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Mechanisms of Antipsychotic Action: From the Researcher Bench to the Patient Bedside 2.0

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Neurobiology".

Deadline for manuscript submissions: 30 June 2024 | Viewed by 4489

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Department of Neuroscience, University School of Naples "Federico II", Via Pansini, 80131 Naples, Italy
Interests: neurotransmitter
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Special Issue Information

Dear Colleagues,

Schizophrenia is among the most debilitating causes of morbidity worldwide, with a progressively worsening course. The WHO stated that schizophrenia should be treated by integrated therapeutic strategies, including pharmacological and non-pharmacological interventions, both considered mandatory to cure these patients efficaciously. The mainstay of pharmacological treatment of schizophrenia is the class of Antipsychotic agents, which comprises several chemically unrelated compounds. However, all antipsychotics (with the possible exception of clozapine) share a variable degree of action as dopamine D2 receptor blockers. Despite this common mechanism of action, antipsychotics exert molecular actions on multiple dopaminergic and non-dopaminergic receptors. The relevance to the therapeutic efficacy of these actions, as well as their molecular consequences, are largely unknown. Also, the molecular effects triggered by antipsychotics after their interaction with target receptors have been only limitedly characterized.  

The lack of in-depth data on antipsychotic molecular action is a major cause of relevant clinical challenges since currently available antipsychotics suffer from several limitations in the treatment of schizophrenia. According to some estimations, approximately 30% of all schizophrenia patients have positive symptoms that are unresponsive or only minimally responsive to antipsychotics. The so-called negative symptoms, which include several distinct pathological phenotypes, as well as cognitive dysfunctions in schizophrenia patients are not ameliorated by current antipsychotics. Also, it has been suggested that antipsychotics may cause iatrogenic worsening and/or occurrence of negative or cognitive symptoms. Unfortunately, these symptoms are those maximally associated with long-term disability in schizophrenia patients and pharmacological therapeutic strategies addressing them are among the most relevant unmet need of schizophrenia clinics. As a further consideration, antipsychotics are burdened from multiple side effects, that in part stem from their therapeutic mechanism of action but, in many other cases, derives from the action on receptor targets that are not strictly necessary for their efficacy against psychotic symptoms.

All these considerations indicate the urge to gain more insights into the molecular mechanism of actions of currently available antipsychotics and to unravel other mechanisms of action, even including the possibility of sharp paradigmatic changes, e.g., using small molecules; gene therapy; or acting on post-receptor or non-receptor neuronal sites.

This special issue is supervised by Dr. Felice Iasevoli and assisted by our Topical Advisory Panel Member Dr.  Annarita Barone (University School of Naples "Federico II). The Special Issue, “Mechanisms of Antipsychotic Action: From the Researcher Bench to the Patient Bedside 2.0” of the International Journal of Molecular Sciences will include a selection of research papers and reviews about various aspects of the molecular and cellular biology of antipsychotics. In addition, studies on molecules able to modulate various aspects of synaptic signaling, and their possible use in the treatment of psychotic diseases will also be considered.

Dr. Felice Iasevoli
Guest Editor

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Keywords

  • schizophrenia
  • glutamate
  • dopamine
  • gene expression
  • synapse
  • post-synaptic density
  • second-messenger
  • psychosis
  • synaptic plasticity

Published Papers (3 papers)

