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Bloemhof-Bris E, Meiri D, Sulimani L, Genesh SN, Wexler G, Cohen I, Salama A, Burshtein I, Hirschmann S, Feffer K, Weizman S, Stryjer R, Shelef A. Alterations in plasma endocannabinoid concentrations among individuals with major depression treated with electroconvulsive therapy. Psychiatry Res 2024; 337:115967. [PMID: 38796933 DOI: 10.1016/j.psychres.2024.115967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 05/12/2024] [Accepted: 05/13/2024] [Indexed: 05/29/2024]
Abstract
The role of the endocannabinoid system (ECS) in depression and suicidality has recently emerged. The purpose of the study was to identify changes in plasma endocannabinoid concentrations of several endocannabinoids and correlate them with depressive symptoms and suicidality in patients with severe major depression undergoing electroconvulsive therapy (ECT). The study included 17 patients that were evaluated in four visits at different stages of therapy. At each visit depression, anxiety and suicidality symptoms were assessed and blood samples collected. Several endocannabinoid concentrations increased following six sessions of ECT, as 2-AG (p < 0.05) and LEA (p < 0.01), and following twelve sessions of ECT, as 2-AG (p < 0.05), AEA (p < 0.05), LEA (p < 0.05) and DH-Gly (p < 0.05). Endocannabinoids also correlated with symptoms of depression, anxiety and suicidality at baseline and at the sixth ECT session. Finally, we found one endocannabinoid, l-Gly, that differentiated between remitted and not-remitted patients at the seventh and thirteenth ECT sessions (p < 0.05). Our findings suggest that depression is markedly related to imbalance of the endocannabinoid system, and further regulated by ECT. Plasma endocannabinoids could be promising biomarkers for detection of depression response and remission.
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Affiliation(s)
| | - David Meiri
- The Laboratory of Cancer Biology and Cannabinoid Research, Faculty of Biology, Technion-Israel Institute of Technology, Haifa, Israel
| | - Liron Sulimani
- Department of Biology, The Kleifeld Laboratory, Technion-Israel Institute of Technology, Haifa, Israel
| | | | - Gay Wexler
- Lev Hasharon Mental Health Center, Tzur Moshe, Israel
| | - Itzhak Cohen
- Department of Health Promotion, School of Public Health, Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Anas Salama
- Lev Hasharon Mental Health Center, Tzur Moshe, Israel
| | | | - Shmuel Hirschmann
- Lev Hasharon Mental Health Center, Tzur Moshe, Israel; Departement of Psychiatry, School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Kfir Feffer
- Lev Hasharon Mental Health Center, Tzur Moshe, Israel; Departement of Psychiatry, School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Shira Weizman
- Departement of Psychiatry, School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel; Abarbanel Mental Health Center, Bat Yam, Israel
| | - Rafael Stryjer
- Departement of Psychiatry, School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel; Abarbanel Mental Health Center, Bat Yam, Israel
| | - Assaf Shelef
- Lev Hasharon Mental Health Center, Tzur Moshe, Israel; Departement of Psychiatry, School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
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Gowatch LC, Evanski JM, Ely SL, Zundel CG, Bhogal A, Carpenter C, Shampine MM, O'Mara E, Mazurka R, Barcelona J, Mayo LM, Marusak HA. Endocannabinoids and Stress-Related Neurospsychiatric Disorders: A Systematic Review and Meta-Analysis of Basal Concentrations and Response to Acute Psychosocial Stress. Cannabis Cannabinoid Res 2024. [PMID: 38683635 DOI: 10.1089/can.2023.0246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024] Open
Abstract
Background: Dysregulation of the endocannabinoid (eCB) system is implicated in various stress-related neuropsychiatric disorders (SRDs), including anxiety, depression, and post-traumatic stress disorder (PTSD). In this systematic review and meta-analysis, our objectives were to characterize circulating anandamide (AEA) and 2-arachidonoylglycerol (2-AG) concentrations at rest and in response to acute laboratory-based psychosocial stress in individuals with SRDs and without (controls). Our primary aims were to assess the effects of acute psychosocial stress on eCB concentrations in controls (Aim 1), compare baseline (prestress) eCB concentrations between individuals with SRDs and controls (Aim 2), and explore differential eCB responses to acute psychosocial stress in individuals with SRDs compared with controls (Aim 3). Methods: On June 8, 2023, a comprehensive review of the MEDLINE (PubMed) database was conducted to identify original articles meeting inclusion criteria. A total of 1072, 1341, and 400 articles were screened for inclusion in Aims 1, 2, and 3, respectively. Results: Aim 1, comprised of seven studies in controls, revealed that most studies reported stress-related increases in AEA (86%, with 43% reporting statistical significance) and 2-AG (83%, though none were statistically significant except for one study in saliva). However, meta-analyses did not support these patterns (p's>0.05). Aim 2, with 20 studies, revealed that most studies reported higher baseline concentrations of both AEA (63%, with 16% reporting statistical significance) and 2-AG (60%, with 10% reporting statistical significance) in individuals with SRDs compared with controls. Meta-analyses confirmed these findings (p's<0.05). Aim 3, which included three studies, had only one study that reported statistically different stress-related changes in 2-AG (but not AEA) between individuals with PTSD (decrease) and controls (increase), which was supported by the meta-analysis (p<0.001). Meta-analyses showed heterogeneity across studies and aims (I2=14-97%). Conclusion: Despite substantial heterogeneity in study characteristics, samples, and methodologies, consistent patterns emerged, including elevated baseline AEA and 2-AG in individuals with SRDs compared with controls, as well as smaller stress-related increases in 2-AG in individuals with SRDs compared with controls. To consider eCBs as reliable biomarkers and potential intervention targets for SRDs, standardized research approaches are needed to clarify the complex relationships between eCBs, SRDs, and psychosocial stress.
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Affiliation(s)
- Leah C Gowatch
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan, USA
| | - Julia M Evanski
- Neuroscience Graduate Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Samantha L Ely
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan, USA
- Translational Neuroscience PhD Program, Wayne State University, Detroit, Michigan, USA
| | - Clara G Zundel
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan, USA
| | - Amanpreet Bhogal
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan, USA
| | - Carmen Carpenter
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan, USA
| | - MacKenna M Shampine
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan, USA
| | - Emilie O'Mara
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan, USA
| | - Raegan Mazurka
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Jeanne Barcelona
- Center for Health and Community Impact, College of Education, Wayne State University, Detroit, Michigan, USA
| | - Leah M Mayo
- Hotchkiss Brain Institute and Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Hilary A Marusak
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan, USA
- Translational Neuroscience PhD Program, Wayne State University, Detroit, Michigan, USA
- Department of Pharmacology, Wayne State University, Detroit, Michigan, USA
- Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, Michigan, USA
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3
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Obermanns J, Meiser H, Hoberg S, Vesterager CS, Schulz F, Juckel G, Emons B. Genetic variation of the 5-HT1A rs6295, 5-HT2A rs6311, and CNR1 rs1049353 and an altered endocannabinoid system in depressed patients. Brain Behav 2023; 13:e3323. [PMID: 37984468 PMCID: PMC10726863 DOI: 10.1002/brb3.3323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 10/16/2023] [Accepted: 10/31/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND The reasons for developing depression are not fully understood. However, it is known that the serotonergic system plays a role in the etiology, but the endocannabinoid system receives attention. METHOD In this study, 161 patients with a depressive disorder and 161 healthy participants were examined for the distribution of the CNR1 rs4940353, 5-HT2A rs6311, and 5-HT1A rs6295 by high-resolution melting genotyping. The concentration of arachidonoyl ethanolamide (AEA) and 2-arachidonoylglycerol (2-AG) in the blood was measured by liquid chromatography-tandem mass spectrometry. Additionally, depression and anxiety symptoms were evaluated based on self-questionnaires. Fifty-nine patients participated in a second appointment to measure the concentration of AEA, 2-AG, and symptoms of depression and anxiety. RESULTS We observed higher AEA and decreased 2-AG concentrations in patients with depression compared to healthy participants. During the treatment, the concentrations of AEA and 2-AG did not change significantly. In patients higher symptoms of anxiety correlated with lower concentrations of 2-AG. Gender differences were found concerning increased 2-AG concentration in male patients and increased anxiety symptoms in female patients. Genotypic variations of 5-HT1A rs6295 and 5-HT2A rs6311 are associated with altered serotonergic activity and serotonin content in patients. CONCLUSION In conclusion, it seems that the endocannabinoid system, especially the endocannabinoids 2-AG and AEA, and genetic variations of the 5-HT1A and 5-HT2A could play a role in patients with depression and may be involved in a depressive disorder.
