Department of Pediatrics, College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA.
Department of Biochemistry and Molecular Biology, College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA.
Biomolecules. 2023 Aug 28;13(9):1321. doi: 10.3390/biom13091321.
The concurrent use of several medications is a common practice in the treatment of complex psychiatric conditions. One such commonly used combination is aripiprazole (ARI), an antipsychotic, and trazodone (TRZ), an antidepressant. In addition to their effects on dopamine and serotonin systems, both of these compounds are inhibitors of the 7-dehydrocholesterol reductase (DHCR7) enzyme. To evaluate the systemic and nervous system distribution of ARI and TRZ and their effects on cholesterol biosynthesis, adult mice were treated with both ARI and TRZ for 21 days. The parent drugs, their metabolites, and sterols were analyzed in the brain and various organs of mice using LC-MS/MS. The analyses revealed that ARI, TRZ, and their metabolites were readily detectable in the brain and organs, leading to changes in the sterol profile. The levels of medications, their metabolites, and sterols differed across tissues with notable sex differences. Female mice showed higher turnover of ARI and more cholesterol clearance in the brain, with several post-lanosterol intermediates significantly altered. In addition to interfering with sterol biosynthesis, ARI and TRZ exposure led to decreased ionized calcium-binding adaptor molecule 1 (IBA1) and increased DHCR7 protein expression in the cortex. Changes in sterol profile have been also identified in the spleen, liver, and serum, underscoring the systemic effect of ARI and TRZ on sterol biosynthesis. Long-term use of concurrent ARI and TRZ warrants further studies to fully evaluate the lasting consequences of altered sterol biosynthesis on the whole body.
同时使用多种药物是治疗复杂精神疾病的常见做法。其中一种常用的组合是阿立哌唑(ARI),一种抗精神病药,和曲唑酮(TRZ),一种抗抑郁药。除了对多巴胺和 5-羟色胺系统的影响外,这两种化合物都是 7-脱氢胆固醇还原酶(DHCR7)的抑制剂。为了评估 ARI 和 TRZ 的全身和神经系统分布及其对胆固醇生物合成的影响,成年小鼠接受了 21 天的 ARI 和 TRZ 联合治疗。使用 LC-MS/MS 分析了母药、其代谢物和甾醇在小鼠大脑和各种器官中的分布。分析表明,ARI、TRZ 及其代谢物在大脑和器官中很容易被检测到,导致甾醇谱发生变化。药物、其代谢物和甾醇的水平在组织中存在差异,具有明显的性别差异。雌性小鼠表现出更高的 ARI 周转率和大脑中更多的胆固醇清除,几种前羊毛甾醇中间体明显改变。除了干扰胆固醇生物合成外,ARI 和 TRZ 暴露还导致皮质中离子钙结合衔接蛋白 1(IBA1)减少和 DHCR7 蛋白表达增加。在脾脏、肝脏和血清中也发现了甾醇谱的变化,这突显了 ARI 和 TRZ 对胆固醇生物合成的全身影响。长期同时使用 ARI 和 TRZ 需要进一步研究,以充分评估改变的胆固醇生物合成对全身的持久影响。
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