Glycine transport inhibitors in the treatment of schizophrenia

Handb Exp Pharmacol. 2012:(213):367-99. doi: 10.1007/978-3-642-25758-2_12.

Abstract

Schizophrenia is a severe neuropsychiatric disorder without adequate current treatment. Recent theories of schizophrenia focus on disturbances of glutamatergic neurotransmission particularly at N-methyl-D-aspartate (NMDA)-type glutamate receptors. NMDA receptors are regulated in vivo by the amino acids glycine and D-serine. Glycine levels, in turn, are regulated by glycine type I (GlyT1) transporters, which serve to maintain low subsaturating glycine levels in the vicinity of the NMDA receptor. A proposed approach to treatment of schizophrenia, therefore, is inhibition of GlyT1-mediated transport. Over the past decade, several well tolerated, high affinity GlyT1 inhibitors have been developed and shown to potentiate NMDA receptor-mediated neurotransmission in animal models relevant to schizophrenia. In addition, clinical trials have been conducted with sarcosine (N-methylglycine), a naturally occurring GlyT1 inhibitor, and with the high affinity compound RG1678. Although definitive trials remain ongoing, encouraging results to date have been reported.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Glycine / physiology
  • Glycine Plasma Membrane Transport Proteins / antagonists & inhibitors*
  • Humans
  • Piperazines / therapeutic use
  • Receptors, N-Methyl-D-Aspartate / chemistry
  • Receptors, N-Methyl-D-Aspartate / physiology
  • Schizophrenia / drug therapy*
  • Sulfones / therapeutic use

Substances

  • (4-(3-fluoro-5-trifluoromethylpyridin-2-yl)piperazin-1-yl)(5-methanesulfonyl-2-(2,2,2-trifluoro-1-methylethoxy)phenyl)methanone
  • Glycine Plasma Membrane Transport Proteins
  • Piperazines
  • Receptors, N-Methyl-D-Aspartate
  • Sulfones
  • Glycine