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Griška V, Pranckevičienė A, Pakalnienė J, Gabrijolavičiūtė D, Veje M, Studahl M, Ahlberg J, Schwieler L, Lindquist L, Mickienė A. Long-term neurological and neurocognitive impairments after tick-borne encephalitis in Lithuania - a prospective study. Infect Dis (Lond) 2024:1-11. [PMID: 38709658 DOI: 10.1080/23744235.2024.2346793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 04/19/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND The aim of this study was to characterise long-term neurological and neurocognitive sequelae after tick-borne encephalitis (TBE) in adults. METHODS 98 prospective consecutive TBE patients, classified by disease severity, were included. Immediate outcomes were evaluated with Glasgow Outcome Scale (GOS) and Rankin Scale (RS). After 6 and 18 months, long-term disability was evaluated using Modified Rankin Scale (MRS) and neurocognitive assessment was performed with Matrics Consensus Cognitive Battery (MCCB), measuring processing speed, attention/vigilance, working memory, verbal learning, visual learning, reasoning/problem solving and social cognition. The MCCB results were compared to healthy age, gender and education-matched controls. RESULTS Mild, moderate, and severe TBE was diagnosed in 53.1%, 38.8%, and 8.2% of cases, respectively. At discharge, 25.5% of the patients had major or moderate impairments (GOS) and various levels of disability in 34.7% (RS). Up to 18 months from the onset of TBE, over 20% remained with slight to moderate disability (MRS). GOS, RS and MRS scores correlated with disease severity. At 6 months after the onset, TBE patients scored significantly lower than controls in processing speed, verbal, and visual learning. Two latter domains were significantly more impaired in patients with mild TBE. Patients aged 18-39 performed significantly worse in attention/vigilance and working memory, whereas aged 60+ in verbal learning. A year later, significant improvement was observed in six of seven cognitive domains. CONCLUSIONS Long-term neurological sequelae persist in a substantial proportion of TBE patients with significant impairment in several cognitive domains, especially in younger patients and even after mild TBE.
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Affiliation(s)
- Vytautas Griška
- Department of Infectious Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Aistė Pranckevičienė
- Department of Health Psychology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jolita Pakalnienė
- Department of Infectious Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Diana Gabrijolavičiūtė
- Department of Health Psychology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Malin Veje
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Infectious Diseases, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Marie Studahl
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Infectious Diseases, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jacob Ahlberg
- Institution of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Lilly Schwieler
- Institution of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Lars Lindquist
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Auksė Mickienė
- Department of Infectious Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Orhan F, Schwieler L, Engberg G, Samuelsson M. Kynurenine Metabolites in CSF and Plasma in Healthy Males. Int J Tryptophan Res 2024; 17:11786469241245323. [PMID: 38665132 PMCID: PMC11044574 DOI: 10.1177/11786469241245323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
In recent years, kynurenine metabolites generated by tryptophan catabolism have gained increasing attention in the context of brain diseases. The question of importance is whether there is a relationship between peripheral and central levels of these metabolites. Some of these compounds do not cross the blood-brain barrier; in particular, kynurenic acid, and most analyses of kynurenines from psychiatric patients have been performed using plasma samples. In the present study, we recruited 30 healthy volunteers with no history of psychiatric or neurological diagnosis, to analyze tryptophan, kynurenine, kynurenic acid, and quinolinic acid levels in CSF and plasma. In addition, kynurenic acid was analyzed in urine. The most important finding of this study is that CSF kynurenic acid levels do not correlate with those in plasma or urine. However, we found a correlation between plasma kynurenine and CSF kynurenic acid. Further, plasma kynurenine and plasma quinolinic acid were correlated. Our findings clarify the distribution of tryptophan and its metabolites in various body compartments and may serve as a guide for the analysis of these metabolites in humans. The most significant finding of the present study is that a prediction of brain kynurenic acid by of the analysis of the compound in plasma cannot be made.
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Affiliation(s)
- Funda Orhan
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Lilly Schwieler
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Göran Engberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Martin Samuelsson
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Sweden
- Department of Psychiatry, Linköping University Hospital, Sweden
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3
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Eren F, Schwieler L, Orhan F, Malmqvist A, Piehl F, Cervenka S, Sellgren CM, Fatouros-Bergman H, Engberg G, Erhardt S. Preanalytic handling of clinical blood samples in assessing immunological proteins - Role of storage duration. Brain Behav Immun 2023; 114:163-164. [PMID: 37595878 DOI: 10.1016/j.bbi.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/20/2023] Open
Affiliation(s)
- Feride Eren
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Lilly Schwieler
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Funda Orhan
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Anna Malmqvist
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Fredrik Piehl
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Simon Cervenka
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden; Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Carl M Sellgren
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Helena Fatouros-Bergman
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Göran Engberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
| | - Sophie Erhardt
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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Zheng YR, Tufvesson-Alm M, Trepci A, Imbeault S, Li XQ, Schwieler L, Engberg G, Erhardt S. Dual administration of lipopolysaccharide induces behavioural changes in rats relevant to psychotic disorders. Acta Neuropsychiatr 2023:1-13. [PMID: 37592805 DOI: 10.1017/neu.2023.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
OBJECTIVE We previously reported that dual injections of lipopolysaccharide (LPS) in mice constitute a valuable tool for investigating the contribution of inflammation to psychotic disorders. The present study investigated how immune activation affects the kynurenine pathway and rat behaviour of relevance for psychotic disorders. METHODS Male Sprague Dawley rats were treated with either dual injections of LPS (0.5 mg/kg + 0.5 mg/kg, i.p.) or dual injections of saline. Twenty-four hours after the second injection, behavioural tests were carried out, including locomotor activity test, fear conditioning test, spontaneous alternation Y-maze test, and novel object recognition test. In a separate batch of animals, in vivo striatal microdialysis was performed, and tryptophan, kynurenine, quinolinic acid, and kynurenic acid (KYNA) in the dialysate were measured using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). RESULTS Dual-LPS treatment decreased spontaneous locomotion, exaggerated d-amphetamine-induced locomotor activity, and impaired recognition memory in male Sprague-Dawley rats. In vivo microdialysis showed that dual-LPS treatment elicited metabolic disturbances in the kynurenine pathway with increased extracellular levels of kynurenine and KYNA in the striatum. CONCLUSION The present study further supports the feasibility of using the dual-LPS model to investigate inflammation-related psychotic disorders and cognitive impairments.
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Affiliation(s)
- Yi-Ran Zheng
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | | | - Ada Trepci
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Sophie Imbeault
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Xue-Qi Li
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Lilly Schwieler
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Göran Engberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Sophie Erhardt
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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Eren F, Schwieler L, Orhan F, Malmqvist A, Piehl F, Cervenka S, Sellgren CM, Fatouros-Bergman H, Engberg G, Erhardt S. Immunological protein profiling of first-episode psychosis patients identifies CSF and blood biomarkers correlating with disease severity. Brain Behav Immun 2023; 111:376-385. [PMID: 37146654 DOI: 10.1016/j.bbi.2023.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 04/21/2023] [Accepted: 04/30/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND AND HYPOTHESIS Immune activation is suggested to play an important role in psychosis. In this study, a large number of immune-related proteins were analyzed to obtain a more comprehensive picture of immune aberrations in schizophrenia. STUDY DESIGN Ninety-two immune markers were analyzed by the Olink Protein Extension Assay (Inflammatory Panel) in plasma and cerebrospinal fluid (CSF) from 77 first-episode psychosis (FEP) patients (of which 43 later received the diagnosis of schizophrenia) and 56 healthy controls, all recruited from the Karolinska Schizophrenia Project (KaSP), Stockholm, Sweden. STUDY RESULTS Differential analysis showed that 12 of 92 inflammatory proteins were significantly higher in the plasma of FEP patients (n = 77) than in controls, and several proteins were positively correlated with disease severity. Patients from the same cohort diagnosed with schizophrenia (n = 43), showed significantly higher levels of 15 plasma proteins compared to controls whereas those not receiving this diagnosis showed no significant differences. The presently used OLINK inflammatory panel allowed the detection of only 47 CSF proteins of which only CD5 differed between patients and controls. CONCLUSIONS The levels of several peripheral immune markers, particularly those interfering with WNT/β-catenin signaling, were significantly higher in patients with FEP than in healthy controls and associated with illness severity.
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Affiliation(s)
- Feride Eren
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Lilly Schwieler
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Funda Orhan
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Anna Malmqvist
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Fredrik Piehl
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Simon Cervenka
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden; Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Carl M Sellgren
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Helena Fatouros-Bergman
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Göran Engberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
| | - Sophie Erhardt
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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Orhan F, Goiny M, Becklén M, Mathé L, Piehl F, Schwieler L, Fatouros-Bergman H, Farde L, Cervenka S, Sellgren CM, Engberg G, Erhardt S. CSF dopamine is elevated in first-episode psychosis and associates to symptom severity and cognitive performance. Schizophr Res 2023; 257:34-40. [PMID: 37271040 DOI: 10.1016/j.schres.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 01/13/2023] [Accepted: 05/11/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND The hypothesis of dopamine dysfunction in psychosis has evolved since the mid-twentieth century. However, clinical support from biochemical analysis of the transmitter in patients is still missing. The present study assessed dopamine and related metabolites in the cerebrospinal fluid (CSF) of first-episode psychosis (FEP) subjects. METHODS Forty first-episode psychosis subjects and twenty healthy age-matched volunteers were recruited via the Karolinska Schizophrenia Project, a multidisciplinary research consortium that investigates the pathophysiology of schizophrenia. Psychopathology, disease severity, and cognitive performance were rated as well as cerebrospinal fluid concentrations of dopamine and related metabolites were measured using a sensitive high-pressure liquid chromatography assay. RESULTS CSF dopamine was reliably detected in 50 % of healthy controls and in 65 % of first-episode psychosis subjects and significantly higher in first-episode psychosis subjects compared to age-matched healthy controls. No difference in CSF dopamine levels was observed between drug-naive subjects and subjects with short exposure to antipsychotics. The dopamine concentrations were positively associated with illness severity and deficits in executive functioning. CONCLUSIONS Dopamine dysfunction has long been considered a cornerstone of the pathophysiology of schizophrenia, although biochemical support for elevated brain dopamine levels has been lacking. The results of the present study, showing that FEP subjects have increased CSF dopamine levels that correlate to disease symptoms, should fill the knowledge gap in this regard.
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Affiliation(s)
- Funda Orhan
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Michel Goiny
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Meneca Becklén
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Levida Mathé
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Fredrik Piehl
- Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Lilly Schwieler
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Helena Fatouros-Bergman
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, Sweden
| | - Lars Farde
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, Sweden
| | - Simon Cervenka
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, Sweden
| | - Carl M Sellgren
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, Sweden
| | - Göran Engberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
| | - Sophie Erhardt
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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Balter LJ, Li X, Schwieler L, Erhardt S, Axelsson J, Olsson MJ, Lasselin J, Lekander M. Lipopolysaccharide-induced changes in the kynurenine pathway and symptoms of sickness behavior in humans. Psychoneuroendocrinology 2023; 153:106110. [PMID: 37075653 DOI: 10.1016/j.psyneuen.2023.106110] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/07/2023] [Accepted: 04/06/2023] [Indexed: 04/21/2023]
Abstract
Metabolites of the kynurenine pathway are hypothesized to be implicated in inflammation-associated depression, but there is a lack of experimental studies in humans assessing the kinetics of kynurenine metabolites in relation to experimentally-induced sickness. The aim of the present study was to assess changes in the kynurenine pathway and to explore its relation to symptoms of sickness behavior during an acute experimental immune challenge. This double-blind placebo-controlled randomized cross-over study included 22 healthy human participants (n = 21 both sessions, Mage = 23.4, SD = 3.6, nine women) who received an intravenous injection of 2.0 ng/kg lipopolysaccharide (LPS) and saline (placebo) on two different occasions in a randomized order. Blood samples (0 h, 1 h, 1.5 h, 2 h, 3 h, 4 h, 5 h, 7 h post-injection) were analyzed for kynurenine metabolites and inflammatory cytokines. The intensity of symptoms of sickness behavior was assessed using the 10-item Sickness Questionnaire at 0 h, 1.5 h, 3 h, 5 h, and 7 h post-injection. LPS induced significantly lower concentrations of plasma tryptophan (at 2 h, 4 h, 5 h, and 7 h post-injection), kynurenine (at 2 h, 3 h, 4 h, and 5 h post-injection), nicotinamide (at 4 h, 5 h, and 7 h post-injection), and higher levels for quinolinic acid at 5 h post-injection as compared to placebo. LPS did not affect kynurenic acid, 3-hydroxykynurenine, and picolinic acid. The development of the sickness symptoms was largely similar across items, with the highest levels around 1.5-3 h post-injection. Changes in plasma levels of kynurenine metabolites seem to coincide rather than precede or follow changes in subjective sickness. Exploratory analyses indicate that higher Sickness Questionnaire total scores at 1.5-5 h post-injection were correlated with lower kynurenic acid and nicotinamide levels. These results lend further support for LPS-induced changes in the kynurenine pathway, but may not, as interpreted from blood levels, causally link to LPS-induced acute symptoms of sickness behavior. Future research may consider a larger sample to further scrutinize the role of the kynurenine pathway in the sickness response.
