controls. Conditional depletion of HDAC2 function in glutamatergic pyramidal neurons led to a protective phenotype against behavior models induced by psychedelic and dissociative drugs, such as DOI and MK801, respectively. Immunoreactivity toward synaptophysin, which labels presynaptic terminals of functional synapses, was decreased in the frontal cortex of control mice chronically treated with clozapine - an opposite effect occurred in HDAC2-cKO mice. Chronic treatment with the class I and class II HDAC inhibitor SAHA prevented via HDAC2 the disruptive effects of MK801 on recognition memory. Additionally, chronic SAHA treatment affected transcription of numerous plasticity-related genes in the frontal cortex of control mice, an effect that was not observed in HDAC2-cKO animals. Together, these findings suggest that HDAC2 may represent a novel target to improve synaptic plasticity and cognition in treated schizophrenia patients.
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Affiliation(s)
- Mario de la Fuente Revenga
- Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, United States
| | - Daisuke Ibi
- Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, United States; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States; Department of Chemical Pharmacology, Meijo University, Nagoya 468-8503, Japan
| | - Justin M Saunders
- Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, United States
| | - Travis Cuddy
- Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, United States
| | - Maryum K Ijaz
- Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, United States
| | - Rudy Toneatti
- Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, United States
| | - Mitsumasa Kurita
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Terrell Holloway
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Li Shen
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Jeremy Seto
- Department of Biological Sciences, New York City College of Technology, Brooklyn, NY 11201, United States
| | - Mikhail G Dozmorov
- Department of Biostatistics, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, United States
| | - Javier González-Maeso
- Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, United States; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States; Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States.
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Huang XF, Song X. Effects of antipsychotic drugs on neurites relevant to schizophrenia treatment. Med Res Rev 2018; 39:386-403. [PMID: 29785841 DOI: 10.1002/med.21512] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 04/06/2018] [Accepted: 04/30/2018] [Indexed: 12/31/2022]
Abstract
Although antipsychotic drugs are mainly used for treating schizophrenia, they are widely used for treating various psychiatric diseases in adults, the elderly, adolescents and even children. Today, about 1.2% of the worldwide population suffers from psychosis and related disorders, which translates to about 7.5 million subjects potentially targeted by antipsychotic drugs. Neurites project from the cell body of neurons and connect neurons to each other to form neural networks. Deficits in neurite outgrowth and integrity are implicated in psychiatric diseases including schizophrenia. Neurite deficits contribute to altered brain development, neural networking and connectivity as well as symptoms including psychosis and altered cognitive function. This review revealed that (1) antipsychotic drugs could have profound effects on neurites, synaptic spines and synapse, by which they may influence and regulate neural networking and plasticity; (2) antipsychotic drugs target not only neurotransmitter receptors but also intracellular signaling molecules regulating the signaling pathways responsible for neurite outgrowth and maintenance; (3) high doses and chronic administration of antipsychotic drugs may cause some loss of neurites, synaptic spines, or synapsis in the cortical structures. In addition, confounding effects causing neurite deficits may include elevated inflammatory cytokines and antipsychotic drug-induced metabolic side effects in patients on chronic antipsychotic therapy. Unraveling how antipsychotic drugs affect neurites and neural connectivity is essential for improving therapeutic outcomes and preventing aversive effects for patients on antipsychotic drug treatment.
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Affiliation(s)
- Xu-Feng Huang
- Henan Medical Key Laboratory of Translational Research on Psychiatric Diseases, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.,The Illawarra Health and Medical Research Institute and School of Medicine, University of Wollongong, Wollongong, Australia
| | - Xueqin Song
- Henan Medical Key Laboratory of Translational Research on Psychiatric Diseases, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
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Zhou X, Ren L, Yu Z, Huang X, Li Y, Wang C. The antipsychotics sulpiride induces fatty liver in rats via phosphorylation of insulin receptor substrate-1 at Serine 307-mediated adipose tissue insulin resistance. Toxicol Appl Pharmacol 2018; 345:66-74. [PMID: 29551354 DOI: 10.1016/j.taap.2018.02.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 02/25/2018] [Accepted: 02/28/2018] [Indexed: 12/13/2022]
Abstract
Cumulative evidence has suggested that many antipsychotics cause metabolic abnormalities. Adipose tissue insulin resistance (Adipo-IR) contributes to the development and progress of metabolic abnormalities including fatty liver by inducing excessive free fatty acid release from adipose tissue. Sulpiride is an old antipsychotic still frequently used in many developing countries. However, its adverse metabolic effects remain poorly understood. Here, chronic administration of sulpiride (80 mg/kg, subcutaneously, once daily for 6 weeks) elevated fasting insulin concentration and the index of the homeostasis model assessment of insulin resistance in rats. More importantly, sulpiride increased hepatic triglyceride accumulation and Oil Red O-stained area, indicating the induction of fatty liver by sulpiride. Sulpiride also increased plasma non-esterified fatty acid concentrations at the baseline and during an oral glucose tolerance test, the Adipo-IR index, and adipocyte size. Adipose gene expression profile revealed that sulpiride decreased mRNA and protein expression of insulin receptor substrate (IRS)-1, but not IRS-2. Furthermore, sulpiride increased phosphorylation of both Ser307 in IRS-1 and Ser473 in Akt at baseline. Co-treatment with bromocriptine (a dopamine D2 receptor agonist) attenuated sulpiride-induced hyperprolactinemia, but it was without effect on insulin resistance and fatty liver. Therefore, the present results suggest that sulpiride induces fatty liver in rats via phosphorylation of IRS-1 at Ser307-mediated adipose tissue insulin resistance, in which dopamine D2 receptor is possibly not involved. Our findings may provide new insights into the mechanisms underlying the steatotic effect of the old antipsychotic.
