Social stress induces autoimmune responses against the brain

Gastrodin prevents stress-induced synaptic plasticity impairment and behavioral dysfunction via cAMP/PKA/CREB signaling pathway

BACKGROUND

Chronic stress is widely recognized as a critical factor that impairs synaptic plasticity dependent brain function and behavior, contributing to the onset of depression and anxiety disorders, which subsequently undermine learning and memory processes. Gastrodin (GAS), a prominent bioactive constituent of Gastrodiae Rhizoma exhibiting notable neuroprotective properties, holds significant potential for the prevention and treatment of stress-induced neurological dysfunction. However, the protective effects of GAS on stress-induced synaptic plasticity impairment and the underlying mechanisms have yet to be fully elucidated.

OBJECTIVES

To investigate the potential of GAS in protecting synaptic plasticity from chronic stress and its underlying cellular and molecular mechanisms.

METHOD

A chronic stress model was constructed in C57BL/6J mice, and the effects of GAS on synaptic plasticity were examined using Golgi staining and immunohistochemistry. Systematic behavioral analysis was employed to assess the impact of GAS on depressive- and anxiety-like behaviors and cognitive function of mice. Metabolomics, transcriptomics, Western blotting, immunolocalization, enzyme-linked immunosorbent assay, and the administration of signal blockers were utilized to investigate the cellular and molecular pathways via which GAS safeguards synaptic plasticity.

RESULTS

The results showed that chronic stress exposure reduces the dendritic arbor complexity, density of dendritic spines, proportion of mushroom spines of hippocampal neurons, as well as disrupts synaptic function, impairs cognitive function and induces depressive-like behaviors. Importantly, impairment of hippocampal synaptic plasticity, anxiety- and depressive-like behaviors, and cognitive decline induced by chronic stress were significantly ameliorated following GAS treatment. Moreover, we identified the cAMP/PKA/CREB signaling in hippocampal neurons as a potential mechanism through which GAS prevents synaptic plasticity impairment from chronic stress exposure. Blockade of cAMP/PKA/CREB signaling abolished the protective effects of GAS on synaptic plasticity of hippocampal neurons and behaviors in stress-exposed mice.

CONCLUSION

This study is the first to identify GAS as a potential natural compound for alleviating stress-induced synaptic plasticity impairment and behavioral dysfunction by activating the cAMP/PKA/CREB signaling pathway in hippocampal neurons, offering a promising strategy for stress-induced neurological disorders.

Oligodendroglia Are Primed for Antigen Presentation in Response to Chronic Stress-Induced Microglial-Derived Inflammation

Chronic stress is a major contributor to the development of major depressive disorder, one of the leading causes of disability worldwide. Using a model of repeated social defeat stress in mice, we and others have reported that neuroinflammation plays a dynamic role in the development of behavioral deficits consistent with social avoidance and impaired reward responses. Animals susceptible to the model also exhibit hypomyelination in the medial prefrontal cortex, indicative of changes in the differentiation pathway of cells of the oligodendroglial lineage (OLN). We computationally confirmed the presence of immune oligodendrocytes, a population of OLN cells, which express immune markers and myelination deficits. In the current study, we report that microglia are necessary to induce expression of antigen presentation markers (and other immune markers) on oligodendroglia. We further associate the appearance of these markers with changes in the OLN and confirm that microglial changes precede OLN changes. Using co-cultures of microglia and OLN, we show that under inflammatory conditions the processes of phagocytosis and expression of MHCII are linked, suggesting potential priming for antigen presentation by OLN cells. Our findings provide insights into the nature of these OLN cells with immune capabilities, their obligatory interaction with microglia, and identify them as a potential cellular contributor to the pathological manifestations of psychosocial stress.

Advancing an Inflammatory Subtype of Major Depression

Chronic inflammation plays a prominent role in multiple medical disorders, including psychiatric diseases such as major depression. Exposure to inflammatory stimuli leads to changes in neurotransmitter systems and neurocircuits in the brain that are associated with depressive symptoms. Blockade of inflammatory cytokines can reduce depressive symptoms in medically ill and medically healthy individuals with depression. Increased levels of biomarkers of inflammation are associated with an overrepresentation of neurovegetative symptoms, including anhedonia, fatigue, and psychomotor slowing, and can predict response to antidepressant treatments. Importantly, however, increased inflammatory biomarkers occur in only a subgroup of individuals with depression. Thus, there appears to be a subset of patients with depression with a unique symptom presentation and treatment response whose disease is primarily driven by inflammation. Further identifying and characterizing this inflammatory subtype of depression can foster the development of treatments targeting the immune system and its effects on the brain. Moreover, by using this mechanism-based approach to parsing the heterogeneity of depression, we can refine our diagnostic nosology and model a strategy for precision medicine and targeted therapeutics in psychiatry.

