Abstract
Background: GABAergic deficits have been considered to be associated with the pathophysiology of schizophrenia, and hence, GABA receptors subtype A (GABAARs) modulators, such as commonly used volatile anesthetic sevoflurane, may have therapeutic values for schizophrenia. The present study investigates the therapeutic effectiveness of low-concentration sevoflurane in MK801-induced schizophrenia-like mice and schizophrenia patients.
Methods: Three weeks after MK801 administration (0.5 mg kg-1, i.p. twice a day for 5 days), mice were exposed to 1% sevoflurane 1hr/day for 5 days. Behavioral tests, immunohistochemical analysis, western blot assay, and electrophysiology assessments were performed 1-week post-exposure. Ten schizophrenia patients received 1% sevoflurane 5 hrs per day for 6 days and were assessed with the Positive and Negative Syndrome Scale (PANSS) and the 18-item Brief Psychiatric Rating Scale (BPRS-18) at week 1 and week 2.
Results: MK801 induced hypolocomotion and social deficits, downregulated expression of NMDARs subunits and postsynaptic density protein 95 (PSD95), reduced parvalbumin - and GAD67-positive neurons, altered amplitude and frequency of mEPSCs and mIPSCs, and increased the excitation/inhibition ratio. All these changes induced by MK-801 were attenuated by sevoflurane administration. Six and eight patients achieved a response defined as a reduction of at least 30% in the PANSS total score at 1st and 2nd week after treatments. The BPRS-18 total score was found to be significantly decreased by 38% at the 2nd week (p < 0.01).
Conclusion: Low-concentration sevoflurane effectively reversed MK801-induced schizophrenialike disease in mice and alleviated schizophrenia patients’ symptoms. Our work suggests sevoflurane to be a valuable therapeutic strategy for treating schizophrenia patients.
Keywords: Low-concentration, sevoflurane, E/I balance, social deficits, early response, schizophrenia.
Graphical Abstract
[http://dx.doi.org/10.1186/s12888-015-0578-7] [PMID: 26263900]
[http://dx.doi.org/10.1016/S0140-6736(15)60692-4] [PMID: 26063472]
[http://dx.doi.org/10.1177/0269881114563634] [PMID: 25586400]
[http://dx.doi.org/10.1017/S1092852918001013] [PMID: 29954475]
[http://dx.doi.org/10.1017/S1092852914000601] [PMID: 25403863]
[http://dx.doi.org/10.1001/jamapsychiatry.2017.0624] [PMID: 28514486]
[http://dx.doi.org/10.4088/JCP.0207e04] [PMID: 17335312]
[http://dx.doi.org/10.1016/j.euroneuro.2014.03.008] [PMID: 24820238]
[http://dx.doi.org/10.1016/j.neuropharm.2008.07.045] [PMID: 18760291]
[http://dx.doi.org/10.1038/nrd3502] [PMID: 21799515]
[http://dx.doi.org/10.1038/s41380-019-0426-0] [PMID: 31089192]
[http://dx.doi.org/10.1038/nm.2315] [PMID: 21441918]
[http://dx.doi.org/10.1213/ANE.0000000000001634] [PMID: 27828800]
[http://dx.doi.org/10.1007/s12630-020-01791-5] [PMID: 32812189]
[http://dx.doi.org/10.1213/ANE.0000000000000321] [PMID: 24977633]
[http://dx.doi.org/10.1093/schbul/sbx065] [PMID: 28586462]
[http://dx.doi.org/10.1111/j.1600-0447.2008.01308.x] [PMID: 19132961]
[http://dx.doi.org/10.1038/npp.2009.164] [PMID: 19890258]
[PMID: 22201090]
[http://dx.doi.org/10.2174/1568026618666181115102518] [PMID: 30430939]
[http://dx.doi.org/10.1016/j.biopsych.2005.07.026] [PMID: 16199013]
[http://dx.doi.org/10.1016/j.pharmthera.2010.07.004] [PMID: 20705091]
[http://dx.doi.org/10.1073/pnas.0308455101] [PMID: 15159546]
[http://dx.doi.org/10.1177/1073858411435129] [PMID: 22343826]
[http://dx.doi.org/10.1038/nrn3504] [PMID: 23686171]
[http://dx.doi.org/10.1016/j.neuroscience.2004.09.042] [PMID: 15590141]
[http://dx.doi.org/10.1016/j.neubiorev.2008.03.012] [PMID: 18471877]
[http://dx.doi.org/10.1016/j.pharmthera.2019.107426] [PMID: 31629007]
[http://dx.doi.org/10.2174/1566524015666150330142807] [PMID: 25817860]
[http://dx.doi.org/10.1016/j.pnpbp.2011.02.017] [PMID: 21371516]
[http://dx.doi.org/10.1002/dneu.22536] [PMID: 28901728]
[http://dx.doi.org/10.1016/S0166-2236(96)80023-3] [PMID: 8658597]
[http://dx.doi.org/10.1038/nrn1625] [PMID: 15738957]
[http://dx.doi.org/10.1007/s40263-017-0463-7] [PMID: 29039138]
[http://dx.doi.org/10.1523/JNEUROSCI.3131-11.2011] [PMID: 21917809]
[http://dx.doi.org/10.1093/cercor/4.1.40] [PMID: 8180490]
[http://dx.doi.org/10.1038/nn.2447] [PMID: 19915563]
[http://dx.doi.org/10.1523/JNEUROSCI.2213-07.2007] [PMID: 17959792]
[http://dx.doi.org/10.1016/j.bja.2021.03.002] [PMID: 33814118]
[http://dx.doi.org/10.1007/s12640-018-9877-3] [PMID: 29427282]
[http://dx.doi.org/10.1213/00000539-200007000-00029] [PMID: 10866904]
[http://dx.doi.org/10.1093/bja/aet056] [PMID: 23524149]
[http://dx.doi.org/10.1007/s00213-014-3459-8] [PMID: 24488407]
[http://dx.doi.org/10.1038/nrn2214] [PMID: 17882254]
[http://dx.doi.org/10.1089/ars.2009.3074] [PMID: 20446769]
[http://dx.doi.org/10.1007/s11064-010-0304-2] [PMID: 21042850]
[http://dx.doi.org/10.1097/01.anes.0000287213.98020.b6] [PMID: 18073558]
[http://dx.doi.org/10.1016/j.lfs.2016.02.094] [PMID: 26946305]
[http://dx.doi.org/10.4088/JCP.MS19053BR3C] [PMID: 32297721]
[http://dx.doi.org/10.3389/fpsyt.2018.00054] [PMID: 29535649]