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Athira KV, Bandopadhyay S, Samudrala PK, Naidu VGM, Lahkar M, Chakravarty S. An Overview of the Heterogeneity of Major Depressive Disorder: Current Knowledge and Future Prospective. Curr Neuropharmacol 2020; 18:168-187. [PMID: 31573890 PMCID: PMC7327947 DOI: 10.2174/1570159x17666191001142934] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 08/05/2019] [Accepted: 09/27/2019] [Indexed: 02/08/2023] Open
Abstract
Major depressive disorder (MDD) is estimated to impose maximum debilitating effects on the society by 2030, with its critical effects on health, functioning, quality of life and concomitant high levels of morbidity and mortality. Yet, the disease is inadequately understood, diagnosed and treated. Moreover, with the recent drastic rise in the pace of life, stress has materialized as one of the most potent environmental factors for depression. In this scenario, it is important to understand the modern pathogenetic hypotheses and mechanisms, and possibly try to shift from the traditional approaches in depression therapy. These include the elaboration of pathophysiological changes in heterogeneous systems such as genetic, epigenetic, serotonergic, noradrenergic, gamma-aminobutyric acid, glutamatergic and endocannabinoid systems, neurotrophic factors, HPA axis, immune system as well as cellular stress mechanisms. These components interact with each other in a complex matrix and further elucidation of their mechanism and cascade pathways are needed. This might aid in the identification of MDD subtypes as well as the development of sophisticated biomarkers. Further, characterization might also aid in developing multitargeted therapies that hold much promise as compared to the conventional monoamine based treatment. New candidate pharmacons, refined psychotherapeutic modalities, advanced neuro-surgical and imaging techniques as well as the implementation of pharmacokinetic, pharmacogenetic prescribing guidelines constitute the emerging expanses of MDD treatment.
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Affiliation(s)
- Kaipuzha Venu Athira
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Guwahati, 781125, Assam, India.,Applied Biology Division, CSIR-Indian Institute of Chemical Technology, Tarnaka, Uppal Road, Hyderabad 500007, India.,Department of Pharmacology, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, 682 041, Kerala, India
| | - Sikta Bandopadhyay
- Applied Biology Division, CSIR-Indian Institute of Chemical Technology, Tarnaka, Uppal Road, Hyderabad 500007, India
| | - Pavan Kumar Samudrala
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Guwahati, 781125, Assam, India
| | - V G M Naidu
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Guwahati, 781125, Assam, India
| | - Mangala Lahkar
- Department of Pharmacology, Gauhati Medical College, Guwahati, 781032, Assam, India
| | - Sumana Chakravarty
- Applied Biology Division, CSIR-Indian Institute of Chemical Technology, Tarnaka, Uppal Road, Hyderabad 500007, India
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52
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Fox HC, Milivojevic V, MacDougall A, LaVallee H, Simpson C, Angarita GA, Sinha R. Stress-related suppression of peripheral cytokines predicts future relapse in alcohol-dependent individuals with and without subclinical depression. Addict Biol 2020; 25:e12832. [PMID: 31736187 DOI: 10.1111/adb.12832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 07/22/2019] [Accepted: 08/28/2019] [Indexed: 12/01/2022]
Abstract
Chronic alcohol abuse and depressive symptoms are both associated with peripheral cytokine changes. Despite this, cytokine adaptations have not been assessed in co-morbid populations or prospectively as predictors of relapse. We examine cytokine responses to stress in alcohol-dependent individuals and social drinkers, both with and without subclinical depression. We also examine the potential link between cytokine adaptations in response to stress and prospective alcohol relapse risk. Thirty-three, alcohol-dependent individuals (21 with and 12 without high depressive symptoms) and 37 controls (16 with and 21 without high depressive symptoms) were exposed to two 5-minute personalized guided imagery conditions (stress and neutral) across consecutive days in a randomized and counterbalanced order. Alcohol craving and serum measures of tumor necrosis factor alpha (TNFα), tumor necrosis factor receptor 1 (TNFR1), interleukin-6 (IL-6), and interleukin-1 receptor antagonist (IL-1ra) were collected prior to and following imagery exposure. Following treatment discharge, follow-up interviews were conducted over 90 days to assess relapse. Dampened IL-1ra and IL-6 in response to stress was observed as a function of alcohol dependence and not moderated by depressive symptoms. Lower levels of IL-6 following stress also predicted greater drinking days following treatment. Conversely, high depressive symptomatology was associated solely with pro-inflammatory adaptations. Stress-related suppression of TNFα predicted drinking severity only in alcohol-dependent individuals with subclinical depression, and suppressed TNFR1 following stress was only seen in individuals with subclinical depression. Stress-induced suppression of pro-inflammatory TNF markers may indicate a risk factor for alcohol-dependent individuals with co-occurring depressive symptoms.