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Research

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15 pages, 1881 KiB  
Article
The Antidepressant Activity of a Taurine-Containing Derivative of 4-Phenylpyrrolidone-2 in a Model of Chronic Unpredictable Mild Stress
by Denis A. Borozdenko, Darya I. Gonchar, Vlada I. Bogorodova, Dmitri V. Tarasenko, Evgeniya P. Kramarova, Svetlana S. Khovanova, Yaroslav V. Golubev, Nina M. Kiseleva, Tatiana A. Shmigol, Aiarpi A. Ezdoglian, Konstantin A. Sobyanin, Vadim V. Negrebetsky and Yuri I. Baukov
Int. J. Mol. Sci. 2023, 24(23), 16564; https://doi.org/10.3390/ijms242316564 - 21 Nov 2023
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Abstract
This study investigates the therapeutic potential of a new compound, potassium 2-[2-(2-oxo-4-phenylpyrrolidin-1-yl) acetamido]ethanesulfonate (Compound I), in depression. Willner’s chronic unpredictable mild stress model of male Wistar rats was used as a depression model. The rats were randomized into four groups, including an [...] Read more.
This study investigates the therapeutic potential of a new compound, potassium 2-[2-(2-oxo-4-phenylpyrrolidin-1-yl) acetamido]ethanesulfonate (Compound I), in depression. Willner’s chronic unpredictable mild stress model of male Wistar rats was used as a depression model. The rats were randomized into four groups, including an intact group, a Compound I group, a Fluoxetine group, and a control group with saline. Behavioral tests, such as the Porsolt forced swim test, hole-board test, elevated plus maze test, and light–dark box, were used to assess the animals’ conditions. Our results demonstrated that Compound I effectively reduced the immobilization time of rats in the forced swim test, increased orientation and exploratory behavior, and decreased the latency period of going into the dark compartment compared to the control group. Hippocampal and striatal serotonin concentrations were increased in the Compound I group, and the compound also reduced the level of corticosterone in the blood plasma of rats compared to the intact animals. These results suggest that Compound I has reliable antidepressant activity, comparable to that of the reference antidepressant Fluoxetine. Full article
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14 pages, 2802 KiB  
Article
Epigenetic Histone Methylation of PPARγ and CPT1A Signaling Contributes to Betahistine Preventing Olanzapine-Induced Dyslipidemia
by Yueqing Su, Chao Deng, Xuemei Liu and Jiamei Lian
Int. J. Mol. Sci. 2023, 24(11), 9143; https://doi.org/10.3390/ijms24119143 - 23 May 2023
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Abstract
As a partial histamine H1 receptor agonist and H3 antagonist, betahistine has been reported to partially prevent olanzapine-induced dyslipidemia and obesity through a combination therapy, although the underlying epigenetic mechanisms are still not known. Recent studies have revealed that histone regulation of key [...] Read more.
As a partial histamine H1 receptor agonist and H3 antagonist, betahistine has been reported to partially prevent olanzapine-induced dyslipidemia and obesity through a combination therapy, although the underlying epigenetic mechanisms are still not known. Recent studies have revealed that histone regulation of key genes for lipogenesis and adipogenesis in the liver is one of the crucial mechanisms for olanzapine-induced metabolic disorders. This study investigated the role of epigenetic histone regulation in betahistine co-treatment preventing dyslipidemia and fatty liver caused by chronic olanzapine treatment in a rat model. In addition to abnormal lipid metabolism, the upregulation of peroxisome proliferator-activated receptor γ (PPARγ) and CCAAT/enhancer binding protein (C/EBPα), as well as the downregulation of carnitine palmitoyltransferase 1A (CPT1A) in the liver induced by olanzapine, were significantly attenuated by betahistine co-treatment. In addition, betahistine co-treatment significantly enhanced the global expression of H3K4me and the enrichment of H3K4me binding on the promoter of Cpt1a gene as revealed by ChIP-qPCR, but inhibited the expression of one of its site-specific demethylases, lysine (K)-specific demethylase 1A (KDM1A). Betahistine co-treatment also significantly enhanced the global expression of H3K9me and the enrichment of H3K9me binding on the promoter of the Pparg gene, but inhibited the expression of two of its site-specific demethylases, lysine demethylase 4B (KDM4B) and PHD finger protein 2 (PHF2). These results suggest that betahistine attenuates abnormal adipogenesis and lipogenesis triggered by olanzapine through modulating hepatic histone methylation, and thus inhibiting the PPARγ pathway-mediated lipid storage, while at the same time promoting CP1A-mediated fatty acid oxidation. Full article
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Review

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13 pages, 2032 KiB  
Review
Insights into the Mechanism of Action of Antipsychotic Drugs Derived from Animal Models: Standard of Care versus Novel Targets
by Anthony A. Grace and Daniela L. Uliana
Int. J. Mol. Sci. 2023, 24(15), 12374; https://doi.org/10.3390/ijms241512374 - 03 Aug 2023
Cited by 1 | Viewed by 1650
Abstract
Therapeutic intervention for schizophrenia relies on blockade of dopamine D2 receptors in the associative striatum; however, there is little evidence for baseline overdrive of the dopamine system. Instead, the dopamine system is in a hyper-responsive state due to excessive drive by the hippocampus. [...] Read more.
Therapeutic intervention for schizophrenia relies on blockade of dopamine D2 receptors in the associative striatum; however, there is little evidence for baseline overdrive of the dopamine system. Instead, the dopamine system is in a hyper-responsive state due to excessive drive by the hippocampus. This causes more dopamine neurons to be in a spontaneously active, hyper-responsive state. Antipsychotic drugs alleviate this by causing depolarization block, or excessive depolarization-induced dopamine neuron inactivation. Indeed, both first- and second-generation antipsychotic drugs cause depolarization block in the ventral tegmentum to relieve positive symptoms, whereas first-generation drugs also cause depolarization in the nigrostriatal dopamine system to lead to extrapyramidal side effects. However, by blocking dopamine receptors, these drugs are activating multiple synapses downstream from the proposed site of pathology: the loss of inhibitory influence over the hippocampus. An overactive hippocampus not only drives the dopamine-dependent positive symptoms, but via its projections to the amygdala and the neocortex can also drive negative and cognitive symptoms, respectively. On this basis, a novel class of drugs that can reverse schizophrenia at the site of pathology, i.e., the hippocampal overdrive, could be effective in alleviating all three classes of symptoms of schizophrenia while also being better tolerated. Full article
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