Sex-specific regulation of microglial MyD88 in HMGB1-Induced anxiety phenotype in mice

Stress is a significant risk factor for the development and recurrence of anxiety disorders. Stress can profoundly impact the immune system, and lead to microglial functional alterations in the medial prefrontal cortex (mPFC), a brain region involved in the pathogenesis of anxiety. High mobility group box 1 protein (HMGB1) is a potent pro-inflammatory stimulus and danger-associated molecular pattern (DAMP) released from neuronal and non-neuronal cells following stress. HMGB1 provokes pro-inflammatory responses in the brain and, when administered locally, alters behavior in the absence of other stressors. In this study, we administered dsHMGB1 into the mPFC of male and female mice for 5 days to investigate the cellular and molecular mechanisms underlying HMGB1-induced behavioral dysfunction, with a focus on cell-type specificity and potential sex differences. Here, we demonstrate that dsHMGB1 infusion into the mPFC elicited behavior changes in both sexes but only altered microglial morphology robustly in female mice. Moreover, preventing microglial changes with cell-specific ablation of the MyD88 pathway prevented anxiety-like behaviors only in females. These results support the hypothesis that microglial MyD88 signaling is a critical mediator of HMGB1-induced stress responses, particularly in adult female mice.

Association between a history of mental illness and the risk of systemic autoimmune rheumatic diseases: a nationwide, population-based case-control study

OBJECTIVE

Patients with systemic autoimmune rheumatic diseases (SARD) are at risk of mental illness, but whether mental illnesses are risk factors for SARD, including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Sjögren's syndrome (SS), systemic sclerosis (SSc), dermatomyositis (DM)/polymyositis (PM), are still unknown. Therefore, we aim to address the association between a history of mental illnesses and the risk of SARD using a population-based database.

METHODS

We used the 2000-2020 Taiwanese National Health Insurance Research Database in this case-control study. Multivariable logistic regression was conducted to estimate the adjusted odds ratios (aORs) with 95% confidence interval (CIs). Sensitivity analyses were conducted using distinct definitions of mental illnesses and wash-out periods.

RESULTS

A total of 77,848 SARD cases and 313,392 age- and sex-matched non-SARD controls (1:4) were included for analyses. Patients with SARD were more likely to have history of mental illness (39.8% vs. 27.0%, p < 0.001). After adjusting for potential confounders, we found significant associations of between a history of mental illnesses with SARD (aOR, 1.65, 95%CI, 1.62-1.68), RA (aOR, 1.28, 95% CI, 1.24-1.32), SLE (aOR, 1.62, 95% CI, 1.54-1.71), SS (aOR, 2.35, 95% CI, 2.28-2.42), SSc (aOR, 1.40, 95% CI, 1.24-1.58), and DM/PM (aOR, 1.18, 95% CI, 1.05-1.32). The results remained robust after using various definitions of mental illnesses and wash-out periods.

CONCLUSION

We found that a history of mental illnesses was significantly associated with incident SARD, and the strength of association tended to be strong in patients with SS, followed by SLE. More studies are warranted to clarify the underlying mechanism. Key Points • Patients with systemic autoimmune rheumatic diseases (SARD) are at risk of mental illness, but whether mental illnesses are risk factors for SARD are still unknown. • We used a population-based database to demonstrate that mental illness was associated with the risk of SARD, particularly Sjögren's syndrome and systemic lupus erythematosus. • These findings underscore the importance of integrated care approaches, including surveys for autoimmune diseases, among patients with mental illness.

Possible roles of neuropeptide/transmitter and autoantibody modulation in emotional problems and aggression

The theoretical foundations of understanding psychiatric disorders are undergoing changes. Explaining behaviour and neuroendocrine cell communication leaning towards immunology represents a different approach compared to previous models for understanding complex central nervous system processes. One such approach is the study of immunoglobulins or autoantibodies, and their effect on peptide hormones in the neuro-endocrine system. In the present review, we provide an overview of the literature on neuropeptide/transmitter and autoantibody modulation in psychiatric disorders featuring emotional problems and aggression, including associated illness behaviour. Finally, we discuss the role of psycho-immunology as a growing field in the understanding of psychiatric disorders, and that modulation and regulation by IgG autoAbs represent a relatively new subcategory in psycho-immunology, where studies are currently being conducted.