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Affiliation(s)
- Jasmin Obermanns
- LWL University HospitalDepartment of PsychiatryPsychotherapy and Preventive MedicineRuhr University BochumBochumGermany
| | - Hanna Meiser
- LWL University HospitalDepartment of PsychiatryPsychotherapy and Preventive MedicineRuhr University BochumBochumGermany
| | - Saskia Hoberg
- LWL University HospitalDepartment of PsychiatryPsychotherapy and Preventive MedicineRuhr University BochumBochumGermany
| | | | - Frank Schulz
- Chemistry and Biochemistry of Natural ProductsRuhr University BochumBochumGermany
| | - Georg Juckel
- LWL University HospitalDepartment of PsychiatryPsychotherapy and Preventive MedicineRuhr University BochumBochumGermany
| | - Barbara Emons
- LWL University HospitalDepartment of PsychiatryPsychotherapy and Preventive MedicineRuhr University BochumBochumGermany
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Jayan D, Timmer-Murillo S, Fitzgerald JM, Hillard CJ, de Roon-Cassini TA. Endocannabinoids, cortisol, and development of post-traumatic psychopathological trajectories. Gen Hosp Psychiatry 2023; 85:199-206. [PMID: 37956620 PMCID: PMC10843734 DOI: 10.1016/j.genhosppsych.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 11/01/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVE Our prior published work using the 2-factor model of PTSD identified four subgroups of trauma survivors on average 6 months following trauma: Resilient, Dysphoria, High Comorbid, and Severe Comorbid. Some findings indicate that low and high cortisol responses may increase risk for the development of PTSD and depression respectively, yet ways in which cortisol interacts with other physiological systems to enhance risk is unclear. This study examined the role of circulating eCBs in the development of previously identified psychopathological trajectories that is differentiated by cortisol in traumatically injured adults (N = 169). METHODS Circulating concentrations of eCBs, 2-arachidonoylglycerol (2-AG) and N-arachidonoylethanolamine (AEA) were measured during post-injury hospitalization and on average 6 months following trauma. Differences in 2-AG and AEA among the subgroups were tested using multivariate ANCOVA. RESULTS Dysphoria (with highest cortisol levels) and High Comorbid subgroups exhibited higher post-injury AEA compared to the Resilient group. Dysphoria subgroup showed a significant decline in AEA by 6 months compared to Resilient and High Comorbid subgroups. CONCLUSION Change in AEA over time in individuals with high post-injury cortisol may serve as a buffer against risk for severe psychopathology. Assessing AEA and cortisol levels concurrently across time may serve as indicators of risk.
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Affiliation(s)
- Devi Jayan
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637, United States of America
| | - Sydney Timmer-Murillo
- Departments of Trauma & Acute Care Surgery, Psychiatry & Behavioral Medicine, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA.
| | - Jacklynn M Fitzgerald
- Department of Psychology, Marquette University, 317 Cramer Hall, Milwaukee 53233, USA.
| | - Cecilia J Hillard
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA.
| | - Terri A de Roon-Cassini
- Departments of Trauma & Acute Care Surgery, Psychiatry & Behavioral Medicine, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA; Institute for Health & Equity, Comprehensive Injury Center, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA.
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5
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Hitzler M, Matits L, Gumpp AM, Bach AM, Ziegenhain U, Gao W, Kolassa IT, Behnke A. Longitudinal course of endocannabinoids and N-acylethanolamines in hair of mothers and their children in the first year postpartum: investigating the relevance of maternal childhood maltreatment experiences. Psychol Med 2023; 53:7446-7457. [PMID: 37198936 PMCID: PMC10719681 DOI: 10.1017/s0033291723001204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/10/2023] [Accepted: 04/11/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Childhood maltreatment (CM) exerts long-lasting psychological and biological alterations in affected individuals and might also affect the endocannabinoid (eCB) system which modulates inflammation and the endocrine stress response. Here, we investigated the eCB system of women with and without CM and their infants using hair samples representing eCB levels accumulated during the last trimester of pregnancy and 10-12 months postpartum. METHODS CM exposure was assessed with the Childhood Trauma Questionnaire. At both timepoints, 3 cm hair strands were collected from mothers and children (N = 170 resp. 150) to measure anandamide (AEA), 2/1-arachidonoylglycerol (2-AG/1-AG), stearoylethanolamide (SEA), oleoylethanolamide (OEA), and palmitoylethanolamide (PEA). RESULTS Maternal hair levels of 2-AG/1-AG increased and SEA levels decreased from late pregnancy to one year postpartum. Maternal CM was associated with lower SEA levels in late pregnancy, but not one year later. In the children's hair, levels of 2-AG/1-AG increased while levels of SEA, OEA, and PEA decreased from late pregnancy to one year later. Maternal CM was not consistently associated with the eCB levels measured in children's hair. CONCLUSIONS We provide first evidence for longitudinal change in the eCB system of mothers and infants from pregnancy to one year later. While maternal CM influenced the maternal eCB system, we found no consistent intergenerational effects on early regulation of the eCB system in children. Longitudinal research on the importance of the eCB system for the course and immunoregulation of pregnancy as well as for the children's development.
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Affiliation(s)
- Melissa Hitzler
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Lynn Matits
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
- Division of Sports and Rehabilitation Medicine, Department of Medicine, Ulm University Hospital, Ulm, Germany
| | - Anja M. Gumpp
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Alexandra M. Bach
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Ute Ziegenhain
- Department of Child and Adolescent Psychiatry, Ulm University Hospital, Ulm, Germany
| | - Wei Gao
- Department of Biopsychology, Technische Universität Dresden, Dresden, Germany
| | - Iris-Tatjana Kolassa
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Alexander Behnke
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
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Herrera-Imbroda J, Flores-López M, Requena-Ocaña N, Araos P, García-Marchena N, Ropero J, Bordallo A, Suarez J, Pavón-Morón FJ, Serrano A, Mayoral F, Rodríguez de Fonseca F. Antidepressant Medication Does Not Contribute to the Elevated Circulating Concentrations of Acylethanolamides Found in Substance Use Disorder Patients. Int J Mol Sci 2023; 24:14788. [PMID: 37834235 PMCID: PMC10573451 DOI: 10.3390/ijms241914788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/20/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
Circulating acylethanolamides (NAEs) are bioactive signaling molecules that modulate multiple homeostatic functions including mood and hedonic responses. Variations in their plasma concentrations are associated with substance use disorders (SUD) and recent studies suggest that psychotropic medication might influence its circulating levels, limiting its use as a clinical biomarker of addiction. In addition, they might have a role as mediators of the pharmacological effects of psychotropic drugs. Thus, in mild depression, the response to selective serotonin reuptake inhibitor-type antidepressants (SSRI) is associated with a marked increase in circulating NAEs. To further investigate if antidepressants are able to modify the plasma concentration of NAEs in SUD patients, we analyzed the circulating levels of NAEs in 333 abstinent and 175 healthy controls on the basis of the treatment with SSRI antidepressants. As described previously, SUD patients display higher concentrations of NAEs than those measured in a control population. This increase was not further modified by antidepressant therapy. Only marginal increases in palmitoylethanolamide (PEA), oleoylethanolamide (OEA), or docosatetraenoyl-ethanolamide (DEA) were found, and the net effect was very small. Thus, our study shows that treatment with SSRI-type antidepressants does not modify the clinical utility of monitoring enhanced NAE production as biomarkers of SUD. In addition, the possibility that a blunted NAE response to antidepressant therapy might be related to the loss of efficacy of SSRIs in dual depression emerges as an attractive hypothesis that needs to be addressed in future studies.
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Affiliation(s)
- Jesús Herrera-Imbroda
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina—IBIMA Plataforma Bionand, 29590 Málaga, Spain; (J.H.-I.); (M.F.-L.); (N.R.-O.); (P.A.); (N.G.-M.); (J.R.); (J.S.); (F.J.P.-M.); (F.M.)
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain;
- Departamento de Farmacología y Pediatría, Facultad de Medicina, Universidad de Málaga, 29071 Málaga, Spain
| | - María Flores-López
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina—IBIMA Plataforma Bionand, 29590 Málaga, Spain; (J.H.-I.); (M.F.-L.); (N.R.-O.); (P.A.); (N.G.-M.); (J.R.); (J.S.); (F.J.P.-M.); (F.M.)
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain;
| | - Nerea Requena-Ocaña
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina—IBIMA Plataforma Bionand, 29590 Málaga, Spain; (J.H.-I.); (M.F.-L.); (N.R.-O.); (P.A.); (N.G.-M.); (J.R.); (J.S.); (F.J.P.-M.); (F.M.)
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain;
| | - Pedro Araos
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina—IBIMA Plataforma Bionand, 29590 Málaga, Spain; (J.H.-I.); (M.F.-L.); (N.R.-O.); (P.A.); (N.G.-M.); (J.R.); (J.S.); (F.J.P.-M.); (F.M.)
- Departamento de Psicología Básica, Facultad de Psicología, Universidad de Málaga, 29071 Málaga, Spain
| | - Nuria García-Marchena
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina—IBIMA Plataforma Bionand, 29590 Málaga, Spain; (J.H.-I.); (M.F.-L.); (N.R.-O.); (P.A.); (N.G.-M.); (J.R.); (J.S.); (F.J.P.-M.); (F.M.)
- Departamento de Psicobiología y Metodología, Facultad de Psicología, Universidad Complutense de Madrid, 28223 Madrid, Spain
| | - Jessica Ropero
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina—IBIMA Plataforma Bionand, 29590 Málaga, Spain; (J.H.-I.); (M.F.-L.); (N.R.-O.); (P.A.); (N.G.-M.); (J.R.); (J.S.); (F.J.P.-M.); (F.M.)
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain;
| | - Antonio Bordallo
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain;
| | - Juan Suarez
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina—IBIMA Plataforma Bionand, 29590 Málaga, Spain; (J.H.-I.); (M.F.-L.); (N.R.-O.); (P.A.); (N.G.-M.); (J.R.); (J.S.); (F.J.P.-M.); (F.M.)
- Departamento of Anatomía, Medicina Legal e Historia de la Ciencia, Facultad de Medicina, Universidad de Málaga, 29071 Málaga, Spain
| | - Francisco J. Pavón-Morón
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina—IBIMA Plataforma Bionand, 29590 Málaga, Spain; (J.H.-I.); (M.F.-L.); (N.R.-O.); (P.A.); (N.G.-M.); (J.R.); (J.S.); (F.J.P.-M.); (F.M.)
