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Salo KI, Scharfen J, Wilden ID, Schubotz RI, Holling H. Confining the Concept of Vascular Depression to Late-Onset Depression: A Meta-Analysis of MRI-Defined Hyperintensity Burden in Major Depressive Disorder and Bipolar Disorder. Front Psychol 2019; 10:1241. [PMID: 31214072 PMCID: PMC6555192 DOI: 10.3389/fpsyg.2019.01241] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 05/10/2019] [Indexed: 12/14/2022] Open
Abstract
Background: The vascular depression hypothesis emphasizes the significance of vascular lesions in late-life depression. At present, no meta-analytic model has investigated whether a difference in hyperintensity burden compared to controls between late-life and late-onset depression is evident. By including a substantial number of studies, focusing on a meaningful outcome measure, and considering several moderating and control variables, the present meta-analysis investigates the severity of hyperintensity burden in major depressive disorder (MDD) and bipolar disorder (BD). A major focus of the present meta-analysis refers to the role of age at illness onset. It is analyzed whether late-onset rather than late-life depression characterizes vascular depression. Method: In total, 68 studies were included in the meta-analysis and a multilevel random effects model was calculated using Hedges' g as the effect size measure. Results: The severity of hyperintensity burden was significantly greater in the patient group compared to the control group. This effect was evident regarding the whole patient group (g = 0.229) as well as both depression subgroups, with a significantly greater effect in BD (g = 0.374) compared to MDD (g = 0.189). Hyperintensity burden was more pronounced in late-onset depression than in early-onset depression or late-life depression. A considerable heterogeneity between the included studies was observed, which is reflected by the large variability in effects sizes. Conclusion: In conclusion, the present meta-analysis underscores the association of hyperintensities with MDD and BD. Especially late-onset depression is associated with an increased hyperintensity burden, which is in line with the vascular depression hypothesis. The results suggest that it might be more feasible to confine the concept of vascular depression specifically to late-onset depression as opposed to late-life depression. Further research is needed to understand the causal mechanisms that might underlie the relation between hyperintensity burden and depression.
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Affiliation(s)
- Katharina I. Salo
- Department of Psychology and Sports Sciences, Institute of Psychology, Westfälische Wilhelms-Universität, Münster, Germany
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152
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Peirce JM, Alviña K. The role of inflammation and the gut microbiome in depression and anxiety. J Neurosci Res 2019; 97:1223-1241. [PMID: 31144383 DOI: 10.1002/jnr.24476] [Citation(s) in RCA: 214] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 04/26/2019] [Accepted: 05/15/2019] [Indexed: 02/06/2023]
Abstract
The study of the gut microbiome has increasingly revealed an important role in modulating brain function and mental health. In this review, we underscore specific pathways and mechanisms by which the gut microbiome can promote the development of mental disorders such as depression and anxiety. First, we review the involvement of the stress response and immune system activation in the development of depression and anxiety. Then, we examine germ-free murine models used to uncover the role of the gut microbiome in developing and modulating pertinent activity in the brain and the immune system. We also document multiple pathways by which stress-induced inflammation harms brain function and ultimately affects mental health, and review how probiotic and prebiotic treatments have shown to be beneficial. Lastly, we provide an overview of gut microbiome-derived compounds (short-chain fatty acids, tryptophan catabolites, microbial pattern recognition) and related mechanisms (vagal nerve activity and fecal microbiota transplants) involved in mediating the influence of the gut microbiome to mental health. Overall, a picture of the gut microbiome playing a facilitating role between stress response, inflammation, and depression, and anxiety is emerging. Future research is needed to firmly establish the microbiome's causal role, to further elucidate the mechanisms by which gut microbes influence brain function and mental health, and to possibly develop treatments that improve mental health through microbiotic targets.
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Affiliation(s)
- Jason M Peirce
- Department of Biological Sciences, Texas Tech University, Lubbock, Texas.,Honors College, Texas Tech University, Lubbock, Texas
| | - Karina Alviña
- Department of Biological Sciences, Texas Tech University, Lubbock, Texas
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153
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Ghasemi M. Nitric oxide: Antidepressant mechanisms and inflammation. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2019; 86:121-152. [PMID: 31378250 DOI: 10.1016/bs.apha.2019.04.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Millions of individuals worldwide suffers from mood disorders, especially major depressive disorder (MDD), which has a high rate of disease burden in society. Although targeting the biogenic amines including serotonin, and norepinephrine have provided invaluable links with the pharmacological treatment of MDD over the last four decades, a growing body of evidence suggest that other biologic systems could contribute to the pathophysiology and treatment of MDD. In this chapter, we highlight the potential role of nitric oxide (NO) signaling in the pathophysiology and thereby treatment of MDD. This has been investigated over the last four decades by showing that (i) levels of NO are altered in patients with major depression; (ii) modulators of NO signaling exert antidepressant effects in patients with MDD or in the animal studies; (iii) NO signaling could be targeted by a variety of antidepressants in animal models of depression; and (iv) NO signaling can potentially modulate the inflammatory pathways that underlie the pathophysiology of MDD. These findings, which hypothesize an NO involvement in MDD, can provide a new insight into novel therapeutic approaches for patients with MDD in the future.
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Affiliation(s)
- Mehdi Ghasemi
- Department of Neurology, University of Massachusetts Medical School, Worcester, MA, United States; Department of Neurology, Massachusetts and General Hospital, Boston, MA, United States.
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154
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Mesripour A, Rabian N, Yegdaneh A. The effect of different partitions of seaweed Sargassum plagyophylum on depression behavior in mice model of despair. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2019; 16:/j/jcim.2019.16.issue-4/jcim-2018-0207/jcim-2018-0207.xml. [PMID: 31125315 DOI: 10.1515/jcim-2018-0207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 01/27/2019] [Indexed: 02/07/2023]
Abstract
Background Seaweeds are a famous traditional food resource in some countries containing different types of secondary metabolites. These marine organisms have shown different biological activities. The aim of this study was to investigate the effects of hexane and methanol extracts of Sargassum plagyophylum on depression. Methods Sargassum plagyophylum was collected from Persian Gulf. The plant was extracted by maceration with methanol-ethyl acetate solvent. The extract was evaporated and partitioned by hexane and methanol solvents. The two partitions were administered i.p. to male mice either a single dose or for 7 days. Depression was evaluated by the forced swimming test (FST) which higher immobility time indicates depressive-like behavior. Results The immobility time during FST decreased significantly by all the doses of the hexane partitions (notably 40 mg/kg; 10 s ± 2 vs. 114 s ± 12 control group). However, only the lowest dose (20 mg/kg) of the methanol partition reduced immobility time during FST (23 s ± 8, p<0.001). Following the long term administration both of the partitions reduced the immobility time in FST (hexane 27 s ± 11, methanol 70 s ± 14, p<0.05 vs. control 140 s ± 14). Conclusion The hexane partition showed antidepressant effects not only by long-term administration but also by the single dose during FST. The 7 days therapy with methanol partition also induced antidepressant behavior, but only the lowest single dose reduced immobility in FST. The methanol partitions possibly have certain substance that interfered with behavior in the FST. Therefore, S. plagyophylum should be considered for further antidepressant studies.
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Affiliation(s)
- Azadeh Mesripour
- Department of Pharmacology and Isfahan Pharmaceutical Sciences Research Center, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Neda Rabian
- Department of Pharmacognosy and Isfahan Pharmaceutical Sciences Research Center, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Afsaneh Yegdaneh
- Department of Pharmacognosy and Isfahan Pharmaceutical Sciences Research Center, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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155
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Köhler-Forsberg O, N Lydholm C, Hjorthøj C, Nordentoft M, Mors O, Benros ME. Efficacy of anti-inflammatory treatment on major depressive disorder or depressive symptoms: meta-analysis of clinical trials. Acta Psychiatr Scand 2019; 139:404-419. [PMID: 30834514 DOI: 10.1111/acps.13016] [Citation(s) in RCA: 233] [Impact Index Per Article: 46.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/25/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND No study has gathered evidence from all randomized clinical trials (RCTs) with anti-inflammatory drugs measuring antidepressant effects including a detailed assessment of side-effects and bias. METHODS We performed a systematic review identifying RCTs published prior to January 1, 2018, studying antidepressant treatment effects and side-effects of pharmacological anti-inflammatory intervention in adults with major depressive disorder (MDD) or depressive symptoms. Outcomes were depression scores after treatment, remission, response, and side-effects. Pooled standard mean differences (SMD) and risk ratios (RR) including 95% confidence intervals (95%-CI) were calculated. RESULTS We identified 36 RCTs, whereof 13 investigated NSAIDs (N = 4214), 9 cytokine inhibitors (N = 3345), seven statins (N = 1576), 3 minocycline (N = 151), 2 pioglitazone (N = 77), and 2 glucocorticoids (N = 59). Anti-inflammatory agents improved depressive symptoms compared to placebo as add-on in patients with MDD (SMD = -0.64; 95%-CI = -0.88, -0.40; I2 = 51%; N = 597) and as monotherapy (SMD = -0.41; 95%-CI = -0.60, -0.22; I2 = 93%, N = 8825). Anti-inflammatory add-on improved response (RR = 1.76; 95%-CI = 1.44-2.16; I2 = 16%; N = 341) and remission (RR = 2.14; 95%-CI = 1.03-4.48; I2 = 57%; N = 270). We found a trend toward an increased risk for infections, and all studies showed high risk of bias. CONCLUSION Anti-inflammatory agents improved antidepressant treatment effects. Future RCTs need to include longer follow-up, identify optimal doses and subgroups of patients that can benefit from anti-inflammatory intervention.
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Affiliation(s)
- O Köhler-Forsberg
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.,Copenhagen Research Center for Mental Health -CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - C N Lydholm
- Copenhagen Research Center for Mental Health -CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - C Hjorthøj
- Copenhagen Research Center for Mental Health -CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.,iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen
| | - M Nordentoft
- Copenhagen Research Center for Mental Health -CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.,iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - O Mors
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.,iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - M E Benros
- Copenhagen Research Center for Mental Health -CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.,iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
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156
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Zhang J, Yue Y, Thapa A, Fang J, Zhao S, Shi W, Yang Z, Li Y, Yuan Y. Baseline serum C-reactive protein levels may predict antidepressant treatment responses in patients with major depressive disorder. J Affect Disord 2019; 250:432-438. [PMID: 30878656 DOI: 10.1016/j.jad.2019.03.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 02/15/2019] [Accepted: 03/03/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Inflammation has been shown previously to predict antidepressant treatment response. This retrospective study was conducted to test if the baseline serum C-reactive protein (CRP) levels could predict antidepressant treatment responses in a Chinese sample. METHODS 75 adult inpatients (26 male, 49 female) with major depressive disorder (MDD) diagnosed according to DSM-5 were included in this study. Sociodemographic and clinical features, baseline CRP levels, 17-item Hamilton Depression Rating Scale (HDRS-17) and Hamilton Anxiety Rating Scale (HARS) scores assessed at baseline and weeks 1, 2, 3 and 4 were then collected. Afterwards patients were divided into two groups: the low CRP group (baseline CRP < 1 mg/L, n = 47) and the high CRP group (baseline CRP ≥ 1 mg/L, n = 28). Depression severity and treatment response were compared between the two groups. RESULTS Repeated-measures ANOVA showed a significant group * assessments interaction in HDRS-17 scores (F = 4.754; p = 0.005). Post-hoc test showed that the two groups differed in HDRS-17 scores at week 4 (F = 6.698; p = 0.012), with the low CRP group having lower HDRS-17 scores than the high CRP group. Moreover, the low CRP group exhibited higher percent reduction in HDRS-17 scores at week 3 (F = 5.016; p = 0.028) and week 4 (F = 9.865; p = 0.003) as compared to the high CRP group. Cox proportional hazard model showed that the remission rate was higher in the low CRP group (p = 0.010). LIMITATIONS Patients received uncontrolled antidepressant therapy and the sample size was limited. CONCLUSIONS Baseline serum CRP levels may predict antidepressant treatment responses in patients with MDD and patients with higher levels of CRP were less likely to get remission.
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Affiliation(s)
- Jun Zhang
- Department of Clinical Psychology, Changshu Third People's Hospital, Changshu Mental Health Center, Changshu, China, 215500
| | - Yingying Yue
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China, 210009
| | - Ashok Thapa
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China, 210009
| | - Jianzhong Fang
- Department of Clinical Psychology, Changshu Third People's Hospital, Changshu Mental Health Center, Changshu, China, 215500
| | - Shengjun Zhao
- Department of Clinical Psychology, Changshu Third People's Hospital, Changshu Mental Health Center, Changshu, China, 215500
| | - Weihua Shi
- Department of Clinical Psychology, Changshu Third People's Hospital, Changshu Mental Health Center, Changshu, China, 215500
| | - Zhong Yang
- Department of Clinical Psychology, Changshu Third People's Hospital, Changshu Mental Health Center, Changshu, China, 215500
| | - Yanfang Li
- Department of Information, Changshu Third People's Hospital, Changshu Mental Health Center, Changshu, China, 215500
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China, 210009.
