Clozapine Induced Disturbances in Hepatic Glucose Metabolism: The Potential Role of PGRMC1 Signaling

Front Endocrinol (Lausanne). 2021 Dec 14:12:727371. doi: 10.3389/fendo.2021.727371. eCollection 2021.

Abstract

Newly emerging evidence has implicated that progesterone receptor component 1 (PGRMC1) plays a novel role not only in the lipid disturbance induced by atypical antipsychotic drugs (AAPD) but also in the deterioration of glucose homoeostasis induced by clozapine (CLZ) treatment. The present study aimed to investigate the role of PGRMC1 signaling on hepatic gluconeogenesis and glycogenesis in male rats following CLZ treatment (20 mg/kg daily for 4 weeks). Recombinant adeno-associated viruses (AAV) were constructed for the knockdown or overexpression of hepatic PGRMC1. Meanwhile, AG205, the specific inhibitor of PGRMC1 was also used for functional validation of PGRMC1. Hepatic protein expressions were measured by western blotting. Meanwhile, plasma glucose, insulin and glucagon, HbA1c and hepatic glycogen were also determined by assay kits. Additionally, concentrations of progesterone (PROG) in plasma, liver and adrenal gland were measured by a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. Our study demonstrated that CLZ promoted the process of gluconeogenesis and repressed glycogenesis, respectively mediated by PI3K-Akt-FOXO1 and GSK3β signaling via inhibition of PGRMC1-EGFR/GLP1R in rat liver, along with an increase in fasting blood glucose, HbA1c levels and a decrease in insulin and hepatic glycogen levels. Furthermore, through PGRMC1-EGFR/GLP1R-PI3K-Akt pathway, knockdown or inhibition (by AG205) of PGRMC1 mimics, whereas its overexpression moderately alleviates CLZ-induced glucose disturbances. Potentially, the PGRMC1 target may be regarded as a novel therapeutic strategy for AAPD-induced hepatic glucose metabolism disorder.

Keywords: PGRMC1; clozapine; gluconeogenesis; glycogenesis; hepatic glucose disturbances.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antipsychotic Agents / adverse effects
  • Antipsychotic Agents / pharmacology
  • Carbohydrate Metabolism / drug effects
  • Carbohydrate Metabolism / genetics
  • Clozapine / adverse effects
  • Clozapine / pharmacology*
  • Glucose / metabolism*
  • Glucose Metabolism Disorders / chemically induced
  • Glucose Metabolism Disorders / genetics
  • Glucose Metabolism Disorders / metabolism
  • Liver / drug effects*
  • Liver / metabolism
  • Male
  • Membrane Proteins / genetics
  • Membrane Proteins / physiology*
  • Rats
  • Rats, Sprague-Dawley
  • Receptors, Progesterone / genetics
  • Receptors, Progesterone / physiology*
  • Signal Transduction / drug effects
  • Signal Transduction / genetics

Substances

  • Antipsychotic Agents
  • Membrane Proteins
  • Pgrmc1 protein, rat
  • Receptors, Progesterone
  • Glucose
  • Clozapine