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Macrophage migration inhibitory factor mediates metabolic dysfunction induced by atypical antipsychotic therapy
Donghong Cui, … , Dake Qi, Richard Bucala
Donghong Cui, … , Dake Qi, Richard Bucala
Published October 8, 2018
Citation Information: J Clin Invest. 2018;128(11):4997-5007. https://doi.org/10.1172/JCI93090.
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Research Article Metabolism

Macrophage migration inhibitory factor mediates metabolic dysfunction induced by atypical antipsychotic therapy

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Abstract

Atypical antipsychotics are highly effective antischizophrenic medications but their clinical utility is limited by adverse metabolic sequelae. We investigated whether upregulation of macrophage migration inhibitory factor (MIF) underlies the insulin resistance that develops during treatment with the most commonly prescribed atypical antipsychotic, olanzapine. Olanzapine monotherapy increased BMI and circulating insulin, triglyceride, and MIF concentrations in drug-naive schizophrenic patients with normal MIF expression, but not in genotypic low MIF expressers. Olanzapine administration to mice increased their food intake and hypothalamic MIF expression, which led to activation of the appetite-related AMP-activated protein kinase and Agouti-related protein pathway. Olanzapine also upregulated MIF expression in adipose tissue, which reduced lipolysis and increased lipogenic pathways. Increased plasma lipid concentrations were associated with abnormal fat deposition in liver and skeletal muscle, which are important determinants of insulin resistance. Global MIF-gene deletion protected mice from olanzapine-induced insulin resistance, as did intracerebroventricular injection of neutralizing anti–MIF antibody, supporting the role of increased hypothalamic MIF expression in metabolic dysfunction. These findings uphold the potential pharmacogenomic value of MIF genotype determination and suggest that MIF may be a tractable target for reducing the metabolic side effects of atypical antipsychotic therapy.

Authors

Donghong Cui, Yanmin Peng, Chengfang Zhang, Zezhi Li, Yousong Su, Yadan Qi, Mengjuan Xing, Jia Li, Grace E. Kim, Kevin N. Su, Jinjie Xu, Meiti Wang, Wenhua Ding, Marta Piecychna, Lin Leng, Michiru Hirasawa, Kaida Jiang, Lawrence Young, Yifeng Xu, Dake Qi, Richard Bucala

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Figure 3

MIF modulates food intake and obesity by activating AMPK in the hypothalamus following olanzapine treatment.

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MIF modulates food intake and obesity by activating AMPK in the hypothal...
WT and MIF knockout (Mif–/–) C57BL/6 mice were administered vehicle or 3 mg/kg olanzapine per day for 2 months. (A) Body weight and (B) food intake were monitored. Quantification of (C) MIF transcript levels by qPCR, (D) MIF protein, and (E) AMPK levels (pAMPK: Thr172 phosphorylated AMPK; T-AMPK: total AMPK) in homogenates of murine hypothalamic tissue after 2 months of treatment. (F) Transcript levels of NPY, AgRP, and POMC measured by qPCR in hypothalamic homogenates from mice treated with or without olanzapine for 2 months. Immunostaining was performed in the hypothalamus from WT mice. The staining for neural cells (NeuN, top panels), microglia (IBA1, middle panels), and astrocytes (GFAP, bottom panels) is red, while the staining for MIF is green (G). Arrow and arrowheads represent costaining of MIF and NeuN in neural cells. Isolated hypothalamic cells were treated with increasing concentrations of olanzapine for 24 hours, after which (H) MIF protein content was measured by Western blot. (I) Total and phospho-AMPK levels in isolated hypothalamic cells were evaluated following 24-hour MIF stimulation in vitro. (J) NPY, AgRP, and POMC gene expression measured in hypothalamic cells following 24 hours of MIF treatment. IgG or anti–MIF monoclonal antibody (2 μg/day) was administered i.c.v. by an osmotic pump to WT mice treated with olanzapine for 2 months. The cumulative food intake (K) and body weight gain (L) were subsequently evaluated. The hypothalamic tissues were collected for AMPK measurements (M). The pAMPK and T-AMPK Western blots are from parallel gels run contemporaneously on identical samples. For each animal group, n = 4–6. A, B, K, and L were analyzed by multivariate (2-way) ANOVA and the rest of the data were analyzed by 2-tailed Student’s t test or 1-way ANOVA. Mean ± SE in A, B, K, and L; mean ± SD in other panels; *P < 0.05 versus vehicle in C–F, versus other groups in A and B, versus control in H–J, versus IgG group in K–M. Olz: olanzapine.

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ISSN: 0021-9738 (print), 1558-8238 (online)

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