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Affiliation(s)
- Helen C. Fox
- Department of Psychiatry, School of Medicine Stony Brook University Stony Brook NY USA
| | - Verica Milivojevic
- The Yale Stress Center, Department of Psychiatry Yale University School of Medicine New Haven CT USA
| | - Alicia MacDougall
- The Yale Stress Center, Department of Psychiatry Yale University School of Medicine New Haven CT USA
| | - Heather LaVallee
- The Yale Stress Center, Department of Psychiatry Yale University School of Medicine New Haven CT USA
| | - Christine Simpson
- Department of Internal Medicine Yale University School of Medicine New Haven CT USA
| | - Gustavo A. Angarita
- Clinical Neuroscience Research Unit, The Connecticut Mental Health Center, Department of Psychiatry Yale University School of Medicine New Haven CT USA
| | - Rajita Sinha
- The Yale Stress Center, Department of Psychiatry Yale University School of Medicine New Haven CT USA
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53
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Takekawa D, Kudo T, Saito J, Nikaido Y, Sawada K, Takanashi S, Hirota K. Lower fractional exhaled nitric oxide levels are associated with depressive symptom in males: A population-based cross-sectional study. Psychiatry Res 2020; 293:113453. [PMID: 32971403 DOI: 10.1016/j.psychres.2020.113453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 09/13/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND We examined cross-sectional associations between depression and both inflammatory markers and fractional exhaled nitric oxide (FeNO). METHODS This cross-sectional study is a secondary analysis of the data of the Iwaki Health Promotion Project 2016 (1,148 subjects). We analyzed the subjects' characteristics and laboratory data including plasma interleukin (IL)-6, high-sensitivity C-reactive protein (hs-CRP), and FeNO. The subjects with Center for Epidemiologic Studies Depression Scale scores ≥16 were assigned to the depression group. We performed a multivariate logistic regression analysis to determine whether inflammatory markers and FeNO were associated with depression. RESULTS We assessed 1,099 subjects (430 males, 669 females). The depression group was 237 subjects (21.5%) [84 males (19.5%), 153 females (22.9%)]. The non-depression group was 862 subjects (346 males and 516 females). There were no significant differences in IL-6, hs-CRP, or FeNO between both groups. However, the multivariate logistic regression analysis indicated that lower FeNO was significantly associated with depression in males after adjusting for possible confounding factors (age, BMI, comorbidities, high-sensitivity troponin T, FEV1%, asthma, antidepressant use, smoker and alcohol drinker) (per 1 bpm increase, OR: 0.982; 95%CI: 0.967-0.998; p = 0.032). CONCLUSION Our findings indicate that lower FeNO may be associated with depression in males.
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Affiliation(s)
- Daiki Takekawa
- Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki 036-8562, Japan.
| | - Takashi Kudo
- Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki 036-8562, Japan
| | - Junichi Saito
- Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki 036-8562, Japan
| | - Yoshikazu Nikaido
- Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki 036-8562, Japan
| | - Kaori Sawada
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan
| | - Shingo Takanashi
- Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan
| | - Kazuyoshi Hirota
- Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki 036-8562, Japan
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54
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Alshammari TK, Alghamdi HM, Alduhailan HE, Saja MF, Alrasheed NM, Alshammari MA. Examining the central effects of chronic stressful social isolation on rats. Biomed Rep 2020; 13:56. [PMID: 33123370 PMCID: PMC7583698 DOI: 10.3892/br.2020.1363] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 09/16/2020] [Indexed: 11/23/2022] Open
Abstract
Stress-related disorders are extremely complex and current treatment strategies have limitations. The present study investigated alternative pathological mechanisms using a combination of multiple environmental approaches with biochemical and molecular tools. The aim of the present study was to evaluate blood-brain-barrier (BBB) integrity in socially manipulated animal housing conditions. Multiple environmentally-related models were employed in the current study. The main model proposed (chronically isolated rats) was biochemically validated using the level of peripheral corticosterone. The current study examined and compared the mRNA levels of certain inflammatory and BBB markers in the hippocampal tissue of chronically isolated rats, including claudin-5 (cldn5) and tight junction protein (tjp). Animals were divided into four groups: i) Standard housed rats (controls); ii) chronically isolated rats; iii) control rats treated with fluoxetine, which is a standard selective serotonin reuptake inhibitor; and iv) isolated rats treated with fluoxetine. To further examine the effect of environmental conditions on BBB markers, the current study assessed BBB markers in enriched environmental (EE) housing and short-term isolation conditions. The results demonstrated a significant increase in cldn5 and tjp levels in the chronically isolated group. Despite some anomalous results, alterations in mRNA levels were further confirmed in EE housing conditions compared with chronically isolated rats. This trend was also observed in rats subjected to short-term isolation compared with paired controls. Additionally, levels of IL-6, an inflammatory marker associated with neuroinflammation, were markedly increased in the isolated group. However, treatment with fluoxetine treatment reversed these effects. The results indicated that BBB integrity may be compromised in stress-related disorders, highlighting a need for further functional studies on the kinetics of BBB in stress-related models.
