Different serine and glycine metabolism in patients with schizophrenia receiving clozapine
Jaromir Hons, Martina Vasatova, Eva Cermakova, Pavel Doubek, Jan Libiger
DOI: 10.1016/j.jpsychires.2012.03.015
Klíčová slova: Adult, Aged, Antipsychotic Agents, Clozapine, Excitatory Amino Acids, Female, Glycine, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Serine, Schizophrenia, Statistics, Nonparametric, Young Adult
Anotace: Dysfunction of the N-methyl-d-aspartate receptor, which is modulated by excitatory amino acids (EAA), is involved in the pathophysiology of schizophrenia. The effects of antipsychotics on EAA metabolism are uncertain. Positive clinical effects of treatment with antipsychotics were not always associated with changes in EAA serum levels in patients with schizophrenia in clinical trials. To examine EAA serum levels in relation to the intensity of psychotic symptoms and the type of medication received we compared these variables among patients with schizophrenia (n = 49) treated with first (FGA) or second (SGA) generation antipsychotics or clozapine. Glutamate, aspartate, glycine, total serine and d-serine serum levels were measured by High Performance Liquid Chromatography. The Positive and Negative Syndrome Scale (PANSS) and the Scale for the Assessment of Negative Symptoms (SANS) were used to assess symptoms of schizophrenia. Lower average levels of glycine and total serine were found in the serum of patients receiving clozapine when compared to the groups of patients treated with FGA or SGA. There were no differences in serum glutamate, aspartate or d-serine levels or in the intensity of schizophrenic symptoms assessed by PANSS or SANS among the groups of patients treated with FGA or SGA or clozapine. Lower glycine and total serine serum levels could be caused by the particular characteristics of the population of patients receiving clozapine rather than as an effect of the clozapine. The results suggest selective deficiency of l-serine synthesis in the patients with resistance to non-clozapine treatment. It might be an unique biochemical and pathophysiological characteristic of the treatment-resistance in schizophrenia.
Citace: HONS, Jaromir, Martina VASATOVA, Eva CERMAKOVA, Pavel DOUBEK a Jan LIBIGER. Different serine and glycine metabolism in patients with schizophrenia receiving clozapine. Journal of psychiatric research. 2012, 46(6), 811-818. ISSN 18791379. Dostupné z: doi:10.1016/j.jpsychires.2012.03.015