1
|
Predictors of iron-deficiency anemia in primary care older adults: a real-world European multi-country longitudinal study. Aging Clin Exp Res 2020; 32:2211-2216. [PMID: 31893385 DOI: 10.1007/s40520-019-01454-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 12/16/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Iron deficiency is a major cause of anemia in older people. Increasing the knowledge on the predictors of iron-deficiency anemia (IDA) may facilitate its timely diagnosis. AIM To investigate the predictors of IDA in older people in four European countries. DESIGN AND SETTING Retrospective longitudinal study. Primary care patients aged 65 or older (N = 24,051) in four European countries. METHODS IDA predictors were estimated using multivariate Cox regression based on information gathered from national primary care databases: Italy (years 2002-2013), Belgium, Germany and Spain (years 2007-2012). Adjusted hazard ratios (aHR) with 95% confidence intervals (CIs) were estimated. RESULTS In Spain and Belgium, men were at greater risk of IDA than women, while they had a lower risk in Italy. Weakness, irritability, alopecia and xerostomia were signs and symptoms significantly associated with IDA. Concurrent diseases, potential causes of anemia, positively associated with IDA were small bowel polyposis, stomach cancer, obesity, gastritis and peptic ulcer, esophagitis, Crohn's disease, celiac disease, lymphangiectasis, gastrectomy or gastric atrophy, gut resection or bypass, and cardiac prosthetic valve. Aspirin users had a 12-35% higher hazard of IDA than non-users. Similarly, corticosteroids and anti-acids were positively associated with IDA. A higher level of comorbidity was associated with an increased hazard of IDA in all countries. CONCLUSIONS Specific signs and symptoms, chronic conditions, a greater comorbidity burden, and specific pharmacological treatments registered in primary care databases represent relevant predictors and correlates of incident IDA in older people in Europe. General practitioners might employ this information to obtain early diagnosis of IDA in community-dwelling older adults.
Collapse
|
2
|
Lavorini F, Bianco A, Blasi F, Braido F, Corsico AG, Di Marco F, Gentile A, Paggiaro PL, Pegoraro V, Pelaia G, Rogliani P, Santus P, Scichilone N, Soldi A, Canonica GW. What drives inhaler prescription for asthma patients? Results from a real-life retrospective analysis. Respir Med 2020; 166:105937. [PMID: 32250870 DOI: 10.1016/j.rmed.2020.105937] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 02/27/2020] [Accepted: 03/17/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND The choice of inhaler device for asthma patients depends upon multiple attributes. We investigated factors that may drive general practitioners (GPs) and respiratory specialists in the prescription of inhaler devices for asthma patients who initiated inhalation therapy. METHODS We retrospectively analysed prescriptions by GPs and respiratory specialists to asthma patients commencing inhaled corticosteroid/long-acting β2-agonist combination therapy available as both pressurised metered-dose inhalers (pMDIs) and dry powder inhalers (DPIs). Patient characteristics were compared by device and multivariate analysis was used to model the likelihood of receiving a pMDI as opposed to a DPI in order to identify drivers for prescription. A sample of the respiratory specialists completed an ad-hoc survey of their perceived success in achieving asthma control in their patients and barriers to attaining full control. RESULTS Prescription of a particular inhaler device was unrelated to the characteristics of the patients. Multivariate analysis revealed that the main driver for the choice of inhaler device was the medication (Odds Ratio and 95% Confidence Interval, respectively for GPs and specialists: 0.19 [0.16-0.23]; 0.17 [0.08-0.37]). Specialists perceived asthma as being inadequately controlled in 41% of their patients, and considered patients' difficulties in using DPIs and pMDIs as instrumental in this, citing a need for a novel, more effective inhaler technology. CONCLUSION Physicians choose inhaler devices according to the prescribed drugs and not to the characteristics of the individual patient. This may reflect a lack of confidence in existing inhaler devices and underlines the need for technologies, which are more reliable and easier to use by patients.