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157
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Locachevic GA, Prado MKB, Zoccal KF, Pereira PAT, Sorgi CA, Bortolanza M, Peti APF, Fogaça MV, Guimarães FS, Del Bel E, Faccioli LH. Paradoxical Effect of LTB 4 on the Regulation of Stress-Induced Corticosterone Production. Front Behav Neurosci 2019; 13:73. [PMID: 31057373 PMCID: PMC6477085 DOI: 10.3389/fnbeh.2019.00073] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 03/26/2019] [Indexed: 01/17/2023] Open
Abstract
Depression is a mental illness with a complex and multifactorial etiology, which has been associated with stress and inflammation. Infections, autoimmune diseases, envenomation, and trauma induce an inflammatory response that is characterized by increasing levels of circulating cytokines (e.g., IL-1β) and lipid mediators [e.g., PGE2 and leukotrienes B4 (LTB4)]. Recently, we showed that LTB4 production by the 5-lipoxygenase (5-LO) pathway regulates IL-1β and PGE2 release, reducing tissue damage in a model of sterile inflammation. Since IL-1β and PGE2 increase in serum of stressed patients and potentially trigger depression, we used an animal model of chronic unpredictable stress (CUS) to investigate the potential impact of LTB4 over depression-like symptoms. At basal conditions, 5-LO deficiency (Alox5−/−) reduces the preference for sucrose, while inducing a higher immobilization time on the tail suspension test when compared 129sv. Moreover, Alox5−/− mice present increased caspase-1 expression and elevated levels of IL-1β, IL-17 and PGE2 in the spleen, with increasing corticosterone levels in the frontal cortex but reducing systemic levels. Compared to 129sv mice, CUS induced higher levels of systemic, frontal cortex and hippocampal corticosterone, and also reduced sucrose preference, increased levels of splenic IL-1β, IL-17 and PGE2 and reduced levels of LTB4. Interestingly, CUS exposure did not alter the reduced sucrose preference shown by Alox5−/− mice but greatly enhanced splenic PGE2 production. Compared to Alox5−/− mice at basal conditions, CUS exposure also increased levels of systemic corticosterone, which remained lower than those of CUS-129sv animals. We also observed that treatment with LTB4 decreased caspase-1 expression and systemic levels of corticosterone in CUS-Alox5−/− mice but there was no significant impact on the reduced sucrose preference. Our results demonstrate that LTB4 controls the hypothalamic-pituitary-adrenal (HPA) axis by regulating levels of systemic corticosterone associated with the repression of caspase-1 expression and production of inflammatory mediators. One limitation of our study is that 129sv and Alox5−/− mice were not littermates, not sharing, therefore, the same intra-uterine and preweaning environment. Even so, taken together our results indicate that 5-LO activity is critical for the regulation of stress-induced symptoms, suggesting that the Alox5−/− mouse could be a natural model of corticosterone-independent reduced reward sensitivity.
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Affiliation(s)
- Gisele A Locachevic
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Morgana K B Prado
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Karina F Zoccal
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Priscilla A T Pereira
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Carlos A Sorgi
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Mariza Bortolanza
- Departamento de Morfologia, Fisiologia e Patologia Básica, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Ana Paula F Peti
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Manoela V Fogaça
- Departamento de Farmacologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Francisco S Guimarães
- Departamento de Farmacologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Elaine Del Bel
- Departamento de Morfologia, Fisiologia e Patologia Básica, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - Lúcia H Faccioli
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
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158
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Zinc inhibited LPS-induced inflammatory responses by upregulating A20 expression in microglia BV2 cells. J Affect Disord 2019; 249:136-142. [PMID: 30772740 DOI: 10.1016/j.jad.2019.02.041] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 02/05/2019] [Accepted: 02/11/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Our previous studies have proved that zinc supplement effectively alleviate depression symptoms in mice, but the mechanisms are still uncertain. Neuroinflammation is considered as an important aspect in pathogenesis of depression. To elucidate the role of zinc on neuroinflammation, in this study, we investigated effects of zinc on lipopolysaccharide (LPS)-induced inflammation in BV2 microglia cells, a kind of innate immune cells in central nervous system. METHODS BV2 cells were treated by 100 ng/ml LPS to induce inflammatory responses and the effects of zinc sulfate (ZnSO4) addition on LPS-induced inflammation were observed. Besides, through culturing HT-22 hippocampus cells by using medium transferred from zinc-intervened BV2 cells, the protective roles of zinc on hippocampus cells were identified. RESULTS LPS treatment up-regulated expressions of CD11b, inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX2), tumor necrosis factor α (TNFα) and interleukin-6 (IL-6) and level of reactive oxygen species (ROS). Meaningfully, zinc was capable of blocking ROS generation and reducing expressions of the above inflammatory cytokines at both 10 μM and 30 μM. In addition, it was proved that zinc intervention to BV2 cells could increase the viabilities of hippocampal HT-22 cells cultured by medium of BV2 cells. Furthermore, the zinc-finger protein A20, an anti-inflammation factor, was increased by zinc supplement, while levels of p65, p-IκB and p-p65 were significantly decreased. LIMITATIONS More compelling proofs were needed to ensure roles of A20 in anti-inflammatory effects of zinc. CONCLUSIONS The present results suggested that zinc inhibits inflammatory responses mediated by microglia cells via upregulation of zinc-finger A20. It was proposed that this anti-inflammatory action might be underlying mechanism of previously observed anti-depressive effects of zinc.
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159
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Woelfer M, Kasties V, Kahlfuss S, Walter M. The Role of Depressive Subtypes within the Neuroinflammation Hypothesis of Major Depressive Disorder. Neuroscience 2019; 403:93-110. [DOI: 10.1016/j.neuroscience.2018.03.034] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 01/25/2018] [Accepted: 03/20/2018] [Indexed: 12/21/2022]
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160
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Lipopolysaccharide-induced depressive-like, anxiogenic-like and hyperalgesic behavior is attenuated by acute administration of α-(phenylselanyl) acetophenone in mice. Neuropharmacology 2019; 146:128-137. [DOI: 10.1016/j.neuropharm.2018.11.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 10/25/2018] [Accepted: 11/19/2018] [Indexed: 12/29/2022]
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161
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Furuyashiki T, Akiyama S, Kitaoka S. Roles of multiple lipid mediators in stress and depression. Int Immunol 2019; 31:579-587. [DOI: 10.1093/intimm/dxz023] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 02/23/2019] [Indexed: 12/28/2022] Open
Abstract
AbstractProlonged or excessive stress may induce emotional and cognitive disturbances, and is a risk factor for mental illnesses. Using rodent chronic stress models of depression, roles of multiple lipid mediators related to inflammation have been revealed in chronic stress-induced emotional alterations. Prostaglandin (PG) E2, an arachidonic acid (AA)-derived lipid mediator, and its receptor subtype EP1 mediate depression-like behavior induced by repeated social defeat stress through attenuating prefrontal dopaminergic activity. Repeated social defeat stress activates microglia through innate immune receptors, and induces PGE2 synthesis through cyclooxygenase-1, a prostaglandin synthase enriched in microglia. PGD2, another AA-derived lipid mediator, has been implicated in depression induced by chronic stress, although either pro-depressive or anti-depressive actions have been reported. Chronic stress up-regulates hippocampal expression of 5-lipoxygenase, hence synthesis of cysteinyl leukotrienes, thereby inducing depression through their receptors. Consistent with beneficial effects of n-3 fatty acids in the diet of depressive patients, resolvins—a novel class of pro-resolving lipid mediators—in the brain attenuate neuroinflammation-associated depression. These findings in animal models of depression offer lipid mediators and related molecules as novel therapeutic targets for treating depression. To translate these findings into clinics, translational biomarkers to visualize lipid mediator profiles in depressive patients need to be established.
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Affiliation(s)
- Tomoyuki Furuyashiki
- Division of Pharmacology, Kobe University Graduate School of Medicine, Kusunoki-cho, Kobe, Hyogo, Japan
- Japan Agency for Medical Research and Development (AMED),Otemachi, Tokyo, Japan
| | - Satoshi Akiyama
- Division of Pharmacology, Kobe University Graduate School of Medicine, Kusunoki-cho, Kobe, Hyogo, Japan
- Japan Agency for Medical Research and Development (AMED),Otemachi, Tokyo, Japan
- Department of CNS Research, New Drug Research Division, Otsuka Pharmaceutical Co., Ltd., Kagasuno, Tokushima, Japan
| | - Shiho Kitaoka
- Division of Pharmacology, Kobe University Graduate School of Medicine, Kusunoki-cho, Kobe, Hyogo, Japan
- Japan Agency for Medical Research and Development (AMED),Otemachi, Tokyo, Japan
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162
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Harth M, Nielson WR. Pain and affective distress in arthritis: relationship to immunity and inflammation. Expert Rev Clin Immunol 2019; 15:541-552. [PMID: 30669892 DOI: 10.1080/1744666x.2019.1573675] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Most arthritides are associated with pain and psychological distress (clinically significant depression and anxiety). Pain and depression are mutually exacerbating; both may continue even when joint involvement appears well controlled. Area covered: There is strong evidence that arthritis-related stress impacts the central nervous system and, together with peripheral inflammatory changes, can cause central sensitization that can lead to chronic pain and worsening of affective distress. Cytokines and chemokines participate both in joint inflammation and in central sensitization. We review evidence of these relationships in five arthritides, namely rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, gout, and in osteoarthritis of the hips and knees. Central sensitization in these conditions results in long-lasting pain and psychological distress. Expert commentary: Chronic pain and depression are important but often neglected in the clinical assessment and treatment of arthritis. The potential role of biologic cytokines and Janus kinase inhibitors in dealing with these symptoms needs further study.
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Affiliation(s)
- Manfred Harth
- a Medicine , Western University , London , Ontario , Canada
| | - Warren R Nielson
- b Lawson Health Research Institute , London , Ontario , Canada.,c Department of Psychology , Western University , London , Ontario , Canada
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163
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Müller N. COX-2 Inhibitors, Aspirin, and Other Potential Anti-Inflammatory Treatments for Psychiatric Disorders. Front Psychiatry 2019; 10:375. [PMID: 31214060 PMCID: PMC6555131 DOI: 10.3389/fpsyt.2019.00375] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 05/13/2019] [Indexed: 12/16/2022] Open
Abstract
Inflammatory processes associated with persistent (chronic) infection have long been discussed as etiological factors in psychiatric disorders. Studies have found that people with major depression have higher levels of pro-inflammatory cytokines, for example, IL-1, IL-6, and tumor necrosis factor-alpha, and C-reactive protein. In schizophrenia, many reports have described raised levels of cytokines, for example, IL-6; and meta-analyses have confirmed these findings. Microglia cells are important in inflammatory processes, and positron emission tomography studies have shown microglia activation in both depression and schizophrenia.As a consequence of the above findings, immunomodulation is widely discussed as a potential treatment approach in both major depression and schizophrenia. The COX-2 inhibitor celecoxib was found to have a significant positive effect on major depression, not only in single studies but also in meta-analyses. Celecoxib has also been studied in schizophrenia and has shown efficacy, in particular, in early disease stages. The mixed COX inhibitor aspirin (acetylsalicylic acid) seems to have both protective and therapeutic effects on schizophrenia.This paper discusses the hypothesized role of inflammation in major depression and schizophrenia, including markers of inflammation; pertinent studies on celecoxib and aspirin; and additional immunomodulatory therapeutic strategies.
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Affiliation(s)
- Norbert Müller
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität Munich, Munich, Germany.,Marion von Tessin Memory Center, Munich, Germany
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164
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Hafizi S, Tabatabaei D, Lai MC. Review of Clinical Studies Targeting Inflammatory Pathways for Individuals With Autism. Front Psychiatry 2019; 10:849. [PMID: 31824351 PMCID: PMC6886479 DOI: 10.3389/fpsyt.2019.00849] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 10/28/2019] [Indexed: 12/11/2022] Open
Abstract
Immune dysfunction and abnormal immune response may be associated with certain mechanisms underlying autism spectrum disorder (ASD). The early evidence for this link was based on the increased incidence of ASD in children with a history of maternal infection during pregnancy. Observational studies show increased prevalence of immune-related disorders-ranging from atopy, food allergy, viral infections, asthma, primary immunodeficiency, to autoimmune disorders-in individuals with ASD and their families. Evidence of neuroglial activation and focal brain inflammation in individuals with ASD implies that the central nervous system immunity may also be atypical in some individuals with ASD. Also, both peripheral and central inflammatory responses are suggested to be associated with ASD-related behavioral symptoms. Atypical immune responses may be evident in specific ASD subgroups, such as those with significant gastrointestinal symptoms. The present review aimed to evaluate current literature of potential interventions that target inflammatory pathways for individuals with ASD and to summarize whether these interventions were associated with improvement in autism symptoms and adaptation. We found that the current literature on the efficacy of anti-inflammatory interventions in ASD is still limited and large-scale randomized controlled trials are needed to provide robust evidence. We concluded that the role of immune-mediated mechanisms in the emergence of ASD or related challenges may be specific to subsets of individuals (e.g. those with concurrent immunological disorders, developmental regression, or high irritability). These subsets of individuals of ASD might be more likely to benefit from interventions that target immune-mediated mechanisms and with whom next-stage immune-mediated clinical trials could be conducted.