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Affiliation(s)
- Leonie Jt Balter
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden; Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden.
| | - Xueqi Li
- Department of Physiology, Karolinska Institutet, Stockholm, Sweden
| | - Lilly Schwieler
- Department of Physiology, Karolinska Institutet, Stockholm, Sweden
| | - Sophie Erhardt
- Department of Physiology, Karolinska Institutet, Stockholm, Sweden
| | - John Axelsson
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden; Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Mats J Olsson
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Julie Lasselin
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden; Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden; Osher Center for Integrative Health, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Mats Lekander
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden; Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden; Osher Center for Integrative Health, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
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Solianik R, Schwieler L, Trepci A, Erhardt S, Brazaitis M. Two-day fasting affects kynurenine pathway with additional modulation of short-term whole-body cooling: a quasi-randomised crossover trial. Br J Nutr 2022; 129:1-8. [PMID: 35791050 DOI: 10.1017/s0007114522002069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Metabolites of the kynurenine (KYN) pathway of tryptophan (TRP) degradation have attracted interest as potential pathophysiological mediators and future diagnostic biomarkers. A greater knowledge of the pathological implications of the metabolites is associated with a need for a better understanding of how the normal behaviour and physiological activities impact their concentrations. This study aimed to investigate whether fasting (FAST) and whole-body cold-water immersion (CWI) affect KYN pathway metabolites. Thirteen young women were randomly assigned to receive the 2-d FAST with two 10-min CWI on separate days (FAST-CWI), 2-d FAST without CWI (FAST-CON), 2-d two CWI on separate days without FAST (CON-CWI) or the 2-d usual diet without CWI (CON-CON) in a randomised crossover fashion. Changes in plasma concentrations of TRP, kynurenic acid (KYNA), 3-hydroxy-kynurenine (3-HK), picolinic acid (PIC), quinolinic acid (QUIN) and nicotinamide (NAA) were determined with ultra-performance liquid chromatography-tandem mass spectrometer. FAST-CWI and FAST-CON lowered TRP concentration (P < 0·05, ηp2 = 0·24), and increased concentrations of KYNA, 3-HK and PIC (P < 0·05, ηp2 = 0·21-0·71) with no additional effects of CWI. The ratio of PIC/QUIN increased after FAST-CWI and FAST-CON trials (P < 0·05) but with a blunted effect in the FAST-CWI trial (P < 0·05) compared with the FAST-CON trials (ηp2 = 0·67). Concentrations of QUIN and NAA were unaltered. This study demonstrated that fasting for 2 d considerably impacts the concentration of several metabolites in the KYN pathway. This should be considered when discussing the potential of KYN pathway metabolites as biomarkers.
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Affiliation(s)
- Rima Solianik
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Lilly Schwieler
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Ada Trepci
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Sophie Erhardt
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Marius Brazaitis
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
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Paul ER, Schwieler L, Erhardt S, Boda S, Trepci A, Kämpe R, Asratian A, Holm L, Yngve A, Dantzer R, Heilig M, Hamilton JP, Samuelsson M. Peripheral and central kynurenine pathway abnormalities in major depression. Brain Behav Immun 2022; 101:136-145. [PMID: 34999196 PMCID: PMC9045681 DOI: 10.1016/j.bbi.2022.01.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/22/2021] [Accepted: 01/03/2022] [Indexed: 12/14/2022] Open
Abstract
Considerable data relate major depressive disorder (MDD) with aberrant immune system functioning. Pro-inflammatory cytokines facilitate metabolism of tryptophan along the kynurenine pathway (KP) putatively resulting in reduced neuroprotective and increased neurotoxic KP metabolites in MDD, in addition to modulating metabolic and immune function. This central nervous system hypothesis has, however, only been tested in the periphery. Here, we measured KP-metabolite levels in both plasma and cerebrospinal fluid (CSF) of depressed patients (n = 63/36 respectively) and healthy controls (n = 48/33). Further, we assessed the relation between KP abnormalities and brain-structure volumes, as well as body mass index (BMI), an index of metabolic disturbance associated with atypical depression. Plasma levels of picolinic acid (PIC), the kynurenic/quinolinic acid ratio (KYNA/QUIN), and PIC/QUIN were lower in MDD, but QUIN levels were increased. In the CSF, we found lower PIC in MDD. Confirming previous work, MDD patients had lower hippocampal, and amygdalar volumes. Hippocampal and amygdalar volumes were correlated positively with plasma KYNA/QUIN ratio in MDD patients. BMI was increased in the MDD group relative to the control group. Moreover, BMI was inversely correlated with plasma and CSF PIC and PIC/QUIN, and positively correlated with plasma QUIN levels in MDD. Our results partially confirm previous peripheral KP findings and extend them to the CSF in MDD. We present the novel finding that abnormalities in KP metabolites are related to metabolic disturbances in depression, but the relation between KP metabolites and depression-associated brain atrophy might not be as direct as previously hypothesized.
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Affiliation(s)
- Elisabeth R Paul
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Center for Medical Imaging and Visualization, Linköping University, Linköping, Sweden
| | - Lilly Schwieler
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - Sophie Erhardt
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - Sandra Boda
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Center for Medical Imaging and Visualization, Linköping University, Linköping, Sweden; Department of Psychiatry, Region Östergötland, Linköping, Sweden
| | - Ada Trepci
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - Robin Kämpe
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Center for Medical Imaging and Visualization, Linköping University, Linköping, Sweden
| | - Anna Asratian
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Lovisa Holm
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Adam Yngve
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Center for Medical Imaging and Visualization, Linköping University, Linköping, Sweden
| | - Robert Dantzer
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Markus Heilig
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Department of Psychiatry, Region Östergötland, Linköping, Sweden
| | - J Paul Hamilton
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Center for Medical Imaging and Visualization, Linköping University, Linköping, Sweden.
| | - Martin Samuelsson
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Department of Psychiatry, Region Östergötland, Linköping, Sweden
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10
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Sellgren CM, Imbeault S, Larsson MK, Oliveros A, Nilsson IAK, Codeluppi S, Orhan F, Bhat M, Tufvesson-Alm M, Gracias J, Kegel ME, Zheng Y, Faka A, Svedberg M, Powell SB, Caldwell S, Kamenski ME, Vawter MP, Schulmann A, Goiny M, Svensson CI, Hökfelt T, Schalling M, Schwieler L, Cervenka S, Choi DS, Landén M, Engberg G, Erhardt S. Correction: GRK3 deficiency elicits brain immune activation and psychosis. Mol Psychiatry 2022; 27:1855. [PMID: 34744164 PMCID: PMC9119248 DOI: 10.1038/s41380-021-01371-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Carl M. Sellgren
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden ,grid.4714.60000 0004 1937 0626Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Sophie Imbeault
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Markus K. Larsson
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Alfredo Oliveros
- grid.66875.3a0000 0004 0459 167XDepartment of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic College of Medicine, Rochester, MN USA
| | - Ida A. K. Nilsson
- grid.4714.60000 0004 1937 0626Translational Psychiatry, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Simone Codeluppi
- grid.4714.60000 0004 1937 0626Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - Funda Orhan
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Maria Bhat
- grid.418151.80000 0001 1519 6403Research and Development, Innovative Medicines, Personalised Healthcare and Biomarkers, Translational Science Centre, Science for Life Laboratory, AstraZeneca, Solna, Sweden ,grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Maximilian Tufvesson-Alm
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Jessica Gracias
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Magdalena E. Kegel
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Yiran Zheng
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Anthi Faka
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Marie Svedberg
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Susan B. Powell
- grid.266100.30000 0001 2107 4242Department of Psychiatry, University of California San Diego, La Jolla, CA USA
| | - Sorana Caldwell
- grid.266100.30000 0001 2107 4242Department of Psychiatry, University of California San Diego, La Jolla, CA USA
| | - Mary E. Kamenski
- grid.266100.30000 0001 2107 4242Department of Psychiatry, University of California San Diego, La Jolla, CA USA
| | - Marquis P. Vawter
- grid.266093.80000 0001 0668 7243Functional Genomics Laboratory, Department of Psychiatry and Human Behavior, University of California Irvine School of Medicine, Irvine, CA USA
| | - Anton Schulmann
- grid.266093.80000 0001 0668 7243Functional Genomics Laboratory, Department of Psychiatry and Human Behavior, University of California Irvine School of Medicine, Irvine, CA USA ,grid.416868.50000 0004 0464 0574Human Genetics Branch, National Institute of Mental Health, Bethesda, MD USA
| | - Michel Goiny
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Camilla I. Svensson
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Tomas Hökfelt
- grid.4714.60000 0004 1937 0626Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Martin Schalling
- grid.4714.60000 0004 1937 0626Translational Psychiatry, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Lilly Schwieler
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Simon Cervenka
- grid.4714.60000 0004 1937 0626Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Doo-Sup Choi
- grid.66875.3a0000 0004 0459 167XDepartment of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic College of Medicine, Rochester, MN USA ,grid.66875.3a0000 0004 0459 167XDepartment of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN USA
| | - Mikael Landén
- grid.8761.80000 0000 9919 9582Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden ,grid.4714.60000 0004 1937 0626Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Göran Engberg
- Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden.
| | - Sophie Erhardt
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
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11
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Wyckelsma VL, Trepci A, Schwieler L, Venckunas T, Brazaitis M, Kamandulis S, Paulauskas H, Gapeyeva H, Pääsuke M, Gastaldello S, Imbeault S, Westerblad H, Erhardt S, Andersson DC. Vitamin C and E Treatment Blocks Changes in Kynurenine Metabolism Triggered by Three Weeks of Sprint Interval Training in Recreationally Active Elderly Humans. Antioxidants (Basel) 2021; 10:antiox10091443. [PMID: 34573075 PMCID: PMC8465740 DOI: 10.3390/antiox10091443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/30/2021] [Accepted: 09/08/2021] [Indexed: 02/06/2023] Open
Abstract
The kynurenine pathway (KP) is gaining attention in several clinical fields. Recent studies show that physical exercise offers a therapeutic way to improve ratios of neurotoxic to neuroprotective KP metabolites. Antioxidant supplementation can blunt beneficial responses to physical exercise. We here studied the effects of endurance training in the form of sprint interval training (SIT; three sessions of 4–6 × 30 s cycling sprints per week for three weeks) in elderly (~65 years) men exposed to either placebo (n = 9) or the antioxidants vitamin C (1 g/day) and E (235 mg/day) (n = 11). Blood samples and muscle biopsies were taken under resting conditions in association with the first (untrained state) and last (trained state) SIT sessions. In the placebo group, the blood plasma level of the neurotoxic quinolinic acid was lower (~30%) and the neuroprotective kynurenic acid to quinolinic acid ratio was higher (~50%) in the trained than in the untrained state. Moreover, muscle biopsies showed a training-induced increase in kynurenine aminotransferase (KAT) III in the placebo group. All these training effects were absent in the vitamin-treated group. In conclusion, KP metabolism was shifted towards neuroprotection after three weeks of SIT in elderly men and this shift was blocked by antioxidant treatment.
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Affiliation(s)
- Victoria L. Wyckelsma
- Department of Physiology and Pharmacology, Karolinska Institutet, 171 77 Stockholm, Sweden; (V.L.W.); (A.T.); (L.S.); (S.G.); (S.I.); (H.W.); (S.E.)
| | - Ada Trepci
- Department of Physiology and Pharmacology, Karolinska Institutet, 171 77 Stockholm, Sweden; (V.L.W.); (A.T.); (L.S.); (S.G.); (S.I.); (H.W.); (S.E.)
- Institute of Sports Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (T.V.); (M.B.); (S.K.); (H.P.)
| | - Lilly Schwieler
- Department of Physiology and Pharmacology, Karolinska Institutet, 171 77 Stockholm, Sweden; (V.L.W.); (A.T.); (L.S.); (S.G.); (S.I.); (H.W.); (S.E.)
| | - Tomas Venckunas
- Institute of Sports Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (T.V.); (M.B.); (S.K.); (H.P.)
| | - Marius Brazaitis
- Institute of Sports Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (T.V.); (M.B.); (S.K.); (H.P.)
| | - Sigitas Kamandulis
- Institute of Sports Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (T.V.); (M.B.); (S.K.); (H.P.)
| | - Henrikas Paulauskas
- Institute of Sports Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (T.V.); (M.B.); (S.K.); (H.P.)
| | - Helena Gapeyeva
- Clinic of Medical Rehabilitation, Inpatient Rehabilitation Centre, East Tallinn Central Hospital, 10138 Tallinn, Estonia;
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, 50090 Tartu, Estonia;
| | - Mati Pääsuke
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, 50090 Tartu, Estonia;
| | - Stefano Gastaldello
- Department of Physiology and Pharmacology, Karolinska Institutet, 171 77 Stockholm, Sweden; (V.L.W.); (A.T.); (L.S.); (S.G.); (S.I.); (H.W.); (S.E.)
| | - Sophie Imbeault
- Department of Physiology and Pharmacology, Karolinska Institutet, 171 77 Stockholm, Sweden; (V.L.W.); (A.T.); (L.S.); (S.G.); (S.I.); (H.W.); (S.E.)
| | - Håkan Westerblad
- Department of Physiology and Pharmacology, Karolinska Institutet, 171 77 Stockholm, Sweden; (V.L.W.); (A.T.); (L.S.); (S.G.); (S.I.); (H.W.); (S.E.)