Collapse
Affiliation(s)
- F Lavorini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
| | - A Bianco
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples, Italy
| | - F Blasi
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Internal Medicine Department, Respiratory Unit and Adult Cystic Fibrosis Center, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - F Braido
- Department of Internal Medicine, Respiratory Diseases and Allergy Clinic, University of Genova, Azienda Policlinico IRCCs San Martino, Genoa, Italy
| | - A G Corsico
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation - Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - F Di Marco
- Department of Health Sciences, University of Milan, Italy - Respiratory Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - A Gentile
- Mundipharma Pharmaceuticals, Milan, Italy
| | - P L Paggiaro
- Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Pisa, Italy
| | | | - G Pelaia
- Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - P Rogliani
- Respiratory Medicine Department of Experimental Medicine, University of Rome "Tor Vergata" - Respiratory Unit, Policlinico Tor Vergata, Rome, Italy
| | - P Santus
- Department of Biomedical and Clinical Sciences (DIBIC) - University of Milan. Division of Respiratory Diseases - "L. Sacco" University Hospital - ASST Fatebenefratelli Sacco - Milan, Italy
| | - N Scichilone
- PROMISE Department, University of Palermo, Palermo, Italy
| | - A Soldi
- Mundipharma Pharmaceuticals, Milan, Italy
| | - G W Canonica
- Personalized Medicine, Asthma and Allergy Clinic, Humanitas Research Hospital - Department of Biomedical Sciences, Humanitas University, Milan, Italy
| |
Collapse
|
3
|
Agostoni E, Barbanti P, Frediani F, Trifirò G, Burgio L, di Nola L, Pegoraro V, Pulimeno S, Cepparulo M. Real-world insights on the management of migraine patients: an Italian nationwide study. Curr Med Res Opin 2019; 35:1545-1554. [PMID: 30924392 DOI: 10.1080/03007995.2019.1602032] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: Understanding migraine management using data from a sample of patients representative of the Italian general adult population.Methods: Retrospective analysis on IQVIA Italian Longitudinal Patient Database. Two cohorts were created. (a) The triptan user cohort included patients with triptan prescriptions between November 2015 and October 2016. Migraine days were estimated counting triptan and indometacin/caffeine/prochlorperazine (ICP) pills prescribed during the 6 months following first triptan prescription. Patients were categorized as having episodic (EM) or chronic (CM) migraine based on the number of migraine days following International Classification of Headache Disorders criteria. (b) The migraine preventive treatment (MPT) user cohort included patients with MPT prescriptions during the period June 2016-May 2017. MPTs considered included beta-blockers, calcium-channel blockers, antiepileptics, antidepressants and antiserotoninergics. Migraine days experienced by MPTs users were estimated counting triptan and ICP pills prescribed during the 6 months following the most recent MPT prescription, while the number of MPT switches was estimated based on MPT prescriptions during the previous two years.Results: There were 9461 patients with triptan prescriptions to treat migraine acute attacks, which accounted yearly for 0.8% of general adult population. CM patients accounted for 3% of triptan users. There were 2004 patients prescribed with MPTs, which accounted for 0.16% of general adult population. Overall, among MPT users, 291 (15%) were still experiencing at least four migraine days/month, with this proportion increasing with the increase in the number of MPT switches.Conclusions: Results from this study suggest an unmet need in the management of migraine: too many patients did not receive MPTs, with this potentially due to several reasons requiring further investigations. Furthermore, even among patients receiving MPTs, disease control level with now available drugs seems to be sub-optimal.
