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Arrestin-3 Agonism at Dopamine D3 Receptors Defines a Subclass of Second-Generation Antipsychotics That Promotes Drug Tolerance

Selin Schamiloglu, Elinor Lewis, Caroline M. Keeshen, Anne C. Hergarden, Kevin J. Bender, Jennifer L. Whistler

2023Biological Psychiatry14 citationsDOIOpen Access PDF

Abstract

BackgroundSecond-generation antipsychotics (SGAs) are frontline treatments for serious mental illness. Often, individual patients benefit only from some SGAs and not others. The mechanisms underlying this unpredictability in treatment efficacy remain unclear. All SGAs bind the dopamine D3 receptor (D3R) and are traditionally considered antagonists for dopamine receptor signaling.MethodsHere, we used a combination of two-photon calcium imaging, in vitro signaling assays, and mouse behavior to assess signaling by SGAs at D3R.ResultsWe report that some clinically important SGAs function as arrestin-3 agonists at D3R, resulting in modulation of calcium channels localized to the site of action potential initiation in prefrontal cortex pyramidal neurons. We further show that chronic treatment with an arrestin-3 agonist SGA, but not an antagonist SGA, abolishes D3R function through postendocytic receptor degradation by GASP1 (G protein–coupled receptor–associated sorting protein-1).ConclusionsThese results implicate D3R–arrestin-3 signaling as a source of SGA variability, highlighting the importance of including arrestin-3 signaling in characterizations of drug action. Furthermore, they suggest that postendocytic receptor trafficking that occurs during chronic SGA treatment may contribute to treatment efficacy.

Topics & Concepts

AgonismDopamine receptor D3SubclassPharmacologyDopamine receptorReceptorDopamineDrugDopamine receptor D2MedicineNeurosciencePsychologyInternal medicineImmunologyAntibodyPoliticsPolitical scienceLawReceptor Mechanisms and SignalingNeurotransmitter Receptor Influence on BehaviorNeural dynamics and brain function
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