- Institute of Sports Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (T.V.); (M.B.); (S.K.); (H.P.)
| | - Sophie Erhardt
- Department of Physiology and Pharmacology, Karolinska Institutet, 171 77 Stockholm, Sweden; (V.L.W.); (A.T.); (L.S.); (S.G.); (S.I.); (H.W.); (S.E.)
| | - Daniel C. Andersson
- Department of Physiology and Pharmacology, Karolinska Institutet, 171 77 Stockholm, Sweden; (V.L.W.); (A.T.); (L.S.); (S.G.); (S.I.); (H.W.); (S.E.)
- Cardiology Unit, Karolinska University Hospital, 171 64 Stockholm, Sweden
- Correspondence:
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12
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Millischer V, Heinzl M, Faka A, Resl M, Trepci A, Klammer C, Egger M, Dieplinger B, Clodi M, Schwieler L. Intravenous administration of LPS activates the kynurenine pathway in healthy male human subjects: a prospective placebo-controlled cross-over trial. J Neuroinflammation 2021; 18:158. [PMID: 34273987 PMCID: PMC8286561 DOI: 10.1186/s12974-021-02196-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 06/16/2021] [Indexed: 12/12/2022] Open
Abstract
Background Administration of lipopolysaccharide (LPS) from Gram-negative bacteria, also known as the human endotoxemia model, is a standardized and safe model of human inflammation. Experimental studies have revealed that peripheral administration of LPS leads to induction of the kynurenine pathway followed by depressive-like behavior and cognitive dysfunction in animals. The aim of the present study is to investigate how acute intravenous LPS administration affects the kynurenine pathway in healthy male human subjects. Methods The present study is a prospective, single-blinded, randomized, placebo-controlled cross-over study to investigate the effects of intravenously administered LPS (Escherichia coli O113, 2 ng/kg) on tryptophan and kynurenine metabolites over 48 h and their association with interleukin-6 (IL-6) and C-reactive protein (CRP). The study included 10 healthy, non-smoking men (18–40 years) free from medication. Statistical differences in tryptophan and kynurenine metabolites as well as associations with IL-6 and CRP in LPS and placebo treated subjects were assessed with linear mixed-effects models. Results Systemic injection of LPS was associated with significantly lower concentrations of plasma tryptophan and kynurenine after 4 h, as well as higher concentrations of quinolinic acid (QUIN) after 48 h compared to the placebo injection. No differences were found in kynurenic acid (KYNA) or picolinic acid plasma concentrations between LPS or placebo treatment. The KYNA/kynurenine ratio peaked at 6 h post LPS injection while QUIN/kynurenine maintained significantly higher from 3 h post LPS injection until 24 h. The kynurenine/tryptophan ratio was higher at 24 h and 48 h post LPS treatment. Finally, we report an association between the kynurenine/tryptophan ratio and CRP. Conclusions Our findings strongly support the concept that an inflammatory challenge with LPS induces the kynurenine pathway in humans, activating both the neurotoxic (QUIN) and neuroprotective (KYNA) branch of the kynurenine pathway. Trial registration This study is based on a study registered at ClinicalTrials.gov, NCT03392701. Registered 21 December 2017. Supplementary Information The online version contains supplementary material available at 10.1186/s12974-021-02196-x.
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Affiliation(s)
- Vincent Millischer
- Department of Molecular Medicine and Surgery (MMK), Karolinska Institutet, Stockholm, Sweden.,Translational Psychiatry, Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.,Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Matthias Heinzl
- Department of Internal Medicine, Konventhospital Barmherzige Brueder (St. John of God Hospital), Seilerstaette 2, 4021, Linz, Austria.,ICMR-Institute for Cardiovascular and Metabolic Research, JKU Linz, Linz, Austria
| | - Anthi Faka
- Department of Physiology & Pharmacology, Sec. Neuropsychoimmunology, Karolinska Institutet, Stockholm, Sweden
| | - Michael Resl
- Department of Internal Medicine, Konventhospital Barmherzige Brueder (St. John of God Hospital), Seilerstaette 2, 4021, Linz, Austria.,ICMR-Institute for Cardiovascular and Metabolic Research, JKU Linz, Linz, Austria
| | - Ada Trepci
- Department of Physiology & Pharmacology, Sec. Neuropsychoimmunology, Karolinska Institutet, Stockholm, Sweden
| | - Carmen Klammer
- Department of Internal Medicine, Konventhospital Barmherzige Brueder (St. John of God Hospital), Seilerstaette 2, 4021, Linz, Austria.,ICMR-Institute for Cardiovascular and Metabolic Research, JKU Linz, Linz, Austria
| | - Margot Egger
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder (St. John of God Hospital), Linz, Austria
| | - Benjamin Dieplinger
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder (St. John of God Hospital), Linz, Austria
| | - Martin Clodi
- Department of Internal Medicine, Konventhospital Barmherzige Brueder (St. John of God Hospital), Seilerstaette 2, 4021, Linz, Austria. .,ICMR-Institute for Cardiovascular and Metabolic Research, JKU Linz, Linz, Austria.
| | - Lilly Schwieler
- Department of Physiology & Pharmacology, Sec. Neuropsychoimmunology, Karolinska Institutet, Stockholm, Sweden
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13
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Wickström R, Fowler Å, Goiny M, Millischer V, Ygberg S, Schwieler L. The Kynurenine Pathway is Differentially Activated in Children with Lyme Disease and Tick-Borne Encephalitis. Microorganisms 2021; 9:microorganisms9020322. [PMID: 33557172 PMCID: PMC7913947 DOI: 10.3390/microorganisms9020322] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/21/2021] [Accepted: 01/29/2021] [Indexed: 01/03/2023] Open
Abstract
In children, tick-borne encephalitis and neuroborreliosis are common infections affecting the central nervous system. As inflammatory pathways including cytokine expression are activated in these children and appear to be of importance for outcome, we hypothesized that induction of the kynurenine pathway may be part of the pathophysiological mechanism. Inflammatory biomarkers were analyzed in cerebrospinal fluid from 22 children with tick-borne encephalitis (TBE), 34 children with neuroborreliosis (NB) and 6 children with no central nervous system infection. Cerebrospinal fluid levels of kynurenine and kynurenic acid were increased in children with neuroborreliosis compared to the comparison group. A correlation was seen between expression of several cerebrospinal fluid cytokines and levels of kynurenine and kynurenic acid in children with neuroborreliosis but not in children with tick-borne encephalitis. These findings demonstrate a strong induction of the kynurenine pathway in children with neuroborreliosis which differs from that seen in children with tick-borne encephalitis. The importance of brain kynurenic acid (KYNA) in both immune modulation and neurotransmission raises the possibility that abnormal levels of the compound in neuroborreliosis might be of importance for the pathophysiology of the disease. Drugs targeting the enzymes of this pathway may open the venue for novel therapeutic interventions.
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Affiliation(s)
- Ronny Wickström
- Neuropediatric Unit, Department for Women’s and Children’s Health, Karolinska Institutet, 171 77 Stockholm, Sweden; (R.W.); (S.Y.)
| | - Åsa Fowler
- Division of Paediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 52 Stockholm, Sweden;
| | - Michel Goiny
- Department of Physiology & Pharmacology, Karolinska Institutet, 171 77 Stockholm, Sweden;
| | - Vincent Millischer
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria;
- Department of Molecular Medicine and Surgery (MMK), Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Sofia Ygberg
- Neuropediatric Unit, Department for Women’s and Children’s Health, Karolinska Institutet, 171 77 Stockholm, Sweden; (R.W.); (S.Y.)
| | - Lilly Schwieler
- Department of Physiology & Pharmacology, Karolinska Institutet, 171 77 Stockholm, Sweden;
- Correspondence: ; Tel.: +46-707489402; Fax: +46-8-310-622
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14
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Hedberg M, Imbeault S, Erhardt S, Schwieler L. Disrupted sensorimotor gating in first-episode psychosis patients is not affected by short-term antipsychotic treatment. Schizophr Res 2021; 228:118-123. [PMID: 33434725 DOI: 10.1016/j.schres.2020.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 10/23/2020] [Accepted: 12/12/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Impaired sensorimotor gating, commonly measured as disrupted prepulse inhibition (PPI) of the acoustic startle response, has been widely observed in psychotic diseases. However, most PPI studies published so far involve patients with long illness duration and different drug treatments. Few studies have investigated untreated patients at their first episode of psychotic symptoms. METHOD PPI is an acoustic startle paradigm (30, 60-, 120-ms interstimulus intervals). Startle reactivity and habituation were succesfully assessed in 49 antipsychotic-naïve first-episode psychosis (FEP) patients and compared with 35 age- and gender-matched healthy control subjects. Mean age of patients was 28 years and 27 for controls. Patients treated with antipsychotics more than 30 days were not included in the study and twenty-three out of forty-nine patients received antipsychotic treatment with a mean treatment time of 13 days. RESULTS PPI was significantly lower in FEP patients, compared to healthy controls. The PPI deficiency found in these patients was not due to antipsychotic treatment since PPI did not differ between treated (n=23) and untreated patients n=(26). By using the latent curve modeling we identified a delayed habituation in patients treated with antipsychotics, suggesting that antipsychotic treatment should be considered as a confound when investigating habituation in schizophrenia. CONCLUSIONS Our results suggest that acute pharmacological treatment does not normalize PPI in FEP patients but should be considered as a confound when investigating habituation in these patients.
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Affiliation(s)
- Mikael Hedberg
- Dept. of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Sophie Imbeault
- Dept. of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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- Dept. of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Sophie Erhardt
- Dept. of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
| | - Lilly Schwieler
- Dept. of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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15
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Trepci A, Sellgren CM, Pålsson E, Brundin L, Khanlarkhani N, Schwieler L, Landén M, Erhardt S. Central levels of tryptophan metabolites in subjects with bipolar disorder. Eur Neuropsychopharmacol 2021; 43:52-62. [PMID: 33339712 DOI: 10.1016/j.euroneuro.2020.11.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/17/2020] [Accepted: 11/30/2020] [Indexed: 02/06/2023]
Abstract
The kynurenine pathway of tryptophan degradation produces several neuroactive metabolites such as kynurenic acid (KYNA), quinolinic acid (QUIN), and picolinic acid (PIC) thought to be involved in the pathophysiology of psychosis, major depression, and suicidal behavior. Here, we analyzed cerebrospinal fluid (CSF) concentrations of tryptophan, kynurenine, KYNA, QUIN, and PIC utilizing ultra-performance liquid chromatography - tandem mass spectrometry system (UPLC-MS/MS) in persons with bipolar disorder (n = 101) and healthy controls (n = 80) to investigate if the metabolites correlated with depressive symptoms or to the history of suicidal behavior. Furthermore, we analyzed if genetic variants of the enzyme amino-β-carboxymuconate-semialdehyde-decarboxylase (ACMSD) were associated with the CSF concentrations of PIC and QUIN. We found that CSF KYNA and PIC concentrations, as well as the kynurenine/tryptophan ratio were increased in bipolar disorder compared with controls. CSF PIC concentrations were lower in subjects with a history of suicidal behavior than those without, supporting the hypothesis that low CSF PIC is a marker of vulnerability for suicidality. Bipolar subjects taking antidepressants had higher CSF concentrations of kynurenine and KYNA than subjects not given these medications. A negative association was found between a genetic variant of ACMSD and the ratio of PIC/QUIN, indicating that a polymorphism in ACMSD is associated with excess of QUIN formation at the expense of PIC. The present results confirm that the kynurenine pathway is activated in bipolar disorder, and suggest that shifting the activity of the kynurenine pathway away from QUIN production towards a production of KYNA and PIC might be a beneficial therapeutic strategy.
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Affiliation(s)
- Ada Trepci
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm SE17177, Sweden
| | - Carl M Sellgren
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm SE17177, Sweden; Centre for Psychiatry Research, Department of Clinical Neuroscience, Stockholm County Council, Karolinska Institutet & Stockholm Health Care Services, Karolinska University Hospital, Stockholm, Sweden
| | - Erik Pålsson
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Mölndal, Sweden
| | - Lena Brundin
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm SE17177, Sweden; Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI, USA
| | - Neda Khanlarkhani
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm SE17177, Sweden
| | - Lilly Schwieler
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm SE17177, Sweden
| | - Mikael Landén
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Mölndal, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Sophie Erhardt
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm SE17177, Sweden.
