Abstract
RationaleCalcineurin is a protein regulating cytokine expression in T lymphocytes and calcineurin inhibitors such as cyclosporine A (CsA) are widely used for immunosuppressive therapy. It also plays a functional role in distinct neuronal processes in the central nervous system. Disturbed information processing as seen in neuropsychiatric disorders is reflected by deficient sensorimotor gating, assessed as prepulse inhibition (PPI) of the acoustic startle response (ASR).ObjectivePatients who require treatment with immunosuppressive drugs frequently display neuropsychiatric alterations during treatment with calcineurin inhibitors. Importantly, knockout of calcineurin in the forebrain of mice is associated with cognitive impairments and symptoms of schizophrenia-like psychosis as seen after treatment with stimulants.MethodsThe present study investigated in rats effects of systemic acute and subchronic administration of CsA on sensorimotor gating. Following a single injection with effective doses of CsA, adult healthy male Dark Agouti rats were tested for PPI. For subchronic treatment, rats were injected daily with the same doses of CsA for 1 week before PPI was assessed. Since calcineurin works as a modulator of the dopamine pathway, activity of the enzyme tyrosine hydroxylase was measured in the prefrontal cortex and striatum after accomplishment of the study.ResultsAcute and subchronic treatment with the calcineurin inhibitor CsA disrupted PPI at a dose of 20 mg/kg. Concomitantly, following acute CsA treatment, tyrosine hydroxylase activity was reduced in the prefrontal cortex, which suggests that dopamine synthesis was downregulated, potentially reflecting a stimulatory impact of CsA on this neurotransmitter system.ConclusionsThe results support experimental and clinical evidence linking impaired calcineurin signaling in the central nervous system to the pathophysiology of neuropsychiatric symptoms. Moreover, these findings suggest that therapy with calcineurin inhibitors may be a risk factor for developing neurobehavioral alterations as observed after the abuse of psychomotor stimulant drugs.
Highlights
Disruptions in attention and cognition are seen in patients with idiopathic schizophrenia and during psychotic states induced by stimulants, such as methamphetamine (Druhan et al 1998)
The present study investigated in healthy rats effects of acute and subchronic treatment with the immunosuppressant and calcineurin inhibitor cyclosporine A (CsA) on sensorimotor gating
analysis of variance (ANOVA) showed an effect for the factor treatment (F(2,81) = 3.545; p = 0.043) and for the factor prepulse (F(3,81) = 44.057; p < 0.001), but no treatment × prepulse interaction (F(6,81) = 0.989; p = 0.438), following acute injections with the immunosuppressant and the calcineurin inhibitor CsA (Fig. 2a)
Summary
Disruptions in attention and cognition are seen in patients with idiopathic schizophrenia and during psychotic states induced by stimulants, such as methamphetamine (Druhan et al 1998). Schizophrenic patients show impairment in PPI and similar deficits can be produced in rats experimentally by a variety of drugs, e.g., Psychopharmacology (2021) 238:1047–1057 dopamine receptor agonists such as methamphetamine (Geyer et al 2001; Hadamitzky et al 2011; Hutchison and Swift 1999). The most specific and well-known potent inhibitors of calcineurin are the small-molecule drugs cyclosporine A (CsA) and tacrolimus (FK506). Due to their immunosuppressive action, these compounds are commonly used in clinical routine for the prevention of graft rejection after kidney, liver, and heart transplantation, as well as for treatment of inflammatory autoimmune diseases such as rheumatoid arthritis, or psoriasis (Halloran 2004; Lindenfeld et al 2004; Taylor et al 2001). In the CNS, calcineurin has been shown to play an important functional role in distinct processes like neurite extension, synaptic plasticity, or learning and memory (Winder and Sweatt 2001; Zeng et al 2001)
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