Rojas Camilo, Alt Jesse, Ator Nancy A, Thomas Ajit G, Wu Ying, Hin Niyada, Wozniak Krystyna, Ferraris Dana, Rais Rana, Tsukamoto Takashi, Slusher Barbara S
Johns Hopkins Drug Discovery, Baltimore, MD, USA.
Department of Molecular and Comparative Pathobiology, Baltimore, MD, USA.
Neuropsychopharmacology. 2016 May;41(6):1610-9. doi: 10.1038/npp.2015.319. Epub 2015 Oct 16.
D-serine has been shown to improve positive, negative, and cognitive symptoms when used as add-on therapy for the treatment of schizophrenia. However, D-serine has to be administered at high doses to observe clinical effects. This is thought to be due to D-serine undergoing oxidation by D-amino-acid oxidase (DAAO) before it reaches the brain. Consequently, co-administration of D-serine with a DAAO inhibitor could be a way to lower the D-serine dose required to treat schizophrenia. Early studies in rodents to evaluate this hypothesis showed that concomitant administration of structurally distinct DAAO inhibitors with D-serine enhanced plasma and brain D-serine levels in rodents compared with administration of D-serine alone. In the present work we used three potent DAAO inhibitors and confirmed previous results in mice. In a follow-up effort, we evaluated plasma D-serine levels in monkeys after oral administration of D-serine in the presence or absence of these DAAO inhibitors. Even though the compounds reached steady state plasma concentrations exceeding their Ki values by >60-fold, plasma D-serine levels remained the same as those in the absence of DAAO inhibitors. Similar results were obtained with dogs. In summary, in contrast to rodents, DAAO inhibition in monkeys and dogs did not influence the exposure to exogenously administered D-serine. Results could be due to differences in D-serine metabolism and/or clearance mechanisms and suggest that the role of DAAO in the metabolism of D-serine is different across species. These data provide caution regarding the utility of DAAO inhibition for patients with schizophrenia.
D-丝氨酸作为精神分裂症附加治疗药物使用时,已显示可改善阳性、阴性及认知症状。然而,必须给予高剂量的D-丝氨酸才能观察到临床效果。这被认为是由于D-丝氨酸在到达大脑之前就被D-氨基酸氧化酶(DAAO)氧化。因此,将D-丝氨酸与DAAO抑制剂联合使用可能是降低治疗精神分裂症所需D-丝氨酸剂量的一种方法。早期在啮齿动物中评估这一假设的研究表明,与单独给予D-丝氨酸相比,将结构不同的DAAO抑制剂与D-丝氨酸联合给予可提高啮齿动物血浆和脑内D-丝氨酸水平。在本研究中,我们使用了三种强效DAAO抑制剂,并在小鼠中证实了先前的结果。在后续研究中,我们评估了在有或没有这些DAAO抑制剂存在的情况下,给猴子口服D-丝氨酸后其血浆D-丝氨酸水平。尽管这些化合物达到的稳态血浆浓度超过其Ki值60多倍,但血浆D-丝氨酸水平与没有DAAO抑制剂时相同。在狗身上也得到了类似的结果。总之,与啮齿动物不同,在猴子和狗中抑制DAAO并不影响外源性给予的D-丝氨酸的暴露。结果可能是由于D-丝氨酸代谢和/或清除机制的差异,这表明DAAO在不同物种中对D-丝氨酸代谢的作用不同。这些数据为DAAO抑制对精神分裂症患者的效用提供了警示。