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16
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Isung J, Granqvist M, Trepci A, Huang J, Schwieler L, Kierkegaard M, Erhardt S, Jokinen J, Piehl F. Differential effects on blood and cerebrospinal fluid immune protein markers and kynurenine pathway metabolites from aerobic physical exercise in healthy subjects. Sci Rep 2021; 11:1669. [PMID: 33462306 PMCID: PMC7814004 DOI: 10.1038/s41598-021-81306-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 01/04/2021] [Indexed: 02/01/2023] Open
Abstract
Mounting evidence shows that physical exercise modulates systemic inflammation. However, its effect on cerebrospinal fluid (CSF) immune-marker profiles in man are largely unknown. We here report a study on healthy subjects (n = 27, males = 12, mean age 28.7, range 22-52) allocated to either an acute exercise setting over four consecutive days, or a training intervention over 4 weeks. Paired plasma and CSF samples collected at baseline, after 7 days of exercise abstention, and the day after completion of the exercise interventions, were analyzed for protein inflammation markers using a multiplex proximity extension assay and neurotransmitters and kynurenine pathway (KP) metabolites using liquid chromatography, respectively. Routine cell counts, and albumin, immunoglobulin G and neurofilament light chain concentrations in CSF remained unchanged in both paradigms, while several inflammatory proteins became upregulated after acute exercise. However, only changes in three CSF (vascular endothelial growth factor-A, interleukin-7 and matrix metalloproteinase-10) and 12 plasma proteins reached significance levels after adjustment for multiple comparisons and exclusion of less stable proteins. Similarly, KP metabolites only changed among participants after acute exercise, while neurotransmitter levels, except for increased CSF serine, remained stable. Both in plasma and CSF changes in KP metabolites and inflammatory proteins correlated, suggesting that these processes are functionally linked. These findings suggest that acute aerobic physical exercise affects immune markers and KP metabolites systemically and in the CSF.
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Affiliation(s)
- Josef Isung
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
| | - Mathias Granqvist
- Division of Physiotherapy, Division of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, and Academic Specialist Center, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Ada Trepci
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Jesse Huang
- Division of Physiotherapy, Division of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, and Academic Specialist Center, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Lilly Schwieler
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Marie Kierkegaard
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Academic Specialist Center, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Sophie Erhardt
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Jussi Jokinen
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.,Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - Fredrik Piehl
- Division of Physiotherapy, Division of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, and Academic Specialist Center, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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17
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Sellgren CM, Imbeault S, Larsson MK, Oliveros A, Nilsson IAK, Codeluppi S, Orhan F, Bhat M, Tufvesson-Alm M, Gracias J, Kegel ME, Zheng Y, Faka A, Svedberg M, Powell SB, Caldwell S, Kamenski ME, Vawter MP, Schulmann A, Goiny M, Svensson CI, Hökfelt T, Schalling M, Schwieler L, Cervenka S, Choi DS, Landén M, Engberg G, Erhardt S. GRK3 deficiency elicits brain immune activation and psychosis. Mol Psychiatry 2021; 26:6820-6832. [PMID: 33976392 PMCID: PMC8760053 DOI: 10.1038/s41380-021-01106-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 04/07/2021] [Indexed: 02/03/2023]
Abstract
The G protein-coupled receptor kinase (GRK) family member protein GRK3 has been linked to the pathophysiology of schizophrenia and bipolar disorder. Expression, as well as protein levels, of GRK3 are reduced in post-mortem prefrontal cortex of schizophrenia subjects. Here, we investigate functional behavior and neurotransmission related to immune activation and psychosis using mice lacking functional Grk3 and utilizing a variety of methods, including behavioral, biochemical, electrophysiological, molecular, and imaging methods. Compared to wildtype controls, the Grk3-/- mice show a number of aberrations linked to psychosis, including elevated brain levels of IL-1β, increased turnover of kynurenic acid (KYNA), hyper-responsiveness to D-amphetamine, elevated spontaneous firing of midbrain dopamine neurons, and disruption in prepulse inhibition. Analyzing human genetic data, we observe a link between psychotic features in bipolar disorder, decreased GRK expression, and increased concentration of CSF KYNA. Taken together, our data suggest that Grk3-/- mice show face and construct validity relating to the psychosis phenotype with glial activation and would be suitable for translational studies of novel immunomodulatory agents in psychotic disorders.
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Affiliation(s)
- Carl M. Sellgren
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden ,grid.4714.60000 0004 1937 0626Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Sophie Imbeault
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Markus K. Larsson
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Alfredo Oliveros
- grid.66875.3a0000 0004 0459 167XDepartment of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic College of Medicine, Rochester, MN USA
| | - Ida A. K. Nilsson
- grid.4714.60000 0004 1937 0626Translational Psychiatry, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Simone Codeluppi
- grid.4714.60000 0004 1937 0626Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - Funda Orhan
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Maria Bhat
- grid.418151.80000 0001 1519 6403Research and Development, Innovative Medicines, Personalised Healthcare and Biomarkers, Translational Science Centre, Science for Life Laboratory, AstraZeneca, Solna, Sweden ,grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Maximilian Tufvesson-Alm
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Jessica Gracias
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Magdalena E. Kegel
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Yiran Zheng
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Anthi Faka
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Marie Svedberg
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Susan B. Powell
- grid.266100.30000 0001 2107 4242Department of Psychiatry, University of California San Diego, La Jolla, CA USA
| | - Sorana Caldwell
- grid.266100.30000 0001 2107 4242Department of Psychiatry, University of California San Diego, La Jolla, CA USA
| | - Mary E. Kamenski
- grid.266100.30000 0001 2107 4242Department of Psychiatry, University of California San Diego, La Jolla, CA USA
| | - Marquis P. Vawter
- grid.266093.80000 0001 0668 7243Functional Genomics Laboratory, Department of Psychiatry and Human Behavior, University of California Irvine School of Medicine, Irvine, CA USA
| | - Anton Schulmann
- grid.416868.50000 0004 0464 0574Human Genetics Branch, National Institute of Mental Health, Bethesda, MD USA
| | - Michel Goiny
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Camilla I. Svensson
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Tomas Hökfelt
- grid.4714.60000 0004 1937 0626Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Martin Schalling
- grid.4714.60000 0004 1937 0626Translational Psychiatry, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Lilly Schwieler
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Simon Cervenka
- grid.4714.60000 0004 1937 0626Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Doo-Sup Choi
- grid.66875.3a0000 0004 0459 167XDepartment of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic College of Medicine, Rochester, MN USA ,grid.66875.3a0000 0004 0459 167XDepartment of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN USA
| | - Mikael Landén
- grid.8761.80000 0000 9919 9582Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden ,grid.4714.60000 0004 1937 0626Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Göran Engberg
- Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden.
| | - Sophie Erhardt
- grid.4714.60000 0004 1937 0626Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
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18
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Trepci A, Imbeault S, Wyckelsma VL, Westerblad H, Hermansson S, Andersson DC, Piehl F, Venckunas T, Brazaitis M, Kamandulis S, Brundin L, Erhardt S, Schwieler L. Quantification of Plasma Kynurenine Metabolites Following One Bout of Sprint Interval Exercise. Int J Tryptophan Res 2020; 13:1178646920978241. [PMID: 33354112 PMCID: PMC7734489 DOI: 10.1177/1178646920978241] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 11/04/2020] [Indexed: 01/17/2023] Open
Abstract
The kynurenine pathway of tryptophan degradation produces several neuroactive metabolites suggested to be involved in a wide variety of diseases and disorders, however, technical challenges in reliably detecting these metabolites hampers cross-comparisons. The main objective of this study was to develop an accurate, robust and precise bioanalytical method for simultaneous quantification of ten plasma kynurenine metabolites. As a secondary aim, we applied this method on blood samples taken from healthy subjects conducting 1 session of sprint interval exercise (SIE). It is well accepted that physical exercise is associated with health benefits and reduces risks of psychiatric illness, diabetes, cancer and cardiovascular disease, but also influences the peripheral and central concentrations of kynurenines. In line with this, we found that in healthy old adults (n = 10; mean age 64 years), levels of kynurenine increased 1 hour (P = .03) after SIE, while kynurenic acid (KYNA) concentrations were elevated after 24 hours (P = .02). In contrast, no significant changes after exercise were seen in young adults (n = 10; mean age 24 years). In conclusion, the described method performs well in reliably detecting all the analyzed metabolites in plasma samples. Furthermore, we also detected an age-dependent effect on the degree by which a single intense training session affects kynurenine metabolite levels.
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Affiliation(s)
- Ada Trepci
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Sophie Imbeault
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Victoria L Wyckelsma
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Håkan Westerblad
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | | | - Daniel C Andersson
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
- Cardiology Unit, Heart, Vascular and Neurology Theme; Karolinska University Hospital, Stockholm, Sweden
| | - Fredrik Piehl
- Neuroimmunology Unit, Department of Clinical Neuroscience, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
- Division of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Tomas Venckunas
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Marius Brazaitis
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Sigitas Kamandulis
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Lena Brundin
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
- Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI, USA
- Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Psychiatry, Lund, Sweden
| | - Sophie Erhardt
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Lilly Schwieler
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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19
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Peyton L, Oliveros A, Tufvesson-Alm M, Schwieler L, Starski P, Engberg G, Erhardt S, Choi DS. Lipopolysaccharide Increases Cortical Kynurenic Acid and Deficits in Reference Memory in Mice. Int J Tryptophan Res 2019; 12:1178646919891169. [PMID: 31896932 PMCID: PMC6920585 DOI: 10.1177/1178646919891169] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 11/06/2019] [Indexed: 01/24/2023] Open
Abstract
Kynurenic acid (KYNA), a glial-derived metabolite of tryptophan metabolism, is an
antagonist of the alpha 7 nicotinic acetylcholine receptor and the
glycine-binding site of N-methyl-d-aspartate (NMDA)
receptors. Kynurenic acid levels are increased in both the brain and
cerebrospinal fluid of several psychiatric disorders including bipolar disorder,
schizophrenia, and Alzheimer disease. In addition, pro-inflammatory cytokines
have been found to be elevated in the blood of schizophrenic patients suggesting
inflammation may play a role in psychiatric illness. As both pro-inflammatory
cytokines and KYNA can be elevated in the brain by peripheral lipopolysaccharide
(LPS) injection, we therefore sought to characterize the role of
neuroinflammation on learning and memory using a well-described dual-LPS
injection model. Mice were injected with an initial injection (0.25 mg/kg LPS,
0.50 mg/kg, or saline) of LPS and then administrated a second injection 16 hours
later. Our results indicate both 0.25 and 0.50 mg/kg dual-LPS treatment
increased l-kynurenine and KYNA levels in the medial pre-frontal cortex
(mPFC). Mice exhibited impaired acquisition of CS+ (conditioned stimulus)
Pavlovian conditioning. Notably, mice showed impairment in reference memory
while working memory was normal in an 8-arm maze. Taken together, our findings
suggest that neuroinflammation induced by peripheral LPS administration
contributes to cognitive dysfunction.
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Affiliation(s)
- Lee Peyton
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Alfredo Oliveros
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | | | - Lilly Schwieler
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - Phillip Starski
- Neuroscience Program, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Göran Engberg
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - Sopie Erhardt
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - Doo-Sup Choi
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.,Neuroscience Program, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.,Department of Psychiatry and Psychology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
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20
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Orhan F, Schwieler L, Fatouros-Bergman H, Malmqvist A, Cervenka S, Collste K, Flyckt L, Farde L, Sellgren CM, Piehl F, Engberg G, Erhardt S. Increased number of monocytes and plasma levels of MCP-1 and YKL-40 in first-episode psychosis. Acta Psychiatr Scand 2018; 138:432-440. [PMID: 30132802 DOI: 10.1111/acps.12944] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Accumulating evidence implicates immune activation in the development of schizophrenia. Here, monocyte numbers, monocyte chemoattractant protein-1 (MCP-1) and chitinase-3-like protein 1 (YKL-40) were investigated in plasma and cerebrospinal fluid (CSF) in first-episode psychosis (FEP) patients. METHOD CSF and blood were sampled from 42 first-episode psychosis (FEP) patients and 22 healthy controls. The levels of YKL-40 and MCP-1 were measured using electrochemiluminescence assay, and blood monocytes were counted using an XN-9000-hematology analyzer. RESULTS We found higher plasma levels of MCP-1 and YKL-40 in FEP patients compared with healthy controls, a condition that was unrelated to antipsychotic and/or anxiolytic medication. This was combined with an increased number of blood monocytes and a borderline significant increase in YKL-40 levels in the CSF of tobacco-free FEP patients. Plasma or CSF chemokines or blood monocytes did not correlate with the severity of symptoms or the level of functioning. CONCLUSION These data demonstrate activation of monocytes in FEP and strengthens the idea of an immune dysfunction of psychotic disorders. Further studies are required to perceive a role of YKL-40 and MCP-1 in the initiation and progression of schizophrenia.