Collapse
Affiliation(s)
- Elio Agostoni
- Neurology and Stroke Unit, Department of Neurosciences, Niguarda Neuro Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Piero Barbanti
- Headache and Pain Unit, Department of Neurological, Motor and Sensorial Sciences, IRCCS San Raffaele Pisana, Rome, Italy
- San Raffaele University, Rome, Italy
| | - Fabio Frediani
- Headache Center, Neurology and Stroke Unit Division, S. Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Gianluca Trifirò
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | | | | | | | | | | |
Collapse
|
4
|
Marazziti D, Mucci F, Falaschi V, Dell'Osso L. Asenapine for the treatment of bipolar disorder. Expert Opin Pharmacother 2019; 20:1321-1330. [PMID: 31132287 DOI: 10.1080/14656566.2019.1617849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Introduction: Bipolar I disorder (BDI) is amongst the most debilitating psychiatric conditions with a great impact on both patients and their families. A class of drugs commonly used in this condition is second-generation antipsychotics (SGAs) including asenapine, one of the latest to be introduced into the clinical practice worldwide to treat manic episodes in BDI. Areas covered: The aim of this paper is to critically review the literature on the pharmacological characteristics, tolerability, and safety data of asenapine, as well as on its short- and long-term clinical trials in manic episodes as both a monotherapy and as an add-on treatment. Expert opinion: The available data indicate that asenapine is an effective antimanic agent in both adult and pediatric patients and that it might also improve depressive symptoms and recurrences in BDI patients. Its tolerability profile is good, and its most common side effects are somnolence, light extrapyramidal symptoms, dizziness, weight gain, and oral (but reversible) hypoesthesia. Taken together, the published studies indicate that asenapine might be an effective therapeutic agent in BDI with a broad spectrum of clinical activities. Further double-blind, short- and long-term studies are, however, necessary to clarify its precise role in the treatment of BD.
Collapse
Affiliation(s)
- Donatella Marazziti
- a Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry , University of Pisa , Pisa , Italy
| | - Federico Mucci
- a Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry , University of Pisa , Pisa , Italy
| | - Valentina Falaschi
- a Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry , University of Pisa , Pisa , Italy
| | - Liliana Dell'Osso
- a Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry , University of Pisa , Pisa , Italy
| |
Collapse
|
5
|
Gender differences in determinants of iron-deficiency anemia: a population-based study conducted in four European countries. Ann Hematol 2019; 98:1573-1582. [PMID: 31073646 DOI: 10.1007/s00277-019-03707-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 04/28/2019] [Indexed: 12/21/2022]
Abstract
Iron-deficiency anemia (IDA) was the main condition contributing to higher rates of years lived with disabilities in women in 2016. To date, few studies have investigated gender differences in determinants of IDA in Europe. The aim of the present study was to evaluate the determinants of IDA among females and males in four European countries. IDA determinants were estimated using multivariable Cox regression based on information gathered from national primary care databases, namely Italy (for years 2002-2013), Belgium, Germany, and Spain (for years 2007-2012). Adjusted hazard ratios (aHR) with 95% confidence intervals (CIs) were estimated. Age was significantly associated with IDA in females of childbearing age in all four countries, as well as pregnancy, for which the aHR ranged from 1.20 (95% CI 1.15-1.25) in Italy to 1.88 (95% CI 1.53-2.31) in Germany. In males, the aHR increased with age starting from the 65-69 age group. Menometrorrhagia was associated with IDA in Germany (aHR 2.71, 95% CI 1.96-3.73), Italy (aHR 1.80, 95% CI 1.60-2.03), and Spain (aHR 1.52, 95% CI 1.31-1.76). A greater risk for women with alopecia was also observed. Weakness and headache indicated a higher risk in both men and women. Patients with diseases characterized by blood loss or gastrointestinal malabsorption were also at significantly increased risk. Physicians should encourage women of childbearing age to adhere to dietary recommendations regarding iron intake and regularly prescribe screening of iron status. Upper and lower gastrointestinal investigations should be recommended for patients with a confirmed diagnosis of IDA.