- Unidad Clínica Área del Corazón, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Antonia Serrano
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina—IBIMA Plataforma Bionand, 29590 Málaga, Spain; (J.H.-I.); (M.F.-L.); (N.R.-O.); (P.A.); (N.G.-M.); (J.R.); (J.S.); (F.J.P.-M.); (F.M.)
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain;
| | - Fermín Mayoral
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina—IBIMA Plataforma Bionand, 29590 Málaga, Spain; (J.H.-I.); (M.F.-L.); (N.R.-O.); (P.A.); (N.G.-M.); (J.R.); (J.S.); (F.J.P.-M.); (F.M.)
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain;
| | - Fernando Rodríguez de Fonseca
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina—IBIMA Plataforma Bionand, 29590 Málaga, Spain; (J.H.-I.); (M.F.-L.); (N.R.-O.); (P.A.); (N.G.-M.); (J.R.); (J.S.); (F.J.P.-M.); (F.M.)
- Unidad Clínica de Neurología, Hospital Regional Universitario de Málaga, 29010 Malaga, Spain
- Andalusian Network for Clinical and Translational Research in Neurology (NEURO-RECA), 29001 Malaga, Spain
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7
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Herrera-Imbroda J, Flores-López M, Requena-Ocaña N, Araos P, Ropero J, García-Marchena N, Bordallo A, Suarez J, Pavón-Morón FJ, Serrano A, Mayoral F, Rodríguez de Fonseca F. Antipsychotic Medication Influences the Discriminative Value of Acylethanolamides as Biomarkers of Substance Use Disorder. Int J Mol Sci 2023; 24:ijms24119371. [PMID: 37298321 DOI: 10.3390/ijms24119371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/01/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
Plasma acylethanolamides (NAEs), including the endocannabinoid anandamide (AEA), have been proposed as circulating biomarkers of substance use disorders. However, the concentration of these lipid transmitters might be influenced by the use of drugs prescribed for either the treatment of addiction or the associated psychiatric co-morbidities such as psychosis. As an example, neuroleptics, used for attenuation of psychotic symptoms and sedation, might theoretically interfere with the monoamine-mediated production of NAEs, obstructing the interpretation of plasma NAEs as clinical biomarkers. To solve the lack of information on the impact of neuroleptics on the concentration of NAEs, we evaluated the concentrations of NAEs in a control group and compared them to those present in (a) substance use disorders (SUD) patients that are not prescribed with neuroleptics, and (b) SUD patients (both alcohol use disorder and cocaine use disorder patients) using neuroleptics. The results demonstrate that SUD patients exhibited greater concentrations of NAEs than the control population, affecting all species with the exception of stearoylethanolamide (SEA) and palmitoleoylethanolamide (POEA). Neuroleptic treatment enhanced the concentrations of NAEs, especially those of AEA, linoleoylethanolamide (LEA), and oleoylethanolamide (OEA). This effect of neuroleptic treatment was observed independently of the drug addiction that motivated the demand for treatment (either alcohol or cocaine). This study remarks the need to control the current use of psychotropic medication as a potential confounding variable when considering the use of NAEs as biomarkers in SUD.
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Affiliation(s)
- Jesús Herrera-Imbroda
- Grupo de Neuropsicofarmacología, IBIMA-Plataforma BIONAND, 29590 Málaga, Spain
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, IBIMA-Plataforma BIONAND, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
- Facultad de Medicina, Universidad de Málaga, Andalucía Tech, Campus de Teatinos s/n, 29071 Málaga, Spain
| | - María Flores-López
- Grupo de Neuropsicofarmacología, IBIMA-Plataforma BIONAND, 29590 Málaga, Spain
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, IBIMA-Plataforma BIONAND, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
| | - Nerea Requena-Ocaña
- Grupo de Neuropsicofarmacología, IBIMA-Plataforma BIONAND, 29590 Málaga, Spain
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, IBIMA-Plataforma BIONAND, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
| | - Pedro Araos
- Grupo de Neuropsicofarmacología, IBIMA-Plataforma BIONAND, 29590 Málaga, Spain
- Departamento de Psicología Básica, Facultad de Psicología, Universidad de Málaga, 29071 Málaga, Spain
| | - Jessica Ropero
- Grupo de Neuropsicofarmacología, IBIMA-Plataforma BIONAND, 29590 Málaga, Spain
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, IBIMA-Plataforma BIONAND, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
| | - Nuria García-Marchena
- Grupo de Neuropsicofarmacología, IBIMA-Plataforma BIONAND, 29590 Málaga, Spain
- Departamento de Psicobiología y Metodología, Facultad de Psicología, Universidad Complutense de Madrid, 28223 Madrid, Spain
| | - Antonio Bordallo
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, IBIMA-Plataforma BIONAND, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
| | - Juan Suarez
- Grupo de Neuropsicofarmacología, IBIMA-Plataforma BIONAND, 29590 Málaga, Spain
- Departamento de Anatomía, Medicina Legal e Historia de la Ciencia, Facultad de Medicina, Universidad de Málaga, 29071 Málaga, Spain
| | - Francisco Javier Pavón-Morón
- Unidad Clínica Área del Corazón, Hospital Universitario Virgen de la Victoria, IBIMA-Plataforma BIONAND, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Antonia Serrano
- Grupo de Neuropsicofarmacología, IBIMA-Plataforma BIONAND, 29590 Málaga, Spain
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, IBIMA-Plataforma BIONAND, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
| | - Fermín Mayoral
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, IBIMA-Plataforma BIONAND, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
| | - Fernando Rodríguez de Fonseca
- Grupo de Neuropsicofarmacología, IBIMA-Plataforma BIONAND, 29590 Málaga, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Unidad Clínica de Neurología, Hospital Regional Universitario de Málaga, IBIMA-Plataforma BIONAND, 29010 Málaga, Spain
- Andalusian Network for Clinical and Translational Research in Neurology [NEURO-RECA], 29001 Málaga, Spain
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8
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Wang CQ, Su Z, Dai CG, Song JL, Qian B. Multi-omics analysis reveals BDE47 induces depression-like behaviors in mice by interfering with the 2-arachidonoyl glycerol-associated microbiota-gut-brain axis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 259:115041. [PMID: 37224780 DOI: 10.1016/j.ecoenv.2023.115041] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 05/26/2023]
Abstract
2,2',4,4'-tetrabromodiphenyl ether (BDE47) is a foodborne environmental risk factor for depression, but the pathogenic mechanism has yet to be fully characterized. In this study, we clarified the effect of BDE47 on depression in mice. The abnormal regulation of the microbiome-gut-brain axis is evidenced closely associated with the development of depression. Using RNA sequencing, metabolomics, and 16s rDNA amplicon sequencing, the role of the microbiome-gut-brain axis in depression was also explored. The results showed that BDE47 exposure increased depression-like behaviors in mice but inhibited the learning memory ability of mice. The RNA sequencing analysis showed that BDE47 exposure disrupted dopamine transmission in the brain of mice. Meanwhile, BDE47 exposure reduced protein levels of tyrosine hydroxylase (TH) and dopamine transporter (DAT), activated astrocytes and microglia cells, and increased protein levels of NLRP3, IL-6, IL-1β, and TNF-α in the brain of mice. The 16 s rDNA sequencing analysis showed that BDE47 exposure disrupted microbiota communities in the intestinal contents of mice, and faecalibaculum was the most increased genus. Moreover, BDE47 exposure increased the levels of IL-6, IL-1β, and TNF-α in the colon and serum of mice but decreased the levels of tight junction protein ZO-1 and Occludin in the colon and brain of mice. In addition, the metabolomic analysis revealed that BDE47 exposure induced metabolic disorders of arachidonic acid and neurotransmitter 2-Arachidonoyl glycerol (2-AG) was one of the most decreased metabolites. Correlation analysis further revealed gut microbial dysbiosis, particularly faecalibaculum, is associated with altered gut metabolites and serum cytokines in response to BDE47 exposure. Our results suggest that BDE47 might induce depression-like behavior in mice through gut microbial dysbiosis. The mechanism might be associated with the inhibited 2-AG signaling and increased inflammatory signaling in the gut-brain axis.
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Affiliation(s)
- Cheng-Qiang Wang
- Department of Occupational and Environmental Health, Guilin Medical University, Guilin, China; Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Health, Guilin Medical University, Guilin, China
| | - Zou Su
- Department of Psychiatry, Wuhan Wudong Hospital, Wuhan, China
| | - Chun-Guang Dai
- Department of Occupational and Environmental Health, Guilin Medical University, Guilin, China
| | - Jia-Le Song
- Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Health, Guilin Medical University, Guilin, China.
| | - Bo Qian
- Department of Occupational and Environmental Health, Guilin Medical University, Guilin, China; Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Health, Guilin Medical University, Guilin, China.
