Rimessi Alessandro, Pavan Chiara, Ioannidi Elli, Nigro Federica, Morganti Claudia, Brugnoli Alberto, Longo Francesco, Gardin Chiara, Ferroni Letizia, Morari Michele, Vindigni Vincenzo, Zavan Barbara, Pinton Paolo
Department of Morphology, Surgery and Experimental Medicine, Section of Pathology, Oncology and Experimental Biology, Laboratory for Technologies of Advanced Therapies (LTTA), University of Ferrara, Ferrara, Italy.
Unit of Psychiatry, Department of Neurosciences NPSRR, University of Padua, Padua, Italy.
Neuropsychopharmacology. 2017 Jun;42(7):1491-1501. doi: 10.1038/npp.2017.20. Epub 2017 Jan 27.
Antipsychotic drugs are currently used in clinical practice for a variety of mental disorders. Among them, clozapine is the most effective medication for treatment-resistant schizophrenia and is most helpful in controlling aggression and the suicidal behavior in schizophrenia and schizoaffective disorder. Although clozapine is associated with a low likelihood of extrapyramidal symptoms and other neurological side effects, it is well known for the weight gain and metabolic side effects, which expose the patient to a greater risk of cardiovascular disorders and premature death, as well as psychosocial issues, leading to non-adherence to therapy. The mechanisms underlying these iatrogenic metabolic disorders are still controversial. We have therefore investigated the in vivo effects of the selective PKCβ inhibitor, ruboxistaurin (LY-333531), in a preclinical model of long-term clozapine-induced weight gain. Cell biology, biochemistry, and behavioral tests have been performed in wild-type and PKCβ knockout mice to investigate the contribution of endogenous PKCβ and its pharmacological inhibition to the psychomotor effects of clozapine. Finally, we also shed light on a novel aspect of the mechanism underlying the clozapine-induced weight gain, demonstrating that the clozapine-dependent PKCβ activation promotes the inhibition of the lipid droplet-selective autophagy process. This paves the way to new therapeutic approaches to this serious complication of clozapine therapy.
抗精神病药物目前在临床实践中用于治疗多种精神障碍。其中,氯氮平是治疗难治性精神分裂症最有效的药物,对控制精神分裂症和分裂情感性障碍中的攻击行为和自杀行为最有帮助。虽然氯氮平引起锥体外系症状和其他神经副作用的可能性较低,但它因体重增加和代谢副作用而闻名,这些副作用使患者面临更大的心血管疾病风险和过早死亡风险,以及社会心理问题,导致治疗依从性差。这些医源性代谢紊乱的潜在机制仍存在争议。因此,我们在长期氯氮平诱导体重增加的临床前模型中研究了选择性蛋白激酶Cβ(PKCβ)抑制剂鲁伯斯塔林(LY-333531)的体内作用。在野生型和PKCβ基因敲除小鼠中进行了细胞生物学、生物化学和行为测试,以研究内源性PKCβ及其药理学抑制对氯氮平精神运动效应的作用。最后,我们还揭示了氯氮平诱导体重增加潜在机制的一个新方面,证明氯氮平依赖的PKCβ激活促进了对脂滴选择性自噬过程的抑制。这为解决氯氮平治疗这一严重并发症的新治疗方法铺平了道路。