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Affiliation(s)
- Sina Hafizi
- Department of Psychiatry, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Dina Tabatabaei
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Meng-Chuan Lai
- Centre for Addiction and Mental Health and The Hospital for Sick Children, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.,Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
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165
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Coryell W. Impact, Diagnosis, Phenomenology, and Biology. Handb Exp Pharmacol 2019; 250:3-33. [PMID: 31004226 DOI: 10.1007/164_2018_156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This section provides summaries of the epidemiology, phenomenology, nosology, and the suspected biological substrates of the depressive disorders. It particularly emphasizes the historical evolution of the pertinent diagnostic constructs and the prognostic import both of the various diagnostic groupings and of the individual symptoms and symptom clusters.
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Affiliation(s)
- William Coryell
- Department of Psychiatry, Carver College of Medicine, University of Iowa Health Care, Iowa City, IA, USA.
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166
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Sethi R, Gómez-Coronado N, Walker AJ, Robertson OD, Agustini B, Berk M, Dodd S. Neurobiology and Therapeutic Potential of Cyclooxygenase-2 (COX-2) Inhibitors for Inflammation in Neuropsychiatric Disorders. Front Psychiatry 2019; 10:605. [PMID: 31551825 PMCID: PMC6738329 DOI: 10.3389/fpsyt.2019.00605] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 07/30/2019] [Indexed: 12/15/2022] Open
Abstract
Neuropsychiatric disorders, such as depression, bipolar disorder, schizophrenia, obsessive-compulsive disorder, and neurodevelopmental disorders such as autism spectrum disorder, are associated with significant illness burden. Accumulating evidence supports an association between these disorders and inflammation. Consequently, anti-inflammatory agents, such as the cyclooxygenase-2 inhibitors, represent a novel avenue to prevent and treat neuropsychiatric illness. In this paper, we first review the role of inflammation in psychiatric pathophysiology including inflammatory cytokines' influence on neurotransmitters, the hypothalamic-pituitary-adrenal axis, and microglial mechanisms. We then discuss how cyclooxygenase-2-inhibitors influence these pathways with potential therapeutic benefit, with a focus on celecoxib, due to its superior safety profile. A search was conducted in PubMed, Embase, and PsychINFO databases, in addition to Clinicaltrials.gov and the Stanley Medical Research Institute trial registries. The results were presented as a narrative review. Currently available outcomes for randomized controlled trials up to November 2017 are also discussed. The evidence reviewed here suggests cyclooxygenase-2 inhibitors, and in particular celecoxib, may indeed assist in treating the symptoms of neuropsychiatric disorders; however, further studies are required to assess appropriate illness stage-related indication.
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Affiliation(s)
- Rickinder Sethi
- Department of Psychiatry, Western University, London, ON, Canada
| | - Nieves Gómez-Coronado
- Unidad de Gestión Clinica Salud Mental, Hospital Universitario Virgen del Rocio, Sevilla, Spain
| | - Adam J Walker
- IMPACT Strategic Research Centre, Deakin University, Geelong, VIC, Australia
| | - Oliver D'Arcy Robertson
- IMPACT Strategic Research Centre, Deakin University, Geelong, VIC, Australia.,University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
| | - Bruno Agustini
- IMPACT Strategic Research Centre, Deakin University, Geelong, VIC, Australia
| | - Michael Berk
- IMPACT Strategic Research Centre, Deakin University, Geelong, VIC, Australia.,University Hospital Geelong, Barwon Health, Geelong, VIC, Australia.,Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,Department of Psychiatry, Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
| | - Seetal Dodd
- IMPACT Strategic Research Centre, Deakin University, Geelong, VIC, Australia.,University Hospital Geelong, Barwon Health, Geelong, VIC, Australia.,Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
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167
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Miller ES, Grobman WA, Culhane J, Adam E, Buss C, Entringer S, Miller G, Wadhwa PD, Keenan-Devlin L, Borders A. Antenatal depression, psychotropic medication use, and inflammation among pregnant women. Arch Womens Ment Health 2018; 21:785-790. [PMID: 29862416 PMCID: PMC6240365 DOI: 10.1007/s00737-018-0855-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 05/14/2018] [Indexed: 12/14/2022]
Abstract
To evaluate the association between psychotropic medication and inflammatory biomarkers in women with antenatal depressive symptoms (ADS). In this cross-sectional secondary analysis of a prospective multicenter observational study, 723 pregnant women underwent a depression screen using the Center for Epidemiologic Studies Depression Scale (CES-D) between 12 and 21 weeks gestation. Self-reported use of medications for depression and/or anxiety was corroborated with the medical record to document exposure to pharmacotherapy. Serum was collected and inflammatory biomarkers (IFNγ, IL13, IL6, IL8, TNFα, CRP) were measured concomitantly. Women were included if they fell into one of three categories: ADS responsive to treatment (CES-D < 16 with medication), ADS not responsive to medication (CES-D ≥ 23 despite medication), and untreated ADS (CES-D ≥ 23 with no medication). Levels of inflammatory biomarkers were compared among groups and multivariable regressions performed. Of the 85 women studied, 16 (19%) had ADS responsive to treatment, 12 (14%) had ADS not responsive to medication, and 57 (67%) had untreated ADS. TNFα concentrations significantly differed (P = 0.016) across the cohorts. Post hoc bivariate analyses demonstrated that women with ADS responsive to treatment had lower serum TNFα than non-responders (p = 0.02) and women with untreated ADS (p = 0.01). There were no differences in IFNγ, IL13, IL6, IL8, or CRP among the groups. Regressions demonstrated that, compared to women with ADS responsive to treatment, non-responders or women with untreated ADS had higher TNFα levels (β = 0.27, 95% CI 0.02-0.52 and β = 0.23, 95% CI 0.02-0.44, respectively). Pregnant women on pharmacotherapy who respond to treatment for ADS have lower TNFα compared to women not responsive to medication or women with untreated ADS. These data suggest the possibility that either the therapeutic response in the context of pharmacotherapy is accompanied by modulation of the immune system or that pre-existing higher levels of TNFα may be associated with a poorer response to traditional pharmacotherapy.
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Affiliation(s)
- Emily S. Miller
- Northwestern University Feinberg School of Medicine, Chicago IL
| | | | - Jennifer Culhane
- Children’s Hospital of Philadelphia & University of Pennsylvania Perelman School of Medicine, Philadelphia PA
| | - Emma Adam
- Northwestern University Institute for Policy Research & School of Education and Social Policy, Chicago IL
| | - Claudia Buss
- University of California, Irvine, CA, & Charité, Universitätsmedizin Berlin, Germany
| | - Sonja Entringer
- University of California, Irvine, CA, & Charité, Universitätsmedizin Berlin, Germany
| | - Gregory Miller
- Northwestern University, Institute for Policy Research, Evanston IL
| | | | - Lauren Keenan-Devlin
- Northwestern University Center for Healthcare Studies, & NorthShore University Health System, University of Chicago Pritzker School of Medicine, Chicago IL
| | - Ann Borders
- Northwestern University Feinberg School of Medicine, Chicago IL,Northwestern University Center for Healthcare Studies, & NorthShore University Health System, University of Chicago Pritzker School of Medicine, Chicago IL
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168
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Østergaard L, Jørgensen MB, Knudsen GM. Low on energy? An energy supply-demand perspective on stress and depression. Neurosci Biobehav Rev 2018; 94:248-270. [DOI: 10.1016/j.neubiorev.2018.08.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 07/09/2018] [Accepted: 08/13/2018] [Indexed: 12/17/2022]
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169
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Cai YJ, Wang F, Chen ZX, Li L, Fan H, Wu ZB, Ge JF, Hu W, Wang QN, Zhu DF. Hashimoto's thyroiditis induces neuroinflammation and emotional alterations in euthyroid mice. J Neuroinflammation 2018; 15:299. [PMID: 30373627 PMCID: PMC6206655 DOI: 10.1186/s12974-018-1341-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 10/22/2018] [Indexed: 12/16/2022] Open
Abstract
Background Although studies have reported an increased risk for mood disorders in Hashimoto’s thyroiditis (HT) patients even in the euthyroid state, the mechanisms involved remain unclear. Neuroinflammation may play a key role in the etiology of mood disorders in humans and behavioral disturbances in rodents. Therefore, this study established a euthyroid HT model in mice and investigated whether HT itself was capable of triggering neuroinflammation accompanied by emotional alterations. Methods Experimental HT was induced by immunizing NOD mice with thyroglobulin and adjuvant twice. Four weeks after the last challenge, mice were tested for anxiety-like behavior in the open field and elevated plus maze tests and depression-like behavior in the forced swimming and tail suspension tests. Then, animals were sacrificed for thyroid-related parameter measure as well as detection of cellular and molecular events associated with neuroinflammation. The changes in components of central serotonin signaling were also investigated. Results HT mice showed intrathyroidal monocyte infiltration and rising serum thyroid autoantibody levels accompanied by normal thyroid function, which defines euthyroid HT in humans. These mice displayed more anxiety- and depressive-like behaviors than controls. HT mice further showed microglia and astrocyte activation in the frontal cortex detected by immunohistochemistry, real-time RT-PCR, and transmission electron microscopy (TEM). These observations were also accompanied by enhanced gene expression of proinflammatory cytokines IL-1β and TNF-α in the frontal cortex. Despite this inflammatory response, no signs of neuronal apoptosis were visible by the TUNEL staining and TEM in the frontal cortex of HT mice. Additionally, IDO1 and SERT, key serotonin-system-related genes activated by proinflammatory cytokines, were upregulated in HT mice, accompanied by reduced frontal cortex serotonin levels. Conclusions Our results are the first to suggest that HT induces neuroinflammation and alters related serotonin signaling in the euthyroid state, which may underlie the deleterious effects of HT itself on emotional function.
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Affiliation(s)
- Yao-Jun Cai
- Department of Endocrinology, Anhui Geriatric Institute, the First Affiliated Hospital of Anhui Medical University, Hefei, 230032, China
| | - Fen Wang
- Department of Endocrinology, Anhui Geriatric Institute, the First Affiliated Hospital of Anhui Medical University, Hefei, 230032, China
| | - Zhang-Xiang Chen
- Department of Endocrinology, Anhui Geriatric Institute, the First Affiliated Hospital of Anhui Medical University, Hefei, 230032, China
| | - Li Li
- Department of Endocrinology, Anhui Geriatric Institute, the First Affiliated Hospital of Anhui Medical University, Hefei, 230032, China
| | - Hua Fan
- Department of Endocrinology, Anhui Geriatric Institute, the First Affiliated Hospital of Anhui Medical University, Hefei, 230032, China
| | - Zhang-Bi Wu
- Department of Endocrinology, Anhui Geriatric Institute, the First Affiliated Hospital of Anhui Medical University, Hefei, 230032, China
| | - Jin-Fang Ge
- Anhui Key Laboratory of Bioactivity of Natural Products, School of Pharmacy, Anhui Medical University, Hefei, 230032, China
| | - Wen Hu
- Department of Pathology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, 230032, China
| | - Qu-Nan Wang
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei, 230032, China.
| | - De-Fa Zhu
- Department of Endocrinology, Anhui Geriatric Institute, the First Affiliated Hospital of Anhui Medical University, Hefei, 230032, China.
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170
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Neuroimmunomodulation in Major Depressive Disorder: Focus on Caspase 1, Inducible Nitric Oxide Synthase, and Interferon-Gamma. Mol Neurobiol 2018; 56:4288-4305. [PMID: 30306457 PMCID: PMC6505498 DOI: 10.1007/s12035-018-1359-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 09/19/2018] [Indexed: 12/13/2022]
Abstract
Major depressive disorder (MDD) is one of the leading causes of disability worldwide, and its incidence is expected to increase. Despite tremendous efforts to understand its underlying biological mechanisms, MDD pathophysiology remains elusive and pharmacotherapy outcomes are still far from ideal. Low-grade chronic inflammation seems to play a key role in mediating the interface between psychological stress, depressive symptomatology, altered intestinal microbiology, and MDD onset. We review the available pre-clinical and clinical evidence of an involvement of pro-inflammatory pathways in the pathogenesis, treatment, and remission of MDD. We focus on caspase 1, inducible nitric oxide synthase, and interferon gamma, three inflammatory systems dysregulated in MDD. Treatment strategies aiming at targeting such pathways alone or in combination with classical therapies could prove valuable in MDD. Further studies are needed to assess the safety and efficacy of immune modulation in MDD and other psychiatric disorders with neuroinflammatory components.