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Affiliation(s)
- Tahani K Alshammari
- Department of Pharmacology and Toxicology, College of Medicine, King Saud University, Riyadh 11451, Kingdom of Saudi Arabia
| | - Hajar M Alghamdi
- Pharmacology and Toxicology Graduate Program, College of Pharmacy, King Saud University, Riyadh 11451, Kingdom of Saudi Arabia
| | - Hessa E Alduhailan
- Department of Pharmacology and Toxicology, College of Medicine, King Saud University, Riyadh 11451, Kingdom of Saudi Arabia
| | - Maha F Saja
- Department of Physiology, College of Medicine, King Saud University, Riyadh 11451, Kingdom of Saudi Arabia
| | - Nouf M Alrasheed
- Department of Pharmacology and Toxicology, College of Medicine, King Saud University, Riyadh 11451, Kingdom of Saudi Arabia
| | - Musaad A Alshammari
- Department of Pharmacology and Toxicology, College of Medicine, King Saud University, Riyadh 11451, Kingdom of Saudi Arabia
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55
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Xiaoyaosan improves depressive-like behaviors by regulating the NLRP3 signaling pathway in the rat cerebral cortex. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2020. [DOI: 10.1016/j.jtcms.2020.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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56
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Kim YK, Kim OY, Song J. Alleviation of Depression by Glucagon-Like Peptide 1 Through the Regulation of Neuroinflammation, Neurotransmitters, Neurogenesis, and Synaptic Function. Front Pharmacol 2020; 11:1270. [PMID: 32922295 PMCID: PMC7456867 DOI: 10.3389/fphar.2020.01270] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/31/2020] [Indexed: 12/11/2022] Open
Abstract
Depression has emerged as a major cause of mortality globally. Many studies have reported risk factors and mechanisms associated with depression, but it is as yet unclear how these findings can be applied to the treatment and prevention of this disorder. The onset and recurrence of depression have been linked to diverse metabolic factors, including hyperglycemia, dyslipidemia, and insulin resistance. Recent studies have suggested that depression is accompanied by memory loss as well as depressive mood. Thus, many researchers have highlighted the relationship between depressive behavior and metabolic alterations from various perspectives. Glucagon-like peptide-1 (GLP-1), which is secreted from gut cells and hindbrain areas, has been studied in metabolic diseases such as obesity and diabetes, and was shown to control glucose metabolism and insulin resistance. Recently, GLP-1 was highlighted as a regulator of diverse pathways, but its potential as the therapeutic target of depressive disorder was not described comprehensively. Therefore, in this review, we focused on the potential of GLP-1 modulation in depression.
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Affiliation(s)
- Young-Kook Kim
- Department of Biochemistry, Chonnam National University Medical School, Hwasun, South Korea
| | - Oh Yoen Kim
- Department of Food Science and Nutrition, Dong-A University, Busan, South Korea.,Center for Silver-targeted Biomaterials, Brain Busan 21 Plus Program, Graduate School, Dong-A University, Busan, South Korea
| | - Juhyun Song
- Department of Anatomy, Chonnam National University Medical School, Hwasun, South Korea
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57
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Correlation between immune response and self-reported depression during convalescence from COVID-19. Brain Behav Immun 2020; 88:39-43. [PMID: 32464158 PMCID: PMC7247486 DOI: 10.1016/j.bbi.2020.05.062] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/09/2020] [Accepted: 05/09/2020] [Indexed: 01/19/2023] Open
Abstract
Self-reported depression has been observed in coronavirus disease-2019 (COVID-19) patients, infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), during discharge from the hospital. However, the cause of this self-reported depression during the convalescent period remains unclear. Here, we report the mental health status of 96 convalescent COVID-19 patients who were surveyed using an online questionnaire at the Shenzhen Samii Medical Center from March 2 to March 12, 2020 in Shenzhen, China. After obtaining their informed consent, we retrospectively analyzed the clinical characteristics of patients, including routine blood and biochemical data. The results suggested that patients with self-reported depression exhibited increased immune response, as indicated by increased white blood cell and neutrophil counts, as well as neutrophil-to-lymphocyte ratio. However, the mechanism linking self-reported depression to these cellular changes needs further study. In conclusion, self-reported depression occurred at an early stage in convalescent COVID-19 patients, and changes in immune function were apparent during short-term follow-up of these patients after discharge. Appropriate psychological interventions are necessary, and changes in immune function should be emphasized during long-term follow up of these patients.
