Effect of Atypical Antipsychotics on Fructose Metabolism and the Implications for

非典型抗精神病药对果糖代谢的影响及其意义

基本信息

批准号：
8207554
负责人：
Caroline Palavicino-Maggio
金额：
$ 3.91万
依托单位：
UNIV OF MED/DENT OF NJ-NJ MEDICAL SCHOOL
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-06-25 至 2013-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8207554
关键词：
Acetyl-CoA Carboxylase Address Adipocytes Adjuvant Analgesic Adult Adverse effects Affect Affinity Agonist American Animal Model Antipsychotic Agents Area Binding Proteins Blood C57BL/6 Mouse Cardiovascular Diseases Cardiovascular system Catabolism Cessation of life Chronic Clinical Research Clozapine Communities Comorbidity Consumption Cyclic AMP Data Development Diabetes Mellitus Disease Dopamine Receptor Energy Intake Enteral Enterocytes Epithelial Cells Event Fasting Fatty-acid synthase Food Processing Fructokinases Fructose Fructose-1,6-Bisphosphatase GLUT2 gene Gene Expression General Population Genes Genetic Glucose Goals Health Histamine Receptor Hypertension Indium Intake Intestinal Mucosa Intestines Knockout Mice Lead Link Measures Mediating Mental Health Mental disorders Metabolic Metabolic Diseases Metabolic syndrome Metabolism Molecular Mus National Institute of Mental Health Neuraxis Non-Insulin-Dependent Diabetes Mellitus Obesity Pathway interactions Patients Peroxisome Proliferation Pharmaceutical Preparations Phosphoenolpyruvate Carboxylase Protein Tyrosine Phosphatase Public Health Quality of life Regulatory Element Relapse Research Resistance Risk Role Sterols Testing Translational Research Triglycerides Weight Gain Wild Type Mouse absorption atypical antipsychotic base clinically significant dopamine D4 receptor glucose-6-phosphatase high risk improved inhibitor/antagonist mortality neuropsychiatry non-compliance novel prevent receptor research and development serotonin receptor soft drink therapy development transcription factor uptake

项目摘要

DESCRIPTION (provided by applicant): Antipsychotics induce significant weight gain which increases the risk of chronic health problems such as diabetes, metabolic syndrome and cardiovascular disease. Antipsychotics-induced weight gain contributes to medication non-compliance which results in psychotic relapse. Additionally, the mortality risk of patients suffering from mental disorders is much higher than the general population and 60% of these deaths are due to the chronic health problems associated with obesity. Since obesity is a critical element in the progression towards the development of diabetes, metabolic syndrome and cardiovascular disease, it is important to determine the mechanisms by which antipsychotics induce weight gain. In this R36 project, I propose a novel hypothesis that antipsychotics induce weight gain by altering fructose absorption and metabolism in the intestine. The hypothesis is based on the following observations- (1) The target receptors for antipsychotics including dopamine, serotonin and histamine receptors are expressed in the intestine; (2) our preliminary result that chronic clozapine treatment increases intestinal fructose uptake in C57BL/6 wild type mice; (3) our preliminary result that wild type C57BL/6 mice show significant weight gain following chronic clozapine treatment; however, GLUT5 null mice of the same genetic background fail to show any clozapine-induced weight gain under the same experimental paradigm. Together our preliminary results strongly suggest that the intestinal GLUT5 fructose transporter is involved in clozapine-induced weight gain. In this project, I will determine the molecular mechanism by which, the atypical antipsychotic clozapine, induces weight gain. I will focus on the mechanisms by which enteric dopamine receptors regulate GLUT5 fructose transporter function and how clozapine modulates the expression of genes involved in the intestinal gluconeogenic and lipogenic pathways. All studies will be done using GLUT5 null mice and wild type littermates of the same genetic background. The results from this project will identify a novel role for antipsychotics in modulating intestinal fructose transport and metabolism. Identifying novel molecular mechanisms involved in the gut sensing of atypical antipsychotics may lead to break through therapies that will lead to improved antipsychotics. This will help improve the quality of life of those suffering from neuropsychiatric disorders and rely on these medications. This R36 dissertation proposal addresses an area of high priority for the Division of Adult Translational Research and Treatment Development at NIMH as it delineates the mechanisms through which specific psychotropic medications produce adverse metabolic and cardiovascular events. PUBLIC HEALTH RELEVANCE: This project addresses a major public health problem in the mental health community. Antipsychotics cause weight gain which leads to medication non-compliance. The goal of this project is to test a new hypothesis that antipsychotics enhance intestinal fructose uptake which may contribute to the development of obesity.

描述（由申请人提供）：抗精神病药会导致体重显着增加，从而增加患糖尿病、代谢综合征和心血管疾病等慢性健康问题的风险。抗精神病药物引起的体重增加会导致药物不依从，从而导致精神病复发。此外，精神障碍患者的死亡风险远高于一般人群，其中 60% 的死亡是由于与肥胖相关的慢性健康问题造成的。由于肥胖是糖尿病、代谢综合征和心血管疾病发展的关键因素，因此确定抗精神病药物引起体重增加的机制非常重要。在这个 R36 项目中，我提出了一个新的假设，即抗精神病药物通过改变肠道中果糖的吸收和代谢来导致体重增加。该假设基于以下观察：（1）抗精神病药的靶受体包括多巴胺、血清素和组胺受体在肠道中表达； (2)我们的初步结果表明，长期氯氮平治疗增加了C57BL/6野生型小鼠肠道果糖的摄取； (3)我们的初步结果表明，野生型C57BL/6小鼠在长期氯氮平治疗后体重显着增加；然而，相同遗传背景的 GLUT5 缺失小鼠在相同的实验范式下未能表现出任何氯氮平诱导的体重增加。我们的初步结果强烈表明肠道 GLUT5 果糖转运蛋白参与氯氮平诱导的体重增加。在这个项目中，我将确定非典型抗精神病药物氯氮平引起体重增加的分子机制。我将重点关注肠道多巴胺受体调节 GLUT5 果糖转运蛋白功能的机制，以及氯氮平如何调节肠道糖异生和脂肪生成途径相关基因的表达。所有研究都将使用 GLUT5 缺失小鼠和具有相同遗传背景的野生型同窝小鼠进行。该项目的结果将确定抗精神病药物在调节肠道果糖转运和代谢方面的新作用。识别非典型抗精神病药物肠道感知中涉及的新分子机制可能会带来突破性的治疗，从而改进抗精神病药物。这将有助于改善那些患有神经精神疾病并依赖这些药物的人的生活质量。这份 R36 论文提案涉及 NIMH 成人转化研究和治疗开发部门的高度优先领域，因为它描述了特定精神药物产生不良代谢和心血管事件的机制。公共卫生相关性：该项目解决了心理健康界的一个主要公共卫生问题。抗精神病药物会导致体重增加，从而导致不服药。该项目的目标是测试一个新的假设，即抗精神病药物会增强肠道果糖的吸收，这可能会导致肥胖的发生。