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Affiliation(s)
- Xia Zhou
- Department of Pharmacy, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Liying Ren
- Department of Pharmacy, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Zhiling Yu
- School of Chinese Medicine, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China
| | - Xiaoqian Huang
- Department of Pharmacy, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Yuhao Li
- Endocrinology and Metabolism Group, Sydney Institute of Health Sciences/Sydney Institute of Traditional Chinese Medicine, NSW 2000, Australia
| | - Chunxia Wang
- Department of Pharmacy, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China.
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Ovenden ES, McGregor NW, Emsley RA, Warnich L. DNA methylation and antipsychotic treatment mechanisms in schizophrenia: Progress and future directions. Prog Neuropsychopharmacol Biol Psychiatry 2018; 81:38-49. [PMID: 29017764 DOI: 10.1016/j.pnpbp.2017.10.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 10/01/2017] [Accepted: 10/04/2017] [Indexed: 12/15/2022]
Abstract
Antipsychotic response in schizophrenia is a complex, multifactorial trait influenced by pharmacogenetic factors. With genetic studies thus far providing little biological insight or clinical utility, the field of pharmacoepigenomics has emerged to tackle the so-called "missing heritability" of drug response in disease. Research on psychiatric disorders has only recently started to assess the link between epigenetic alterations and treatment outcomes. DNA methylation, the best characterised epigenetic mechanism to date, is discussed here in the context of schizophrenia and antipsychotic treatment outcomes. The majority of published studies have assessed the influence of antipsychotics on methylation levels in specific neurotransmitter-associated candidate genes or at the genome-wide level. While these studies illustrate the epigenetic modifications associated with antipsychotics, very few have assessed clinical outcomes and the potential of differential DNA methylation profiles as predictors of antipsychotic response. Results from other psychiatric disorder studies, such as depression and bipolar disorder, provide insight into what may be achieved by schizophrenia pharmacoepigenomics. Other aspects that should be addressed in future research include methodological challenges, such as tissue specificity, and the influence of genetic variation on differential methylation patterns.
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Affiliation(s)
- Ellen S Ovenden
- Department of Genetics, Stellenbosch University, Stellenbosch 7600, South Africa
| | - Nathaniel W McGregor
- Department of Genetics, Stellenbosch University, Stellenbosch 7600, South Africa
| | - Robin A Emsley
- Department of Psychiatry, Stellenbosch University, Tygerberg 7505, South Africa
| | - Louise Warnich
- Department of Genetics, Stellenbosch University, Stellenbosch 7600, South Africa.
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Amato D, Vernon AC, Papaleo F. Dopamine, the antipsychotic molecule: A perspective on mechanisms underlying antipsychotic response variability. Neurosci Biobehav Rev 2018; 85:146-159. [DOI: 10.1016/j.neubiorev.2017.09.027] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 09/20/2017] [Accepted: 09/26/2017] [Indexed: 12/12/2022]
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Luoni A, Gass P, Brambilla P, Ruggeri M, Riva MA, Inta D. Altered expression of schizophrenia-related genes in mice lacking mGlu5 receptors. Eur Arch Psychiatry Clin Neurosci 2018; 268:77-87. [PMID: 27581816 DOI: 10.1007/s00406-016-0728-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 08/22/2016] [Indexed: 12/15/2022]
Abstract
The evidence underlying the so-called glutamatergic hypothesis ranges from NMDA receptor hypofunction to an imbalance between excitatory and inhibitory circuits in specific brain structures. Among all glutamatergic system components, metabotropic receptors play a main role in regulating neuronal excitability and synaptic plasticity. Here, we investigated, using qRT-PCR and western blot, consequences in the hippocampus and prefrontal/frontal cortex (PFC/FC) of mice with a genetic deletion of the metabotropic glutamate receptor 5 (mGlu5), addressing key components of the GABAergic and glutamatergic systems. We found that mGlu5 knockout (KO) mice showed a significant reduction of reelin, GAD65, GAD67 and parvalbumin mRNA levels, which is specific for the PFC/FC, and that is paralleled by a significant reduction of protein levels in male KO mice. We next analyzed the main NMDA and AMPA receptor subunits, namely GluN1, GluN2A, GluN2B and GluA1, and we found that mGlu5 deletion determined a significant reduction of their mRNA levels, also within the hippocampus, with differences between the two genders. Our data suggest that neurochemical abnormalities impinging the glutamatergic and GABAergic systems may be responsible for the behavioral phenotype associated with mGlu5 KO animals and point to the close interaction of these molecular players for the development of neuropsychiatric disorders such as schizophrenia. These data could contribute to a better understanding of the involvement of mGlu5 alterations in the molecular imbalance between excitation and inhibition underlying the emergence of a schizophrenic-like phenotype and to understand the potential of mGlu5 modulators in reversing the deficits characterizing the schizophrenic pathology.
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Affiliation(s)
- Alessia Luoni
- Department of Pharmacological and Biomolecular Sciences, Center of Neuropharmacology, Università degli Studi di Milano, Milan, Italy
| | - Peter Gass
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, University of Heidelberg, J 5, 68159, Mannheim, Germany
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Mirella Ruggeri
- Section of Psychiatry, Department of Neurological, Biomedical and Movement Sciences, University of Verona, Verona, Italy
| | - Marco A Riva
- Department of Pharmacological and Biomolecular Sciences, Center of Neuropharmacology, Università degli Studi di Milano, Milan, Italy
| | - Dragos Inta
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, University of Heidelberg, J 5, 68159, Mannheim, Germany. .,Department of Psychiatry (UPK), University of Basel, Wilhelm Klein-Str. 27, 4012, Basel, Switzerland.
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