Do proinflammatory cytokines play a role in clozapine-associated glycometabolism disorders?

Rationale and objective Clozapine (CLZ) is the most effective drug for treatment-resistant schizophrenia but is associated with many side effects, including glycometabolism disorders. Immunological mechanisms may be involved in the development of clozapine side effects. Research relating the immunomodulatory effects of clozapine and its early markers to clinically relevant adverse events is needed to reduce the harmful side effects of clozapine. This study aimed to investigate the role of proinflammatory cytokines in clozapine-associated glycometabolism disorders. Methods We measured the effect of a range of doses of clozapine on glycometabolism-related parameters and proinflammatory cytokines levels in mice peripheral blood. We also examined the differences between these indicators in the peripheral blood of clozapine-treated schizophrenia patients and healthy controls. Furthermore, we detected proinflammatory cytokines expression in mice pancreatic tissue. Results Following clozapine administration, glucagon significantly decreased in mouse serum, and proinflammatory cytokine IL-beta levels markedly increased. Clozapine reliably increased proinflammatory cytokines (IL-1 beta, IL-6, and TNF-alpha) expression in murine pancreatic tissue. Compared with healthy controls, clozapine-treated patients' BMI, blood glucose, and proinflammatory cytokines (IL-1 beta, IL-6, and TNF-alpha) increased significantly. In clozapine-treated patients, a higher clozapine daily dosage was associated with higher levels of the proinflammatory cytokines IL-1 beta and IL-6, and a significant positive correlation was observed between blood glucose levels and the proinflammatory cytokines IL-6 and TNF-alpha. Conclusion Findings from animal experiments and clinical trials have shown clear evidence that clozapine has a regulatory effect on immune-related proinflammatory cytokines and influences glycometabolism indicators.

Automated summary

This study found evidence that clozapine has a regulatory effect on immune-related proinflammatory cytokines and influences glycometabolism indicators, both in animal experiments and clinical trials. Clozapine-treated patients showed significant increases in blood glucose, BMI, and proinflammatory cytokines, with higher dosages associated with higher cytokine levels. Positive correlations were observed between blood glucose levels and proinflammatory cytokines.