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9
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Barba SV, Kirschbaum C, Gao W. Endocannabinoid and perceived stress: Association analysis of endocannabinoid levels in hair versus levels in plasma and urine. Biol Psychol 2023; 178:108541. [PMID: 36918140 DOI: 10.1016/j.biopsycho.2023.108541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 03/05/2023] [Accepted: 03/10/2023] [Indexed: 03/14/2023]
Abstract
The endocannabinoid system is considered to play a role in a wide range of functions, including stress. Hair analysis of endocannabinoids presents a promising methodological advancement for the retrospective assessment of long-term cumulative endocannabinoid secretion. Despite promising pilot study results suggesting the usefulness of hair endocannabinoid assessments, it remains unclear whether hair endocannabinoid levels mirror systemic endocannabinoid levels accurately. Two independent studies were conducted to investigate to what extent hair endocannabinoid and N-Acylethanolamine levels reflect the systemic levels retrospectively. Endocannabinoid and N-Acylethanolamine levels were measured in 3 cm and 1 cm hair segments respectively, and compared with the averaged levels in multiple plasma samples collected during three months (Study I), and in multiple 24-hour urine samples collected over a month (Study II). In addition, the Perceived Stress Scale was used to assess the perceived stress throughout the studies. Against our hypothesis, no association was found between the endocannabinoid or N-Acylethanolamine levels in hair and plasma or urine. However, hair palmitoylethanolamide (PEA), oleoylethanolamide (OEA), and stearoylethanolamide (SEA) levels were positively correlated with perceived stress in Study I. The current findings suggest that hair endocannabinoid or N-Acylethanolamine levels might not accurately reflect the levels of peripheral circulating endocannabinoid or N-Acylethanolamine. Nevertheless, hair N-Acylethanolamine levels might emerge as a useful strategy in the study of some psychological phenotypes, such as stress.
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Affiliation(s)
- Sonia Valdivieso Barba
- Faculty of Psychology, Chair of Biological Psychology, Technische Universität Dresden, Dresden, Germany
| | - Clemens Kirschbaum
- Faculty of Psychology, Chair of Biological Psychology, Technische Universität Dresden, Dresden, Germany
| | - Wei Gao
- Faculty of Psychology, Chair of Biological Psychology, Technische Universität Dresden, Dresden, Germany.
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10
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Anajirih N, O'Sullivan SE, Alexander SP. Endocannabinoid hydrolases differentially distribute in platelets and red blood cells and are differentially released by thrombin. Prostaglandins Other Lipid Mediat 2023; 164:106692. [PMID: 36372184 DOI: 10.1016/j.prostaglandins.2022.106692] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/29/2022] [Accepted: 11/02/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Plasma levels of the major endocannabinoids 2-arachidonoylgycerol (2AG) and anandamide (N-arachidonoylethanolamine, AEA) have been identified to vary independently with particular pathological conditions. The levels of these endocannabinoids are tightly regulated by two hydrolytic enzymes, monoacylglycerol lipase (MAGL) and fatty acid amide hydrolase (FAAH), respectively. OBJECTIVES In this study, we have quantified these enzyme activities in the major blood fractions. PATIENTS/METHODS In blood fractions from human volunteers, radiometric assays were used to quantify monoacylglycerol lipase and fatty acid amide hydrolase. Tagging with fluorophosphonate-rhodamine allowed quantification of platelet serine hydrolase activities. RESULTS Fatty acid amide hydrolase activity was highest in platelets, while MAGL activity was most abundant in erythrocytes. Sampling the blood of donors on two further occasions 15 days apart showed no significant change in platelet FAAH or erythrocyte MAGL activities. Activities were not different when comparing female donors with males. Storage of these blood fractions at - 80 °C was associated with a rapid loss in enzyme activities, which could largely by avoided by storage in liquid nitrogen. Incubation of platelets and erythrocytes in the presence of thrombin lead to release of measurable FAAH, but not MAGL, activity. Tagging of serine hydrolase activities with fluorophosphonate-rhodamine allowed confirmation of MAGL activity in platelet preparations, as well as multiple other enzymes. CONCLUSIONS These investigations suggest a potential role for FAAH in regulation of coagulation, while the role of MAGL in blood requires further investigation.
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Affiliation(s)
- Nuha Anajirih
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, University of Nottingham Medical School, Nottingham NG7 2UH, UK.
| | - Saoirse E O'Sullivan
- Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, Royal Derby Hospital, University of Nottingham, Nottingham, UK.
| | - Stephen Ph Alexander
- Division of Physiology, Pharmacology and Neuroscience, School of Life Sciences, University of Nottingham Medical School, Nottingham NG7 2UH, UK.
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11
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Behnke A, Gumpp AM, Rojas R, Sänger T, Lutz-Bonengel S, Moser D, Schelling G, Krumbholz A, Kolassa IT. Circulating inflammatory markers, cell-free mitochondrial DNA, cortisol, endocannabinoids, and N-acylethanolamines in female depressed outpatients. World J Biol Psychiatry 2023; 24:58-69. [PMID: 35532037 DOI: 10.1080/15622975.2022.2070666] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Major depressive disorder (MDD) involves peripheral low-grade pro-inflammatory activity. This multi-biomarker case-control study characterises the proinflammatory status in MDD beyond C-reactive protein (CRP) and Interleukin (IL)-6 levels through investigating concomitant alterations of immunoregulatory biomolecules. METHODS In 20 female MDD patients and 24 non-depressed women, circulating levels of CRP, IL-6, cortisol, selected endocannabinoids (ECs; anandamide [AEA], 2-arachidonylglycerol [2-AG]), and N-acylethanolamines (NAEs), as well as circulating cell-free mitochondrial DNA (ccf-mtDNA) were measured. RESULTS We found higher serum CRP and plasma AEA levels in MDD and a positive association of CRP and AEA levels with current depressive symptoms. Blood levels of cortisol, ccf-mtDNA, 2-AG, and NAEs did depend on MDD diagnosis nor correlated with the severity of current depressive symptoms. CRP correlated positively with AEA, and AEA showed positive associations with 2-AG and NAE levels. CONCLUSIONS In this study, female MDD outpatients with mild to moderate disorder severity did not substantially differ from non-depressed controls in the resting levels of multiple immunoregulatory markers in peripheral blood. Instead of investigating resting levels, future research on the role of inflammatory activity in MDD should focus on investigating the reactivity of pathways modulating the immune system upon exposure to physical and psychosocial stressors.
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Affiliation(s)
- Alexander Behnke
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Anja Maria Gumpp
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Roberto Rojas
- University Psychotherapeutic Outpatient Clinic, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Timo Sänger
- Forensic Molecular Biology, Institute of Forensic Medicine, Medical Centre-University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sabine Lutz-Bonengel
- Forensic Molecular Biology, Institute of Forensic Medicine, Medical Centre-University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dirk Moser
- Molecular Genetics Lab, Department of Genetic Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Gustav Schelling
- Department of Anaesthesiology, Ludwig Maximilians University, Munich, Germany
| | - Aniko Krumbholz
- Institute of Doping Analysis and Sports Biochemistry (IDAS) Dresden, Kreischa, Germany
| | - Iris-Tatjana Kolassa
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
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12
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Hu G, Zhang M, Wang Y, Yu M, Zhou Y. Potential of Heterogeneous Compounds as Antidepressants: A Narrative Review. Int J Mol Sci 2022; 23:ijms232213776. [PMID: 36430254 PMCID: PMC9692659 DOI: 10.3390/ijms232213776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/30/2022] [Accepted: 11/05/2022] [Indexed: 11/11/2022] Open
Abstract
Depression is a globally widespread disorder caused by a complicated interplay of social, psychological, and biological factors. Approximately 280 million people are suffering from depression worldwide. Traditional frontline antidepressants targeting monoamine neurotransmitters show unsatisfactory effects. The development and application of novel antidepressants for dissimilar targets are on the agenda. This review characterizes the antidepressant effects of multiple endogenous compounds and/or their targets to provide new insight into the working mechanism of antidepressants. We also discuss perspectives and challenges for the generation of novel antidepressants.
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Affiliation(s)
- Gonghui Hu
- Department of Rehabilitation Medicine, Affiliated Hospital of Qingdao University, Qingdao 266000, China
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Qingdao University, Qingdao 266071, China
- Institute of Brain Sciences and Related Disorders, Qingdao University, Qingdao 266071, China
| | - Meng Zhang
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Qingdao University, Qingdao 266071, China
- Institute of Brain Sciences and Related Disorders, Qingdao University, Qingdao 266071, China
| | - Yuyang Wang
- Department of Rehabilitation Medicine, Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Ming Yu
- Neuroscience and Neurorehabilitation Institute, University of Health and Rehabilitation Sciences, Qingdao 266000, China
| | - Yu Zhou
- Department of Rehabilitation Medicine, Affiliated Hospital of Qingdao University, Qingdao 266000, China
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Qingdao University, Qingdao 266071, China
- Institute of Brain Sciences and Related Disorders, Qingdao University, Qingdao 266071, China
- Neuroscience and Neurorehabilitation Institute, University of Health and Rehabilitation Sciences, Qingdao 266000, China
- Correspondence:
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13
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Modulation of Endocannabinoid System Components in Depression: Pre-Clinical and Clinical Evidence. Int J Mol Sci 2022; 23:ijms23105526. [PMID: 35628337 PMCID: PMC9146799 DOI: 10.3390/ijms23105526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/09/2022] [Accepted: 05/09/2022] [Indexed: 02/05/2023] Open
Abstract
Depression is characterized by continuous low mood and loss of interest or pleasure in enjoyable activities. First-line medications for mood disorders mostly target the monoaminergic system; however, many patients do not find relief with these medications, and those who do suffer from negative side effects and a discouragingly low rate of remission. Studies suggest that the endocannabinoid system (ECS) may be involved in the etiology of depression and that targeting the ECS has the potential to alleviate depression. ECS components (such as receptors, endocannabinoid ligands, and degrading enzymes) are key neuromodulators in motivation and cognition as well as in the regulation of stress and emotions. Studies in depressed patients and in animal models for depression have reported deficits in ECS components, which is motivating researchers to identify potential diagnostic and therapeutic biomarkers within the ECS. By understanding the effects of cannabinoids on ECS components in depression, we enhance our understanding of which brain targets they hit, what biological processes they alter, and eventually how to use this information to design better therapeutic options. In this article, we discuss the literature on the effects of cannabinoids on ECS components of specific depression-like behaviors and phenotypes in rodents and then describe the findings in depressed patients. A better understanding of the effects of cannabinoids on ECS components in depression may direct future research efforts to enhance diagnosis and treatment.