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171
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Graham D, Wu QX, Gilligan I, Ismail R, Walker M. Improvement of late life depression after therapeutic enoxaparin: two case reports. Australas Psychiatry 2018; 26:534-536. [PMID: 30198320 DOI: 10.1177/1039856218797441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Late life depression (LLD) may have a significant vascular component. While this organic basis remains controversial it would explain the refractory nature of LLD. Moreover, depression is a risk factor for venous thrombus embolism (VTE). This paper aims to describe two elderly patients with LLD who developed and were treated for pulmonary embolism (PE). METHODS Two cases of elderly patients who developed PE while they were undergoing inpatient treatment for depression are presented. This is discussed using the vascular and the cytokine hypotheses of depression as an explanatory framework. RESULTS Both patients showed significant clinical improvement in their mental state following therapeutic enoxaparin despite no other changes to their management of depression. This observed benefit of enoxaparin can be explained by the vascular hypothesis of LLD, and possibly the cytokine hypothesis of major depression. CONCLUSION Enoxaparin may be a novel adjunct to the treatment of depression in elderly patients. The possible benefit of enoxaparin would require further study to exclude a coincidence in these clinical cases.
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Affiliation(s)
- David Graham
- Kids Neuroscience Centre, Kids Research Institute, The Children's Hospital at Westmead, Westmead, NSW, and; Concord Centre for Mental Health, Concord Hospital, Concord, NSW, Australia
| | - Qi Xuan Wu
- Department of Psychiatry, Nepean Hospital, Penrith, NSW, Australia
| | - Ian Gilligan
- Department of Psychiatry, Nepean Hospital, Penrith, NSW, and; Department of Archaeology, University of Sydney, Sydney, NSW, Australia
| | - Raiz Ismail
- Department of Psychiatry, Nepean Hospital, Penrith, NSW, Australia
| | - Mark Walker
- Department of Psychiatry, Nepean Hospital, Penrith, NSW, Australia
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172
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Stapel B, Sieve I, Falk CS, Bleich S, Hilfiker-Kleiner D, Kahl KG. Second generation atypical antipsychotics olanzapine and aripiprazole reduce expression and secretion of inflammatory cytokines in human immune cells. J Psychiatr Res 2018; 105:95-102. [PMID: 30216787 DOI: 10.1016/j.jpsychires.2018.08.017] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 08/10/2018] [Accepted: 08/10/2018] [Indexed: 12/21/2022]
Abstract
Schizophrenia and major depression are associated with alterations in peripheral inflammatory markers, and anti-inflammatory therapy has been proposed as a promising add-on approach in the pharmacologic treatment of both disorders. Second-generation atypical antipsychotics are currently first-line drugs in the treatment of schizophrenia and are also used as augmentation strategies in treatment-resistant major depression. Furthermore, these drugs have been reported to exhibit distinct metabolic side effects and to influence inflammatory processes. In this study, we used ex vivo stimulation of primary human peripheral blood mononuclear cells (PBMC) from healthy blood donors with atypical antipsychotics olanzapine or aripiprazole to examine effects on cytokine production independent from metabolic side effects and disease status. Both olanzapine and aripiprazole stimulation decreased mRNA levels of IL-1β, IL-6, and TNF-α and resulted in diminished protein concentrations of IL-6 and TNF-α in conditioned medium of stimulated PBMC. A multiplex approach revealed additional downregulation of IL-2; MIP-1β and IP-10 secretion. Similarly, olanzapine and aripiprazole stimulation of the human monocytic cell line THP-1 resulted in a significant decrease in expression and secretion of IL-1β and TNF-α. Our results suggest that atypical antipsychotics directly influence immune cell function and thereby highlight the importance to factor in potential side effects of drugs routinely used in treatment of schizophrenia and major depression on inflammatory processes when considering anti-inflammatory drug therapy as an additional treatment option.
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Affiliation(s)
- Britta Stapel
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; Department of Cardiology and Angiology, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Irina Sieve
- Department of Cardiology and Angiology, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Christine S Falk
- Institute of Transplant Immunology, Integrated Research and Treatment Center Transplantation, IFB-Tx, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hannover, Germany
| | - Stefan Bleich
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | | | - Kai G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
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173
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Herman FJ, Pasinetti GM. Principles of inflammasome priming and inhibition: Implications for psychiatric disorders. Brain Behav Immun 2018; 73:66-84. [PMID: 29902514 PMCID: PMC6526722 DOI: 10.1016/j.bbi.2018.06.010] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 05/28/2018] [Accepted: 06/09/2018] [Indexed: 12/27/2022] Open
Abstract
The production of inflammatory proteins by the innate immune system is a tightly orchestrated procedure that allows the body to efficiently respond to exogenous and endogenous threats. Recently, accumulating evidence has indicated that disturbances in the inflammatory response system not only provoke autoimmune disorders, but also can have deleterious effects on neuronal function and mental health. As inflammation in the brain is primarily mediated by microglia, there has been an expanding focus on the mechanisms through which these cells initiate and propagate neuroinflammation. Microglia can enter persistently active states upon their initial recognition of an environmental stressor and are thereafter prone to elicit amplified and persistent inflammatory responses following subsequent exposures to stressors. A recent focus on why primed microglia cells are susceptible to environmental insults has been the NLRP3 inflammasome. Its function within the innate immune system is regulated in such a manner that supports a role for the complex in gating neuroinflammatory responses. The activation of NLRP3 inflammasome in microglia results in the cleavage of zymogen inflammatory interleukins into functional forms that elicit a number of consequential effects in the local neuronal environment. There is evidence to support the principle that within primed neuroimmune systems a lowered threshold for NLRP3 activation can cause persistent neuroinflammation or the amplified production of inflammatory cytokines, such as IL-1β and IL-18. Over the course of an individual's lifetime, persistent neuroinflammation can subsequently lead to the pathophysiological signatures that define psychological disorders. Therefore, targeting the NLRP3 inflammasome complex may represent an innovative and consequential approach to limit neuroinflammatory states in psychiatric disorders, such as major depressive disorder.
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Affiliation(s)
- Francis J. Herman
- Department of Neurology, Mount Sinai School of Medicine, New York, NY 10029, USA,Department of Genomic Sciences, Mount Sinai School of Medicine, New York, NY 10029, USA
| | - Giulio Maria Pasinetti
- Department of Neurology, Mount Sinai School of Medicine, New York, NY 10029, USA; Department of Genomic Sciences, Mount Sinai School of Medicine, New York, NY 10029, USA; Geriatric Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY 10468, USA.
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174
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Sub-chronic celecoxib prevents soluble beta amyloid-induced depressive-like behaviour in rats. J Affect Disord 2018; 238:118-121. [PMID: 29879605 DOI: 10.1016/j.jad.2018.05.030] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 04/16/2018] [Accepted: 05/21/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Depression and Alzheimer's disease (AD) are co-morbid conditions. Neuropsychiatric symptoms have been reported as prodromal symptoms of AD-like dementia and soluble forms of beta amyloid peptide (Aβ), the main constituent of insoluble plaques typical of AD brains, have been implicated in such an effect. We have previously shown that intracerebral injection of Aβ can evoke a depressive-like state in rats, accompanied by neurochemical and neuroendocrine alterations reminiscent of depressive symptoms in humans. AD and depression are crucially linked by neuroinflammation and cyclooxygenase II (COX-2) enzyme involvement is an intriguing field of research. Indeed, its pharmacological inhibition has shown both antidepressant and Aβ modulating effects. METHODS Male rats were exposed to sub-chronic celecoxib (15 mg/kg/day sc for 8 days), a selective COX-2 inhibitor or vehicle (saline), starting from the day before central intracerebroventricular injection of Aβ peptide (5µL of 4 µM solution or vehicle for sham). Animals were tested for depressive-like behaviour by using the forced swimming test paradigm and prefrontal serotonin (5-HT) content and plasma Aβ levels were further evaluated. RESULTS We found that celecoxib treatment prevented the pro-depressive effects induced by Aβ. Moreover, it also prevented the reduction in 5-HT content in prefrontal cortex of Aβ-treated rats and decreased their plasma Aβ levels. CONCLUSIONS Taken together, our data indicate that celecoxib could be a suitable pharmaceutical tool for the treatment of depressive state related to increased Aβ levels.
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175
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Deng YT, Zhao MG, Xu TJ, Li XH. Gentiopicroside abrogates lipopolysaccharide-induced depressive-like behavior in mice through tryptophan-degrading pathway. Metab Brain Dis 2018; 33:1413-1420. [PMID: 29948656 DOI: 10.1007/s11011-018-0246-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 05/02/2018] [Indexed: 01/08/2023]
Abstract
Targeting neuroinflammatory disturbances has been acknowledged as a potential strategy for treatment of depressive disorder in humans. Over-activation of tryptophan-degrading pathway by pro-inflammatory cytokines resulted in N-methyl-d-aspartate (NMDA)-mediated excitotoxicity, which is implicated in pathophysiology of depression. Gentiopicroside (Gent) has powerful anti-inflammatory property and exhibits promising antidepressant effect in an animal model of pain/depression dyad by down-regulating GluN2B-containing NMDA receptors. Therefore, the present study aimed to investigate the ability of Gent to abolish depressive-like behavior induced by lipopolysaccharide (LPS) in mice. Acute administration of LPS (0.5 mg/kg, i.p.) increased immobility time in both forced swimming test (FST) and tail suspension test (TST) without affecting spontaneous locomotor activity, indicative of depressive-like behavior. Gent (50 mg/kg, i.p.) administered once a day for three consecutive days prevented the development of depressive-like behavior induced by LPS. The antidepressant-like effect was paralleled with restoration of LPS-induced alterations in brain inflammatory mediators (i.e. IL-1β and TNF-α). In addition, Gent prevented over-activation of indoleamine 2,3-double oxygen enzyme (IDO) and recovered GluN2B subunit expression in the PFC challenged by LPS. In conclusion, our results suggested that Gent pretreatment provided protection against LPS-induced depressive-like behavior and the effect appeared to be demonstrated, at least partially, by blocking various steps of tryptophan-degrading pathway.
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Affiliation(s)
- Ya-Ting Deng
- Department of Pharmacology, School of Pharmacy, Xi'an Medical University, Xi'an, 710021, China.
- Department of Pharmacology, Fourth Military Medical University, Xi'an, 710032, China.
| | - Ming-Gao Zhao
- Department of Pharmacology, Fourth Military Medical University, Xi'an, 710032, China.
| | - Tian-Jiao Xu
- Department of Pharmacology, School of Pharmacy, Xi'an Medical University, Xi'an, 710021, China
| | - Xin-Hua Li
- Department of Pharmacology, School of Pharmacy, Xi'an Medical University, Xi'an, 710021, China
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176
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Wang H, Hai S, Liu Y, Cao L, Liu Y, Liu P, Zhou J, Yang Y, Dong B. Association between depressive symptoms and sarcopenia in older Chinese community-dwelling individuals. Clin Interv Aging 2018; 13:1605-1611. [PMID: 30233157 PMCID: PMC6130547 DOI: 10.2147/cia.s173146] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Purpose The aim of this study was to assess the prevalence of sarcopenia and depressive symptoms and estimate the association between them in elderly Chinese community-dwelling individuals. Patients and methods A total of 948 elderly Chinese community-dwelling individuals were recruited through leaflets and posters from three communities in Chengdu, and 865 participants were analyzed in this cross-sectional study. Muscle mass was measured using the bioimpedance analysis, handgrip strength was measured with a handheld dynamometer, and physical performance was assessed via usual gait speed on a 6 m course. Sarcopenia was defined according to the recommended diagnostic algorithm of the Asia Working Group for Sarcopenia (AWGS). Depressive symptoms were assessed using the Chinese version of 15-item Geriatric Depression Scale (GDS-15) with a score of ≥5 indicative of the presence of depressive symptoms. Results A total of 865 participants were included in the analysis. The participants had a mean age of 68.68±6.46 years. Sixty-one (7.1%) participants and 71 (8.2%) participants were identified as having sarcopenia and depressive symptoms, respectively. After adjusting for age, sex, and other potential confounders, sarcopenia was found to be significantly associated with depressive symptoms (odds ratio [OR]: 2.23, 95% CI 1.06–4.92). Conclusion The prevalence rates of sarcopenia and depressive symptoms were 7.1 and 8.2%, respectively, in elderly Chinese community-dwelling individuals, and sarcopenia was significantly associated with depressive symptoms.
