Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
Mouse Behavioral and Neuroendocrine Analysis Core Facility, Duke University Medical Center, Durham, NC, USA.
Neuropsychopharmacology. 2017 Oct;42(11):2163-2177. doi: 10.1038/npp.2017.52. Epub 2017 Mar 15.
All FDA-approved antipsychotic drugs (APDs) target primarily dopamine D or serotonin (5-HT) receptors, or both; however, these medications are not universally effective, they may produce undesirable side effects, and provide only partial amelioration of negative and cognitive symptoms. The heterogeneity of pharmacological responses in schizophrenic patients suggests that additional drug targets may be effective in improving aspects of this syndrome. Recent evidence suggests that 5-HT receptors may be a promising target for schizophrenia since their activation reduces mesolimbic nigrostriatal dopamine release (which conveys antipsychotic action), they are expressed almost exclusively in CNS, and have weight-loss-promoting capabilities. A difficulty in developing 5-HT agonists is that most ligands also possess 5-HT and/or 5-HT activities. We have developed selective 5-HT ligands and herein describe their preclinical effectiveness for treating schizophrenia-like behaviors. JJ-3-45, JJ-3-42, and JJ-5-34 reduced amphetamine-stimulated hyperlocomotion, restored amphetamine-disrupted prepulse inhibition, improved social behavior, and novel object recognition memory in NMDA receptor hypofunctioning NR1-knockdown mice, and were essentially devoid of catalepsy. However, they decreased motivation in a breakpoint assay and did not promote reversal learning in MK-801-treated mice. Somewhat similar effects were observed with lorcaserin, a 5-HT agonist with potent 5-HT and 5-HT agonist activities, which is approved for treating obesity. Microdialysis studies revealed that both JJ-3-42 and lorcaserin reduced dopamine efflux in the infralimbic cortex, while only JJ-3-42 decreased it in striatum. Collectively, these results provide additional evidence that 5-HT receptors are suitable drug targets with fewer side effects, greater therapeutic selectivity, and enhanced efficacy for treating schizophrenia and related disorders than current APDs.
所有经美国食品药品监督管理局批准的抗精神病药物(APD)主要靶向多巴胺 D 或 5-羟色胺(5-HT)受体,或两者兼而有之;然而,这些药物并非普遍有效,它们可能产生不良副作用,并且仅能部分改善阴性和认知症状。精神分裂症患者的药理学反应的异质性表明,其他药物靶点可能有助于改善这种综合征的某些方面。最近的证据表明,5-HT 受体可能是治疗精神分裂症的一个有前途的靶点,因为它们的激活可减少中脑边缘黑质纹状体多巴胺的释放(这可传递抗精神病作用),它们几乎仅在中枢神经系统中表达,并且具有促进体重减轻的能力。开发 5-HT 激动剂的一个困难是,大多数配体也具有 5-HT 和/或 5-HT 活性。我们已经开发了选择性 5-HT 配体,并在此描述了它们在治疗类精神分裂症行为方面的临床前有效性。JJ-3-45、JJ-3-42 和 JJ-5-34 减少了安非他命刺激的过度运动,恢复了安非他命破坏的前脉冲抑制,改善了 NMDA 受体功能低下 NR1 敲低小鼠的社会行为和新物体识别记忆,并且基本上没有出现僵住症。然而,它们在断点测定中降低了动机,并且没有促进 MK-801 处理的小鼠的反转学习。洛卡西林是一种具有强大 5-HT 和 5-HT 激动剂活性的 5-HT 激动剂,已被批准用于治疗肥胖症,其观察到的效果有些类似,它在 NMDA 受体功能低下 NR1 敲低小鼠中也表现出类似的作用,减少了安非他命刺激的过度运动,恢复了安非他命破坏的前脉冲抑制,改善了社会行为和新物体识别记忆,并且基本上没有出现僵住症。然而,它们在断点测定中降低了动机,并且没有促进 MK-801 处理的小鼠的反转学习。洛卡西林是一种具有强大 5-HT 和 5-HT 激动剂活性的 5-HT 激动剂,已被批准用于治疗肥胖症,其观察到的效果有些类似,它在 NMDA 受体功能低下 NR1 敲低小鼠中也表现出类似的作用,减少了安非他命刺激的过度运动,恢复了安非他命破坏的前脉冲抑制,改善了社会行为和新物体识别记忆,并且基本上没有出现僵住症。然而,它们在断点测定中降低了动机,并且没有促进 MK-801 处理的小鼠的反转学习。洛卡西林是一种具有强大 5-HT 和 5-HT 激动剂活性的 5-HT 激动剂,已被批准用于治疗肥胖症,其观察到的效果有些类似,它在 NMDA 受体功能低下 NR1 敲低小鼠中也表现出类似的作用,减少了安非他命刺激的过度运动,恢复了安非他命破坏的前脉冲抑制,改善了社会行为和新物体识别记忆,并且基本上没有出现僵住症。然而,它们在断点测定中降低了动机,并且没有促进 MK-801 处理的小鼠的反转学习。
微透析研究表明,JJ-3-42 和洛卡西林均降低了内侧前额叶皮质中的多巴胺流出,而只有 JJ-3-42 降低了纹状体中的多巴胺流出。
总的来说,这些结果提供了额外的证据,表明 5-HT 受体是合适的药物靶点,与当前的 APD 相比,它们具有更少的副作用、更大的治疗选择性和增强的疗效,可用于治疗精神分裂症和相关疾病。