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14
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Molecular Alterations of the Endocannabinoid System in Psychiatric Disorders. Int J Mol Sci 2022; 23:ijms23094764. [PMID: 35563156 PMCID: PMC9104141 DOI: 10.3390/ijms23094764] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/22/2022] [Accepted: 04/23/2022] [Indexed: 02/07/2023] Open
Abstract
The therapeutic benefits of the current medications for patients with psychiatric disorders contrast with a great variety of adverse effects. The endocannabinoid system (ECS) components have gained high interest as potential new targets for treating psychiatry diseases because of their neuromodulator role, which is essential to understanding the regulation of many brain functions. This article reviewed the molecular alterations in ECS occurring in different psychiatric conditions. The methods used to identify alterations in the ECS were also described. We used a translational approach. The animal models reproducing some behavioral and/or neurochemical aspects of psychiatric disorders and the molecular alterations in clinical studies in post-mortem brain tissue or peripheral tissues were analyzed. This article reviewed the most relevant ECS changes in prevalent psychiatric diseases such as mood disorders, schizophrenia, autism, attentional deficit, eating disorders (ED), and addiction. The review concludes that clinical research studies are urgently needed for two different purposes: (1) To identify alterations of the ECS components potentially useful as new biomarkers relating to a specific disease or condition, and (2) to design new therapeutic targets based on the specific alterations found to improve the pharmacological treatment in psychiatry.
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15
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A Duet Between Histamine and Oleoylethanolamide in the Control of Homeostatic and Cognitive Processes. Curr Top Behav Neurosci 2021; 59:389-410. [PMID: 34410679 DOI: 10.1007/7854_2021_236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
In ballet, a pas de deux (in French it means "step of two") is a duet in which the two dancers perform ballet steps together. The suite of dances shares a common theme of partnership. How could we better describe the fine interplay between oleoylethanolamide (OEA) and histamine, two phylogenetically ancient molecules controlling metabolic, homeostatic and cognitive processes? Contrary to the pas de deux though, the two dancers presumably never embrace each other as a dancing pair but execute their "virtuoso solo" constantly exchanging interoceptive messages presumably via vagal afferents, the blood stream, the neuroenteric system. With one exception, which is in the control of liver ketogenesis, as in hepatocytes, OEA biosynthesis strictly depends on the activation of histaminergic H1 receptors. In this review, we recapitulate our main findings that evidence the interplay of histamine and OEA in the control of food consumption and eating behaviour, in the consolidation of emotional memory and mood, and finally, in the synthesis of ketone bodies. We will also summarise some of the putative underlying mechanisms for each scenario.
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16
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Galván ST, Flores-López M, Romero-Sanchiz P, Requena-Ocaña N, Porras-Perales O, Nogueira-Arjona R, Mayoral F, Araos P, Serrano A, Muga R, Pavón FJ, García-Marchena N, de Fonseca FR. Plasma concentrations of granulocyte colony-stimulating factor (G-CSF) in patients with substance use disorders and comorbid major depressive disorder. Sci Rep 2021; 11:13629. [PMID: 34211033 PMCID: PMC8249412 DOI: 10.1038/s41598-021-93075-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 06/21/2021] [Indexed: 12/13/2022] Open
Abstract
Granulocyte colony-stimulating factor (G-CSF) has raised much interest because of its role in cocaine addiction in preclinical models. We explored the plasma concentrations of G-CSF in patients diagnosed with substance use disorder (SUD) and highly comorbid psychiatric disorders. In particular, we investigated the association between G-CSF concentrations and comorbid major depressive disorder (MDD) in patients with cocaine and alcohol use disorders (CUD and AUD, respectively). Additionally, patients with MDD but not SUD were included in the study. Three hundred and eleven participants were enrolled in this exploratory study: 136 control subjects, 125 patients with SUD (SUD group) from outpatient treatment programs for cocaine (N = 60, cocaine subgroup) and alcohol (N = 65, alcohol subgroup), and 50 patients with MDD but not SUD (MDD group) from primary-care settings. Participants were assessed based on DSM-IV-TR criteria, and a blood sample was collected to examine the plasma concentrations of G-CSF. G-CSF concentrations were negatively correlated with age in the entire sample (r = - 0.233, p < 0.001) but not in the patients with MDD. G-CSF concentrations were lower in patients with SUD than in controls (p < 0.05), specifically in the cocaine subgroup (p < 0.05). Patients with SUD and comorbid MDD had lower G-CSF concentrations than patients with SUD but not comorbid MDD or controls (p < 0.05). In contrast, patients with MDD but not SUD showed no differences compared with their controls. The negative association between G-CSF concentrations and age in the sample was not observed in patients with MDD. G-CSF concentrations were decreased in patients with SUD and comorbid MDD but not in patients with MDD. Therefore, G-CSF may be useful to improve the stratification of patients with dual diagnosis seeking treatment. Further investigation is needed to explore the impact of sex and type of drug on the expression of G-CSF.
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Affiliation(s)
- Sandra Torres Galván
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
- Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain
| | - María Flores-López
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
- Facultad de Psicología, Universidad de Málaga, Málaga, Spain
| | - Pablo Romero-Sanchiz
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
- Department of Psychology, University of Roehampton, London, UK
| | - Nerea Requena-Ocaña
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
| | - Oscar Porras-Perales
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
- Facultad de Psicología, Universidad de Málaga, Málaga, Spain
- Unidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de La Victoria, Málaga, Spain
| | - Raquel Nogueira-Arjona
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
- Department of Psychology, University of Roehampton, London, UK
| | - Fermín Mayoral
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
| | - Pedro Araos
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
- Facultad de Psicología, Universidad de Málaga, Málaga, Spain
| | - Antonia Serrano
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
| | - Roberto Muga
- Unidad de Adicciones- Servicio de Medicina Interna. Institut D'Investigació en Ciències de La Salut Germans Trias I Pujol (IGTP), Campus Can Ruti, Carrer del Canyet s/n, 08916, Badalona, Spain
- Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Francisco Javier Pavón
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain.
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain.
- Unidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de La Victoria, Málaga, Spain.
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.
| | - Nuria García-Marchena
- Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain.
- Unidad de Adicciones- Servicio de Medicina Interna. Institut D'Investigació en Ciències de La Salut Germans Trias I Pujol (IGTP), Campus Can Ruti, Carrer del Canyet s/n, 08916, Badalona, Spain.
| | - Fernando Rodríguez de Fonseca
- Laboratorio de Medicina Regenerativa, Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Avda. Carlos Haya 82, sótano, 29010, Málaga, Spain.
- Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain.
- Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain.
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17
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Jin W, Yang J, Liu D, Zhong Q, Zhou T. Determination of inflammation-related lipids in depressive rats by on-line supercritical fluid extraction-supercritical fluid chromatography-tandem mass spectrometry. J Pharm Biomed Anal 2021; 203:114210. [PMID: 34171739 DOI: 10.1016/j.jpba.2021.114210] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/04/2021] [Accepted: 06/13/2021] [Indexed: 12/16/2022]
Abstract
An on-line supercritical fluid extraction coupled with supercritical fluid chromatography-quadrupole tandem mass spectrometry method was developed to determine lipids related to inflammation in brain tissues of depressed rats. The analysis of 23 lipids from extraction to separation and detection only took 15 min and required 1 mg of brain tissue powder. The matrix effect of the on-line method for endogenous lipids was systematically investigated, and targeted lipids were quantified by matrix effect corrected calibration curves in this study. The on-line method was comprehensively optimized and evaluated. All calibration curves for lipids showed good linearity (correlation coefficient >0.99). The limits of detection and the limits of quantification were in the range of 0.0261-0.396 pg and 0.0791-1.20 pg. The recoveries and the matrix effect were in the range of 85.3-117.5% and 51.9-176.6%, respectively. The relative standard deviations of precision ranged from 2.7 to 14.2%, with accuracies higher than 87.2%. Compared with liquid-liquid extraction coupled with liquid chromatography-tandem mass spectrometry method, the on-line method obtained higher recovery and sensitivity with significantly reduced analytical time, manual operations, and sample amounts. Finally, this on-line method was applied to analyses of brain tissues of depressed rats. Six pro-inflammatory lipids increased in depressed rats, while six anti-inflammatory lipids decreased. Liquiritin and fluoxetine were presumed to promote a similar synthesis of anti-inflammatory lipids. Based on the results, this on-line method showed great promise in analyzing lipids in complex biological samples.
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Affiliation(s)
- Wenbin Jin
- School of Biology and Biological Engineering, South China University of Technology, Guangzhou, 510006, China
| | - Jina Yang
- School of Biology and Biological Engineering, South China University of Technology, Guangzhou, 510006, China
| | - Danyang Liu
- School of Biology and Biological Engineering, South China University of Technology, Guangzhou, 510006, China
| | - Qisheng Zhong
- Shimadzu (China) Corporation, Guangzhou Branch, 510010, China
| | - Ting Zhou
- School of Biology and Biological Engineering, South China University of Technology, Guangzhou, 510006, China.