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Affiliation(s)
- Hui Wang
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China, .,National Clinical Research Center for Geriatrics, West China Hospital, Chengdu 610041, People's Republic of China,
| | - Shan Hai
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China,
| | - Yixin Liu
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China,
| | - Li Cao
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China,
| | - Ying Liu
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China,
| | - Ping Liu
- National Clinical Research Center for Geriatrics, West China Hospital, Chengdu 610041, People's Republic of China,
| | - Jianghua Zhou
- Chengdu Fifth People's Hospital, Chengdu 611130, People's Republic of China
| | - Ying Yang
- Chengdu Fifth People's Hospital, Chengdu 611130, People's Republic of China
| | - Birong Dong
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China, .,National Clinical Research Center for Geriatrics, West China Hospital, Chengdu 610041, People's Republic of China,
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Nakamura Y, Nakanishi T, Tamai I. Membrane Transporters Contributing to PGE 2 Distribution in Central Nervous System. Biol Pharm Bull 2018; 41:1337-1347. [DOI: 10.1248/bpb.b18-00169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Yoshinobu Nakamura
- Faculty of Pharmaceutical Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University
| | - Takeo Nakanishi
- Faculty of Pharmaceutical Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University
| | - Ikumi Tamai
- Faculty of Pharmaceutical Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University
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Li H, Luo Y, Xu Y, Yang L, Hu C, Chen Q, Yang Y, Ma J, Zhang J, Xia H, Li Y, Yang J. Meloxicam Improves Cognitive Impairment of Diabetic Rats through COX2-PGE2-EPs-cAMP/pPKA Pathway. Mol Pharm 2018; 15:4121-4131. [PMID: 30109938 DOI: 10.1021/acs.molpharmaceut.8b00532] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Diabetics often face greater risk of cognitive impairment than nondiabetics. However, how to prevent this disease is still unconfirmed. In this study, we investigated the potential protection and mechanism of meloxicam on cognitive impairment in diabetic rats. The diabetic rat model was established with a high-fat diet and a small dose of streptozotocin (40 mg/kg). The changes of spatial learning and memory, histopathology, and the protein expressions of amyloid protein precursor (APP) and β-amyloid (Aβ) indicated that diabetic rats had neuronal injury and cognitive impairment. Tumor necrosis factor α (TNFα), interleukin 6 (IL-6), C reactive protein (CRP) and prostaglandin E2 (PGE2) levels, and microglial cell number were significantly increased in the diabetic rat brain. Meanwhile, the protein expressions of APP, Aβ, cyclooxygenases2 (COX2), E-type prostanoid recptors 1 (EP1) and EP2, and the level of cyclic adenosine monophosphate (cAMP) were significantly increased, while the protein expressions of EP3 and phosphorylated protein kinase A (pPKA) were significantly decreased in the diabetic rat hippocampus and cortex. However, the EP4 protein expression had no significant changes. Meloxicam significantly improved neuronal injury and cognitive impairment, and significantly decreased inflammatory cytokines levels. Meloxicam also significantly decreased the protein expressions of APP, Aβ, COX2, EP1 and EP2, and the level of cAMP and significantly increased the EP3 and pPKA protein expressions in rat hippocampus and cortex. However, meloxicam did not significantly influence the levels of blood glucose, lipids, and insulin of rats. Our results suggest that meloxicam could significantly protect diabetic rats from cognitive impairment via a mechanism that may be associated with rebalancing the COX2-PGE2-EPs-cAMP/PKA pathway.
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Affiliation(s)
- Huan Li
- The Key Laboratory of Biochemistry and Molecular Pharmacology, Department of Pharmacology , Chongqing Medical University , Chongqing 400016 , China
| | - Ying Luo
- The Key Laboratory of Biochemistry and Molecular Pharmacology, Department of Pharmacology , Chongqing Medical University , Chongqing 400016 , China
| | - Ying Xu
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences , State University of New York at Buffalo , Buffalo , New York 14214 , United States
| | - Lu Yang
- The Key Laboratory of Biochemistry and Molecular Pharmacology, Department of Pharmacology , Chongqing Medical University , Chongqing 400016 , China
| | - Congli Hu
- The Key Laboratory of Biochemistry and Molecular Pharmacology, Department of Pharmacology , Chongqing Medical University , Chongqing 400016 , China
| | - Qi Chen
- The Key Laboratory of Biochemistry and Molecular Pharmacology, Department of Pharmacology , Chongqing Medical University , Chongqing 400016 , China
| | - Yang Yang
- The Key Laboratory of Biochemistry and Molecular Pharmacology, Department of Pharmacology , Chongqing Medical University , Chongqing 400016 , China
| | - Jie Ma
- The Key Laboratory of Biochemistry and Molecular Pharmacology, Department of Pharmacology , Chongqing Medical University , Chongqing 400016 , China
| | - Jiahua Zhang
- The Key Laboratory of Biochemistry and Molecular Pharmacology, Department of Pharmacology , Chongqing Medical University , Chongqing 400016 , China
| | - Hui Xia
- The Key Laboratory of Biochemistry and Molecular Pharmacology, Department of Pharmacology , Chongqing Medical University , Chongqing 400016 , China
| | - Yuke Li
- The Key Laboratory of Biochemistry and Molecular Pharmacology, Department of Pharmacology , Chongqing Medical University , Chongqing 400016 , China
| | - Junqing Yang
- The Key Laboratory of Biochemistry and Molecular Pharmacology, Department of Pharmacology , Chongqing Medical University , Chongqing 400016 , China
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Abnormal hippocampal neurogenesis in Parkinson’s disease: relevance to a new therapeutic target for depression with Parkinson’s disease. Arch Pharm Res 2018; 41:943-954. [DOI: 10.1007/s12272-018-1063-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 07/31/2018] [Indexed: 10/28/2022]
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180
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Fourrier C, Sampson E, Mills NT, Baune BT. Anti-inflammatory treatment of depression: study protocol for a randomised controlled trial of vortioxetine augmented with celecoxib or placebo. Trials 2018; 19:447. [PMID: 30126458 PMCID: PMC6102899 DOI: 10.1186/s13063-018-2829-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 07/30/2018] [Indexed: 12/12/2022] Open
Abstract
Background In patients with major depressive disorder (MDD), antidepressant response and remission rates are low, highlighting the need for new treatment approaches. Recently, the abundant literature linking inflammatory processes and depressive symptoms have led to the hypothesis that selecting treatment for MDD based on the patient’s inflammatory status could be a promising strategy to improve outcomes in patients suffering from MDD. The aim of the randomised control trial we propose is to investigate the antidepressant efficacy of the combined treatment of MDD with antidepressant medication plus anti-inflammatory medication in individuals with raised inflammation levels. For the first time, this study will prospectively test the efficacy of an antidepressant plus anti-inflammatory augmentation based on baseline inflammatory maker levels in MDD using a randomised controlled trial design. Methods This study proposes to measure blood C-reactive protein (CRP) levels before the initiation of treatment in 200 participants with MDD. Study participants are then assigned into one of two study strata: either into the ‘Depression with inflammation’ stratum (CRP levels > 3 mg/L); or into the ‘Depression without inflammation’ stratum (CRP levels ≤ 3 mg/L). Within each of the two study strata, participants randomly receive either antidepressant medication alone (vortioxetine) plus anti-inflammatory medication (celecoxib) or vortioxetine plus placebo for six weeks. At the end of the treatment period, participants have the opportunity to continue vortioxetine alone for a six-month post-trial period. Clinical outcomes are measured at baseline, fortnightly during the treatment period and at the three-month and six-month post-trial visits. The primary outcome is change in MADRS score, with a primary endpoint of a score reduction by 50% from baseline to six weeks (end of augmentation treatment with celecoxib). Secondary clinical outcomes are changes in the cognitive dimensions of depression (cognitive function, emotion processing and social cognition). Biological outcome measures (levels of CRP and other inflammatory markers) are measured at baseline, after six weeks of treatment and at the six-month post-trial visit. Discussion The current study will generate novel evidence for biomarker-based personalised antidepressant treatment selection based on patient inflammatory status before treatment. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12617000527369p. Registered on 11 April 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-2829-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Célia Fourrier
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
| | - Emma Sampson
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
| | - Natalie T Mills
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
| | - Bernhard T Baune
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, 3010, VIC, Australia.
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Differentially expressed genes related to major depressive disorder and antidepressant response: genome-wide gene expression analysis. Exp Mol Med 2018; 50:1-11. [PMID: 30076325 PMCID: PMC6076250 DOI: 10.1038/s12276-018-0123-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 03/25/2018] [Accepted: 04/17/2018] [Indexed: 12/15/2022] Open
Abstract
Treatment response to antidepressants is limited and varies among patients with major depressive disorder (MDD). To discover genes and mechanisms related to the pathophysiology of MDD and antidepressant treatment response, we performed gene expression analyses using peripheral blood specimens from 38 MDD patients and 14 healthy individuals at baseline and at 6 weeks after the initiation of either selective serotonin reuptake inhibitor (SSRI) or mirtazapine treatment. The results were compared with results from public microarray data. Seven differentially expressed genes (DEGs) between MDD patients and controls were identified in our study and in the public microarray data: CD58, CXCL8, EGF, TARP, TNFSF4, ZNF583, and ZNF587. CXCL8 was among the top 10 downregulated genes in both studies. Eight genes related to SSRI responsiveness, including BTNL8, showed alterations in gene expression in MDD. The expression of the FCRL6 gene differed between SSRI responders and nonresponders and changed after SSRI treatment compared to baseline. In evaluating the response to mirtazapine, 21 DEGs were identified when comparing MDD patients and controls and responders and nonresponders. These findings suggest that the pathophysiology of MDD and treatment response to antidepressants are associated with a number of processes, including DNA damage and apoptosis, that can be induced by immune activation and inflammation. Differences in the expression of several genes before and after different antidepressant treatments were found in patients with major depressive disorder (MDD), and may help identify patients most likely to benefit from specific drugs. Researchers in South Korea led by Doh Kwan Kim and Soo-Youn Lee at Samsung Medical Center, Seoul, examined gene expression across the 28,869 genes in 38 patients with MDD and 14 healthy individuals. They also validated their findings using existing databases of gene expression in patients with MDD and healthy controls. The research suggests that genes involved in the immune response and inflammation are significantly alternated in MDD and are predictable in which patients respond well to antidepressants. These findings may help develop new approaches to antidepressant therapies, and assist tailoring of treatment to the specific needs of different patients.
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Alboni S, Benatti C, Capone G, Tascedda F, Brunello N. Neither all anti-inflammatory drugs nor all doses are effective in accelerating the antidepressant-like effect of fluoxetine in an animal model of depression. J Affect Disord 2018; 235:124-128. [PMID: 29655073 DOI: 10.1016/j.jad.2018.04.063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 03/14/2018] [Accepted: 04/05/2018] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Non-steroidal anti-inflammatory drugs (NSAIDs) have been studied as possible adjunctive therapy in the treatment of depression. However, administering NSAIDs to increase the effectiveness of antidepressant has yielded inconsistent results. METHODS We evaluated the effect of the co-administration of fluoxetine (5 mg/kg) and flurbiprofen (5 mg/kg) or fluoxetine (5 mg/kg) and celecoxib (5 mg/kg) in the chronic escape deficit (CED) model of depression after 7 days of treatment. The co-administration of fluoxetine plus acetylsalicylic acid (ASA, 45 mg/kg i.p.) was used as a positive control. Moreover, we tested the behavioral effect of different doses (45, 22.5, and 11.25 mg/Kg i.p.) of ASA as potentiating agent of the effect of fluoxetine in the same paradigm. RESULTS Our study showed that only the co-administration of ASA with fluoxetine was able to revert the stress-induced condition of escape deficit after 7 days of treatment, and that the amplitude of the antidepressant-like effect of ASA was dose dependent. In the same experimental conditions, celecoxib with fluoxetine only partially resolved the stress-induced impaired behavior while flurbiprofen/fluoxetine cotreatment was ineffective. LIMITATIONS Our study is still exploratory, more doses, longer treatment regimens, and different behavioral outcomes must be investigated to draw a clear conclusion. CONCLUSION Our results further stress the importance of the type and dose when NSAIDs are associated with antidepressants to ameliorate a clinical response.
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Affiliation(s)
- Silvia Alboni
- Department of Life Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy.
| | - Cristina Benatti
- Department of Life Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy; Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena Italy
| | - Giacomo Capone
- AIFA-Agenzia Italiana del Farmaco, Via del Tritone, 181-00187 Rome, Italy
| | - Fabio Tascedda
- Department of Life Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy; Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena Italy
| | - Nicoletta Brunello
- Department of Life Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy; Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena Italy
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Kranaster L, Hoyer C, Aksay SS, Bumb JM, Müller N, Zill P, Schwarz MJ, Sartorius A. Antidepressant efficacy of electroconvulsive therapy is associated with a reduction of the innate cellular immune activity in the cerebrospinal fluid in patients with depression. World J Biol Psychiatry 2018; 19:379-389. [PMID: 28714751 DOI: 10.1080/15622975.2017.1355473] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES A bidirectional link between the antidepressant effects of electroconvulsive therapy (ECT) and the modulation of the immune system has been proposed. To elucidate the interplay between antidepressant treatment and macrophage/microglia activation in humans, we performed a study on the effects of the antidepressant treatment by ECT on markers of macrophage/microglia activation in patients with depression. METHODS We measured six different markers (IL-6, neopterin, sCD14, sCD163 MIF and MCP1) of macrophage/microglia activation in the cerebrospinal fluid (CSF) and blood of 12 patients with a severe, treatment-resistant depressive episode before and after a course of ECT. RESULTS Some markers in the CSF of remitters were reduced after the ECT course and differed from non-remitters, but no differences were found before and after ECT independently from the antidepressant efficacy. CSF baseline levels of some markers could predict the reduction of depressive psychopathology during ECT. Higher CSF levels indicating increased macrophage/microglia activation at baseline predicted a better treatment response to ECT. CONCLUSIONS Although the sample size was small, our data suggest that macrophages/microglia are involved in the pathophysiology of major depression and that antidepressant efficacy by ECT might be partly explained by the modulation of the innate immune system within the brain.