Collapse
|
6
|
Šenk B, Goričar K, Kravos NA, Jensterle Sever M, Janež A, Dolžan V. SLC6A4 5HTTLPR Polymorphism Affects Insulin Secretion in Patients with Polycystic Ovary Syndrome. Int J Endocrinol 2018; 2018:6130487. [PMID: 30123264 PMCID: PMC6079412 DOI: 10.1155/2018/6130487] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 04/22/2018] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To investigate in a pilot study of genetic polymorphisms in serotonin system influencing basal- and glucose-stimulated insulin secretion in women with polycystic ovary syndrome (PCOS). METHODS A cross-sectional study included 65 female patients with PCOS followed up at the endocrine outpatient clinic of the University Medical Center Ljubljana and a control group of 94 young healthy female blood donors. Oral glucose tolerance test was performed only in PCOS patients and basal- and glucose-stimulated blood glucose and insulin levels were measured. All the subjects were genotyped for 5HTR1A rs6295, 5HTR1B rs13212041, and SLC6A4 5HTTLPR polymorphisms in the serotonin system. RESULTS Genotype distributions were in accordance with the Hardy-Weinberg equilibrium (HWE), except for 5HTR1A rs6295 in healthy controls and 5HTR1B rs13212041 in PCOS patients that were not consistent with HWE. SLC6A4 5HTTLPR polymorphism was significantly associated with insulin secretion (p = 0.030) and with the area under the curve of insulin blood levels during OGTT (p = 0.021). None of the investigated polymorphisms was significantly associated with basal- or glucose-stimulated blood glucose levels at any point in time during OGTT or with the basal insulin concentration. CONCLUSIONS Serotonin system may play a role in glucose-stimulated insulin secretion in patients with insulin resistance (IR) and decreased insulin sensitivity. Further studies are needed to conclude whether the observed effect is characteristic for PCOS-related metabolic disturbances or for the identified mutation in different high metabolic risk populations.
Collapse
Affiliation(s)
- Barbara Šenk
- Faculty of Medicine, Institute of Biochemistry, Pharmacogenetics Laboratory, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, Slovenia
| | - Katja Goričar
- Faculty of Medicine, Institute of Biochemistry, Pharmacogenetics Laboratory, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, Slovenia
| | - Nika Aleksandra Kravos
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, Zaloška Cesta 7, 1000 Ljubljana, Slovenia
| | - Mojca Jensterle Sever
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, Zaloška Cesta 7, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, Slovenia
| | - Andrej Janež
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, Zaloška Cesta 7, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, Slovenia
| | - Vita Dolžan
- Faculty of Medicine, Institute of Biochemistry, Pharmacogenetics Laboratory, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, Slovenia
| |
Collapse
|
7
|
Katz P, Pegoraro V, Liedgens H. Characteristics, resource utilization and safety profile of patients prescribed with neuropathic pain treatments: a real-world evidence study on general practices in Europe - the role of the lidocaine 5% medicated plaster. Curr Med Res Opin 2017; 33:1481-1489. [PMID: 28537441 DOI: 10.1080/03007995.2017.1335191] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To identify characteristics, resource utilization, and safety profile of patients prescribed with lidocaine 5% medicated plaster, pregabalin, gabapentin, amitriptyline and duloxetine when experiencing pain in the real-world setting of general practitioners (GPs) in Europe. METHODS Retrospective analysis on real world data from IMS Health Longitudinal Patient Database. Patients with at least one prescription of the drugs of interest during 2014 were selected and those with a non-neuropathic pain-related diagnosis were excluded. Patients' demographic and clinical characteristics, resource utilization data and adverse drug reactions (ADRs) as described in the leaflet were extracted. The association between treatments and ADR occurrence was evaluated applying multivariate logistic models. RESULTS A total of 70,515 patients were selected from Italy, Germany, the UK, Spain and Belgium. Lidocaine 5% medicated plaster patients were the oldest in Italy, the UK and Spain and the most health impaired in Italy, Spain and Belgium. No relevant differences in the number of co-prescriptions, specialist visits, examinations and hospitalizations were found. Significantly less lidocaine 5% plasters patients experienced ADRs, with odds ratios in favor of lidocaine 5% medicated plasters ranging from 3.41 (p = .036) to 52.33 (p < .001). CONCLUSIONS Evidence from daily clinical practice in GP settings agrees with the findings from more controlled clinical-trial settings, with lidocaine 5% medicated plaster patients showing a better safety profile, but also a comparable level of resource utilization. A possible re-evaluation of the scientific value coming from this retrospective study in building up a diagnostic as well as a therapeutic algorithm is suggested.