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18
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Silveira KM, Wegener G, Joca SRL. Targeting 2-arachidonoylglycerol signalling in the neurobiology and treatment of depression. Basic Clin Pharmacol Toxicol 2021; 129:3-14. [PMID: 33905617 DOI: 10.1111/bcpt.13595] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/14/2021] [Accepted: 04/22/2021] [Indexed: 12/22/2022]
Abstract
The endocannabinoid 2-arachidonoylglycerol (2-AG) is an atypical neurotransmitter synthesized on demand in response to a wide range of stimuli, including exposure to stress. Through the activation of cannabinoid receptors, 2-AG can interfere with excitatory and inhibitory neurotransmission in different brain regions and modulate behavioural, endocrine and emotional components of the stress response. Exposure to chronic or intense unpredictable stress predisposes to maladaptive behaviour and is one of the main risk factors involved in developing mood disorders, such as major depressive disorder (MDD). In this review, we describe the molecular mechanisms involved in 2-AG signalling in the brain of healthy and stressed animals and discuss how such mechanisms could modulate stress adaptation and susceptibility to depression. Furthermore, we review preclinical evidence indicating that the pharmacological modulation of 2-AG signalling stands as a potential new therapeutic target in treating MDD. Particular emphasis is given to the pharmacological augmentation of 2-AG levels by monoacylglycerol lipase (MAGL) inhibitors and the modulation of CB2 receptors.
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Affiliation(s)
- Kennia M Silveira
- School of Pharmaceutical Sciences of Ribeirao Preto (FCFRP), University of Sao Paulo (USP), Ribeirao Preto, Brazil.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Gregers Wegener
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Sâmia R L Joca
- School of Pharmaceutical Sciences of Ribeirao Preto (FCFRP), University of Sao Paulo (USP), Ribeirao Preto, Brazil.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Biomedicine, Aarhus University, Aarhus, Denmark
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19
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Ballesta A, Alen F, Orio L, Arco R, Vadas E, Decara J, Vargas A, Gómez de Heras R, Ramírez‐López M, Serrano A, Pavón FJ, Suárez J, Rodríguez de Fonseca F. Abrupt cessation of reboxetine along alcohol deprivation results in alcohol intake escalation after reinstatement of drinking. Addict Biol 2021; 26:e12957. [PMID: 32815666 DOI: 10.1111/adb.12957] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 06/10/2020] [Accepted: 07/24/2020] [Indexed: 01/19/2023]
Abstract
Major depression (MD) is a frequent comorbidity in alcohol use disorder (AUD) patients. Antidepressant prescription is often limited by poor clinical outcomes or unwanted side effects in comorbid AUD-MD patients. Recent studies suggest that abrupt cessation of selective serotonin reuptake inhibitors antidepressant treatment increases alcohol consumption after an alcohol deprivation period in rats. However, the appearance of this effect after the treatment with selective noradrenaline reuptake inhibitors (SNRIs) is not known. Here, we report that interruption of subchronic (14 days) treatment with the SNRIs reboxetine (15 mg/kg/day intraperitoneally) resulted in escalation of ethanol intake when the animals resume alcohol self-administration. This effect of reboxetine treatment cessation was associated with a profound deactivation of the endocannabinoid/acylethanolamide signaling system in the prefrontal cortex but not in the dorsal hippocampus, as reflected by the decrease in the protein expression of the cannabinoid CB1 receptor, the PPARα receptor, the 2-arachidonoylglycerol synthesizing enzymes DAGLα and DGALβ, and the endocanabinoid degrading enzyme MAGL. This was associated with dysregulation of the expression of glutamic acid receptors GluN1, GluA1, and mGlu5 in the medial prefrontal cortex and the dorsal hippocampus of the animals exposed to reboxetine. The present results further support the idea that abrupt cessation of antidepressant therapy along alcohol deprivation time can boost alcohol intake after relapse through mechanisms associated with endocannabinoid/glutamate signaling dysregulation. This finding might be relevant for patients suffering AUD/MD comorbidity where antidepressant therapy must be monitored with caution for avoiding unwanted side effects if adherence to the treatment is not fully achieved.
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Affiliation(s)
- Antonio Ballesta
- Departamento de Psicobiología y Metodología en Ciencias del Comportamiento, Facultad de Psicología Universidad Complutense de Madrid Madrid Spain
| | - Francisco Alen
- Departamento de Psicobiología y Metodología en Ciencias del Comportamiento, Facultad de Psicología Universidad Complutense de Madrid Madrid Spain
- Laboratorio de Medicina Regenerativa, Instituto de Investigación Biomédica de Málaga (IBIMA), UGC Salud Mental Hospital Regional Universitario de Málaga Málaga Spain
| | - Laura Orio
- Departamento de Psicobiología y Metodología en Ciencias del Comportamiento, Facultad de Psicología Universidad Complutense de Madrid Madrid Spain
| | - Rocío Arco
- Laboratorio de Medicina Regenerativa, Instituto de Investigación Biomédica de Málaga (IBIMA), UGC Salud Mental Hospital Regional Universitario de Málaga Málaga Spain
| | - Evelyn Vadas
- Laboratorio de Medicina Regenerativa, Instituto de Investigación Biomédica de Málaga (IBIMA), UGC Salud Mental Hospital Regional Universitario de Málaga Málaga Spain
| | - Juan Decara
- Laboratorio de Medicina Regenerativa, Instituto de Investigación Biomédica de Málaga (IBIMA), UGC Salud Mental Hospital Regional Universitario de Málaga Málaga Spain
| | - Antonio Vargas
- Laboratorio de Medicina Regenerativa, Instituto de Investigación Biomédica de Málaga (IBIMA), UGC Salud Mental Hospital Regional Universitario de Málaga Málaga Spain
| | - Raquel Gómez de Heras
- Departamento de Psicobiología y Metodología en Ciencias del Comportamiento, Facultad de Psicología Universidad Complutense de Madrid Madrid Spain
| | - Mayte Ramírez‐López
- Departamento de Psicobiología y Metodología en Ciencias del Comportamiento, Facultad de Psicología Universidad Complutense de Madrid Madrid Spain
| | - Antonia Serrano
- Laboratorio de Medicina Regenerativa, Instituto de Investigación Biomédica de Málaga (IBIMA), UGC Salud Mental Hospital Regional Universitario de Málaga Málaga Spain
| | - Francisco Javier Pavón
- Laboratorio de Medicina Regenerativa, Instituto de Investigación Biomédica de Málaga (IBIMA), UGC Salud Mental Hospital Regional Universitario de Málaga Málaga Spain
| | - Juan Suárez
- Laboratorio de Medicina Regenerativa, Instituto de Investigación Biomédica de Málaga (IBIMA), UGC Salud Mental Hospital Regional Universitario de Málaga Málaga Spain
| | - Fernando Rodríguez de Fonseca
- Departamento de Psicobiología y Metodología en Ciencias del Comportamiento, Facultad de Psicología Universidad Complutense de Madrid Madrid Spain
- Laboratorio de Medicina Regenerativa, Instituto de Investigación Biomédica de Málaga (IBIMA), UGC Salud Mental Hospital Regional Universitario de Málaga Málaga Spain
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20
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Endocannabinoid system in psychotic and mood disorders, a review of human studies. Prog Neuropsychopharmacol Biol Psychiatry 2021; 106:110096. [PMID: 32898588 PMCID: PMC8582009 DOI: 10.1016/j.pnpbp.2020.110096] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/13/2020] [Accepted: 09/01/2020] [Indexed: 12/21/2022]
Abstract
Despite widespread evidence of endocannabinoid system involvement in the pathophysiology of psychiatric disorders, our understanding remains rudimentary. Here we review studies of the endocannabinoid system in humans with psychotic and mood disorders. Postmortem, peripheral, cerebrospinal fluid and in vivo imaging studies provide evidence for the involvement of the endocannabinoid system in psychotic and mood disorders. Psychotic disorders and major depressive disorder exhibit alterations of brain cannabinoid CB1 receptors and peripheral blood endocannabinoids. Further, these changes may be sensitive to treatment status, disease state, and symptom severity. Evidence from psychotic disorder extend to endocannabinoid metabolizing enzymes in the brain and periphery, whereas these lines of evidence remain poorly developed in mood disorders. A paucity of studies examining this system in bipolar disorder represents a notable gap in the literature. Despite a growing body of productive work in this field of research, there is a clear need for investigation beyond the CB1 receptor in order to more fully elucidate the role of the endocannabinoid system in psychotic and mood disorders.
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21
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Giacobbe J, Marrocu A, Di Benedetto MG, Pariante CM, Borsini A. A systematic, integrative review of the effects of the endocannabinoid system on inflammation and neurogenesis in animal models of affective disorders. Brain Behav Immun 2021; 93:353-367. [PMID: 33383145 DOI: 10.1016/j.bbi.2020.12.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/18/2020] [Accepted: 12/22/2020] [Indexed: 12/09/2022] Open
Abstract
The endocannabinoid (eCB) system is considered relevant in the pathophysiology of affective disorders, and a potential therapeutic target, as its hypoactivity is considered an important risk factor of depression. However, the biological mechanisms whereby the eCB system affects mood remain elusive. Through a systematic review, thirty-seven articles were obtained from the PubMed/Medline, Web of Science, Embase, PsychInfo, and CINAHL databases, investigating the role of the eCB system on the immune system and neurogenesis, as well as resulting behavioural effects in rodent models of affective disorders. Overall, activation of the eCB system appears to decrease depressive-like behaviour and to be anti-inflammatory, while promoting neuro- and synaptogenesis in various models. Activation of cannabinoid receptors (CBRs) is shown to be crucial in improving depressive-like and anxiety-like behaviour, although cannabidiol administration suggests a role of additional mechanisms. CB1R signalling, as well as fatty acid amide hydrolase (FAAH) inhibition, are associated with decreased pro-inflammatory cytokines. Moreover, activation of CBRs is required for neurogenesis, which is also upregulated by FAAH inhibitors. This review is the first to assess the association between the eCB system, immune system and neurogenesis, alongside behavioural outcomes, across rodent models of affective disorders. We confirm the therapeutic potential of eCB system activation in depression and anxiety, highlighting immunoregulation as an important mechanism whereby dysfunctional behaviour and neurogenesis can be improved.