Preventing social defeat stress-induced behavioural and neurochemical alterations by repeated treatment with a mix of Centella asiatica, Echinacea purpurea and Zingiber officinale standardized extracts

Background: Prolonged exposure to stress is a risk factor for the onset of several disorders. Modern life is burdened by a pervasive prevalence of stress, which represents a major societal challenge requiring new therapeutic strategies. In this context, botanical drug-based therapies can have a paramount importance. Methods: Here we studied the preventive effects of a repeated treatment (p.o. daily, 3 weeks) with a combination of Centella asiatica (200 mg/kg), Echinacea purpurea (20 mg/kg) and Zingiber officinale (150 mg/kg) standardized extracts, on the chronic social defeat stress (CSDS) deleterious outcomes. After 10 days of CSDS exposure, male mice' performances were evaluated in paradigms relevant for social (social interaction test), emotional (tail suspension test), cognitive (novel object recognition) domains as well as for pain perception (cold plate and von Frey tests) and motor skills (rotarod). Mice were then sacrificed, the spinal cords, hippocampi and frontal cortices dissected and processed for RT-PCR analysis. Results: Extracts mix treatment prevented stress-induced social aversion, memory impairment, mechanical and thermal allodynia and reduced behavioural despair independently of stress exposure. The treatment stimulated hippocampal and cortical BDNF and TrkB mRNA levels and counteracted stress-induced alterations in pro- (TNF-α, IL-1β and IL-6) and anti-inflammatory (IL4, IL10) cytokines expression in the same areas. It also modulated expression of pain related genes (GFAP and Slc1a3) in the spinal cord. Conclusion: The treatment with the extracts mix obtained from C. asiatica, E. purpurea and Z. officinale may represent a promising strategy to promote resilience and prevent the deleterious effects induced by extended exposure to psychosocial stress.

Microglial MyD88-dependent pathways are regulated in a sex-specific manner in the context of HMGB1-induced anxiety

Chronic stress is a significant risk factor for the development and recurrence of anxiety disorders. Chronic stress impacts the immune system, causing microglial functional alterations in the medial prefrontal cortex (mPFC), a brain region involved in the pathogenesis of anxiety. High mobility group box 1 protein (HMGB1) is an established modulator of neuronal firing and a potent pro-inflammatory stimulus released from neuronal and non-neuronal cells following stress. HMGB1, in the context of stress, acts as a danger-associated molecular pattern (DAMP), instigating robust proinflammatory responses throughout the brain, so much so that localized drug delivery of HMGB1 alters behavior in the absence of any other forms of stress, i.e., social isolation, or behavioral stress models. Few studies have investigated the molecular mechanisms that underlie HMGB1-associated behavioral effects in a cell-specific manner. The aim of this study is to investigate cellular and molecular mechanisms underlying HMGB1-induced behavioral dysfunction with regard to cell-type specificity and potential sex differences. Here, we report that both male and female mice exhibited anxiety-like behavior following increased HMGB1 in the mPFC as well as changes in microglial morphology. Interestingly, our results demonstrate that HMGB1-induced anxiety may be mediated by distinct microglial MyD88-dependent mechanisms in females compared to males. This study supports the hypothesis that MyD88 signaling in microglia may be a crucial mediator of the stress response in adult female mice.

Restoring immune tolerance in pemphigus vulgaris

Intravenous immunoglobulin (IVIg), a preparation of polyclonal serum IgG pooled from numerous blood donors, has been used for nearly three decades and is proving to be an efficient treatment for many autoimmune blistering diseases, including pemphigus vulgaris (PV). Despite its widespread use and therapeutic success, its mechanisms of action are not completely understood. Some of its anti-inflammatory and immunomodulatory actions have been studied. In this study, the authors present a twenty-year follow-up of 21 patients with clinical and immunopathological confirmed PV, treated with IVIg as monotherapy, according to an established published protocol. IVIg therapy produced long-term sustained, clinical, serological, and immunopathological remission. For 20 y, these patients received no drugs and experienced no disease. This observation suggests that there was the establishment of immune balance or restoration of immune regulation in these PV patients. Twelve (57%) patients experienced no relapse during follow-up. Six (29%) patients experienced a relapse due to acute stress or post-coronavirus infection and/or vaccination. Reinstitution of IVIg resulted in prompt sustained recovery. Three (14.2%) patients, in clinical and serological remission, died due to unrelated causes. No severe adverse effects from IVIg were documented in all 21 patients. The simultaneous or sequential anti-inflammatory and immunomodulatory effects of IVIg may have influenced the long-term clinical remission observed. This study provides a human prototype to examine the pathophysiology of autoimmunity and a model to study immune regulation and mechanisms that can facilitate restoring immune tolerance.