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58
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Karabatsiakis A, Schönfeldt-Lecuona C. Depression, mitochondrial bioenergetics, and electroconvulsive therapy: a new approach towards personalized medicine in psychiatric treatment - a short review and current perspective. Transl Psychiatry 2020; 10:226. [PMID: 32647150 PMCID: PMC7347855 DOI: 10.1038/s41398-020-00901-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 06/10/2020] [Accepted: 06/16/2020] [Indexed: 11/09/2022] Open
Abstract
Major depressive disorder (MDD) is a globally occurring phenomenon and developed into a severe socio-economic challenge. Despite decades of research, the underlying pathophysiological processes of MDD remain incompletely resolved. Like other mental disorders, MDD is hypothesized to mainly affect the central nervous system (CNS). An increasing body of research indicates MDD to also change somatic functioning, which impairs the physiological performance of the whole organism. As a consequence, a paradigm shift seems reasonable towards a systemic view of how MDD affects the body. The same applies to treatment strategies, which mainly focus on the CNS. One new approach highlights changes in the bioenergetic supply and intracellular network dynamics of mitochondria for the pathophysiological understanding of MDD. Mitochondria, organelles of mostly all eukaryotic cells, use carbon compounds to provide biochemical energy in terms of adenosine triphosphate (ATP). ATP is the bioenergetic currency and the main driver for enzymatic activity in all cells and tissues. Clinical symptoms of MDD including fatigue, difficulties concentrating, and lack of motivation were reported to be associated with impaired mitochondrial ATP production and changes in the density of the mitochondrial network. Additionally, the severity of these symptoms correlates negatively with mitochondrial functioning. Psychotherapy, antidepressant medication, and electroconvulsive therapy (ECT), a method used to treat severe and treatment-resistant forms of MDD, achieve robust antidepressant effects. The biological mechanisms beyond the treatment response to antidepressant strategies are partially understood. Here, mitochondrial functioning is discussed as a promising new biomarker for diagnosis and treatment effects in MDD.
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Affiliation(s)
| | - Carlos Schönfeldt-Lecuona
- Clinic for Psychiatry and Psychotherapy III, Ulm University Clinic, Ulm, Baden-Wuerttemberg, Germany
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59
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Caruso G, Fresta CG, Grasso M, Santangelo R, Lazzarino G, Lunte SM, Caraci F. Inflammation as the Common Biological Link Between Depression and Cardiovascular Diseases: Can Carnosine Exert a Protective Role? Curr Med Chem 2020; 27:1782-1800. [PMID: 31296155 DOI: 10.2174/0929867326666190712091515] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 01/15/2019] [Accepted: 02/05/2019] [Indexed: 01/03/2023]
Abstract
Several epidemiological studies have clearly shown the high co-morbidity between depression and Cardiovascular Diseases (CVD). Different studies have been conducted to identify the common pathophysiological events of these diseases such as the overactivation of the hypothalamic- pituitary-adrenal axis and, most importantly, the dysregulation of immune system which causes a chronic pro-inflammatory status. The biological link between depression, inflammation, and CVD can be related to high levels of pro-inflammatory cytokines, such as IL-1β, TNF-α, and IL-6, released by macrophages which play a central role in the pathophysiology of both depression and CVD. Pro-inflammatory cytokines interfere with many of the pathophysiological mechanisms relevant to depression by upregulating the rate-limiting enzymes in the metabolic pathway of tryptophan and altering serotonin metabolism. These cytokines also increase the risk to develop CVD, because activation of macrophages under this pro-inflammatory status is closely associated with endothelial dysfunction and oxidative stress, a preamble to atherosclerosis and atherothrombosis. Carnosine (β-alanyl-L-histidine) is an endogenous dipeptide which exerts a strong antiinflammatory activity on macrophages by suppressing reactive species and pro-inflammatory cytokines production and altering pro-inflammatory/anti-inflammatory macrophage polarization. This dipeptide exhibits antioxidant properties scavenging reactive species and preventing oxidative stress-induced pathologies such as CVD. In the present review we will discuss the role of oxidative stress and chronic inflammation as common pathophysiological events both in depression and CVD and the preclinical and clinical evidence on the protective effect of carnosine in both diseases as well as the therapeutic potential of this dipeptide in depressed patients with a high co-morbidity of cardiovascular diseases.
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Affiliation(s)
- Giuseppe Caruso
- Oasi Research Institute - IRCCS, Via Conte Ruggero, 73, Troina 94018, Italy
| | - Claudia G Fresta
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania 95125, Italy
| | - Margherita Grasso
- Oasi Research Institute - IRCCS, Via Conte Ruggero, 73, Troina 94018, Italy.,Department of Drug Sciences, University of Catania, Catania 95125, Italy
| | - Rosa Santangelo
- Department of Drug Sciences, University of Catania, Catania 95125, Italy
| | - Giuseppe Lazzarino
- Department of Biomedical and Biotechnological Sciences, Division of Medical Biochemistry, University of Catania, Catania 95125, Italy
| | - Susan M Lunte
- Ralph N. Adams Institute for Bioanalytical Chemistry, University of Kansas, Lawrence 66045, Kansas, United States.,Department of Pharmaceutical Chemistry, University of Kansas, Lawrence 66045, Kansas, United States.,Department of Chemistry, University of Kansas, Lawrence 66045, Kansas, United States
| | - Filippo Caraci
- Oasi Research Institute - IRCCS, Via Conte Ruggero, 73, Troina 94018, Italy.,Department of Drug Sciences, University of Catania, Catania 95125, Italy
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60
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di Michele F, Talamo A, Niolu C, Siracusano A. Vitamin D and N-Acetyl Cysteine Supplementation in Treatment-Resistant Depressive Disorder Patients: A General Review. Curr Pharm Des 2020; 26:2442-2459. [DOI: 10.2174/1381612826666200406090051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 03/31/2020] [Indexed: 12/20/2022]
Abstract
:
Major Depressive Disorder (MDD) is often a lifetime disabling mental illness as individuals with
MDD might not benefit from standard-therapy, including both pharmacological and psychosocial interventions.
