Regional increase in P-glycoprotein function in the blood-brain barrier of patients with chronic schizophrenia: A PET study with [(11)C]verapamil as a probe for P-glycoprotein function.

Psychiatry research 2010 Jul 8; In press

de Klerk O OL, Willemsen A AT, Bosker F FJ, Bartels A AL, Hendrikse N NH, Den Boer J JA, Dierckx R RA

Department of Psychiatry, University Medical Center Groningen (UMCG), P.O. Box 30.001, 9700 RB Groningen, The Netherlands; Psychiatric Hospital GGZ Drenthe, P.O. Box 30007, 9400 RA Assen, The Netherlands.

P-glycoprotein (P-gp), a major efflux pump in the blood-brain barrier (BBB) has a profound effect on entry of drugs, peptides and other substances into the central nervous system (CNS). The brain's permeability can be negatively influenced by modulation of the transport function of P-gp. Inflammatory mediators play a role in schizophrenia, and may be able to influence the integrity of the BBB, via P-gp modulation. We hypothesized that P-gp function in the BBB is changed in patients with schizophrenia. Positron-emission tomography was used to measure brain uptake of [(11)C]verapamil, which is normally extruded from the brain by P-gp. We found that patients with chronic schizophrenia under treatment with antipsychotic drugs compared with healthy controls showed a significant decrease in [(11)C]verapamil uptake in the temporal cortex, the basal ganglia, and the amygdala, and amygdalae, and a trend towards a significant decrease was seen throughout the brain. The decrease of [(11)C]verapamil uptake correlates with an increased activity of the P-gp pump. Increased P-gp activity may be a factor in drug resistance in schizophrenia, induced by the use of antipsychotic agents.

Keywords: P-glycoprotein schizophrenia