Abstract

Although antipsychotics, such as olanzapine, are effective in the management of psychiatric conditions, some patients experience excessive antipsychotic-induced weight gain (AIWG). To illuminate pathways underlying AIWG, we compared baseline blood gene expression profiles in two cohorts of mice that were either prone (AIWG-P) or resistant (AIWG-R) to weight gain in response to olanzapine treatment for two weeks. We found that transcripts elevated in AIWG-P mice relative to AIWG-R are enriched for high-confidence transcriptional targets of numerous inflammatory and immunomodulatory signaling nodes. Moreover, these nodes are themselves enriched for genes whose disruption in mice is associated with reduced body fat mass and slow postnatal weight gain. In addition, we identified gene expression profiles in common between our mouse AIWG-P gene set and an existing human AIWG-P gene set whose regulation by immunomodulatory transcription factors is highly conserved between species. Finally, we identified striking convergence between mouse AIWG-P transcriptional regulatory networks and those associated with body weight and body mass index in humans. We propose that immunomodulatory transcriptional networks drive AIWG, and that these networks have broader conserved roles in whole body-metabolism.

Highlights

  • Antipsychotic drugs are effective medications for the treatment of psychiatric disease but have significant side effects, including antipsychotic-induced weight gain (AIWG) [1, 2]

  • This study conformed to the international standards for research ethics and was approved by the Cantabria Ethics Institutional Review Board (IRB)

  • We identified the five mice that gained the most weight (‘prone’, AIWG-P) and compared them with five mice at the other end of the spectrum that were ‘resistant’ to weight gain (AIWG-R)

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Summary

Introduction

Antipsychotic drugs are effective medications for the treatment of psychiatric disease but have significant side effects, including antipsychotic-induced weight gain (AIWG) [1, 2]. 20% of patients treated with a broad range of APs gain clinically significant amounts of weight (>7% of their baseline weight) [1]. Metabolic side effects are the most commonly reported reason for noncompliance with second generation antipsychotic medications [6]. Almost all antipsychotics result in some degree of weight gain [1], the extent of weight gain varies between individuals [7, 8]. Some individuals can gain a pound per week of treatment, while others are relatively refractory to weight gain [1, 9,10,11,12,13]

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