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Affiliation(s)
- F Orhan
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - L Schwieler
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - H Fatouros-Bergman
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - A Malmqvist
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - S Cervenka
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - K Collste
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - L Flyckt
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - L Farde
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.,PET Science Centre, Precision Medicine and Genomics, IMED Biotech Unit, AstraZeneca, Karolinska Institutet, Stockholm, Sweden
| | - C M Sellgren
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA.,Center for Experimental Drugs and Diagnostics, Center for Human Genetic Research and Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - F Piehl
- Department of Clinical Neuroscience, Neuroimmunology Unit, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | | | - G Engberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - S Erhardt
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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21
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Price JB, Bronars C, Erhardt S, Cullen KR, Schwieler L, Berk M, Walder K, McGee SL, Frye MA, Tye SJ. Bioenergetics and synaptic plasticity as potential targets for individualizing treatment for depression. Neurosci Biobehav Rev 2018; 90:212-220. [DOI: 10.1016/j.neubiorev.2018.04.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 03/07/2018] [Accepted: 04/03/2018] [Indexed: 02/07/2023]
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22
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Tufvesson-Alm M, Schwieler L, Schwarcz R, Goiny M, Erhardt S, Engberg G. Importance of kynurenine 3-monooxygenase for spontaneous firing and pharmacological responses of midbrain dopamine neurons: Relevance for schizophrenia. Neuropharmacology 2018; 138:130-139. [PMID: 29879409 DOI: 10.1016/j.neuropharm.2018.06.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 06/01/2018] [Accepted: 06/03/2018] [Indexed: 12/15/2022]
Abstract
Kynurenine 3-monooxygenase (KMO) is an essential enzyme of the kynurenine pathway, converting kynurenine into 3-hydroxykynurenine. Inhibition of KMO increases kynurenine, resulting in elevated levels of kynurenic acid (KYNA), an endogenous N-methyl-d-aspartate and α*7-nicotinic receptor antagonist. The concentration of KYNA is elevated in the brain of patients with schizophrenia, possibly as a result of a reduced KMO activity. In the present study, using in vivo single cell recording techniques, we investigated the electrophysiological characteristics of ventral tegmental area dopamine (VTA DA) neurons and their response to antipsychotic drugs in a KMO knock-out (K/O) mouse model. KMO K/O mice exhibited a marked increase in spontaneous VTA DA neuron activity as compared to wild-type (WT) mice. Furthermore, VTA DA neurons showed clear-cut, yet qualitatively opposite, responses to the antipsychotic drugs haloperidol and clozapine in the two genotypes. The anti-inflammatory drug parecoxib successfully lowered the firing activity of VTA DA neurons in KMO K/O, but not in WT mice. Minocycline, an antibiotic and anti-inflammatory drug, produced no effect in this regard. Taken together, the present data further support the usefulness of KMO K/O mice for studying distinct aspects of the pathophysiology and pharmacological treatment of psychiatric disorders such as schizophrenia.
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Affiliation(s)
| | - Lilly Schwieler
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - Robert Schwarcz
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Michel Goiny
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - Sophie Erhardt
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - Göran Engberg
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden; Department of Physiology and Pharmacology, Karolinska Institute, Biomedicum 5C, 171 77, Stockholm, Sweden.
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23
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Oliveros A, Wininger K, Sens J, Larsson MK, Liu XC, Choi S, Faka A, Schwieler L, Engberg G, Erhardt S, Choi DS. LPS-induced cortical kynurenic acid and neurogranin-NFAT signaling is associated with deficits in stimulus processing during Pavlovian conditioning. J Neuroimmunol 2017; 313:1-9. [PMID: 29153599 DOI: 10.1016/j.jneuroim.2017.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 05/04/2017] [Accepted: 09/27/2017] [Indexed: 12/13/2022]
Abstract
The N-Methyl-d-Aspartate receptor (NMDAR) antagonist kynurenic acid (KYNA) and the post-synaptic calmodulin binding protein neurogranin (Nrgn) have been implicated in neurological and neuropsychiatric conditions including Alzheimer's disease and schizophrenia. This study indicates that systemic dual-lipopolysaccharide (LPS) injections increases KYNA in the medial prefrontal cortex (mPFC), which is accompanied with increased phosphorylation of nuclear factor kappa chain of activated B cells (NFκB) and activation of the nuclear factor of activated T- cells (NFAT). Our results also indicate that dual-LPS increases Nrgn phosphorylation and concomitantly reduces phosphorylation of calmodulin kinase-II (CaMKII). We confirmed that systemic blockade of kynurenine-3 monooxygenase in conjunction with kynurenine administration results in significant increases in Nrgn phosphorylation and a significant reduction of CaMKII phosphorylation in the mPFC. Consequently, dual-LPS administration induced significant impairments in stimulus processing during Pavlovian conditioning. Taken together, our study indicates that elevations in KYNA in the mPFC can directly regulate NMDA-Nrgn-CaMKII signaling, suggesting that neuroinflammatory conditions affecting this pathway may be associated with cognitive dysfunction.
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Affiliation(s)
- A Oliveros
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
| | - K Wininger
- Neurobiology of Disease Program, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
| | - J Sens
- Neurobiology of Disease Program, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
| | - M K Larsson
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - X C Liu
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - S Choi
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
| | - A Faka
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - L Schwieler
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - G Engberg
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - S Erhardt
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - D S Choi
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic College of Medicine, Rochester, MN 55905, USA; Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA; Neurobiology of Disease Program, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
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24
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Holmberg D, Franzén-Röhl E, Idro R, Opoka RO, Bangirana P, Sellgren CM, Wickström R, Färnert A, Schwieler L, Engberg G, John CC. Cerebrospinal fluid kynurenine and kynurenic acid concentrations are associated with coma duration and long-term neurocognitive impairment in Ugandan children with cerebral malaria. Malar J 2017; 16:303. [PMID: 28754152 PMCID: PMC5534063 DOI: 10.1186/s12936-017-1954-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 07/22/2017] [Indexed: 01/26/2023] Open
Abstract
Background One-fourth of children with cerebral malaria (CM) retain cognitive sequelae up to 2 years after acute disease. The kynurenine pathway of the brain, forming neuroactive metabolites, e.g. the NMDA-receptor antagonist kynurenic acid (KYNA), has been implicated in long-term cognitive dysfunction in other CNS infections. In the present study, the association between the kynurenine pathway and neurologic/cognitive complications in children with CM was investigated. Methods Cerebrospinal fluid (CSF) concentrations of KYNA and its precursor kynurenine in 69 Ugandan children admitted for CM to Mulago Hospital, Kampala, Uganda, between 2008 and 2013 were assessed. CSF kynurenine and KYNA were compared to CSF cytokine levels, acute and long-term neurologic complications, and long-term cognitive impairments. CSF kynurenine and KYNA from eight Swedish children without neurological or infectious disease admitted to Astrid Lindgren’s Children’s Hospital were quantified and used for comparison. Results Children with CM had significantly higher CSF concentration of kynurenine and KYNA than Swedish children (P < 0.0001 for both), and CSF kynurenine and KYNA were positively correlated. In children with CM, CSF kynurenine and KYNA concentrations were associated with coma duration in children of all ages (P = 0.003 and 0.04, respectively), and CSF kynurenine concentrations were associated with worse overall cognition (P = 0.056) and attention (P = 0.003) at 12-month follow-up in children ≥5 years old. Conclusions CSF KYNA and kynurenine are elevated in children with CM, indicating an inhibition of glutamatergic and cholinergic signaling. This inhibition may lead acutely to prolonged coma and long-term to impairment of attention and cognition.
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Affiliation(s)
- Dag Holmberg
- Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden.,Department of Medicine Solna, Unit of Infectious Diseases, Karolinska Institutet, Stockholm, Sweden
| | - Elisabeth Franzén-Röhl
- Department of Medicine Solna, Unit of Infectious Diseases, Karolinska Institutet, Stockholm, Sweden.,Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Richard Idro
- Department of Paediatrics and Child Health, Makerere University, Kampala, Uganda
| | - Robert O Opoka
- Department of Paediatrics and Child Health, Makerere University, Kampala, Uganda
| | - Paul Bangirana
- Department of Psychiatry, Makerere University, Kampala, Uganda
| | - Carl M Sellgren
- Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden.,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Ronny Wickström
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Anna Färnert
- Department of Medicine Solna, Unit of Infectious Diseases, Karolinska Institutet, Stockholm, Sweden.,Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Lilly Schwieler
- Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Göran Engberg
- Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden.
| | - Chandy C John
- Department of Pediatrics, Indiana University, Indianapolis, IN, USA.,Department of Pediatrics, University of Minnesota, Minnesota, USA
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25
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Orhan F, Bhat M, Sandberg K, Ståhl S, Piehl F, Svensson C, Erhardt S, Schwieler L. Tryptophan Metabolism Along the Kynurenine Pathway Downstream of Toll-like Receptor Stimulation in Peripheral Monocytes. Scand J Immunol 2017; 84:262-271. [PMID: 27607184 DOI: 10.1111/sji.12479] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 09/04/2016] [Indexed: 01/19/2023]
Abstract
Tryptophan degradation along the kynurenine pathway is of central importance for the immune function. Toll-like receptors (TLRs), representing the first line of immune defence against pathogens, are expressed in various cell types. The most abundant expression is found on monocytes, macrophages and dendritic cells. The aim of this study was to investigate whether stimulation with different TLR ligands induces the kynurenine pathway in human peripheral monocytes. Cell supernatants were analysed using a liquid chromatography/mass spectrometry to measure kynurenine, kynurenic acid (KYNA), quinolinic acid (QUIN) and tryptophan. Stimulation of TLR-2, TLR-3, TLR-4, TLR-7/8 and TLR-9 was found to induce the production of kynurenine, but only stimulation of TLR-3 increased levels of further downstream metabolites, such as KYNA and QUIN. Stimulation of TLR-1, TLR-5 and TLR-6 did not induce the kynurenine pathway. Taken together, this study provides novel evidence demonstrating that TLR activation induces a pattern of downstream tryptophan degradation along the kynurenine pathway in monocytes. The results of this study may implicate that TLRs can be used as new drug targets for the regulation of aberrant tryptophan metabolism along this pathway, a potential therapeutic strategy that may be of importance in several disorders.
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Affiliation(s)
- F Orhan
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - M Bhat
- Protein Biomarkers, Personalized Healthcare & Biomarker Laboratories, Innovative Medicines, Gothenburg, Sweden
| | - K Sandberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.,Department of Medicinal Chemistry, Science for Life Laboratory, Biomedical Center, Uppsala University, Uppsala, Sweden
| | - S Ståhl
- Protein Biomarkers, Personalized Healthcare & Biomarker Laboratories, Innovative Medicines, Gothenburg, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - F Piehl
- Department of Clinical Neuroscience Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | | | - C Svensson
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - S Erhardt
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - L Schwieler
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
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26
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Kegel ME, Johansson V, Wetterberg L, Bhat M, Schwieler L, Cannon TD, Schuppe-Koistinen I, Engberg G, Landén M, Hultman CM, Erhardt S. Kynurenic acid and psychotic symptoms and personality traits in twins with psychiatric morbidity. Psychiatry Res 2017; 247:105-112. [PMID: 27886578 DOI: 10.1016/j.psychres.2016.11.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 10/15/2016] [Accepted: 11/12/2016] [Indexed: 11/17/2022]
Abstract
Increased cytokines and kynurenic acid (KYNA) levels in cerebrospinal fluid (CSF) have been reported in patients with schizophrenia and bipolar disorder. The aim of the present study was to investigate cytokines and kynurenines in the CSF of twin pairs discordant for schizophrenia or bipolar disorder and to study these CSF markers in relation to psychotic symptoms and personality traits. CSF levels of tryptophan (TRP), KYNA, quinolinic acid (QUIN), interleukin (IL)-6, IL-8 and tumor necrosis factor-alpha (TNF-α) were analyzed in 23 twins with schizophrenia or bipolar disorder, and in their not affected co-twins. Ratings of psychotic symptoms and personality traits were made using the Scales for Assessment of Negative and Positive symptoms, the Structured Clinical Interview for DSM-IV - Axis II Disorders, and the Schizotypal Personality Questionnaire - Brief. A total score for psychotic symptoms and personality traits was constructed for analysis. CSF KYNA was associated with the score for psychotic symptom and personality traits. TNF-α and IL-8 were associated, and the intra-pair differences scores of TNF-α and IL-8 were highly correlated. Intraclass correlations indicated genetic influences on CSF KYNA, TRP, IL-8 and TNF-α. The association between KYNA and psychotic symptoms further supports a role of KYNA in psychotic disorders.
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Affiliation(s)
- Magdalena E Kegel
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Viktoria Johansson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Lennart Wetterberg
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Maria Bhat
- Protein Biomarkers, Personalized Healthcare & Biomarker Laboratories, Innovative Medicines, Gothenburg, Sweden
| | - Lilly Schwieler
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Tyrone D Cannon
- Departments of Psychology and Psychiatry, Yale University, New Haven, USA
| | - Ina Schuppe-Koistinen
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden; AstraZeneca, Research & Development, Innovative Medicines, Personalized Healthcare & Biomarkers, Translational Science Centre, Science for Life Laboratory, Solna, Sweden
| | - Göran Engberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Landén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Christina M Hultman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Sophie Erhardt
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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27
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Larsson MK, Faka A, Bhat M, Imbeault S, Goiny M, Orhan F, Oliveros A, Ståhl S, Liu XC, Choi DS, Sandberg K, Engberg G, Schwieler L, Erhardt S. Repeated LPS Injection Induces Distinct Changes in the Kynurenine Pathway in Mice. Neurochem Res 2016; 41:2243-55. [PMID: 27165635 DOI: 10.1007/s11064-016-1939-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 04/19/2016] [Accepted: 04/27/2016] [Indexed: 12/11/2022]
Abstract
The immune system has been recognized as a potential contributor to psychiatric disorders. In animals, lipopolysaccharide (LPS) is used to induce inflammation and behaviors analogous to some of the symptoms in these disorders. Recent data indicate that the kynurenine pathway contributes to LPS-induced aberrant behaviors. However, data are inconclusive regarding optimal LPS dose and treatment strategy. Here, we therefore aimed to evaluate the effects of single versus repeated administration of LPS on the kynurenine pathway. Adult C57BL6 mice were given 0.83 mg/kg LPS as a single or a repeated injection (LPS + LPS) and sacrificed after 24, 48, 72, or 120 h. Mice receiving LPS + LPS had significantly elevated brain kynurenine levels at 24 and 48 h, and elevated serum kynurenine at 24, 48 and 72 h. Brain kynurenic acid and quinolinic acid were significantly increased at 24 and 48 h in mice receiving LPS + LPS, whereas serum kynurenic acid levels were significantly decreased at 24 h. The increase of brain kynurenic acid by LPS + LPS was likely unrelated to the higher total dose as a separate group of mice receiving 1.66 mg/kg LPS as single injection 24 h prior to sacrifice did not show increased brain kynurenic acid. Serum quinolinic acid levels were not affected by LPS + LPS compared to vehicle. Animals given repeated injections of LPS showed a more robust induction of the kynurenine pathway in contrast to animals receiving a single injection. These results may be valuable in light of data showing the importance of the kynurenine pathway in psychiatric disorders.
