Institute of Psychiatry and Neuroscience, Xin Xiang Medical University, Xinxiang, Henan.
Wuhan Mental Health Center.
J Clin Psychopharmacol. 2019 May/Jun;39(3):214-219. doi: 10.1097/JCP.0000000000001028.
Olanzapine, a commonly used second-generation antipsychotic, causes severe metabolic adverse effects, such as elevated blood glucose and insulin resistance (IR). Previous studies have proposed that overexpression of CD36, GGPPS, PTP-1B, GRK2, and adipose triglyceride lipase may contribute to the development of metabolic syndrome, and Pueraria could eliminate the metabolic adverse effects. The study aimed to investigate the association between olanzapine-associated IR and IR-related proteins (IRRPs) and determine the role of Pueraria in protection against the metabolic adverse effects of olanzapine.
The expression levels of IRRPs were examined in schizophrenia patients and rat models with long-term olanzapine treatment. The efficacy of Pueraria on anti-IR by reducing the expression of IRRPs was comprehensively evaluated.
Our study demonstrated that in schizophrenia patients chronically treated with olanzapine, the expression levels of IRRPs in patients with a high IR index significantly increased, and these phenomena were further confirmed in a rat model. The expression levels of IRRPs were reduced significantly in Pueraria-treated IR rat models. The body weight, blood glucose, and IR index were restored to levels similar to those of normal controls.
The IRRPs are closely related to IR induced by olanzapine, and Pueraria could interfere with olanzapine-associated IR and revert overexpressed IRRPs. These findings suggest that IRRPs are key players in olanzapine-associated IR and that Pueraria has potential as a clinical drug to prevent the metabolic adverse effects of olanzapine, further improving compliance of schizophrenia patients.
奥氮平是一种常用的第二代抗精神病药物,会引起严重的代谢不良反应,如血糖升高和胰岛素抵抗(IR)。先前的研究提出,CD36、GGPPS、PTP-1B、GRK2 和脂肪甘油三酯脂肪酶的过度表达可能导致代谢综合征的发生,而葛根可以消除奥氮平的代谢不良反应。本研究旨在探讨奥氮平相关的 IR 与 IR 相关蛋白(IRRPs)之间的关系,并确定葛根在预防奥氮平代谢不良反应中的作用。
在长期奥氮平治疗的精神分裂症患者和大鼠模型中检查了 IRRPs 的表达水平。综合评估了葛根通过降低 IRRPs 的表达来对抗 IR 的效果。
我们的研究表明,在长期接受奥氮平治疗的精神分裂症患者中,IR 指数高的患者的 IRRPs 表达水平显著增加,这一现象在大鼠模型中得到了进一步证实。葛根治疗的 IR 大鼠模型中,IRRPs 的表达水平显著降低。体重、血糖和 IR 指数恢复到接近正常对照的水平。
IRRPs 与奥氮平引起的 IR 密切相关,葛根可以干扰奥氮平相关的 IR 并逆转过度表达的 IRRPs。这些发现表明,IRRPs 是奥氮平相关 IR 的关键因素,葛根具有作为预防奥氮平代谢不良反应的临床药物的潜力,从而进一步提高精神分裂症患者的依从性。