二氯苯哌嗪类,包括一种最近批准的非典型抗精神病药,是胆固醇生物合成中最后一个酶 DHCR7 的有效抑制剂。
Dichlorophenyl piperazines, including a recently-approved atypical antipsychotic, are potent inhibitors of DHCR7, the last enzyme in cholesterol biosynthesis.
机构信息
Department of Chemistry, Vanderbilt Institute of Chemical Biology, Nashville, TN, United States.
Department of Pediatrics and Biochemistry, Molecular Biology, UNMC, Omaha, NE 68198, United States.
出版信息
Toxicol Appl Pharmacol. 2018 Jun 15;349:21-28. doi: 10.1016/j.taap.2018.04.029. Epub 2018 Apr 23.
While antipsychotic medications provide important relief from debilitating psychotic symptoms, they also have significant adverse side effects, which might have relevant impact on human health. Several research studies, including ours, have shown that commonly used antipsychotics such as haloperidol and aripiprazole affect cholesterol biosynthesis at the conversion of 7-dehydrocholesterol (7-DHC) to cholesterol. This transformation is promoted by the enzyme DHCR7 and its inhibition causes increases in plasma and tissue levels of 7-DHC. The inhibition of this enzymatic step by mutations in the Dhcr7 gene leads to Smith-Lemli-Opitz syndrome, a devastating human condition that can be replicated in rats by small molecule inhibitors of DHCR7. The fact that two compounds, brexpiprazole and cariprazine, that were recently approved by the FDA have substructural elements in common with the DHCR7 inhibitor aripiprazole, prompted us to evaluate the effect of brexpiprazole and cariprazine on cholesterol biosynthesis. We report that cariprazine affects levels of 7-DHC and cholesterol in cell culture incubations at concentrations as low as 5 nM. Furthermore, a common metabolite of cariprazine and aripiprazole, 2,3-(dichlorophenyl) piperazine, inhibits DHCR7 activity at concentrations comparable to those of the potent teratogen AY9944. The cell culture experiments were corroborated in mice in studies showing that treatment with cariprazine elevated 7-DHC in brain and serum. The consequences of sterol inhibition by antipsychotics in the developing nervous system and the safety of their use during pregnancy remains to be established.
虽然抗精神病药物能为使人衰弱的精神病症状提供重要缓解,但它们也有显著的不良反应,这可能对人类健康有相关影响。包括我们的研究在内的几项研究表明,常用的抗精神病药物如氟哌啶醇和阿立哌唑会影响 7-脱氢胆固醇(7-DHC)转化为胆固醇的胆固醇生物合成。这种转化由酶 DHCR7 促进,其抑制会导致 7-DHC 在血浆和组织中的水平增加。Dhcr7 基因中的突变会抑制该酶步骤,导致 Smith-Lemli-Opitz 综合征,这是一种破坏性的人类疾病,可通过 DHCR7 的小分子抑制剂在大鼠中复制。最近被 FDA 批准的两种化合物,brexpiprazole 和 cariprazine,与 DHCR7 抑制剂阿立哌唑具有共同的亚结构元素,这一事实促使我们评估 brexpiprazole 和 cariprazine 对胆固醇生物合成的影响。我们报告称,cariprazine 在细胞培养孵育中以低至 5nM 的浓度影响 7-DHC 和胆固醇的水平。此外,cariprazine 和阿立哌唑的常见代谢物 2,3-(二氯苯基)哌嗪,在与强效致畸剂 AY9944 相当的浓度下抑制 DHCR7 活性。细胞培养实验在小鼠研究中得到了证实,研究表明 cariprazine 治疗会使大脑和血清中的 7-DHC 升高。抗精神病药物在发育中的神经系统中抑制固醇的后果及其在怀孕期间使用的安全性仍有待确定。
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