Collapse
|
8
|
Levi M, Rosselli M, Simonetti M, Brignoli O, Cancian M, Masotti A, Pegoraro V, Cataldo N, Heiman F, Chelo M, Cricelli I, Cricelli C, Lapi F. Epidemiology of iron deficiency anaemia in four European countries: a population-based study in primary care. Eur J Haematol 2016; 97:583-593. [DOI: 10.1111/ejh.12776] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2016] [Indexed: 12/12/2022]
Affiliation(s)
- Miriam Levi
- Health Search Italian College of General Practitioners and Primary Care; Florence Italy
- Department of Health Sciences; University of Florence; Florence Italy
| | - Matteo Rosselli
- Institute for Liver and Digestive Health; Royal Free Hospital; University College of London; London UK
| | - Monica Simonetti
- Health Search Italian College of General Practitioners and Primary Care; Florence Italy
| | - Ovidio Brignoli
- Italian College of General Practitioners and Primary Care; Florence Italy
| | - Maurizio Cancian
- Italian College of General Practitioners and Primary Care; Florence Italy
| | - Adriana Masotti
- Department of Transfusion Medicine; Local Health Authority n°5; Pordenone Italy
| | - Valeria Pegoraro
- IMS Health Information Solutions Medical Research srl; Milan Italy
| | - Nazarena Cataldo
- IMS Health Information Solutions Medical Research srl; Milan Italy
| | - Franca Heiman
- IMS Health Information Solutions Medical Research srl; Milan Italy
| | - Manuela Chelo
- Health Search Italian College of General Practitioners and Primary Care; Florence Italy
| | - Iacopo Cricelli
- Health Search Italian College of General Practitioners and Primary Care; Florence Italy
| | - Claudio Cricelli
- Italian College of General Practitioners and Primary Care; Florence Italy
| | - Francesco Lapi
- Health Search Italian College of General Practitioners and Primary Care; Florence Italy
| |
Collapse
|
9
|
Marazziti D, Mucci F, Baroni S, Piccinni A. Asenapine augmentation in bipolar disorders: a case series. Clin Case Rep 2016; 4:499-504. [PMID: 27190616 PMCID: PMC4856245 DOI: 10.1002/ccr3.526] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 02/01/2016] [Accepted: 02/06/2016] [Indexed: 11/08/2022] Open
Abstract
Asenapine, a novel second‐generation antipsychotic is effective in acute treatment of bipolar I disorder patients in combination with mood stabilizers even in resistant cases. Although there is no evidence for asenapine's efficacy to be superior to currently available agents, asenapine's favorable weight and metabolic profile are of clinical interest.
