Biological mechanisms behind clozapine-induced agranulocytosis

Clozapine is the most effective drug in treating therapy-resistant schizophrenia and may even be superior to all other antipsychotics. However, its use is limited by a high incidence (approximately 0.8%) of a severe hematological side effect, agranulocytosis. The exact molecular mechanism(s) of clozapine-induced agranulocytosis is still unknown. We investigated the mechanisms behind responsiveness to clozapine therapy and the risk of developing agranulocytosis by performing an HLA (human leukocyte antigens) association study in patients with schizophrenia. The first group comprised patients defined by responsiveness to first-generation antipsychotics (FGAs) (n= 19). The second group was defined by a lack of response to FGAs but responsiveness to clozapine (n=19). The third group of patients had a history of clozapine-induced granulocytopenia or agranulocytosis (n=26). Finnish healthy blood donors served as controls (n= 120). We found a significantly increased frequency of HLA-A1 among patients who were refractory to FGAs but responsive to clozapine. We also found that the frequency of HLA-A1 was low in patients with clozapine-induced neutropenia or agranulocytosis. These results suggest that HLA-A1 may predict a good therapeutic outcome and a low risk of agranulocytosis and therefore HLA typing may aid in the selection of patients for clozapine therapy. Furthermore, in a subgroup of schizophrenia, HLA-A1 may be in linkage disequilibrium with some vulnerability genes in the MHC (major histocompatibility complex) region on chromosome 6. These genes could be involved in antipsychotic drug response and clozapine-induced agranulocytosis. In addition, we investigated the effect of clozapine on gene expression in granulocytes by performing a microarray analysis on blood leukocytes of 8 schizophrenic patients who had started clozapine therapy for the first time. We identified an altered expression in 4 genes implicated in the maturation or apoptosis of granulocytes: MPO (myeloperoxidase precursor), MNDA (myeloid cell nuclear differentiation antigen), FLT3LG (Fms-related tyrosine kinase 3 ligand) and ITGAL (antigen CD11A, lymphocyte function-associated antigen 1). The altered expression of these genes following clozapine administration may suggest their involvement in clozapine-induced agranulocytosis. Finally, we investigated whether or not normal human bone marrow mesenchymal stromal cells (MSC) are sensitive to clozapine. We treated cultures of human MSCs and human skin fibroblasts with 10 µM of unmodified clozapine and with clozapine bioactivated by oxidation. We found that, independent of bioactivation, clozapine was cytotoxic to MSCs in primary culture, whereas clozapine at the same concentration stimulated the growth of human fibroblasts. This suggests that direct cytotoxicity to MSCs is one possible mechanism by which clozapine induces agranulocytosis.

Tribological properties of γ-Y2Si2O7 ceramic against AISI 52100 steel and Si3N4 ceramic counterparts

Reciprocating ball-on-flat dry sliding friction and wear experiments have been conducted on singlephase γ-Y2Si2O7 ceramic flats in contact with AISI 52100 bearing steel and Si3N4 ceramic balls at 5-15N normal loads in an ambient environment. The kinetic friction coefficients of γ-Y2Si2O7 varied in the range over 0.53-0.63 against AISI 52100 steel and between 0.51-0.56 against Si3N4 ceramic. We found thatwear occurred predominantly during the running-in period and it almost ceased at the steady friction stage. The wear rates of γ-Y2Si2O7 were in the order of 10-4mm3/(N m). Besides, wear debris strongly influenced the friction and wear processes. The strong chemical affinity between γ-Y2Si2O7 and AISI 52100 balls led to a thick transfer layer formed on both contact surfaces of the flat and counterpart ball, which changed the direct sliding between the ball and the flat into a shearing within the transfer layer. For the γ-Y2Si2O7/Si3N4 pair, a thin silica hydrate lubricant tribofilm presented above the compressed debris entrapped in the worn track and contact ball surface. This transfer layer and the tribofilm separated the sliding couple from direct contact and contributed to the low friction coefficient and wear rate.

Anodic deposition of porous RuO2 on stainless steel for supercapacitor studies at high current densities

Ruthenium dioxide is deposited on stainless steel (SS) substrate by galvanostatic oxidation of Ru3+. At high current densities employed for this purpose, there is oxidation of water to oxygen, which occurs in parallel with Ru3+ oxidation. The oxygen evolution consumes a major portion of the charge. The oxygen evolution generates a high porosity to RuO2 films, which is evident from scanning electron microscopy studies. RuO2 is identified by X-ray photoelectron spectroscopy. Cyclic voltammetry and galvanostatic charge–discharge cycling studies indicate that RuO2/SS electrodes possess good capacitance properties. Specific capacitance of 276 F g−1 is obtained at current densities as high as 20 mA cm−2 (13.33 A g−1). Porous nature of RuO2 facilitates passing of high currents during charge–discharge cycling. RuO2/SS electrodes are thus useful for high power supercapacitor applications.