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Affiliation(s)
- Laura Kranaster
- a Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim , Heidelberg University , Mannheim , Germany
| | - Carolin Hoyer
- b Department of Neurology , University Medical Centre Mannheim , Mannheim , Germany
| | - Suna S Aksay
- a Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim , Heidelberg University , Mannheim , Germany
| | - Jan Malte Bumb
- c Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim , Heidelberg University , Mannheim , Germany
| | - Norbert Müller
- d Department of Psychiatry and Psychotherapy , Ludwig Maximilian University Munich , Munich , Germany
| | - Peter Zill
- d Department of Psychiatry and Psychotherapy , Ludwig Maximilian University Munich , Munich , Germany
| | - Markus J Schwarz
- e Department of Laboratory Medicine , Ludwig Maximilian University Munich , Munich , Germany
| | - Alexander Sartorius
- a Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim , Heidelberg University , Mannheim , Germany
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Phillips C, Fahimi A. Immune and Neuroprotective Effects of Physical Activity on the Brain in Depression. Front Neurosci 2018; 12:498. [PMID: 30093853 PMCID: PMC6070639 DOI: 10.3389/fnins.2018.00498] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 07/03/2018] [Indexed: 12/13/2022] Open
Abstract
Physical activity-a lifestyle factor that is associated with immune function, neuroprotection, and energy metabolism-modulates the cellular and molecular processes in the brain that are vital for emotional and cognitive health, collective mechanisms that can go awry in depression. Physical activity optimizes the stress response, neurotransmitter level and function (e.g., serotonergic, noradrenergic, dopaminergic, and glutamatergic), myokine production (e.g., interleukin-6), transcription factor levels and correlates [e.g., peroxisome proliferator-activated receptor C coactivator-1α [PGC-1α], mitochondrial density, nitric oxide pathway activity, Ca2+ signaling, reactive oxygen specie production, and AMP-activated protein kinase [AMPK] activity], kynurenine metabolites, glucose regulation, astrocytic health, and growth factors (e.g., brain-derived neurotrophic factor). Dysregulation of these interrelated processes can effectuate depression, a chronic mental illness that affects millions of individuals worldwide. Although the biogenic amine model has provided some clinical utility in understanding chronic depression, a need remains to better understand the interrelated mechanisms that contribute to immune dysfunction and the means by which various therapeutics mitigate them. Fortunately, convergent evidence suggests that physical activity improves emotional and cognitive function in persons with depression, particularly in those with comorbid inflammation. Accordingly, the aims of this review are to (1) underscore the link between inflammatory correlates and depression, (2) explicate immuno-neuroendocrine foundations, (3) elucidate evidence of neurotransmitter and cytokine crosstalk in depressive pathobiology, (4) determine the immunomodulatory effects of physical activity in depression, (5) examine protocols used to effectuate the positive effects of physical activity in depression, and (6) highlight implications for clinicians and scientists. It is our contention that a deeper understanding of the mechanisms by which inflammation contributes to the pathobiology of depression will translate to novel and more effective treatments, particularly by identifying relevant patient populations that can benefit from immune-based therapies within the context of personalized medicine.
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Affiliation(s)
- Cristy Phillips
- Physical Therapy, Arkansas State University, Jonesboro, AR, United States
- Physical Therapy, University of Tennessee Health Science Center, Memphis, TN, United States
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185
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Vancassel S, Capuron L, Castanon N. Brain Kynurenine and BH4 Pathways: Relevance to the Pathophysiology and Treatment of Inflammation-Driven Depressive Symptoms. Front Neurosci 2018; 12:499. [PMID: 30140200 PMCID: PMC6095005 DOI: 10.3389/fnins.2018.00499] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 07/03/2018] [Indexed: 12/13/2022] Open
Abstract
The prevalence of depressive disorders is growing worldwide, notably due to stagnation in the development of drugs with greater antidepressant efficacy, the continuous large proportion of patients who do not respond to conventional antidepressants, and the increasing rate of chronic medical conditions associated with an increased vulnerability to depressive comorbidities. Accordingly, better knowledge on the pathophysiology of depression and mechanisms underlying depressive comorbidities in chronic medical conditions appears urgently needed, in order to help in the development of targeted therapeutic strategies. In this review, we present evidence pointing to inflammatory processes as key players in the pathophysiology and treatment of depressive symptoms. In particular, we report preclinical and clinical findings showing that inflammation-driven alterations in specific metabolic pathways, namely kynurenine and tetrahydrobiopterin (BH4) pathways, leads to substantial alterations in the metabolism of serotonin, glutamate and dopamine that are likely to contribute to the development of key depressive symptom dimensions. Accordingly, anti-inflammatory interventions targeting kynurenine and BH4 pathways may be effective as novel treatment or as adjuvants of conventional medications rather directed to monoamines, notably when depressive symptomatology and inflammation are comorbid in treated patients. This notion is discussed in the light of recent findings illustrating the tight interactions between known antidepressant drugs and inflammatory processes, as well as their therapeutic implications. Altogether, this review provides valuable findings for moving toward more adapted and personalized therapeutic strategies to treat inflammation-related depressive symptoms.
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Affiliation(s)
- Sylvie Vancassel
- UMR 1286, Laboratory of Nutrition and Integrative Neurobiology (NutriNeuro), INRA, Bordeaux, France
- UMR 1286, Laboratory of Nutrition and Integrative Neurobiology (NutriNeuro), Bordeaux University, Bordeaux, France
| | - Lucile Capuron
- UMR 1286, Laboratory of Nutrition and Integrative Neurobiology (NutriNeuro), INRA, Bordeaux, France
- UMR 1286, Laboratory of Nutrition and Integrative Neurobiology (NutriNeuro), Bordeaux University, Bordeaux, France
| | - Nathalie Castanon
- UMR 1286, Laboratory of Nutrition and Integrative Neurobiology (NutriNeuro), INRA, Bordeaux, France
- UMR 1286, Laboratory of Nutrition and Integrative Neurobiology (NutriNeuro), Bordeaux University, Bordeaux, France
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Inserra A, Rogers GB, Licinio J, Wong ML. The Microbiota-Inflammasome Hypothesis of Major Depression. Bioessays 2018; 40:e1800027. [DOI: 10.1002/bies.201800027] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 06/13/2018] [Indexed: 12/20/2022]
Affiliation(s)
- Antonio Inserra
- Mind and Brain Theme; South Australian Health and Medical Research Institute; Adelaide 5001 SA Australia
- Department of Psychiatry; College of Medicine and Public Health; Flinders University; Bedford Park 5042 SA Australia
- Centre for Neuroscience; Flinders University; Bedford Park 5042 Australia
| | - Geraint B. Rogers
- Infection and Immunity Theme; South Australia Health and Medical Research Institute; North TerracAdelaide 5001 SA Australia
- SAHMRI Microbiome Research Laboratory; Flinders University College of Medicine and Public Health; Bedford Park 5001 SA Australia
| | - Julio Licinio
- Mind and Brain Theme; South Australian Health and Medical Research Institute; Adelaide 5001 SA Australia
- Department of Psychiatry; College of Medicine and Public Health; Flinders University; Bedford Park 5042 SA Australia
- State University of New York Upstate Medical University; Syracuse NY 13210 USA
| | - Ma-Li Wong
- Mind and Brain Theme; South Australian Health and Medical Research Institute; Adelaide 5001 SA Australia
- Department of Psychiatry; College of Medicine and Public Health; Flinders University; Bedford Park 5042 SA Australia
- State University of New York Upstate Medical University; Syracuse NY 13210 USA
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187
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Edberg D, Hoppensteadt D, Walborn A, Fareed J, Sinacore J, Halaris A. Plasma C-reactive protein levels in bipolar depression during cyclooxygenase-2 inhibitor combination treatment. J Psychiatr Res 2018; 102:1-7. [PMID: 29554535 DOI: 10.1016/j.jpsychires.2018.02.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 01/19/2018] [Accepted: 02/08/2018] [Indexed: 01/10/2023]
Abstract
Immune system activation and neuroinflammation appear to play a key role in the pathophysiology and treatment of bipolar depression (BDD). This study is the first to analyze blood levels of the pro-inflammatory biomarker C-reactive protein (CRP) in bipolar disorder patients treated with the cyclooxygenase-2 inhibitor, celecoxib (CBX). In this double-blind study, 47 consenting patients with BDD were randomized to receive either escitalopram (10 mg twice/day) + CBX (200 mg twice/day), or escitalopram (10 mg twice/day) + placebo (twice/day). Plasma CRP levels were measured in both patient groups at baseline, week 4, and week 8, and in a healthy control (HC) group of subjects (N = 35) once. Symptoms were rated using the 17-item Hamilton Depression Scale (HAMD-17). The CBX group had significantly lower HAMD-17 scores vs. placebo at week 4 (P = 0.026) and week 8 (P = 0.002). Therefore, SSRI + CBX is more effective than SSRI + placebo in reversing treatment resistance and augmenting antidepressant response in BDD. Baseline CRP levels were significantly increased amongst BDD patients versus HC subjects, indicating that CRP may be a useful biomarker for BDD (P = 0.044). No significant differences in CRP levels were measured between CBX and placebo groups at baseline (P = 0.156), but by week 8 CRP was significantly decreased in the CBX group vs. placebo (P = 0.003). This indicates reduced inflammation in CBX-treated patients, and that CRP may be a useful biomarker for monitoring treatment response in BDD patients during SSRI + CBX combination treatment. CRP and IL-6 levels were positively correlated in the CBX group, and CRP levels were positively correlated with BMI.
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Affiliation(s)
- David Edberg
- Department of Psychiatry and Behavioral Neuroscience, Loyola University Stritch School of Medicine, Chicago, IL, USA
| | - Debra Hoppensteadt
- Department of Pathology, Loyola University Stritch School of Medicine, Chicago, IL, USA
| | - Amanda Walborn
- Department of Pathology, Loyola University Stritch School of Medicine, Chicago, IL, USA
| | - Jawed Fareed
- Department of Pathology, Loyola University Stritch School of Medicine, Chicago, IL, USA
| | - James Sinacore
- Department of Public Health Sciences, Loyola University Stritch School of Medicine, Chicago, IL, USA
| | - Angelos Halaris
- Department of Psychiatry and Behavioral Neuroscience, Loyola University Stritch School of Medicine, Chicago, IL, USA.
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Lee S, Kim HB, Hwang ES, Kim ES, Kim SS, Jeon TD, Song MC, Lee JS, Chung MC, Maeng S, Park JH. Antidepressant-like Effects of p-Coumaric Acid on LPS-induced Depressive and Inflammatory Changes in Rats. Exp Neurobiol 2018; 27:189-199. [PMID: 30022870 PMCID: PMC6050412 DOI: 10.5607/en.2018.27.3.189] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 06/17/2018] [Accepted: 06/21/2018] [Indexed: 12/20/2022] Open
Abstract
Depression causes mental and physical changes which affect quality of life. It is estimated to become the second most prevalent disease, but despite its commonness, the pathophysiology of depression remains unclear and medicine is not sufficiently protective. p-Coumaric acid (p-CA) is a dietary phenolic acid which has been proven to have antifungal, anti-HIV, anti-melanogenic, antioxidant and anti-inflammatory effects. Considering these effects, we investigated whether p-CA can prevent depressive symptoms by reducing inflammatory cytokines in animals injected with lipopolysaccharide (LPS). Changes in despair-related behaviors, inflammatory cytokines, neurotrophic factors and synaptic activity were measured. In these animals, p-CA improved despair-related behavioral symptoms induced by LPS in the forced swim test (FST), tail suspension test (TST) and sucrose splash test (SST). p-CA also prevented the increase of inflammatory cytokines in the hippocampus such as cycloxigenase-2 and tumor necrosis factor-α due to LPS. Similarly, it prevented the reduction of brain-derived neurotrophic factor (BDNF) by LPS. Electrophysiologically, p-CA blocked the reduction of long-term depression in LPS-treated organotypic tissue slices. In conclusion, p-CA prevented LPS-induced depressive symptoms in animals, as determined by behavioral, biochemical and electrophysiological measures. These findings suggest the potential use of p-CA as a preventive and therapeutic medicine for depression.