Novel therapies are, therefore, required.
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It was shown by recent preclinical and clinical studies that the dysfunction of glutamatergic neurotransmission
might be involved in the pathophysiology of MDD. Furthermore, neuroimmune alterations could have a significant
role in the pathogenesis of MDD.
:
Vitamin D is a neurosteroid hormone essential for several metabolic processes, immune responses, and for regulating
neurotrophic-neuroprotective processes, neurotransmission and synaptic plasticity. Recent studies have also
shown Vitamin D deficiency in patients with severe psychiatric disorders, including MDD.
:
Lately, clinical studies have shown the neuroprotective action of N-acetyl cysteine (NAC) through the modulation
of inflammatory pathways and via the modulation of synaptic release of glutamate in cortico-subcortical
brain regions; the cysteine-glutamate antiporter.
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This paper reviews the therapeutic use of Vitamin D and NAC and among individuals with refractory MDD to the
first- line pharmacological interventions, reviewing the clinical studies published in the last decade.
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A detailed summary of the current evidence in this area aims to better inform psychiatrists and general practitioners
on the potential benefits of Vitamin D and NAC supplementation for this disorder.
:
Nutraceutical supplementation with Vitamin D and NAC in treatment-resistant MDD patients may be important
not only for improving depressive clinical manifestations but also for their safety and tolerability profile. This is
of great interest, especially considering the need for treating special populations affected by MDD, such as
youngsters and elders. Finally, the nutraceutical approach represents a good choice, considering its better compliance
by the patients compared to traditional psychopharmacological treatment.
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Affiliation(s)
- Flavia di Michele
- Acute Psychiatric Unit, PTV Foundation - Policlinico Tor Vergata, Rome, Italy
| | - Alessandra Talamo
- Acute Psychiatric Unit, PTV Foundation - Policlinico Tor Vergata, Rome, Italy
| | - Cinzia Niolu
- Acute Psychiatric Unit, PTV Foundation - Policlinico Tor Vergata, Rome, Italy
| | - Alberto Siracusano
- Acute Psychiatric Unit, PTV Foundation - Policlinico Tor Vergata, Rome, Italy
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61
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Cognitive Fatigability is Independent of Subjective Cognitive Fatigue and Mood in Multiple Sclerosis. Cogn Behav Neurol 2020; 33:113-121. [PMID: 32496296 DOI: 10.1097/wnn.0000000000000228] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sustained cognitive testing is used to detect cognitive fatigability and is often considered a substitute for subjective cognitive fatigue (CF). However, the relationship between cognitive fatigability and subjective CF in people with multiple sclerosis (PwMS) remains undetermined. OBJECTIVE To explore potential associations between fatigability induced by sustained cognitive testing and subjective CF in PwMS. METHODS We gave 120 PwMS and 60 demographically matched, healthy individuals the Beck Depression Inventory-FastScreen (BDI-FS) to measure mood and the Modified Fatigue Impact Scale to measure CF. In addition, we used the Quotient ADHD Test, a sustained attention test, to measure cognitive fatigability. We also explored potential correlations between the individuals' performance on the sustained attention test and thalamic volume using recent MRI scans. RESULTS Forty-one (34.2%) of the PwMS exhibited cognitive fatigability. These 41 were found to be significantly older (P=0.006), had been diagnosed with the disease for longer (P=0.03), had higher scores (P<0.001) on the Expanded Disability Status Scale, and had reduced thalamic volume (P=0.04) compared with the 79 (65.8%) PwMS not exhibiting cognitive fatigability. The PwMS exhibiting cognitive fatigability scored similarly on the BDI-FS (P=0.21) and self-reported similar rates of CF (P=0.62) as the PwMS not exhibiting cognitive fatigability. CONCLUSION Cognitive fatigability induced by sustained cognitive testing is not an accurate clinical alternative to subjective CF. This study provides evidence to support cognitive fatigability and CF in PwMS as two distinct concepts.
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62
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Ciobanu LG, Sachdev PS, Trollor JN, Reppermund S, Thalamuthu A, Mather KA, Cohen-Woods S, Stacey D, Toben C, Schubert KO, Baune BT. Downregulated transferrin receptor in the blood predicts recurrent MDD in the elderly cohort: A fuzzy forests approach. J Affect Disord 2020; 267:42-48. [PMID: 32063571 DOI: 10.1016/j.jad.2020.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 01/28/2020] [Accepted: 02/01/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND At present, no predictive markers for Major Depressive Disorder (MDD) exist. The search for such markers has been challenging due to clinical and molecular heterogeneity of MDD, the lack of statistical power in studies and suboptimal statistical tools applied to multidimensional data. Machine learning is a powerful approach to mitigate some of these limitations. METHODS We aimed to identify the predictive markers of recurrent MDD in the elderly using peripheral whole blood from the Sydney Memory and Aging Study (SMAS) (N = 521, aged over 65) and adopting machine learning methodology on transcriptome data. Fuzzy Forests is a Random Forests-based classification algorithm that takes advantage of the co-expression network structure between genes; it allows to alleviate the problem of p >> n via reducing the dimensionality of transcriptomic feature space. RESULTS By adopting Fuzzy Forests on transcriptome data, we found that the downregulated TFRC (transferrin receptor) can predict recurrent MDD with an accuracy of 63%. LIMITATIONS Although we corrected our data for several important confounders, we were not able to account for the comorbidities and medication taken, which may be numerous in the elderly and might have affected the levels of gene transcription. CONCLUSIONS We found that downregulated TFRC is predictive of recurrent MDD, which is consistent with the previous literature, indicating the role of the innate immune system in depression. This study is the first to successfully apply Fuzzy Forests methodology on psychiatric condition, opening, therefore, a methodological avenue that can lead to clinically useful predictive markers of complex traits.
