Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, Jiangsu Province, 214063, PR China.
Department of Neurology, Yangpu Hospital, Tongji University School of Medicine, Shanghai, 200090, PR China.
BMC Psychiatry. 2020 Mar 6;20(1):106. doi: 10.1186/s12888-020-02509-z.
Clozapine has remarkable efficacy on both negative and cognitive symptoms of schizophrenia due to its slight activation of NMDA receptor. In fact, much evidence to the contrary. NMDAR is a complex containing specific binding sites, which are regulated to improve negative symptoms and cognitive deficits associated with individuals affected by schizophrenia. PQQ is a powerful neuroprotectant that specifically binds with NMDA receptors in the brain to produce beneficial physiological and cognitive outcomes. The aim of this study was to enhance NMDAR function and improve cognitive ability in schizophrenia by PQQ combined with clozapine.
Rats were divided into four groups (n = 5) including control (saline), model (MK-801, 0.5 mg·kg·d), atypical antipsychotic (MK-801 (0.5 mg·kg·d) + Clozapine (1.0 mg·kg·d), and co-agonist NMDA receptor (MK-801 (0.5 mg·kg·d) + Clozapine (0.5 mg·kg·d) + PQQ (1.0 μg·kg·d) group. Each group of rats was injected subcutaneously every day for 6 weeks. Behavior test, including stereotyped behavior, locomotor hyperactivity, learning and memory, was performed. The Western blot assay was performed to analyze the expression of GSK-3β, Akt, NMDAR1, and MGLUR in rat hippocampus.
Results indicated that clozapine and PQQ combination therapy can improve MK801-induced schizophrenia behavior including stereotyped behavior, locomotor hyperactivity and cognitive impairment. Furthermore, we found that modulating NMDA receptors could ameliorate the memory impairments in Mk-801 induced schizophrenia rats by reducing the expression of NMDAR1 and MGLUR3, decreasing hippocampal tau hyperphosphorylation and inhibiting apoptosis through Akt /GSK-3β signaling pathway.
These findings suggest that combination therapy for enhancing NMDA receptors may be able to rescue cognition deficit in schizophrenia. More studies are needed to better elucidate these mechanisms.
氯氮平由于对 NMDA 受体的轻度激活,对精神分裂症的阴性和认知症状均具有显著疗效。事实上,有很多相反的证据。NMDAR 是一种含有特定结合位点的复合物,这些结合位点受到调节,以改善与受精神分裂症影响的个体相关的阴性症状和认知缺陷。PQQ 是一种强大的神经保护剂,可特异性结合大脑中的 NMDA 受体,产生有益的生理和认知结果。本研究旨在通过 PQQ 联合氯氮平增强 NMDAR 功能并改善精神分裂症的认知能力。
将大鼠分为四组(n=5),包括对照组(生理盐水)、模型组(MK-801,0.5mg·kg·d)、非典型抗精神病药组(MK-801(0.5mg·kg·d)+氯氮平(1.0mg·kg·d)和共激动剂 NMDA 受体组(MK-801(0.5mg·kg·d)+氯氮平(0.5mg·kg·d)+PQQ(1.0μg·kg·d)。每组大鼠每天皮下注射一次,共 6 周。进行行为测试,包括刻板行为、运动过度活跃、学习和记忆。采用 Western blot 法分析大鼠海马组织中 GSK-3β、Akt、NMDAR1 和 MGLUR 的表达。
结果表明,氯氮平和 PQQ 联合治疗可改善 MK801 诱导的精神分裂症行为,包括刻板行为、运动过度活跃和认知障碍。此外,我们发现,通过降低 NMDAR1 和 MGLUR3 的表达,减少海马 tau 过度磷酸化,抑制 Akt/GSK-3β信号通路的凋亡,调节 NMDA 受体可以改善 Mk-801 诱导的精神分裂症大鼠的记忆障碍。
这些发现表明,增强 NMDA 受体的联合治疗可能能够挽救精神分裂症的认知缺陷。需要更多的研究来更好地阐明这些机制。