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Affiliation(s)
- Seok Lee
- Department of East-West Medical Science, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea
| | - Hyun-Bum Kim
- Department of East-West Medical Science, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea
| | - Eun-Sang Hwang
- Department of Gerontology, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea
| | - Eun-Seok Kim
- Department of East-West Medicine, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea
| | - Sung-Soo Kim
- Department of East-West Medicine, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea
| | - Tae-Dong Jeon
- Department of East-West Medicine, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea
| | - Min-Cheol Song
- Department of East-West Medical Science, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea
| | - Ji-Seung Lee
- Department of East-West Medical Science, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea
| | - Min-Chan Chung
- Department of East-West Medicine, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea
| | - Sungho Maeng
- Department of Gerontology, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea
| | - Ji-Ho Park
- Department of East-West Medical Science, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea.,Research Institute of Medical Nutrition, Kyung Hee University, Yongin 17104, Korea
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189
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Ghasemi M, Claunch J, Niu K. Pathologic role of nitrergic neurotransmission in mood disorders. Prog Neurobiol 2018; 173:54-87. [PMID: 29890213 DOI: 10.1016/j.pneurobio.2018.06.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 05/30/2018] [Accepted: 06/05/2018] [Indexed: 02/08/2023]
Abstract
Mood disorders are chronic, recurrent mental diseases that affect millions of individuals worldwide. Although over the past 40 years the biogenic amine models have provided meaningful links with the clinical phenomena of, and the pharmacological treatments currently employed in, mood disorders, there is still a need to examine the contribution of other systems to the neurobiology and treatment of mood disorders. This article reviews the current literature describing the potential role of nitric oxide (NO) signaling in the pathophysiology and thereby the treatment of mood disorders. The hypothesis has arisen from several observations including (i) altered NO levels in patients with mood disorders; (ii) antidepressant effects of NO signaling blockers in both clinical and pre-clinical studies; (iii) interaction between conventional antidepressants/mood stabilizers and NO signaling modulators in several biochemical and behavioral studies; (iv) biochemical and physiological evidence of interaction between monoaminergic (serotonin, noradrenaline, and dopamine) system and NO signaling; (v) interaction between neurotrophic factors and NO signaling in mood regulation and neuroprotection; and finally (vi) a crucial role for NO signaling in the inflammatory processes involved in pathophysiology of mood disorders. These accumulating lines of evidence have provided a new insight into novel approaches for the treatment of mood disorders.
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Affiliation(s)
- Mehdi Ghasemi
- Department of Neurology, University of Massachusetts Medical School, Worcester, MA, 01655, USA.
| | - Joshua Claunch
- Department of Neurology, University of Massachusetts Medical School, Worcester, MA, 01655, USA
| | - Kathy Niu
- Department of Neurology, University of Massachusetts Medical School, Worcester, MA, 01655, USA
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190
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Bershad AK, Miller MA, Norman GJ, de Wit H. Effects of opioid- and non-opioid analgesics on responses to psychosocial stress in humans. Horm Behav 2018; 102:41-47. [PMID: 29673620 PMCID: PMC6004330 DOI: 10.1016/j.yhbeh.2018.04.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 02/27/2018] [Accepted: 04/13/2018] [Indexed: 12/21/2022]
Abstract
Both preclinical and clinical evidence suggests that the endogenous opioid system is involved in responses to stress. For example, in animal models opioid agonists reduce isolation distress whereas opioid antagonists increase isolation distress. We recently reported that the mixed mu agonist and kappa antagonist buprenorphine dampened responses to acute psychosocial stress in humans. Now we extend this to study the effects of a pure mu-opioid agonist, hydromorphone, and a non-opioid analgesic, acetaminophen, on response to social stress. We compared the effect of hydromorphone (2 and 4 mg), acetaminophen (1000 mg) to a placebo using a between subject design. Healthy adult volunteers were randomly assigned to receive placebo (N = 13), 2 mg hydromorphone (N = 12), 4 mg hydromorphone (N = 12), or 1000 mg acetaminophen (paracetamol; N = 13) under double-blind conditions before undergoing a stress task or a control task on two separate sessions. The stress task, consisting of a standardized speaking task and the non-stressful control task were presented in counterbalanced order. Dependent measures included mood ratings, subjective appraisal of the stress (or no-stress) task, salivary cortisol, pupil diameter, heart rate, and blood pressure. The stress task produced its expected increase in heart rate, blood pressure, salivary cortisol, pupil diameter, and subjective ratings of anxiety and negative mood. Hydromorphone dose-dependently dampened cortisol responses to stress, and decreased ratings of how "challenging" participants found the task. Acetaminophen did not affect physiological responses, but, like hydromorphone, decreased ratings of how "challenging" the task was. The hydromorphone results support the idea that the mu-opioid system is involved in physiological responses to acute stress in humans, in line with results from preclinical studies. The non-opioid analgesic acetaminophen did not dampen physiological responses, but did reduce some components of psychological stress. It remains to be determined how both opioid and non-opioid systems mediate the complex physiological and psychological responses to social stress.
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Affiliation(s)
- Anya K Bershad
- Interdisciplinary Scientist Training Program, University of Chicago, Chicago, IL, USA; Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Melissa A Miller
- Interdisciplinary Scientist Training Program, University of Chicago, Chicago, IL, USA
| | - Greg J Norman
- Department of Psychology, University of Chicago, Chicago, IL, USA
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA.
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191
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Wium-Andersen IK, Wium-Andersen MK, Jørgensen MB, Osler M. Anti-inflammatory treatment and risk of depression in 91,842 patients with acute coronary syndrome and 91,860 individuals without acute coronary syndrome in Denmark. Int J Cardiol 2018; 246:1-6. [PMID: 28867006 DOI: 10.1016/j.ijcard.2017.05.105] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 05/06/2017] [Accepted: 05/29/2017] [Indexed: 12/26/2022]
Abstract
BACKGROUND We examined if treatment with acetylsalicylic acid (ASA), non-steroid anti-inflammatory drugs (NSAID), or statins after acute coronary syndrome (ACS) are associated with decreased risk of depression. METHOD This register-based cohort study included all individuals with a first-time hospital admissions with an ACS diagnosis registered between January 2001 to December 2009 (N=91,842) and a comparable reference population without ACS (N=91,860). Information of ASA, NSAID, and statin use were retrieved from a national prescription register. The study population was followed for hospitalization with depression or receiving prescription of antidepressant medication for up to one year after ACS or study entry (early depression) or one to twelve years after ACS or study entry (late depression). RESULTS ASA use after ACS was associated with decreased risk of early depression with hazard ratios (HR) of 0.89 (95% confidence interval 0.85-0.93) but not with late depression 0.96 (0.90-1.01). The corresponding HRs for statin were 0.90 (0.86-0.94) and 0.86 (0.82-0.90). In the non-ACS population, statin use was not associated with neither early nor late depression (HRs 1.04 (0.96-1.12) and 1.00 (0.95-1.06)), while ASA was associated with increased risk of late (HR 1.09 (1.04-1.14)) but not early depression (HR 1.03 (0.97-1.09)). In both populations, NSAID use was associated with increased risk of late but not early depression. CONCLUSION Use of ASA or statins were associated with decreased risk of depression in ACS patients but not in individuals without ACS, while use of NSAID was associated with increased risk of late depression in both populations.
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Affiliation(s)
- Ida Kim Wium-Andersen
- Psychiatric Center Copenhagen, Department O, Copenhagen, Denmark; Research Center for Prevention and Health, Rigshospitalet-Glostrup, Glostrup, Denmark.
| | - Marie Kim Wium-Andersen
- Psychiatric Center Frederiksberg, Frederiksberg, Denmark; Research Center for Prevention and Health, Rigshospitalet-Glostrup, Glostrup, Denmark
| | | | - Merete Osler
- Research Center for Prevention and Health, Rigshospitalet-Glostrup, Glostrup, Denmark; Department of Public Health, University of Copenhagen, Denmark
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192
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Jeon SW, Kim YK. The role of neuroinflammation and neurovascular dysfunction in major depressive disorder. J Inflamm Res 2018; 11:179-192. [PMID: 29773951 PMCID: PMC5947107 DOI: 10.2147/jir.s141033] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Although depression has generally been explained with monoamine theory, it is far more multifactorial, and therapies that address the disease’s pathway have not been developed. In this context, an understanding of neuroinflammation and neurovascular dysfunction would enable a more comprehensive approach to depression. Inflammation is in a sense a type of allostatic load involving the immune, endocrine, and nervous systems. Neuroinflammation is involved in the pathophysiology of depression by increasing proinflammatory cytokines, activating the hypothalamus–pituitary–adrenal axis, increasing glucocorticoid resistance, and affecting serotonin synthesis and metabolism, neuronal apoptosis and neurogenesis, and neuroplasticity. In future, identifying the subtypes of depression with increased vulnerability to inflammation and testing the effects of inflammatory modulating agents in these patient groups through clinical trials will lead to more concrete conclusions on the matter. The vascular depression hypothesis is supported by evidence for the association between vascular disease and late-onset depression and between ischemic brain lesions and distinctive depressive symptoms. Vascular depression may be the entity most suitable for studies of the mechanisms of depression. Pharmacotherapies used in the prevention and treatment of cerebrovascular disease may help prevent vascular depression. In future, developments in structural and functional imaging, electrophysiology, chronobiology, and genetics will reveal the association between depression and brain lesions. This article aims to give a general review of the existing issues examined in the literature pertaining to depression-related neuroinflammatory and vascular functions, related pathophysiology, applicability to depression treatment, and directions for future research.
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Affiliation(s)
- Sang Won Jeon
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul
| | - Yong-Ku Kim
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, South Korea
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193
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Nierenberg AA, Ghaznavi SA, Sande Mathias I, Ellard KK, Janos JA, Sylvia LG. Peroxisome Proliferator-Activated Receptor Gamma Coactivator-1 Alpha as a Novel Target for Bipolar Disorder and Other Neuropsychiatric Disorders. Biol Psychiatry 2018; 83:761-769. [PMID: 29502862 DOI: 10.1016/j.biopsych.2017.12.014] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 12/20/2017] [Accepted: 12/29/2017] [Indexed: 11/19/2022]
Abstract
Peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC-1 alpha) is a protein that regulates metabolism and inflammation by activating nuclear receptors, especially the family of peroxisome proliferator-activated receptors (PPARs). PGC-1 alpha and PPARs also regulate mitochondrial biogenesis, cellular energy production, thermogenesis, and lipid metabolism. Brain energy metabolism may also be regulated in part by the interaction between PGC-1 alpha and PPARs. Because neurodegenerative diseases (Huntington's disease, Parkinson's disease, and amyotrophic lateral sclerosis) and bipolar disorder have been associated with dysregulated mitochondrial and brain energy metabolism, PGC-1 alpha may represent a potential drug target for these conditions. The purpose of this article is to review the physiology of PGC-1 alpha, PPARs, and the role of PPAR agonists to target PGC-1 alpha to treat neurodegenerative diseases and bipolar disorder. We also review clinical trials of repurposed antidiabetic thiazolidines and anti-triglyceride fibrates (PPAR agonists) for neurodegenerative diseases and bipolar disorder. PGC-1 alpha and PPARs are innovative potential targets for bipolar disorder and warrant future clinical trials.
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Affiliation(s)
- Andrew A Nierenberg
- Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
| | - Sharmin A Ghaznavi
- Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Isadora Sande Mathias
- Acadêmica da Faculdade de Medicina da Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Kristen K Ellard
- Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | | | - Louisa G Sylvia
- Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
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194
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Sorri A, Järventausta K, Kampman O, Lehtimäki K, Björkqvist M, Tuohimaa K, Hämäläinen M, Moilanen E, Leinonen E. Low tumor necrosis factor-α levels predict symptom reduction during electroconvulsive therapy in major depressive disorder. Brain Behav 2018; 8:e00933. [PMID: 29670819 PMCID: PMC5893337 DOI: 10.1002/brb3.933] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 12/20/2017] [Accepted: 12/21/2017] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Changes in the tumor necrosis factor-α (TNFα) have been associated with major depressive disorder (MDD). Findings concerning the effects of electroconvulsive therapy (ECT) on the TNFα level have been contradictory. The aim was to examine the immediate and long-term changes in the TNFα level and their associations with symptom reduction in patients with MDD during ECT. METHOD The study included 30 patients with MDD. Their TNFα levels were measured at baseline and 2 and 4 hr after the first, fifth and last ECT session. Depressive symptoms were assessed with the Montgomery-Asberg Depression Rating Scale (MADRS). RESULTS The TNFα level decreased from baseline to the 2- and 4-hr measurements. There was a correlation between the first ECT session TNFα levels and the relative symptom reduction according to the MADRS score after the ECT series. Both the first (baseline) ECT and 4-hr TNFα levels were lower in responders than in nonresponders. CONCLUSION ECT consistently induced a decrease in the TNFα level after each studied session. A low TNFα level at the first ECT appeared to predict a symptom reduction. These findings suggest that TNFα might have a role in the pathogenesis in MDD and in the mechanism of action of ECT.