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Affiliation(s)
- Juliette Giacobbe
- Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - Alessia Marrocu
- Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - Maria Grazia Di Benedetto
- Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom; Biological Psychiatry Unit, IRCCS Fatebenefratelli S. Giovanni di Dio, Brescia, Italy
| | - Carmine M Pariante
- Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - Alessandra Borsini
- Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom.
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22
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Circulating endocannabinoids and prospective risk for depression in trauma-injury survivors. Neurobiol Stress 2021; 14:100304. [PMID: 33614866 PMCID: PMC7876629 DOI: 10.1016/j.ynstr.2021.100304] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 01/19/2021] [Accepted: 01/30/2021] [Indexed: 12/19/2022] Open
Abstract
Biological mechanisms associated with response to trauma may impact risk for depression. One such mechanism is endocannabinoid signaling (eCB), a neuromodulatory system comprised of the CB1 subtype of cannabinoid receptors (CB1R), encoded by the CNR1 gene, and two primary endogenous ligands: 2-arachidonoylglycerol (2-AG) and N-arachidonylethanolamine (AEA), hydrolyzed by monoacylglycerol lipase (gene name MGLL) and fatty acid amide hydrolase (gene name FAAH). Preclinical data suggest that eCB/CB1R signaling acts as a stress buffer and its loss or suppression increases depression-like behaviors. We examined circulating concentrations of the eCBs (2-AG and AEA) days and six months after a traumatic injury as a marker of eCB/CB1R signaling and as predictors of Center for Epidemiologic Studies of Depression Scale-Revised [CESD-R] scores as a measure of depression severity six months after injury. We also explored associations of CNR1, FAAH, and MGLL genetic variance with depression severity at six months. Results from hierarchical multiple linear regressions showed that higher 2-AG serum concentrations after trauma predicted greater depression at six months (β = 0.23, p = 0.007); neither AEA after trauma, nor 2-AG and AEA at six months were significant predictors (p's > 0.305). Carriers of minor allele for the putative single nucleotide polymorphism in the CNR1 gene rs806371 (β = 0.19, p = 0.024) experienced greater depression at six months. These data suggest that the eCB signaling system is highly activated following trauma and that eCB/CB1R activity contributes to long-term depression risk.
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23
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Rana T, Behl T, Sehgal A, Mehta V, Singh S, Kumar R, Bungau S. Integrating Endocannabinoid Signalling In Depression. J Mol Neurosci 2021; 71:2022-2034. [PMID: 33471311 DOI: 10.1007/s12031-020-01774-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 12/09/2020] [Indexed: 12/24/2022]
Abstract
Depression is a common mental disorder and is the leading cause of suicide globally. Because of the significant diversity in mental disorders, accurate diagnosis is difficult. Hence, the investigation of novel biomarkers is a key research perspective in psychotherapy to enable an individually tailored treatment approach. The prefrontal cortex (PFC) is a vital cortical region whose circuitry has been implicated in the development of depressive disorder. The endocannabinoid system (ECS) has garnered increasing attention because of its involvement in several diverse physiological brain processes including regulation of emotional, motivational and cognitive functions. The current review article explores the function of the key elements of the ECS as a biomarker in depressive disorder. The activity of endocannabinoids is thought to be moderated by the CB1 receptors in the central nervous system (CNS). Variations in the concentration of endocannabinoids and the binding affinity of CB1 receptors and their density have been identified in the PFC of persons with depression. Such discoveries support our theory that alteration in endocannabinoid function leads to the pathophysiological features of depressive disorders. Moreover, evidence from animal and human studies has revealed that dysfunction in endocannabinoid signalling can produce depression-like behaviours; therefore, improvement of endocannabinoid signalling may represent a new therapeutic approach for the management of depressive disorders.
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Affiliation(s)
- Tarapati Rana
- Government Pharmacy College, Seraj, Mandi, Himachal Pradesh, India.,Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Tapan Behl
- Chitkara College of Pharmacy, Chitkara University, Punjab, India.
| | - Aayush Sehgal
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Vineet Mehta
- Distt. Shimla, Government College of Pharmacy, Himachal Pradesh, Rohru, India
| | - Sukhbir Singh
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Ravinder Kumar
- Cardiovascular Research Institute, Icahn School of Medicine, New York, USA
| | - Simona Bungau
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
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24
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Kang M, Bohorquez-Montoya L, McAuliffe T, Claesges SA, Blair NO, Sauber G, Reynolds CF, Hillard CJ, Goveas JS. Loneliness, Circulating Endocannabinoid Concentrations, and Grief Trajectories in Bereaved Older Adults: A Longitudinal Study. Front Psychiatry 2021; 12:783187. [PMID: 34955928 PMCID: PMC8692767 DOI: 10.3389/fpsyt.2021.783187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 11/16/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Loneliness is one of the most distressing grief symptoms and is associated with adverse mental health in bereaved older adults. The endocannabinoid signaling (ECS) system is stress-responsive and circulating endocannabinoid (eCB) concentrations are elevated following bereavement. This study examined the association between loneliness and circulating eCB concentrations in grieving older adults and explored the role of eCBs on the association between baseline loneliness and grief symptom trajectories. Methods: A total of 64 adults [grief with high loneliness: n = 18; grief with low loneliness: n = 26; and healthy comparison (HC): n = 20] completed baseline clinical assessments for the UCLA loneliness scale. In grief participants, longitudinal clinical assessments, including the Inventory of Complicated Grief and 17-item Hamilton Depression Rating scales, were collected over 6 months. Baseline circulating eCB [N-arachidonoylethanolamine (AEA) and 2-arachidonoylglycerol (2-AG)] concentrations were quantified in the serum using isotope dilution, liquid chromatography-mass spectrometry; cortisol concentrations were measured in the same samples using radioimmunoassay. Results: Circulating AEA concentrations were higher in severely lonely grieving elders than in HC group; cortisol concentrations were not different among the groups. Cross-sectionally, loneliness scores were positively associated with AEA concentrations in grievers; this finding was not significant after accounting for depressive symptom severity. Grieving individuals who endorsed high loneliness and had higher 2-AG concentrations at baseline showed faster grief symptom resolution. Conclusions: These novel findings suggest that in lonely, bereaved elders, increased circulating eCBs, a reflection of an efficient ECS system, are associated with better adaptation to bereavement. Circulating eCBs as potential moderators and mediators of the loneliness-grief trajectory associations should be investigated.
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Affiliation(s)
- Minhi Kang
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Luisa Bohorquez-Montoya
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Timothy McAuliffe
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Stacy A Claesges
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Nutta-On Blair
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Garrett Sauber
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, WI, United States.,Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Charles F Reynolds
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Cecilia J Hillard
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, WI, United States.,Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Joseph S Goveas
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, United States.,Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, United States
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25
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Zajkowska Z, Borsini A, Nikkheslat N, Russell A, Romano GF, Tomassi S, Hepgul N, Forton D, Agarwal K, Hotopf M, Mondelli V, Zunszain P, Pariante CM. Differential effect of interferon-alpha treatment on AEA and 2-AG levels. Brain Behav Immun 2020; 90:248-258. [PMID: 32860939 PMCID: PMC7575143 DOI: 10.1016/j.bbi.2020.08.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 07/14/2020] [Accepted: 08/23/2020] [Indexed: 12/31/2022] Open
Abstract
The endocannabinoid (eCB) system is one of the key players in immunoregulation, and reduced activity of the eCB system has been linked with depressive-like behaviours in animal studies and depression in clinical samples. There is a well-established link between immune activation and depression, such as following the administration of the pro-inflammatory cytokine, interferon-α (IFN-α), used to treat hepatitis C viral (HCV) infection. However, the role of peripheral endocannabinoids (eCBs), anandamide (AEA) and 2-arachidonoylglycerol (2-AG), following immunotherapy with IFN-α and in IFN-α -induced depression, have not been examined yet. In this study, we investigated whether circulating AEA and 2-AG were modified by treatment with IFN-α and whether they were involved in the development of IFN-α-induced depression. We also explored whether circulating eCBs were associated with peripheral cytokines during and after IFN-α treatment. We measured serum concentrations of AEA and 2-AG using High Performance Liquid Chromatography with Tandem Mass Spectrometry, and serum concentrations of cytokines using Meso Scale Discovery electrochemiluminescence V-PLEX assay, in 70 patients with HCV infection and 41 healthy subjects. We assessed HCV patients at baseline, IFN-α-treatment weeks (TW) 4 and 24, end of treatment (END) and at six months follow-up (FU). We assessed depression using M.I.N.I. International Neuropsychiatric Interview. We found a different pattern of change in peripheral AEA and 2-AG during and after IFN-α treatment. Whilst 2-AG increased earlier in immunotherapy (TW4), remained elevated throughout treatment, and reduced at six months follow-up (FU), AEA increased later in treatment (TW24) and remained elevated six months post-treatment. We also found that baseline levels of AEA were lower in HCV patients compared with healthy controls, whereas there were no differences in 2-AG levels. Interestingly, AEA, but not 2-AG, was significantly, negatively correlated with interleukin (IL)-2 and IL-17a at six months follow-up. We did not find any difference in both eCBs between patients with and without IFN-α-induced depression, at any time point. Our findings suggest that AEA and 2-AG are involved in different stages of immunoregulation following IFN-α treatment, where AEA might be involved in chronic inflammation. Lack of association between peripheral eCBs and IFN-α-induced depression suggests that different biological mechanisms may underpin inflammation-induced depression compared with classic "psychiatric" depression, or that any changes in the eCB system in depression may not be captured by peripheral AEA and 2-AG.