Collapse
Affiliation(s)
- Donatella Marazziti
- Dipartimento di Medicina Clinica e Sperimentale Section of Psychiatry University of Pisa Pisa Italy
| | - Federico Mucci
- Dipartimento di Medicina Clinica e Sperimentale Section of Psychiatry University of Pisa Pisa Italy
| | - Stefano Baroni
- Dipartimento di Medicina Clinica e Sperimentale Section of Psychiatry University of Pisa Pisa Italy
| | - Armando Piccinni
- Dipartimento di Medicina Clinica e Sperimentale Section of Psychiatry University of Pisa Pisa Italy
| |
Collapse
|
10
|
Abstract
OBJECTIVE A number of atypical antipsychotic drugs were demonstrated to have anxiolytic effects in patients and in animal models. These effects were mostly suggested to be the consequence of the drugs' affinity to the serotonin system and its receptors. Asenapine is a relatively new atypical antipsychotic that is prescribed for schizophrenia and for bipolar mania. Asenapine has a broad pharmacological profile with significant effects on serotonergic receptors, hence it is reasonable to expect that asenapine may have some anxiolytic effects. The present study was therefore designed to examine possible effects of asenapine on anxiety-like behaviour of mice. METHOD Male ICR mice were repeatedly treated with 0.1 or 0.3 mg/kg injections of asenapine and then tested in a battery of behavioural tests related to anxiety including the open-field test, elevated plus-maze (EPM), defensive marble burying and hyponeophagia tests. In an adjunct experiment, we tested the effects of acute diazepam in the same test battery. RESULTS The results show that diazepam reduced anxiety-like behaviour in the EPM, the defensive marble burying test and the hyponeophagia test but not in the open field. Asenapine has anxiolytic-like effects in the EPM and the defensive marble burying tests but had no effects in the open-field or the hyponeophagia tests. Asenapine had no effects on locomotor activity. CONCLUSION The results suggest that asenapine may have anxiolytic-like properties and recommends that clinical trials examining such effects should be performed.
Collapse
|
11
|
Eftekhari A, Azarmi Y, Parvizpur A, Eghbal MA. Involvement of oxidative stress and mitochondrial/lysosomal cross-talk in olanzapine cytotoxicity in freshly isolated rat hepatocytes. Xenobiotica 2015; 46:369-78. [PMID: 26364812 DOI: 10.3109/00498254.2015.1078522] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
1. Olanzapine (OLZ) is a widely used atypical antipsychotic agent for the treatment of schizophrenia and other disorders. Serious hepatotoxicity and elevated liver enzymes have been reported in patients receiving OLZ. However, the cellular and molecular mechanisms of the OLZ hepatotoxicity are unknown. 2. In this study, the cytotoxic effect of OLZ on freshly isolated rat hepatocytes was assessed. Our results showed that the cytotoxicity of OLZ in hepatocytes is mediated by overproduction of reactive oxygen species (ROS), mitochondrial potential collapse, lysosomal membrane leakiness, GSH depletion and lipid peroxidation preceding cell lysis. All the aforementioned OLZ-induced cellular events were significantly (p < 0.05) prevented by ROS scavengers, antioxidants, endocytosis inhibitors and adenosine triphosphate generators. Also, the present results demonstrated that CYP450 is involved in OLZ-induced oxidative stress and cytotoxicity mechanism. 3. It is concluded that OLZ hepatotoxicity is associated with both mitochondrial/lysosomal involvement following the initiation of oxidative stress in hepatocytes.
Collapse
Affiliation(s)
- Aziz Eftekhari
- a Biotechnology Research Center, Tabriz University of Medical Sciences , Tabriz , Iran .,b Drug Applied Research Center, Tabriz University of Medical Sciences , Tabriz , Iran .,c Pharmacology and Toxicology Department, School of Pharmacy, Tabriz University of Medical Sciences , Tabriz , Iran , and.,d Students' Research Committee, Tabriz University of Medical Sciences , Tabriz , Iran
| | - Yadollah Azarmi
- b Drug Applied Research Center, Tabriz University of Medical Sciences , Tabriz , Iran .,c Pharmacology and Toxicology Department, School of Pharmacy, Tabriz University of Medical Sciences , Tabriz , Iran , and
| | - Alireza Parvizpur
- b Drug Applied Research Center, Tabriz University of Medical Sciences , Tabriz , Iran .,c Pharmacology and Toxicology Department, School of Pharmacy, Tabriz University of Medical Sciences , Tabriz , Iran , and
| | - Mohammad Ali Eghbal
- b Drug Applied Research Center, Tabriz University of Medical Sciences , Tabriz , Iran .,c Pharmacology and Toxicology Department, School of Pharmacy, Tabriz University of Medical Sciences , Tabriz , Iran , and
| |
Collapse
|