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Affiliation(s)
- Liliana G Ciobanu
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, South Australia, Australia; Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, University of South Australia, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Sydney, New South Wales, Australia
| | - Julian N Trollor
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Sydney, New South Wales, Australia; Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Sydney, New South Wales, Australia
| | - Simone Reppermund
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Sydney, New South Wales, Australia; Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Sydney, New South Wales, Australia
| | - Anbupalam Thalamuthu
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Sydney, New South Wales, Australia
| | - Karen A Mather
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Sydney, New South Wales, Australia; Neuroscience Research Australia, Randwick, Australia
| | - Sarah Cohen-Woods
- School of Psychology, Flinders University, South Australia, Australia
| | - David Stacey
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - Catherine Toben
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, South Australia, Australia
| | - K Oliver Schubert
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, South Australia, Australia; Northern Adelaide Local Health Network, Mental Health Services, Lyell McEwin Hospital, Elizabeth Vale, South Australia, Australia
| | - Bernhard T Baune
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany; Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Australia; The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia.
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Sundberg I, Rasmusson AJ, Ramklint M, Just D, Ekselius L, Cunningham JL. Daytime melatonin levels in saliva are associated with inflammatory markers and anxiety disorders. Psychoneuroendocrinology 2020; 112:104514. [PMID: 31776047 DOI: 10.1016/j.psyneuen.2019.104514] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 09/03/2019] [Accepted: 11/12/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND The bidirectional interaction between melatonin and the immune system has largely gone unexplored in a clinical context and especially in a psychiatric population. This study explored the association between melatonin during the day and inflammatory cytokines in young adult patients seeking psychiatric care. METHODS Samples and data were collected from 108 young adults (mean age 21, SD = 2) at an outpatient clinic for affective disorders. Daytime saliva melatonin levels were analyzed with enzyme-linked immunosorbent assay (ELISA) in relation to normalized serum expression levels of 72 inflammatory markers in a proximity extension assay (PEA). In a post hoc analysis the markers associated with melatonin were tested in a generalized linear model to see whether there is a relationship to anxiety disorder or depression. RESULTS After Bonferroni correction for multiple testing, melatonin levels at 11:00 were positively correlated with CD5 (p = 4.2e-4). Melatonin levels after lunch were correlated with CCL2/MCP-1 (p = 4.2e-4), CCL3/MPI-1α (p = 6.5e-4) and VEGF-A (p = 5.3e-6). In the generalized linear model, positive associations were found for the presence of any anxiety disorder with melatonin after lunch (p = 0.046), VEGF-A (p = 0.001) and CCL3/MPI-1α (p = 0.001). CONCLUSION Daytime saliva levels of melatonin were related to several inflammatory markers in young adults with psychiatric disorders. This observation likely reflects the bidirectional relationship between melatonin production and the immune system. These findings may have relevance for the understanding of psychiatric disorders and other conditions associated with low-grade inflammation.
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Affiliation(s)
- Isak Sundberg
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Annica J Rasmusson
- Department of Medical Sciences, Clinical Pharmacology and Osteoporosis, Uppsala University, Uppsala, Sweden
| | - Mia Ramklint
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - David Just
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Lisa Ekselius
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Janet L Cunningham
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden.