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Affiliation(s)
- M K Larsson
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - A Faka
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - M Bhat
- Protein Biomarkers, Personalized Healthcare and Biomarkers Laboratories, Innovative Medicines, AstraZeneca, Gothenburg, Sweden
| | - S Imbeault
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - M Goiny
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - F Orhan
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - A Oliveros
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic College of Medicine, Rochester, MN, 55905, USA
| | - S Ståhl
- Translational Science Centre, Personalized Healthcare and Biomarkers Laboratories, Innovative Medicines, Science for Life Laboratory, AstraZeneca, Stockholm, Sweden
| | - X C Liu
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - D S Choi
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic College of Medicine, Rochester, MN, 55905, USA.,Neurobiology of Disease Program, Mayo Clinic College of Medicine, Rochester, MN, 55905, USA.,Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN, 55905, USA
| | - K Sandberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.,Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic College of Medicine, Rochester, MN, 55905, USA.,Department of Clinical Neuroscience, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - G Engberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - L Schwieler
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - S Erhardt
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
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28
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Schwieler L, Samuelsson M, Frye MA, Bhat M, Schuppe-Koistinen I, Jungholm O, Johansson AG, Landén M, Sellgren CM, Erhardt S. Electroconvulsive therapy suppresses the neurotoxic branch of the kynurenine pathway in treatment-resistant depressed patients. J Neuroinflammation 2016; 13:51. [PMID: 26925576 PMCID: PMC4772340 DOI: 10.1186/s12974-016-0517-7] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 02/21/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Neuroinflammation is increasingly recognized as contributing to the pathogenesis of depression. Key inflammatory markers as well as kynurenic acid (KYNA) and quinolinic acid (QUIN), both tryptophan metabolites, have been associated with depressive symptoms and suicidality. The aim of the present study is to investigate the peripheral concentration of cytokines and tryptophan and kynurenine metabolites in patients with unipolar treatment-resistant depression before and after electroconvulsive therapy (ECT), the most effective treatment for depression. METHODS Cytokines in plasma from patients with major depressive disorder (MDD; n = 19) and healthy volunteers (n = 14) were analyzed with electrochemiluminescence detection. Tryptophan and kynurenine metabolites were detected with high-performance liquid chromatography (HPLC) and LC/MS. KYNA was analyzed in a second healthy control cohort (n = 22). RESULTS Patients with MDD had increased plasma levels of interleukin (IL)-6 compared to healthy volunteers (P < 0.05). We also found an altered kynurenine metabolism in these patients displayed by decreased plasma levels of KYNA (P < 0.0001) as well as a significantly increased QUIN/KYNA ratio (P < 0.001). Plasma levels of tryptophan, kynurenine, and QUIN did not differ between patients and controls. Treatment with ECT was associated with a significant decrease in the plasma levels of tryptophan (P < 0.05), kynurenine (P < 0.01), and QUIN (P < 0.001), whereas plasma levels of KYNA did not change. The QUIN/KYNA ratio was found to significantly decrease in ECT-treated patients (P < 0.05). There was a significant inverse correlation between symptom severity and kynurenine levels at baseline (r = -0.67, P = 0.002). CONCLUSIONS This study confirms an imbalanced kynurenine pathway in MDD supporting the hypothesis of a netstimulation of N-methyl-D-aspartic acid (NMDA) receptors in the disorder. Treatment with ECT profoundly decreased QUIN, an NMDA-receptor agonist previously suggested to be implicated in the pathogenesis of depression, an effect that might have bearing for the good clinical outcome of ECT.
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Affiliation(s)
- Lilly Schwieler
- Department of Physiology and Pharmacology, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
| | - Martin Samuelsson
- Department of Physiology and Pharmacology, Karolinska Institutet, SE-171 77, Stockholm, Sweden.,Department of Clinical and Experimental Medicine, Section of Psychiatry, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - Mark A Frye
- Department of Psychiatry & Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Maria Bhat
- Protein Biomarkers, Personalized Healthcare & Biomarker Laboratories, Innovative Medicines, AstraZeneca, Gothenburg, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ina Schuppe-Koistinen
- Department of Physiology and Pharmacology, Karolinska Institutet, SE-171 77, Stockholm, Sweden.,Science for Life Laboratory, Proteomics & Nanobiotechn, Karolinska Institutet, Stockholm, Sweden
| | - Oscar Jungholm
- Department of Physiology and Pharmacology, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Anette G Johansson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Landén
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Carl M Sellgren
- Department of Physiology and Pharmacology, Karolinska Institutet, SE-171 77, Stockholm, Sweden.,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA.,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sophie Erhardt
- Department of Physiology and Pharmacology, Karolinska Institutet, SE-171 77, Stockholm, Sweden
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29
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Larsson MK, Schwieler L, Goiny M, Erhardt S, Engberg G. Chronic Antipsychotic Treatment in the Rat - Effects on Brain Interleukin-8 and Kynurenic Acid. Int J Tryptophan Res 2015; 8:49-52. [PMID: 26448689 PMCID: PMC4578548 DOI: 10.4137/ijtr.s25915] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 05/27/2015] [Accepted: 06/10/2015] [Indexed: 11/16/2022] Open
Abstract
Schizophrenia is associated with activation of the brain immune system as reflected by increased brain levels of kynurenic acid (KYNA) and proinflammatory cytokines. Although antipsychotic drugs have been used for decades in the treatment of the disease, potential effects of these drugs on brain immune signaling are not fully known. The aim of the present study is to investigate the effects of chronic treatment with antipsychotic drugs on brain levels of cytokines and KYNA. Rats were treated daily by intraperitoneally administered haloperidol (1.5 mg/kg, n = 6), olanzapine (2 mg/kg, n = 6), and clozapine (20 mg/kg, n = 6) or saline (n = 6) for 30 days. Clozapine, but not haloperidol or olanzapine-treated rats displayed significantly lower cerebrospinal fluid (CSF) levels of interleukin-8 compared to controls. Whole brain levels of KYNA were not changed in any group. Our data suggest that the superior therapeutic effect of clozapine may be a result of its presently shown immunosuppressive action. Further, our data do not support the possibility that elevated brain KYNA found in patients with schizophrenia is a result of antipsychotic treatment.
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Affiliation(s)
- Markus K Larsson
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Lilly Schwieler
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Michel Goiny
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Sophie Erhardt
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Göran Engberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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30
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Fatouros-Bergman H, Cervenka C, Flyckt L, Edman G, Schwieler L, Ikonen P, Collste K, Piehl F, Agartz I, Engberg G, Erhardt S, Farde L. Cognitive Performance in Drug-naÏve First Episode Schizophrenia (FES) Patients. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30225-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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31
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Schwieler L, Larsson MK, Skogh E, Kegel ME, Orhan F, Abdelmoaty S, Finn A, Bhat M, Samuelsson M, Lundberg K, Dahl ML, Sellgren C, Schuppe-Koistinen I, Svensson CI, Erhardt S, Engberg G. Increased levels of IL-6 in the cerebrospinal fluid of patients with chronic schizophrenia--significance for activation of the kynurenine pathway. J Psychiatry Neurosci 2015; 40:126-33. [PMID: 25455350 PMCID: PMC4354818 DOI: 10.1503/jpn.140126] [Citation(s) in RCA: 142] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Accumulating evidence indicates that schizophrenia is associated with brain immune activation. While a number of reports suggest increased cytokine levels in patients with schizophrenia, many of these studies have been limited by their focus on peripheral cytokines or confounded by various antipsychotic treatments. Here, well-characterized patients with schizophrenia, all receiving olanzapine treatment, and healthy volunteers were analyzed with regard to cerebrospinal fluid (CSF) levels of cytokines. We correlated the CSF cytokine levels to previously analyzed metabolites of the kynurenine (KYN) pathway. METHODS We analyzed the CSF from patients and controls using electrochemiluminescence detection with regard to cytokines. Cell culture media from human cortical astrocytes were analyzed for KYN and kynurenic acid (KYNA) using high-pressure liquid chromatography or liquid chromatography/mass spectrometry. RESULTS We included 23 patients and 37 controls in our study. Patients with schizophrenia had increased CSF levels of interleukin (IL)-6 compared with healthy volunteers. In patients, we also observed a positive correlation between IL-6 and the tryptophan:KYNA ratio, indicating that IL-6 activates the KYN pathway. In line with this, application of IL-6 to cultured human astrocytes increased cell medium concentration of KYNA. LIMITATIONS The CSF samples had been frozen and thawed twice before analysis of cytokines. Median age differed between patients and controls. When appropriate, all present analyses were adjusted for age. CONCLUSION We have shown that IL-6, KYN and KYNA are elevated in patients with chronic schizophrenia, strengthening the idea of brain immune activation in patients with this disease. Our concurrent cell culture and clinical findings suggest that IL-6 induces the KYN pathway, leading to increased production of the N-methyl-D-aspartate receptor antagonist KYNA in patients with schizophrenia.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Göran Engberg
- Correspondence to: G. Engberg, Department of Physiology and Pharmacology, Karolinska Institutet SE-171 77, Stockholm, Sweden;
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32
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Kegel ME, Bhat M, Skogh E, Samuelsson M, Lundberg K, Dahl ML, Sellgren C, Schwieler L, Engberg G, Schuppe-Koistinen I, Erhardt S. Imbalanced kynurenine pathway in schizophrenia. Int J Tryptophan Res 2014; 7:15-22. [PMID: 25288889 PMCID: PMC4179604 DOI: 10.4137/ijtr.s16800] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 06/23/2014] [Accepted: 06/24/2014] [Indexed: 12/27/2022] Open
Abstract
Several studies suggest a role for kynurenic acid (KYNA) in the pathophysiology of schizophrenia. It has been proposed that increased brain KYNA levels in schizophrenia result from a pathological shift in the kynurenine pathway toward enhanced KYNA formation, away from the other branch of the pathway leading to quinolinic acid (QUIN). Here we investigate the levels of QUIN in cerebrospinal fluid (CSF) of patients with schizophrenia and healthy controls, and relate those to CSF levels of KYNA and other kynurenine metabolites from the same individuals. CSF QUIN levels from stable outpatients treated with olanzapine (n = 22) and those of controls (n = 26) were analyzed using liquid chromatography-mass spectrometry. No difference in CSF QUIN levels between patients and controls was observed (20.6 ± 1.5 nM vs. 18.2 ± 1.1 nM, P = 0.36). CSF QUIN was positively correlated to CSF kynurenine and CSF KYNA in patients but not in controls. The CSF QUIN/KYNA ratio was lower in patients than in controls (P = 0.027). In summary, the present study offers support for an over-activated and imbalanced kynurenine pathway, favoring the production of KYNA over QUIN in patients with schizophrenia.
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Affiliation(s)
- Magdalena E Kegel
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Maria Bhat
- AstraZeneca, Research and Development, Innovative Medicines, Personalised Healthcare and Biomarkers, Translational Science Centre, Science for Life Laboratory, Solna, Sweden. ; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Elisabeth Skogh
- Department of Clinical and Experimental Medicine, Section of Psychiatry, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - Martin Samuelsson
- Department of Clinical and Experimental Medicine, Section of Psychiatry, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - Kristina Lundberg
- Department of Clinical and Experimental Medicine, Section of Psychiatry, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - Marja-Liisa Dahl
- Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Carl Sellgren
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Lilly Schwieler
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Göran Engberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Ina Schuppe-Koistinen
- AstraZeneca, Research and Development, Innovative Medicines, Personalised Healthcare and Biomarkers, Translational Science Centre, Science for Life Laboratory, Solna, Sweden. ; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Sophie Erhardt
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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33
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Liu X, Holtze M, Powell SB, Terrando N, Larsson MK, Persson A, Olsson SK, Orhan F, Kegel M, Asp L, Goiny M, Schwieler L, Engberg G, Karlsson H, Erhardt S. Behavioral disturbances in adult mice following neonatal virus infection or kynurenine treatment--role of brain kynurenic acid. Brain Behav Immun 2014; 36:80-9. [PMID: 24140727 PMCID: PMC3947209 DOI: 10.1016/j.bbi.2013.10.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2013] [Revised: 09/25/2013] [Accepted: 10/11/2013] [Indexed: 12/31/2022] Open
Abstract
Exposure to infections in early life is considered a risk-factor for developing schizophrenia. Recently we reported that a neonatal CNS infection with influenza A virus in mice resulted in a transient induction of the brain kynurenine pathway, and subsequent behavioral disturbances in immune-deficient adult mice. The aim of the present study was to investigate a potential role in this regard of kynurenic acid (KYNA), an endogenous antagonist at the glycine site of the N-methyl-D-aspartic acid (NMDA) receptor and at the cholinergic α7 nicotinic receptor. C57BL/6 mice were injected i.p. with neurotropic influenza A/WSN/33 virus (2400 plaque-forming units) at postnatal day (P) 3 or with L-kynurenine (2×200 mg/kg/day) at P7-16. In mice neonatally treated with L-kynurenine prepulse inhibition of the acoustic startle, anxiety, and learning and memory were also assessed. Neonatally infected mice showed enhanced sensitivity to D-amphetamine-induced (5 mg/kg i.p.) increase in locomotor activity as adults. Neonatally L-kynurenine treated mice showed enhanced sensitivity to D-amphetamine-induced (5 mg/kg i.p.) increase in locomotor activity as well as mild impairments in prepulse inhibition and memory. Also, D-amphetamine tended to potentiate dopamine release in the striatum in kynurenine-treated mice. These long-lasting behavioral and neurochemical alterations suggest that the kynurenine pathway can link early-life infection with the development of neuropsychiatric disturbances in adulthood.
