Journal: British journal of pharmacology
Article Title: Impacts of exposure to and subsequent discontinuation of clozapine on tripartite synaptic transmission.
doi: 10.1111/bph.16503
Figure Lengend Snippet: FIGURE 11 Proposed hypothesis of pathophysiology of clozapine discontinuation syndrome. During clozapine exposure, clozapine increases L-BAIBA and Akt signalling, but inhibits 5-HT receptors (and histamine H1 receptors) (Carli et al., 2021; Fukuyama et al., 2023a, 2023b, 2023c). Inhibition of 5-HT2 receptors decreases IP3 synthesis, leading to attenuation of IP3 receptors (Okada et al., 2005). Increased intracellular calcium levels activate ATP synthase activity (Carli et al., 2021; de Brito & Scorrano, 2010). Clozapine also increases L-BAIBA synthesis, which activates AMPK signalling via possibly MRGPRD activation (Fukuyama et al., 2023a, 2023c; Kitase et al., 2018; Minato et al., 2022). Therefore, clozapine exposure activates AMPK signalling through 5-HT2 receptor inhibition and increases L-BAIBA. Clozapine-induced activation of hypothalamic AMPK signalling plays important roles in weight-gain and metabolic complication of clozapine (Carli et al., 2021). Activation of AMPK signalling suppresses PP2A signalling, resulting in decreasing 5-HT receptors in the plasma membrane via suppression of receptor recycling (Raote et al., 2013; Tsao et al., 2001). On the contrary, connexin43 trafficking is enhanced via activation of Akt signalling, resulting in increased hemichannels containing connexin43 in the astroglial plasma membrane (Fukuyama et al., 2023a; Okada, 2022; Smith et al., 2014). Astroglial D-serine release through hemichannels increases during clozapine exposure. Clozapine discontinuation, intracellular L-BAIBA level and signallings AMPK, Akt and PP2A immediately recovered. PP2A signalling immediately recovered during subsequent clozapine discontinuation, in comparison clozapine exposure transiently increased 5-HT receptor expression (until 7 days of discontinuation), resulting in transiently increased intracellular IP3 levels. PP2A also activates phosphatidylinositol turnover (Zhong et al., 2008). Connexin43 expression also recovered after clozapine discontinuation, but increased astroglial D-serine release persisted until 7 days after clozapine discontinuation due to transiently activation of IP3 receptors via transiently increased IP3 level.
Article Snippet: Primary antibodies against GAPDH (NB300-327, RRID:AB_ 10001915, 1:300, Novus Biologicals, Littleton, CO, USA), β-actin (8475, RRID:AB_3102029, 1:50, Cell Signalling Technology, Danvers, MA, USA), γ-actin (GTX101794, RRID:AB_2036153, 1:100, GeneTex, Irvine, CA, USA), connexin43 (C6219, RRID:AB_476857, 1:100, Sigma-Aldrich), PP2A (AF1653, RRID:AB_354917, 1 μg ml 1, R&D systems, Minneapolis, MN, USA), phosphorylated-PP2A (pPP2A: AF3989, RRID:AB_2169636, 10 μg ml 1, R&D Systems), Akt (AF1775, RRID:AB_354982, 1 μg ml 1, R&D Systems), phosphorylated-Akt (pAkt: AF887, RRID:AB_355685, 5 μg ml 1, R&D Systems), AMPKα (2603, RRID:AB_490795, 1:50, Cell Signalling Technology, Danvers, MA, USA), phosphorylated-AMPKα (pAMPK: 2535, RRID:AB_331250, 1:50, Cell Signalling Technology), 5-HT1A receptor (5-HT1A-R: NBP2–21590, RRID:AB_3102030, 1:100, Novus Biologicals, Littleton, CO, USA), 5-HT2A receptor (5-HT2A-R: LS-C172270, RRID:AB_3102031, 1:50, Lifespan Biosciences, WA, USA), 5-HT7 receptor (5-HT7-R, NB100-56352, RRID:AB_2264237, 1:50, Novus Biologicals) were diluted in an antibody diluent (Immuno Shot Platinum, CosmoBio).
Techniques: Inhibition, Activity Assay, Activation Assay, Clinical Proteomics, Membrane, Comparison, Expressing