Porsolt & Partners Pharmacology, Boulogne-Billancourt, France.
J Pharmacol Exp Ther. 2010 Jun;333(3):632-8. doi: 10.1124/jpet.110.166710. Epub 2010 Mar 3.
Schizophrenia is characterized by three major symptom classes: positive symptoms, negative symptoms, and cognitive deficits. Classical antipsychotics (phenothiazines, thioxanthenes, and butyrophenones) are effective against positive symptoms but induce major side effects, in particular, extrapyramidal symptoms (EPS). The discovery of clozapine, which does not induce EPS and is thought effective against all three classes of symptom, has driven research for novel antipsychotics with a wider activity spectrum and lower EPS liability. To increase predictiveness, current efforts aim to develop translational models where direct parallels can be drawn between the processes studied in animals and in humans. The present article reviews existing procedures in animals for their ability to predict compound efficacy and EPS liability in relation to their translational validity. Rodent models of positive symptoms include procedures related to dysfunction in central dopamine and glutamatergic (N-methyl-D-aspartate) and serotonin (5-hydroxytryptamine) neurotransmission. Procedures for evaluating negative symptoms include rodent models of anhedonia, affective flattening, and diminished social interaction. Cognitive deficits can be assessed in rodent models of attention (prepulse inhibition) and of learning/memory (object and social recognition, Morris water maze and operant-delayed alternation). The relevance of the conditioned avoidance response is also discussed. A final section reviews procedures for assessing EPS liability, in particular, parkinsonism (catalepsy in rodents), acute dystonia (purposeless chewing in rodents, dystonia in monkeys), akathisia (defecation in rodents), and tardive dyskinesia (long-term antipsychotic treatment in rodents and monkeys). It is concluded that, with notable exceptions (attention, learning/memory, EPS liability), current predictive models for antipsychotics fall short of clear translational validity.
阳性症状、阴性症状和认知缺陷。经典的抗精神病药物(吩噻嗪类、噻吨类和丁酰苯类)对阳性症状有效,但会引起主要的副作用,特别是锥体外系症状(EPS)。氯氮平的发现,它不会引起 EPS,并被认为对所有三种症状类别都有效,推动了对具有更广泛活性谱和更低 EPS 倾向的新型抗精神病药物的研究。为了提高预测性,目前的努力旨在开发转化模型,在这些模型中,可以在动物和人类中研究的过程之间建立直接的相似之处。本文综述了现有的动物模型,以评估其在预测化合物疗效和 EPS 倾向方面的能力,以及它们的转化有效性。阳性症状的啮齿动物模型包括与中枢多巴胺和谷氨酸能(N-甲基-D-天冬氨酸)和 5-羟色胺(5-羟色胺)神经传递功能障碍相关的程序。评估阴性症状的程序包括快感缺失、情感平坦和社交互动减少的啮齿动物模型。认知缺陷可以在注意力(前脉冲抑制)和学习/记忆(物体和社会识别、莫里斯水迷宫和操作性延迟交替)的啮齿动物模型中进行评估。条件回避反应的相关性也进行了讨论。最后一节回顾了评估 EPS 倾向的程序,特别是帕金森病(啮齿动物的僵住)、急性肌张力障碍(啮齿动物的无目的咀嚼、猴子的肌张力障碍)、静坐不能(啮齿动物的排便)和迟发性运动障碍(啮齿动物和猴子的长期抗精神病治疗)。结论是,除了一些显著的例外(注意力、学习/记忆、EPS 倾向),目前抗精神病药物的预测模型缺乏明确的转化有效性。