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Affiliation(s)
- Zuzanna Zajkowska
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK.
| | - Alessandra Borsini
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK
| | - Naghmeh Nikkheslat
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK
| | - Alice Russell
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK
| | - Graziella F Romano
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK
| | - Simona Tomassi
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK
| | - Nilay Hepgul
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK
| | - Daniel Forton
- Department of Gastroenterology & Hepatology, St George's University of London, UK
| | - Kosh Agarwal
- Institute of Liver Studies, King's College Hospital, UK
| | - Matthew Hotopf
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK; National Institute for Health Research (NIHR), Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK
| | - Valeria Mondelli
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK; National Institute for Health Research (NIHR), Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK
| | - Patricia Zunszain
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK
| | - Carmine M Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK; National Institute for Health Research (NIHR), Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK
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26
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Harfmann EJ, McAuliffe TL, Larson ER, Claesges SA, Sauber G, Hillard CJ, Goveas JS. Circulating endocannabinoid concentrations in grieving adults. Psychoneuroendocrinology 2020; 120:104801. [PMID: 32682172 PMCID: PMC7348598 DOI: 10.1016/j.psyneuen.2020.104801] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/01/2020] [Accepted: 07/02/2020] [Indexed: 02/04/2023]
Abstract
Bereavement is one of the most intense, distressing, and traumatic events an elderly person will experience. The symptom responses to bereavement vary, particularly during the first year. However, the neurobiology underlying the symptom variance in grief is poorly understood. The endocannabinoid signaling (ECS) system is stress-responsive; mounting evidence implicates the central ECS in psychopathology. The current study aimed to investigate the hypothesis that the ECS is abnormal in grief, using circulating eCB concentrations as a biomarker of central ECS. A predominantly older sample of grief participants, within 13 months following the death of a loved one, and healthy comparison (HC) participants were studied. Associations of circulating eCBs with symptom variance in grievers were also examined. A total of 61 (grief: n = 44; HC: n = 17) adults completed cross-sectional clinical assessments and a fasting blood draw. Assessments included the Inventory of Complicated Grief scale; the 17-item Hamilton Depression Rating Scale; and the Hamilton Anxiety scale. Serum eCB concentrations (i.e., N-arachidonoylethanolamine [AEA] and 2-arachidonoylglycerol [2-AG]) were quantified using isotope dilution, liquid chromatography-mass spectrometry. Relative to HC participants, grievers had significantly elevated serum AEA but similar 2-AG concentrations. In grievers, serum AEA concentrations were positively associated with depressive and anxiety symptoms, but only in those with low grief symptoms. These novel findings indicate that elevated circulating eCB concentrations are found following bereavement. The eCB signaling response varies based on the degree of grief severity. Circulating eCB measures may have the potential to serve as biomarkers of prolonged grief disorder.
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Affiliation(s)
- Elisabeth J. Harfmann
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, Wisconsin, 53226, USA,Clement J. Zablocki Veterans Affairs Medical Center, 5000 W. National Ave, Milwaukee, Wisconsin, 53295, USA
| | - Timothy L. McAuliffe
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, Wisconsin, 53226, USA
| | - Eric R. Larson
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, Wisconsin, 53226, USA,Clement J. Zablocki Veterans Affairs Medical Center, 5000 W. National Ave, Milwaukee, Wisconsin, 53295, USA
| | - Stacy A. Claesges
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, Wisconsin, 53226, USA
| | - Garrett Sauber
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, Wisconsin, 53226, USA,Neuroscience Research Center, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, Wisconsin, 53226, USA
| | - Cecilia J. Hillard
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, Wisconsin, 53226, USA,Neuroscience Research Center, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, Wisconsin, 53226, USA
| | - Joseph S. Goveas
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, Wisconsin, 53226, USA,Neuroscience Research Center, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, Wisconsin, 53226, USA,Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, Wisconsin, 53226, USA,Corresponding author at: Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA
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Gao W, Walther A, Wekenborg M, Penz M, Kirschbaum C. Determination of endocannabinoids and N-acylethanolamines in human hair with LC-MS/MS and their relation to symptoms of depression, burnout, and anxiety. Talanta 2020; 217:121006. [DOI: 10.1016/j.talanta.2020.121006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 04/01/2020] [Accepted: 04/03/2020] [Indexed: 01/17/2023]
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Orio L. The multifaceted potential of the lipid transmitter oleoylethanolamide to treat alcohol-induced neuroinflammation and alcohol use disorders. Neural Regen Res 2020; 15:71-72. [PMID: 31535652 PMCID: PMC6862416 DOI: 10.4103/1673-5374.264457] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Laura Orio
- Department of Psychobiology and Methods in Behavioural Sciences, Complutense University of Madrid, Madrid, Spain
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29
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Navarrete F, García-Gutiérrez MS, Jurado-Barba R, Rubio G, Gasparyan A, Austrich-Olivares A, Manzanares J. Endocannabinoid System Components as Potential Biomarkers in Psychiatry. Front Psychiatry 2020; 11:315. [PMID: 32395111 PMCID: PMC7197485 DOI: 10.3389/fpsyt.2020.00315] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 03/30/2020] [Indexed: 12/19/2022] Open
Abstract
The high heterogeneity of psychiatric disorders leads to a lack of diagnostic precision. Therefore, the search of biomarkers is a fundamental aspect in psychiatry to reach a more personalized medicine. The endocannabinoid system (ECS) has gained increasing interest due to its involvement in many different functional processes in the brain, including the regulation of emotions, motivation, and cognition. This article reviews the role of the main components of the ECS as biomarkers in certain psychiatric disorders. Studies carried out in rodents evaluating the effects of pharmacological and genetic manipulation of cannabinoid receptors or endocannabinoids (eCBs) degrading enzymes were included. Likewise, the ECS-related alterations occurring at the molecular level in animal models reproducing some behavioral and/or neuropathological aspects of psychiatric disorders were reviewed. Furthermore, clinical studies evaluating gene or protein alterations in post-mortem brain tissue or in vivo blood, plasma, and cerebrospinal fluid (CSF) samples were analyzed. Also, the results from neuroimaging studies using positron emission tomography (PET) or functional magnetic resonance (fMRI) were included. This review shows the close involvement of cannabinoid receptor 1 (CB1r) in stress regulation and the development of mood disorders [anxiety, depression, bipolar disorder (BD)], in post-traumatic stress disorder (PTSD), as well as in the etiopathogenesis of schizophrenia, attention deficit hyperactivity disorder (ADHD), or eating disorders (i.e. anorexia and bulimia nervosa). On the other hand, recent results reveal the potential therapeutic action of the endocannabinoid tone manipulation by inhibition of eCBs degrading enzymes, as well as by the modulation of cannabinoid receptor 2 (CB2r) activity on anxiolytic, antidepressive, or antipsychotic associated effects. Further clinical research studies are needed; however, current evidence suggests that the components of the ECS may become promising biomarkers in psychiatry to improve, at least in part, the diagnosis and pharmacological treatment of psychiatric disorders.
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Affiliation(s)
- Francisco Navarrete
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Alicante, Spain.,Red Temática de Investigación Cooperativa en Salud (RETICS), Red de Trastornos Adictivos, Instituto de Salud Carlos III, MICINN and FEDER, Madrid, Spain
| | - María Salud García-Gutiérrez
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Alicante, Spain.,Red Temática de Investigación Cooperativa en Salud (RETICS), Red de Trastornos Adictivos, Instituto de Salud Carlos III, MICINN and FEDER, Madrid, Spain
| | - Rosa Jurado-Barba
- Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain.,Servicio de Psiquiatría, Hospital Universitario 12 de Octubre, Madrid, Spain.,Departamento de Psicología, Facultad de Educación y Salud, Universidad Camilo José Cela, Madrid, Spain
| | - Gabriel Rubio
- Red Temática de Investigación Cooperativa en Salud (RETICS), Red de Trastornos Adictivos, Instituto de Salud Carlos III, MICINN and FEDER, Madrid, Spain.,Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain.,Servicio de Psiquiatría, Hospital Universitario 12 de Octubre, Madrid, Spain.,Department of Psychiatry, Complutense University of Madrid, Madrid, Spain
| | - Ani Gasparyan
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Alicante, Spain.,Red Temática de Investigación Cooperativa en Salud (RETICS), Red de Trastornos Adictivos, Instituto de Salud Carlos III, MICINN and FEDER, Madrid, Spain
| | | | - Jorge Manzanares
- Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Alicante, Spain.,Red Temática de Investigación Cooperativa en Salud (RETICS), Red de Trastornos Adictivos, Instituto de Salud Carlos III, MICINN and FEDER, Madrid, Spain
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