Ellagic acid alleviates clozapine‑induced oxidative stress and mitochondrial dysfunction in cardiomyocytes

Abstract

Clozapine (CLZ) as an antipsychotic agent is very effective in treating of psychosis disorders and resistant schizophrenia, but the risk of severe cardiac toxicity effects restricts its clinical use. There are several interrelated hypotheses to explain clozapine-induced cardiotoxicity which all of them may be related to oxidative stress. Therefore, the current study investigated the harmful effects of clozapine on cardiomyocytes and assessed the cytoprotective effect of ellagic acid (EA). Freshly isolated adult rat ventricular cardiomyocytes were incubated for 4 h at 37 °C with 00.05% ethanol as control, CLZ (50 µM), CLZ (50 µM) + a series of EA concentrations (10, 20 and 50 µM) and EA (50 µM). To evaluate the protective effect of EA, the markers of cell viability, reactive oxygen species (ROS) formation, mitochondria membrane potential (ΔΨm) collapse, lysosomal membrane integrity, malondialdehyde (MDA) and oxidized/reduced glutathione (GSH/GSSG) content were checked by biochemical and flowcytometry techniques. Our results demonstrated that EA (10, 20 and 50 µM) effectively inhibited CLZ-induced cytotoxicity which is associated with ROS overproduction and amelioration of mitochondrial and lysosomal damages. In addition, EA (10, 20 and 50 µM) in the presence of CLZ reduced the production of MDA as a specific marker lipid peroxidation and GSSG. Collectively, these findings suggested that EA protects cardiomyocytes from oxidative injury through inhibiting ROS formation, mitochondria dysfunction, and lysosomal damages, which suggest a potential therapeutic strategy of EA for CLZ-induced oxidative stress and cardiotoxicity.

Keywords:

• Clozapine;
• ellagic acid;
• rat cardiomyocytes;
• reactive oxygen species;
• oxidative stress

Acknowledgment

The data presented in this article were extracted from the Pharm D. thesis of Dr. Roya Ahangari. These theses were conducted under supervision of Dr Ahmad Salimi at Department of Pharmacology and Toxicology, School of Pharmacy, Ardabil University of Medical Sciences. This study was supported by Ardabil of Medical Sciences, Deputy of Research with ethics code IR.ARUMS.REC.1398.288.

Disclosure statement

The authors declare that they have no conflict of interest.