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Affiliation(s)
- Annamari Sorri
- Department of PsychiatryTampere University HospitalTampereFinland.,Department of PsychiatrySchool of MedicineUniversity of TampereTampereFinland
| | - Kaija Järventausta
- Department of PsychiatryTampere University HospitalTampereFinland.,Department of PsychiatrySchool of MedicineUniversity of TampereTampereFinland
| | - Olli Kampman
- Department of PsychiatrySchool of MedicineUniversity of TampereTampereFinland.,Department of PsychiatrySeinäjoki Hospital DistrictSeinäjokiFinland
| | - Kai Lehtimäki
- Department of Neurosurgery, Neurology and RehabilitationTampere University HospitalTampereFinland
| | - Minna Björkqvist
- Department of PsychiatryTampere University HospitalTampereFinland
| | - Kati Tuohimaa
- Department of PsychiatryTampere University HospitalTampereFinland
| | - Mari Hämäläinen
- The Immunopharmacology Research GroupFaculty of Medicine and Life SciencesUniversity of Tampere and Tampere University HospitalTampereFinland
| | - Eeva Moilanen
- The Immunopharmacology Research GroupFaculty of Medicine and Life SciencesUniversity of Tampere and Tampere University HospitalTampereFinland
| | - Esa Leinonen
- Department of PsychiatryTampere University HospitalTampereFinland.,Department of PsychiatrySchool of MedicineUniversity of TampereTampereFinland
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195
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Microglia Polarization and Endoplasmic Reticulum Stress in Chronic Social Defeat Stress Induced Depression Mouse. Neurochem Res 2018; 43:985-994. [PMID: 29574669 DOI: 10.1007/s11064-018-2504-0] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 01/30/2018] [Accepted: 02/23/2018] [Indexed: 12/27/2022]
Abstract
Inflammation recently has been considered to be participated in the pathogenesis of major depressive disorder (MDD). However, the detailed mechanism of inflammation in depression has not been completely understood yet. In the present study, depression mice model was established by chronic social defeat stress (CSDS) method and confirmed by behavior examinations including forced swimming test and sucrose preference test. The decrease of spine density and postsynaptic density protein 95 (PSD95) in hippocampus further verified the depression model. Then, the microglia polarization state and endoplasmic reticulum (ER) stress were investigated. At transcriptional level, M1 marker (inducible nitric oxide synthase (iNOS), CD16, CD86, CXCL10) in CSDS mice was higher than that in control group while there was no difference in M2 marker (Arginase and CD206) between two groups. And it was observed in the hippocampus of CSDS induced depression mice that increased activated microglia was merged with iNOS instead of arginase by immunofluorescence staining. Furthermore, the M1 marker Interleukin (IL)-1β and tumor necrosis factor (TNF)-α were increased in depression mice while the M1 marker IL-6 and M2 marker IL-10 remained unchanged. The expression of ER stress signaling factors, including protein kinase RNA-like ER kinase (PERK), Phosphorylated α-subunit of eukaryotic translation initiation factor 2(p-eIF2α), C/EBP homologous protein (CHOP), and X-box binding protein 1(XBP1) were significantly higher in CSDS-induced depression mice than in control mice. In all, our results suggest that M1 polarization and ER stress play a vital role in MDD pathogenesis.
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196
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He J, Fang P, Zheng X, Wang C, Liu T, Zhang B, Wen J, Xu RA. Inhibitory effect of celecoxib on agomelatine metabolism in vitro and in vivo. DRUG DESIGN DEVELOPMENT AND THERAPY 2018; 12:513-519. [PMID: 29563776 PMCID: PMC5849912 DOI: 10.2147/dddt.s160316] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Aim The aim of this study was to study the effect of celecoxib on agomelatine metabolism in vitro and in vivo. Methods Ten healthy male Sprague–Dawley rats were randomly divided into 2 groups: Group A (control group) and Group B (30 mg/kg celecoxib). Then a single dose of 20 mg/kg agomelatine was administered orally 30 min after administration of celecoxib. In an in vitro study, celecoxib with a series of concentrations was added to an incubation mixture containing recombinant human CYP2C9, human or rat liver microsomes to determine the half-maximal inhibitory concentration on the metabolism of agomelatine. Moreover, a mechanism study was performed to determine the inhibitory effect of celecoxib on CYP2C9. Results The results showed that a single dose of 30 mg/kg celecoxib significantly increased the area under the concentration-time curve and maximum concentration of agomelatine. In addition, celecoxib inhibited the metabolism of agomelatine in the in vitro studies, which was determined to be by a competitive mechanism on CYP2C9. Those results indicated that celecoxib has an inhibitory effect on the metabolism of agomelatine both in vivo and in vitro. Conclusion Thus, more attention should be paid when celecoxib is administered combined with agomelatine.
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Affiliation(s)
- Jiayang He
- Department of Pharmacy, The First Hospital of Jiaxing, Jiaxing, Zhejiang, China
| | - Ping Fang
- Department of Pharmacology, School of Pharmacy of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiang Zheng
- Department of Pharmacology, School of Pharmacy of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chenchen Wang
- Department of Pharmacology, School of Pharmacy of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Tenghui Liu
- Department of Pharmacology, School of Pharmacy of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Bowen Zhang
- Department of Pharmacology, School of Pharmacy of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jian Wen
- Department of Pharmacology, School of Pharmacy of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ren-Ai Xu
- Department of Pharmacy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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197
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Kawasaki K, Muroyama K, Murosaki S. Effect of a water extract of Curcuma longa on emotional states in healthy participants. BIOSCIENCE OF MICROBIOTA FOOD AND HEALTH 2018; 37:25-29. [PMID: 29662734 PMCID: PMC5897237 DOI: 10.12938/bmfh.17-020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 01/16/2018] [Indexed: 01/06/2023]
Abstract
Physiological symptoms of mood disturbances, such as fatigue or anxiety, are closely related to inflammation in the central nervous system or the whole body. Curcuma longa is widely used as a dietary spice and has been reported to have anti-inflammatory activity. To investigate the effect of a water extract of C. longa (WEC) on emotional states, a randomized, double-blind, placebo-controlled, parallel-group study was conducted with healthy participants. Forty-eight participants were randomly assigned to receive five tablets containing 150 mg WEC and 0.40 mg bisacurone (L-WEC group), five tablets containing 900 mg WEC and 2.40 mg bisacurone (H-WEC group), or matching placebo tablets (placebo group) daily for 8 weeks. Participant emotional states were measured every 4 weeks using the Profile of Mood States (POMS). The changes from week 0 to week 8 in the fatigue score of the POMS were significantly lower in the L-WEC group than in the placebo group. This result suggests that daily intake of 150 mg WEC may positively influence emotional fatigue, and further investigation focused on emotional fatigue is needed.
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Affiliation(s)
- Kengo Kawasaki
- Research & Development Institute, House Wellness Foods Corporation, 3-20 Imoji, Itami, Hyogo 664-0011, Japan
| | - Koutarou Muroyama
- Research & Development Institute, House Wellness Foods Corporation, 3-20 Imoji, Itami, Hyogo 664-0011, Japan
| | - Shinji Murosaki
- Research & Development Institute, House Wellness Foods Corporation, 3-20 Imoji, Itami, Hyogo 664-0011, Japan
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198
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Abstract
This review summarises the evidence that chronic low grade inflammation triggers changes that contribute to the mental and physical ill health of patients with major depression. Inflammation, and the activation of the hypothalamic pituitary axis by stress, are normal components of the stress response but when stress is prolonged and the endocrine and immune system become chronic resulting in the activation of the peripheral macrophages, the central microglia and hypercortisolemia, the neuronal networks are damaged and become dysfunctional. The proinflammatory cytokines, in addition to activating the hypothalamic-pituitary-adrenal axis and thereby increasing cortisol synthesis, also activate the tryptophan-kynurenine pathway. This results in the synthesis of the neurotoxic N-methyl-d-aspartate (NMDA) glutamate agonist quinolinic acid and 3-hydroxykynurenine thereby enhancing oxidative stress and contributes to neurodegeneration which characterise major depression particularly in late life.While antidepressants attenuate some of the endocrine and immune changes caused by inflammation, not all therapeutically effective antidepressants do so. This suggests that drugs which specifically target the immune, endocrine and neurotransmitter systems may be more effective antidepressants.The preliminary clinical evidence that some non-steroidal anti-inflammatory drugs, such as the cyclooxygenase 2 inhibitor celecoxib, can enhance the response to standard antidepressant treatment is therefore considered and a critical assessment made of the possible limitations of such an approach to novel antidepressant development.
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199
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Antidepressant activity of anti-cytokine treatment: a systematic review and meta-analysis of clinical trials of chronic inflammatory conditions. Mol Psychiatry 2018; 23:335-343. [PMID: 27752078 PMCID: PMC5794896 DOI: 10.1038/mp.2016.167] [Citation(s) in RCA: 386] [Impact Index Per Article: 64.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 07/01/2016] [Accepted: 08/12/2016] [Indexed: 02/07/2023]
Abstract
Inflammatory cytokines are commonly elevated in acute depression and are associated with resistance to monoaminergic treatment. To examine the potential role of cytokines in the pathogenesis and treatment of depression, we carried out a systematic review and meta-analysis of antidepressant activity of anti-cytokine treatment using clinical trials of chronic inflammatory conditions where depressive symptoms were measured as a secondary outcome. Systematic search of the PubMed, EMBASE, PsycINFO and Cochrane databases, search of reference lists and conference abstracts, followed by study selection process yielded 20 clinical trials. Random effect meta-analysis of seven randomised controlled trials (RCTs) involving 2370 participants showed a significant antidepressant effect of anti-cytokine treatment compared with placebo (standardised mean difference (SMD)=0.40, 95% confidence interval (CI), 0.22-0.59). Anti-tumour necrosis factor drugs were most commonly studied (five RCTs); SMD=0.33 (95% CI; 0.06-0.60). Separate meta-analyses of two RCTs of adjunctive treatment with anti-cytokine therapy and eight non-randomised and/or non-placebo studies yielded similar small-to-medium effect estimates favouring anti-cytokine therapy; SMD=0.19 (95% CI, 0.00-0.37) and 0.51 (95% CI, 0.34-0.67), respectively. Adalimumab, etanercept, infliximab and tocilizumab all showed statistically significant improvements in depressive symptoms. Meta-regression exploring predictors of response found that the antidepressant effect was associated with baseline symptom severity (P=0.018) but not with improvement in primary physical illness, sex, age or study duration. The findings indicate a potentially causal role for cytokines in depression and that cytokine modulators may be novel drugs for depression in chronically inflamed subjects. The field now requires RCTs of cytokine modulators using depression as the primary outcome in subjects with high inflammation who are free of other physical illnesses.
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Carrard A, Elsayed M, Margineanu M, Boury-Jamot B, Fragnière L, Meylan EM, Petit JM, Fiumelli H, Magistretti PJ, Martin JL. Peripheral administration of lactate produces antidepressant-like effects. Mol Psychiatry 2018; 23:392-399. [PMID: 27752076 PMCID: PMC5794893 DOI: 10.1038/mp.2016.179] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 08/18/2016] [Accepted: 08/26/2016] [Indexed: 12/22/2022]
Abstract
In addition to its role as metabolic substrate that can sustain neuronal function and viability, emerging evidence supports a role for l-lactate as an intercellular signaling molecule involved in synaptic plasticity. Clinical and basic research studies have shown that major depression and chronic stress are associated with alterations in structural and functional plasticity. These findings led us to investigate the role of l-lactate as a potential novel antidepressant. Here we show that peripheral administration of l-lactate produces antidepressant-like effects in different animal models of depression that respond to acute and chronic antidepressant treatment. The antidepressant-like effects of l-lactate are associated with increases in hippocampal lactate levels and with changes in the expression of target genes involved in serotonin receptor trafficking, astrocyte functions, neurogenesis, nitric oxide synthesis and cAMP signaling. Further elucidation of the mechanisms underlying the antidepressant effects of l-lactate may help to identify novel therapeutic targets for the treatment of depression.
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Affiliation(s)
- A Carrard
- Center for Psychiatric Neurosciences, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - M Elsayed
- Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - M Margineanu
- King Abdullah University of Science and Technology (KAUST), BESE Division, Thuwal, Saudi Arabia
| | - B Boury-Jamot
- Center for Psychiatric Neurosciences, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland,Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - L Fragnière
- Center for Psychiatric Neurosciences, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - E M Meylan
- Center for Psychiatric Neurosciences, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - J-M Petit
- Center for Psychiatric Neurosciences, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland,Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - H Fiumelli
- King Abdullah University of Science and Technology (KAUST), BESE Division, Thuwal, Saudi Arabia
| | - P J Magistretti
- Center for Psychiatric Neurosciences, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland,Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland,King Abdullah University of Science and Technology (KAUST), BESE Division, Thuwal, Saudi Arabia,Center for Psychiatric Neurosciences, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland. E-mail: or
| | - J-L Martin
- Center for Psychiatric Neurosciences, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland,Center for Psychiatric Neurosciences, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland. E-mail: or
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