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Affiliation(s)
- Xicong Liu
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Maria Holtze
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Susan B Powell
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Niccolò Terrando
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Markus K. Larsson
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Anna Persson
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Sara K. Olsson
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Funda Orhan
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Magdalena Kegel
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Linnea Asp
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Michel Goiny
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Lilly Schwieler
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Göran Engberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Håkan Karlsson
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Sophie Erhardt
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
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Atlas A, Franzen-Röhl E, Söderlund J, Jönsson EG, Samuelsson M, Schwieler L, Sköldenberg B, Engberg G. Sustained elevation of kynurenic Acid in the cerebrospinal fluid of patients with herpes simplex virus type 1 encephalitis. Int J Tryptophan Res 2013; 6:89-96. [PMID: 24324341 PMCID: PMC3855257 DOI: 10.4137/ijtr.s13256] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Herpes simplex virus (HSV) type 1 encephalitis (HSE) is a viral infectious disease with commonly occurring neurodegeneration and neurological/cognitive long-term sequelae. Kynurenic acid (KYNA) is a neuroactive tryptophan metabolite, which is elevated in the cerebrospinal fluid (CSF) during viral infection as a result of immune activation. The aim of the study was to investigate the role of endogenous brain KYNA for the long-term outcome of the disease. CSF KYNA concentration was analyzed in 25 HSE patients along the course of the disease and compared with that of 25 age-matched healthy volunteers. Within 3 weeks of admission CSF KYNA of HSE patients was markedly elevated (median 33.6 nM) compared to healthy volunteers (median 1.45 nM). Following a decline observed after 1-2 months, levels of CSF KYNA were elevated more than 1 year after admission (median 3.4 nM range: 1-9 years). A negative correlation was found between initial CSF KYNA concentrations and severity of the long-term sequelae. This study show a marked elevation in CSF KYNA from patients with HSE, most pronounced during the acute phase of the disease and slowly declining along the recovery. We propose that brain KYNA might potentially protect against neurodegeneration while causing a long-lasting loss in cognitive function associated with the disease.
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Affiliation(s)
- Ann Atlas
- Infectious Diseases Unit, Department of Medicine, Karolinska University Hospital, Stockholm, Sweden
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Abstract
BACKGROUND Kynurenic acid (KYNA) is a neuroactive metabolite of tryptophan that is thought to regulate cognitive functions. Previous studies have shown that levels of KYNA increase during virus infection and that this metabolite interacts with the immune system. OBJECTIVE The aim of the study was to investigate whether patients with tick-borne encephalitis (TBE), a viral infectious disease associated with long-term cognitive impairment, have increased levels of KYNA in the cerebrospinal fluid (CSF). METHODS CSF KYNA was analysed using high-performance liquid chromatography in 108 patients with TBE and 52 age-matched controls. Patients were classified according to the severity of TBE: mild (47%), moderate (44%) or severe (9%). RESULTS Concentrations of CSF KYNA were considerably higher in patients with TBE (5.3 nmol L(-1) ) than in control subjects (0.99 nmol L(-1) ). KYNA concentration in the CSF varied greatly amongst individuals with TBE and increased (P < 0.05) with the severity of disease. CONCLUSIONS This is the first study to demonstrate increased levels of CSF KYNA in patients with TBE. The importance of brain KYNA in both immune modulation and neurotransmission raises the possibility that abnormal levels of the compound in TBE might play a part in the pathophysiology of the disease. A detailed knowledge of endogenous brain KYNA during the course of CNS infection might yield further insights into the neuroimmunological role of the compound and may also provide new pharmacological approaches for the treatment of cognitive symptoms.
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Affiliation(s)
- M Holtze
- Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden
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Holtze M, Saetre P, Engberg G, Schwieler L, Werge T, Andreassen OA, Hall H, Terenius L, Agartz I, Jönsson EG, Schalling M, Erhardt S. Kynurenine 3-monooxygenase polymorphisms: relevance for kynurenic acid synthesis in patients with schizophrenia and healthy controls. J Psychiatry Neurosci 2012; 37:53-7. [PMID: 21693093 PMCID: PMC3244499 DOI: 10.1503/jpn.100175] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Patients with schizophrenia show increased brain and cerebrospinal fluid (CSF) concentrations of the endogenous N-methyl-D-aspartate receptor antagonist kynurenic acid (KYNA). This compound is an end-metabolite of the kynurenine pathway, and its formation indirectly depends on the activity of kynurenine 3-monooxygenase (KMO), the enzyme converting kynurenine to 3-hydroxykynurenine. METHODS We analyzed the association between KMO gene polymorphisms and CSF concentrations of KYNA in patients with schizophrenia and healthy controls. Fifteen single nucleotide polymorphisms (SNPs) were selected covering KMO and were analyzed in UNPHASED. RESULTS We included 17 patients with schizophrenia and 33 controls in our study. We found an association between a KMO SNP (rs1053230), encoding an amino acid change of potential importance for substrate interaction, and CSF concentrations of KYNA. LIMITATIONS Given the limited sample size, the results are tentative until replication. CONCLUSION Our results suggest that the nonsynonymous KMO SNP rs1053230 influences CSF concentrations of KYNA.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Erik G. Jönsson
- Correspondence to: Dr. E.G. Jönsson, Department of Clinical Neuroscience, HUBIN, Project, Karolinska Institutet and University Hospital, R5:00, SE-171 76 Stockholm, Sweden;
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Holtze M, Saetre P, Erhardt S, Schwieler L, Werge T, Hansen T, Nielsen J, Djurovic S, Melle I, Andreassen OA, Hall H, Terenius L, Agartz I, Engberg G, Jönsson EG, Schalling M. Kynurenine 3-monooxygenase (KMO) polymorphisms in schizophrenia: an association study. Schizophr Res 2011; 127:270-2. [PMID: 21030213 DOI: 10.1016/j.schres.2010.10.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2009] [Revised: 09/28/2010] [Accepted: 10/01/2010] [Indexed: 11/17/2022]
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Schwieler L, Linderholm KR, Nilsson-Todd LK, Erhardt S, Engberg G. Clozapine interacts with the glycine site of the NMDA receptor: Electrophysiological studies of dopamine neurons in the rat ventral tegmental area. Life Sci 2008; 83:170-5. [DOI: 10.1016/j.lfs.2008.05.014] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2008] [Revised: 03/12/2008] [Accepted: 05/25/2008] [Indexed: 10/22/2022]
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Abstract
In recent years progress in the field of schizophrenia research has led to the suggestion that dopamine only plays an intermediary role in the pathophysiology of the disease and that the main abnormalities lie elsewhere. In particular, deficits in brain glutamatergic systems are suggested to play a prominent role in the pathophysiology of the disease. Kynurenic acid is an endogenous glutamate antagonist with a preferential action at the glycine-site of the N-methyl-D-aspartate-receptor. Mounting evidence indicates that the compound is significantly involved in basal neurophysiological processes in the brain. Thus, pharmacologically elevated levels of kynurenic acid, in similarity to systemic administration of phencyclidine or ketamine, were associated with increased firing rate and burst firing activity of midbrain dopamine neurons, indicating per se that elevated levels of brain kynurenic acid is associated with psychotomimetic effects. Indeed, cerebrospinal fluid level of kynurenic acid was elevated in schizophrenic patients as compared to healthy controls. The present paper also describes a prostaglandin-mediated regulation of kynurenic acid formation as well as a relationship between brain kynurenic acid concentration and the excitatory responses of ventral tegmental area dopamine neurons by clozapine and nicotine. Our results suggest that kynurenic acid contributes to the pathogenesis of schizophrenia and link the dopamine hypothesis of schizophrenia together with the idea of a deficiency in glutamatergic function in this disease.
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Affiliation(s)
- Sophie Erhardt
- Karolinska Institutet, Department of Physiology and Pharmacology, Stockholm, Sweden.
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Atlas A, Gisslén M, Nordin C, Lindström L, Schwieler L. Acute psychotic symptoms in HIV-1 infected patients are associated with increased levels of kynurenic acid in cerebrospinal fluid. Brain Behav Immun 2007; 21:86-91. [PMID: 16603336 DOI: 10.1016/j.bbi.2006.02.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2005] [Revised: 01/27/2006] [Accepted: 02/26/2006] [Indexed: 11/21/2022] Open
Abstract
Human immunodeficiency virus type 1 (HIV-1) infection is associated with psychiatric complications including cognitive impairment, affective disorders, and psychosis. Previous studies have revealed a disturbed kynurenine metabolism in these patients leading to increased levels of neuroactive compounds acting at glutamatergic neurotransmission. Kynurenic acid (KYNA), one of these metabolites is a glutamate-receptor antagonist, preferentially blocking the glycine site of the N-methyl-d-aspartate (NMDA) receptor. Increased levels of brain KYNA have been suggested to induce a NMDA receptor hypofunction that is associated with psychotic symptoms. In the present study, we analyze the concentration of KYNA in the cerebrospinal fluid (CSF) from HIV-1 infected patients (n=22), including HIV-1 infected patients with psychotic symptoms (n=8) and HIV-1 infected patients without psychiatric symptoms (n=14). We found that HIV-1 infected patients had significantly higher median concentration of CSF KYNA (3.02nM) compared to healthy controls (1.17nM). Furthermore, CSF KYNA levels were significantly elevated in HIV-1 infected patients with psychotic symptoms (4.54nM) compared to patients with HIV-1 without psychiatric symptoms (2.28nM). Present results indicate that increased levels of CSF KYNA may be associated with development of psychotic symptoms in HIV-1 infected patients.
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Affiliation(s)
- Ann Atlas
- Infectious Diseases Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Solna, SE-171 76 Stockholm, Sweden.
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Schwieler L, Erhardt S, Nilsson L, Linderholm K, Engberg G. Effects of COX-1 and COX-2 inhibitors on the firing of rat midbrain dopaminergic neurons--possible involvement of endogenous kynurenic acid. Synapse 2006; 59:290-8. [PMID: 16416446 DOI: 10.1002/syn.20241] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Kynurenic acid (KYNA) is an endogenous glutamate-receptor antagonist with a preferential action at the glycine-site of the NMDA-receptor. In the present in vivo study, the importance of brain KYNA to modulate the activity of dopamine (DA) neurons in the ventral tegmental area (VTA) was analyzed by utilizing the decrease in brain KYNA formation induced by the cyclooxygenase (COX)-2 inhibitor parecoxib. A reduction in brain KYNA concentration (39-44%) by parecoxib (25 mg/kg, i.v., 1 h or, i.p., 3.5 h) was associated with a decreased firing rate and burst firing activity. In concordance, an increase in brain KYNA concentration (150-300%), induced by the COX-1 inhibitor indomethacin (50 mg/kg, i.v., 1 h or, i.p., 3.5 h), produced opposite effects, that is, increased firing rate and burst firing activity. The decrease and increase in neuronal firing of VTA DA neurons by the COX-inhibitors was reversed by L-701,324 (antagonist at the NMDA-glycine site; 0.06-2 mg/kg, i.v.) and by D-cycloserine (partial agonist at the NMDA-glycine site; 2-32 mg/kg, i.v.), respectively. In addition, the parecoxib-induced decrease in firing rate and burst firing activity was effectively blocked by pretreatment with kynurenine (5 mg/kg, i.p., 30 min), the immediate precursor of KYNA. Present results suggest that the action of COX-inhibitors on the firing of VTA DA neurons are linked to their effects on KYNA formation and that endogenous KYNA is tonically modulating the neuronal activity of VTA DA neurons. Such a modulatory action of KYNA should be of importance for the functioning of mesocorticolimbic DA pathway.