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Yang L, Zhao M, Magnussen CG, Veeranki SP, Xi B. Psychological distress and mortality among US adults: prospective cohort study of 330 367 individuals. J Epidemiol Community Health 2020; 74:384-390. [PMID: 31992611 DOI: 10.1136/jech-2019-213144] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 01/12/2020] [Accepted: 01/13/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND Previous studies have shown inconsistent findings on the association between psychological distress and risk of mortality. This study aimed to address this inconsistent association using a large US population-based cohort. METHODS This study used data from 1997 to 2009 US National Health Interview Survey, which were linked with National Death Index through 31 December 2011. Psychological distress was measured using Kessler-6 scale and was categorised into six groups based on scores as 0, 1-3, 4-6, 7-9, 10-12 and ≥13. Main outcomes were all-cause, cancer-specific and cardiovascular disease (CVD)-specific mortality. Analyses were completed in 2019. Cox proportional hazards models were used to determine the association between psychological distress and mortality. RESULTS A total of 330 367 participants aged ≥18 years were included. During a mean follow-up of 8.2 years, 34 074 deaths occurred, including 8320 cancer-related and 8762 CVD-related deaths. There was a dose-response association between psychological distress and all-cause mortality. Compared with the 0 score category, adjusted HRs (95% CIs) for other categorical psychological distress scores, that is, 1-3, 4-6, 7-9, 10-12 and ≥13, were 1.09 (1.05 to 1.12), 1.22 (1.17 to 1.27), 1.38 (1.31 to 1.46), 1.49 (1.40 to 1.59) and 1.57 (1.47 to 1.68), respectively. Corresponding values for cancer-specific mortality were 1.06 (0.99 to 1.12), 1.13 (1.04 to 1.23), 1.27 (1.14 to 1.42), 1.38 (1.22 to 1.57) and 1.32 (1.15 to 1.51), respectively; those for CVD-specific mortality were 1.11 (1.05 to 1.18), 1.22 (1.12 to 1.32), 1.30 (1.17 to 1.45), 1.38 (1.20 to 1.58), and 1.46 (1.27 to 1.68), respectively. CONCLUSIONS We found a dose-response relationship between psychological distress and all-cause and cause-specific mortality, emphasising the need for early prevention strategies among individuals with potential psychological distress.
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Affiliation(s)
- Lili Yang
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong, China
| | - Min Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Shandong University, Jinan, Shandong, China
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Sreenivas P Veeranki
- Precision Health Economics and Outcomes Research, Los Angeles, CA, USA.,Department of Preventive Medicine and Community Health, University of Texas Medical Branch at Galveston, Galveston, Texas, USA
| | - Bo Xi
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong, China
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Díaz-Hung ML, Martínez G, Hetz C. Emerging roles of the unfolded protein response (UPR) in the nervous system: A link with adaptive behavior to environmental stress? INTERNATIONAL REVIEW OF CELL AND MOLECULAR BIOLOGY 2020; 350:29-61. [PMID: 32138903 DOI: 10.1016/bs.ircmb.2020.01.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Stressors elicit a neuroendocrine response leading to increased levels of glucocorticoids, allowing the organism to adapt to environmental changes and maintain homeostasis. Glucocorticoids have a broad effect in the body, modifying the activity of the immune system, metabolism, and behavior through the activation of receptors in the limbic system. Chronic exposition to stressors operates as a risk factor for psychiatric diseases such as depression and posttraumatic stress disorder. Among the cellular alterations observed as a consequence of environmental stress, alterations to organelle function at the level of mitochondria and endoplasmic reticulum (ER) are emerging as possible factors contributing to neuronal dysfunction. ER proteostasis alterations elicit the unfolded protein response (UPR), a conserved signaling network that re-establish protein homeostasis. In addition, in the context of brain function, the UPR has been associated to neurodevelopment, synaptic plasticity and neuronal connectivity. Recent studies suggest a role of the UPR in the adaptive behavior to stress, suggesting a mechanistic link between environmental and cellular stress. Here, we revise recent evidence supporting an evolutionary connection between the neuroendocrine system and the UPR to modulate behavioral adaptive responses.
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Affiliation(s)
- Mei-Li Díaz-Hung
- Biomedical Neuroscience Institute, Faculty of Medicine, University of Chile, Santiago, Chile; Program of Cellular and Molecular Biology, Institute of Biomedical Sciences, University of Chile, Santiago, Chile; Center for Geroscience, Brain Health and Metabolism, Santiago, Chile
| | - Gabriela Martínez
- Biomedical Neuroscience Institute, Faculty of Medicine, University of Chile, Santiago, Chile; Program of Cellular and Molecular Biology, Institute of Biomedical Sciences, University of Chile, Santiago, Chile; Center for Geroscience, Brain Health and Metabolism, Santiago, Chile
| | - Claudio Hetz
- Biomedical Neuroscience Institute, Faculty of Medicine, University of Chile, Santiago, Chile; Program of Cellular and Molecular Biology, Institute of Biomedical Sciences, University of Chile, Santiago, Chile; Center for Geroscience, Brain Health and Metabolism, Santiago, Chile; Buck Institute for Research on Aging, Novato, CA, United States.
