Key result
High-dose clozapine reduces larval zebrafish locomotor activity across light and dark phases.
Why the study?
Regulatory authorities have expressed concerns about the relationship between atypical antipsychotics and cardiovascular risks including QTc prolongation, arrhythmia, and sudden cardiac death, necessitating cardiovascular risk assessment.
Effect estimate: Estimate -0.0946 (log scale)
p-value: p=0.0454
Hypothesis-generating for clozapine toxicity; extends zebrafish larval model utility but leaves clinical translation open.
The zebrafish model has been developed and evaluated for its ability to predict the toxicity of chemicals. Zebrafish additionally serve as an excellent model for assessing drug-induced cardiotoxicity, although zebrafish and mammalian hearts differ in structure. Recently, regulatory authorities have expressed concerns about a possible relationship between antipsychotics and risk of QTc interval prolongation, serious arrhythmia and sudden cardiac death. In the current study, we performed a cardiovascular risk assessment of six atypical antipsychotic drugs in zebrafish, specifically, aripiprazole, clozapine, olanzapine, quetiapine, risperidone and ziprasidone. Visual endpoints, such as lethality, edema (the presence of heart and trunk edema), hemorrhage (clustering of a pool of blood in an area outside the normal circulation), abnormal body shape (including bent or misshapen caudal region of the larvae) and motility, were evaluated as general toxicity endpoints, and the heart beat rate calculated as the cardiovascular toxicity endpoint. The zebrafish model facilitates determination of the heart beat rate, and may thus be an attractive screening tool for cardiovascular risk assessment of atypical antipsychotic drugs to understand the variations in response to QT-prolonging drugs.
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Lee et al. (2011) studied Locomotor behavior in larval zebrafish (n=288). Clozapine vs. Solvent control (0.1% DMSO) and dilution water control was evaluated on Total distance traveled (locomotion) during alternating light and dark phases in the visual motor response (VMR) assay (Estimate -0.0946 (log scale), p=0.0454). In a larval zebrafish model, clozapine exposure significantly reduced locomotor activity during both light and dark phases at the highest concentration (6.25 μM) compared to solvent control.
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