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Affiliation(s)
- Lilly Schwieler
- Department of Physiology and Pharmacology, Karolinska Institutet, 171 77 Stockholm, Sweden
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Nilsson LK, Schwieler L, Engberg G, Linderholm KR, Erhardt S. Activation of noradrenergic locus coeruleus neurons by clozapine and haloperidol: involvement of glutamatergic mechanisms. Int J Neuropsychopharmacol 2005; 8:329-39. [PMID: 15737250 DOI: 10.1017/s1461145705005080] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2004] [Revised: 10/13/2004] [Indexed: 11/07/2022] Open
Abstract
The major brain noradrenergic nucleus locus coeruleus (LC) has long been thought to be involved in states of alertness and cognitive processes. These functional characteristics make this nucleus interesting with regard to the signs of schizophrenia, especially the negative symptoms of the disease. In the present in-vivo electrophysiological study we analyse a putative interaction between endogenous kynurenic acid (KYNA) and the antipsychotic drugs clozapine and haloperidol on noradrenergic LC neurons. Previous studies have shown that systemically administered antipsychotic drugs increase the neuronal activity of LC noradrenaline (NA) neurons. In line with these findings, our results show that clozapine (1.25-10 mg/kg i.v.) and haloperidol (0.05-0.08 mg/kg i.v.) increased the firing rate of LC NA neurons in anaesthetized rats. Pretreatment with PNU 156561A (40 mg/kg i.v., 3 h), a potent inhibitor of kynurenine 3-hydroxylase, produced a 2-fold increase in rat brain KYNA levels. This treatment prevented the increase in firing rate of LC NA neurons induced by haloperidol (0.05-0.08 mg/kg i.v.) and clozapine in high doses (2.5-10 mg/kg i.v.). However, the excitatory action of the lowest dose of clozapine (1.25 mg/kg i.v.) was not abolished by elevated levels of brain KYNA. Furthermore, pretreatment with L-701,324 (4 mg/kg i.v.) a selective antagonist at the glycine site of the NMDA receptor prevented the excitatory effects of both clozapine and haloperidol. The present results suggest that the excitation of LC NA neurons by haloperidol and clozapine involves a glutamatergic component.
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Affiliation(s)
- Linda K Nilsson
- Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden.
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Schwieler L, Erhardt S, Erhardt C, Engberg G. Prostaglandin-mediated control of rat brain kynurenic acid synthesis--opposite actions by COX-1 and COX-2 isoforms. J Neural Transm (Vienna) 2004; 112:863-72. [PMID: 15517427 DOI: 10.1007/s00702-004-0231-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2004] [Accepted: 08/28/2004] [Indexed: 10/26/2022]
Abstract
Kynurenic acid (KYNA), an endogenous glutamate-receptor antagonist preferentially blocking NMDA-receptors, has analgesic properties and has also been implicated in the pathophysiology of schizophrenia. Recently, the non-steroid anti-inflammatory drug (NSAID) diclofenac was found to increase rat brain KYNA. Here, we analyze whether cyclooxygenase (COX)-1 or COX-2 modulate the levels of rat brain KYNA. The non-selective COX-inhibitor diclofenac (50 mg/kg, i.p.) or indomethacin (50 mg/kg, i.p.), a non-selective inhibitor with a preferential selectivity for COX-1, produced an elevation in brain KYNA. In contrast, the COX-2 selective inhibitors parecoxib (25 mg/kg, i.p.) or meloxicam (5 mg/kg, i.p.) decreased brain KYNA. Both elevation and lowering of brain KYNA by indomethacin or parecoxib, respectively, were prevented by the prostaglandin E1/E2 agonist misoprostol (1 mg/kg, s.c.). It is proposed that increased brain KYNA formation induced by NSAIDs displaying an inhibitory action on COX-1 contribute to their analgesic efficacy as well as to their psychiatric side effects.
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Affiliation(s)
- L Schwieler
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
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Erhardt S, Schwieler L, Emanuelsson C, Geyer M. Endogenous kynurenic acid disrupts prepulse inhibition. Biol Psychiatry 2004; 56:255-60. [PMID: 15312813 DOI: 10.1016/j.biopsych.2004.06.006] [Citation(s) in RCA: 137] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2004] [Revised: 05/17/2004] [Accepted: 06/02/2004] [Indexed: 10/26/2022]
Abstract
BACKGROUND Recent studies show that endogenous levels of kynurenic acid (KYNA) are increased in the cerebrospinal fluid of schizophrenic patients. Prepulse inhibition (PPI) of the acoustic startle reflex is an operational measure of sensorimotor gating that is reduced in neuropsychiatric disorders, such as schizophrenia. Previous studies show that administration of N-methyl-D-aspartate (NMDA) receptor antagonists, such as phencyclidine or MK-801, leads to deficits in sensorimotor gating that mimic those observed in schizophrenic patients. METHODS The present study examined the effects of the endogenous NMDA receptor antagonist KYNA on startle and PPI in rats. Elevation of endogenous brain levels of KYNA was achieved through intraperitoneal (IP) administration of kynurenine (100 mg/kg), the precursor of KYNA, or by intravenous administration of PNU 156561A (10 mg/kg). RESULTS A fourfold increase in brain KYNA levels, as induced by kynurenine or PNU 156561A, significantly reduced PPI. There were no differences in startle magnitudes between control rats and drug-treated rats. The disruption of PPI was restored by administration of the antipsychotic drugs haloperidol (.2 mg/kg, IP) or clozapine (7.5 mg/kg, IP). CONCLUSIONS The present results suggest that brain KYNA serves as an endogenous modulator of PPI and are consistent with the hypothesis that KYNA contributes to the pathophysiology of schizophrenia.
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Affiliation(s)
- Sophie Erhardt
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden.
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Abstract
The mode of action by which the atypical antipsychotic drug clozapine exerts its superior efficacy to ameliorate both positive and negative symptoms is still relatively unknown. A recent study shows that a pharmacologically increased concentration of brain kynurenic acid, an endogenous antagonist at the glycine-site of the NMDA receptor as well as at the alpha7* nicotinic receptor, reverses the excitatory effects of clozapine on ventral tegmental area (VTA) dopamine (DA) neurons into an inhibitory action. In the present in vivo electrophysiological study, we further investigated the mechanisms of action of clozapine on VTA DA neurons. In control rats intravenously administered clozapine (1.25-10 mg/kg) was associated with increased firing rate and burst firing activity of VTA DA neurons. However, administration of the N-methyl-D-aspartate (NMDA)-receptor antagonist MK 801 blocked the excitatory action of clozapine. Moreover, in rats pretreated with the antagonist of the glycine-site of the NMDA receptor, L-701,324, the effects of clozapine on VTA DA neurons were converted to purely inhibitory responses, including a decrease in firing rate and burst firing activity. Pretreatment with the alpha7* nicotinic receptor antagonist MLA did not affect the excitatory action of clozapine on VTA DA neurons. The results of the present study suggest that clozapine interacts with the NMDA receptor complex. In this regard, clozapine could affect the glycine site of the NMDA receptor or tentatively inhibit the glycine transporter. The inhibitory action of clozapine on VTA DA neurons may account for its beneficial effects in ameliorating symptoms of schizophrenia and may suggest further studies to investigate a role of the glycine site of the NMDA receptor as a target for novel antipsychotics.
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Affiliation(s)
- Lilly Schwieler
- Department of Physiology and Pharmacology, Karolinska Institute, SE 171 77 Stockholm, Sweden
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Schwieler L, Erhardt S. Inhibitory action of clozapine on rat ventral tegmental area dopamine neurons following increased levels of endogenous kynurenic acid. Neuropsychopharmacology 2003; 28:1770-7. [PMID: 12865892 DOI: 10.1038/sj.npp.1300255] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The mode of action by which the atypical antipsychotic drug clozapine exerts its superior efficacy to ameliorate both positive and negative symptoms is still unknown. In the present in vivo electrophysiological study, we investigate the effects of haloperidol (a typical antipsychotic drug) and clozapine on ventral tegmental area (VTA) dopamine (DA) neurons in a situation of hyperdopaminergic activity in order to mimic tentatively a condition similar to that seen in schizophrenia. Increased DA transmission was induced by elevating endogenous levels of the N-methyl-D-aspartate receptor and alpha7(*) nicotinic receptor antagonist kynurenic acid (KYNA; by means of PNU 156561A, 40 mg /kg, i.v.). In control rats, i.v. administered haloperidol (0.05-0.8 mg/kg) or clozapine (1.25-10 mg/kg) was associated with increased firing rate and burst firing activity of VTA DA neurons. However, in rats displaying hyperdopaminergia (induced by elevated levels of KYNA), the effects of clozapine on VTA DA neurons were converted into pure inhibitory responses, including decrease in burst firing activity. In contrast, haloperidol still produced an excitatory action on VTA DA neurons in rats with elevated levels of endogenous brain KYNA. The results of the present study suggest that clozapine facilitates or inhibits VTA DA neurotransmission, depending on brain concentration of KYNA. Such an effect of clozapine may be related to its unique effect in also ameliorating negative symptoms of schizophrenia.
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Affiliation(s)
- Lilly Schwieler
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden.
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Abstract
The mode of action by which propofol induces anaesthesia is not fully understood, although several studies suggest that the compound acts via potentiation of brain GABA(A)-receptors. The aim of the present study is to investigate a putative GABA(B)-receptor agonistic action of propofol. For this purpose the action of propofol on a GABA-receptor mediated regulation of dopamine neurons was analyzed with extracellular single unit recordings of dopaminergic neurons of the substantia nigra in chloral hydrate anaesthetized rats. Intravenous administration of propofol (1-16 mg/kg) was found to dose-dependently decrease the firing rate and burst firing activity of nigral DA neurons. These effects by propofol were effectively antagonized by pretreatment with the selective GABA(B)-receptor antagonist CGP 35348 (200 mg/kg, i.v.) but not by pretreatment with the GABA(A)-receptor antagonist picrotoxin (4.5 mg/kg, i.v.). It is proposed that an activation of central GABA(B)-receptors may, at least partially, contribute to the anesthetic properties of propofol.
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Affiliation(s)
- L Schwieler
- Department of Physiology and Pharmacology, Karolinska Institute, 171 77, Stockholm, Sweden
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Abstract
In recent years the "dopamine (DA) hypothesis of schizophrenia", has been modified into a more diversified view where an attenuated glutamatergic neurotransmission is believed to participate in the pathogenesis of the disease. Thus, schizophrenia may be regarded as a glutamate deficiency disorder. Kynurenic acid (KYNA) is an endogenous glutamate antagonist with a preferential action at the glycinesite of the N-methyl D-aspartate (NMDA)-receptor. Mounting evidence indicates that the compound is significantly involved in basal neurophysiological processes in the brain. Thus, in anaesthetized rats, pharmacologically elevated KYNA concentration (by means of PNU 156561A) was associated with increased firing rate and burst firing activity of midbrain DA neurons. Similar alterations in basal firing characteristics are also observed following systemic administration of PCP or ketamine, indicating per se that elevated levels of brain KYNA is associated with psychotomimetic effects. Indeed, cerebrospinal fluid (CSF) level of kynurenic acid was elevated in 28 male first episode schizophrenic patients (1.67 +/- 0.27 nM) as compared to 17 male healthy controls (0.97 +/- 0.07 nM. Elevated brain KYNA concentration was also found to dramatically affect the responsivity of rat midbrain DA neurons to the atypical antipsychotic drug clozapine. Thus, whereas clozapine produced increased firing rate and burst firing activity of these neurons in untreated rats, elevation of brain KYNA levels was found to reverse the action of clozapine into a pure inhibitory response. The present study suggests a contribution of KYNA in the pathogenesis of schizophrenia and link the dopamine hypothesis of schizophrenia together with the idea of a deficiency of glutamate function in this disease.
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Affiliation(s)
- Sophie Erhardt
- Dept. of Physiology and Pharmacology, Karolinska Institutet, SE 171 77 Stockholm, Sweden.
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Abstract
In the present electrophysiological study the mechanisms by which nicotine activates dopamine neurons in the ventral tegmental area in anesthetized Sprague-Dawley rats were analyzed. Intravenous administration of nicotine caused a dose-dependent increase in firing rate and percentage of spikes fired in bursts of ventral tegmental area dopamine neurons. However, this activation was preceded by an instantaneous but short-lasting inhibition of the firing rate. The excitation of dopamine neurons by nicotine (1.5-400 microg/kg i.v.) was antagonized and even reversed into an inhibitory response by elevated levels (four-fold) of the endogenous glutamate receptor antagonist kynurenic acid, as induced by a potent inhibitor of kynurenine 3-hydroxylase (PNU 156561A, 40 mg/kg, i.v., 5-9 h). The antagonistic action induced by PNU 156561A pretreatment was prevented by administration of D-cycloserine (128 mg/kg, i.v., 5 min). Administration of the GABA(B)-receptor antagonist CGP 35348 (200 mg/kg, i.v., 3 min) facilitated the nicotine-induced increase in burst firing activity of dopamine neurons and antagonized the short-lasting decrease in firing rate by nicotine. The results of the present study show that nicotine produces both inhibition and excitation of ventral tegmental area dopamine neurons, actions that appear to be related to the release of GABA and glutamate, respectively. Whereas the excitatory action of nicotine may be associated with motivational processes underlying learning and cognitive behavior, the inhibitory action of the drug may play a more prominent role in the situation of a profound dysregulation of the mesocorticolimbic dopamine system and may help to explain the high prevalence of tobacco-smoking in schizophrenics.
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Affiliation(s)
- Sophie Erhardt
- Department of Physiology and Pharmacology, Karolinska Institute, SE 171 77 Stockholm, Sweden.
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