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Peters EMJ, Neusetzer M, Akinci S, Murat A, Treuherz S, Rose M, Leweke F, Leichsenring F, Conrad ML, Kruse J. Multimodal Psychotherapeutic Inpatient Therapy of Depression Is Successful in Patients With High Cytokine Production. Front Psychiatry 2020; 11:571636. [PMID: 33240126 PMCID: PMC7667045 DOI: 10.3389/fpsyt.2020.571636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 10/05/2020] [Indexed: 12/27/2022] Open
Abstract
Objective: In experimental settings, systemically elevated inflammation markers interfere with major depression treatment. In German healthcare, compulsory national health insurance covers treatment of a wide variety of depressive disorders, if it follows evidence-based medicine guidelines combining recommended therapies. To date, little is known about the relevance of immune system cytokine production with regard to real-world clinical care for patients with moderate depression. Methods: Seventy three patients with moderate depression subjected to multimodal psychotherapeutic inpatient therapy (mPT) following a psychodynamic concept at a German university hospital were included. As a primary outcome, mPT success, evidenced by delta HADS "depression," was analyzed according to tumor necrosis factor alpha (TNFα) production by peripheral blood mononuclear cells (PBMC) after phytohemagglutinin (PHA) challenge at baseline. Secondary outcomes addressed the inflammatory response and mental health comparing high and low TNFα-producers. Results: First, higher PBMC TNFα production at baseline predicted a better mPT-outcome (R 2 0.162, p = 0.014). Second, patients with high TNFα (hTNF) at baseline produced significantly more acute inflammatory cytokines [interleukin (IL)1β, IL6), TH1/TH2 cytokines [interferon gamma (IFNγ), IL4] as well as eotaxin and IL2 compared to low TNFα producers (lTNF) (Cohen's ds between -0.532 and -1.013). Demographic data, diagnosis subtype-distribution, medication, systemic inflammation markers [C-reactive protein (CRP), high mobility group box 1 (HMGB1), leptin], anxiety and depression (HADS) did not differ. From baseline to mPT-discharge, HADS "depression" decreased in both hTNF (11.31 to 5.47, p = 0.001, d = 1.184) and lTNF patients (11.50-7.92, p = 0.001, d = -0.765), while PBMC cytokine production decreased significantly in hTNF (Cohen's ds between -0.304 and -0.345) with a significant group by time interaction for TH1/TH2 ratio. At the end of therapy, comparison of TNF groups revealed significantly lower depression-scores in hTNF compared to lTNF patients (5.47 compared to 7.92, p = 0.035, d = 0.504). Conclusions: Our study demonstrates successful treatment of depression in a clinical care setting using multimodal psychotherapy based on a psychodynamic concept following guideline recommendation. The greatest improvement in patient depression was linked to the highest production of TNFα by PBMCs at baseline. Our study contributes to the definition of patient subpopulations with differing cytokine responses that are related to succesful treatment of depression.
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Affiliation(s)
- Eva M J Peters
- Psychoneuroimmunology Laboratory, Department of Psychosomatics and Psychotherapy, Justus-Liebig-University of Gießen, Gießen, Germany.,Division for General Internal Medicine, Psychosomatics and Psychotherapy, Charité Center 12 Internal Medicine and Dermatology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Melanie Neusetzer
- Psychoneuroimmunology Laboratory, Department of Psychosomatics and Psychotherapy, Justus-Liebig-University of Gießen, Gießen, Germany
| | - Secil Akinci
- Department of Psychosomatics and Psychotherapy, Justus-Liebig-University of Gießen, Gießen, Germany
| | - Aysenur Murat
- Psychoneuroimmunology Laboratory, Department of Psychosomatics and Psychotherapy, Justus-Liebig-University of Gießen, Gießen, Germany
| | - Sabine Treuherz
- Department of Psychosomatics and Psychotherapy, Justus-Liebig-University of Gießen, Gießen, Germany
| | - Matthias Rose
- Division for General Internal Medicine, Psychosomatics and Psychotherapy, Charité Center 12 Internal Medicine and Dermatology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Frank Leweke
- Department of Psychosomatics and Psychotherapy, Justus-Liebig-University of Gießen, Gießen, Germany
| | - Falk Leichsenring
- Department of Psychosomatics and Psychotherapy, Justus-Liebig-University of Gießen, Gießen, Germany
| | - Melanie L Conrad
- Division for General Internal Medicine, Psychosomatics and Psychotherapy, Charité Center 12 Internal Medicine and Dermatology, Charité Universitätsmedizin Berlin, Berlin, Germany.,Charité Center 5 Laboratory and Preventive Medicine, Institute of Microbiology, Infectious Diseases and Immunology, Universitätsmedizin Berlin, Berlin, Germany
| | - Johannes Kruse
- Department of Psychosomatics and Psychotherapy, Justus-Liebig-University of Gießen, Gießen, Germany
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Alvarez-Mon MA, Gomez-Lahoz AM, Orozco A, Lahera G, Sosa-Reina MD, Diaz D, Albillos A, Quintero J, Molero P, Monserrat J, Alvarez-Mon M. Blunted Expansion of Regulatory T Lymphocytes Is Associated With Increased Bacterial Translocation in Patients With Major Depressive Disorder. Front Psychiatry 2020; 11:591962. [PMID: 33488424 PMCID: PMC7820111 DOI: 10.3389/fpsyt.2020.591962] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 12/04/2020] [Indexed: 12/20/2022] Open
Abstract
Background: Major Depressive Disorder (MDD) is associated with both proinflammatory and adaptive immune response abnormalities. Regulatory T lymphocytes (Tregs), a subtype of CD4+ T cells, are relevant for maintaining immune-inflammatory system homeostasis and control of inflammation such as the kind potentially induced by the interactions between the intestinal microbiome and gut mucosa. We investigated the Treg population and its distribution along their stages of differentiation/activation, as well as its function in MDD patients without concomitant diseases. We also studied the potential association between Treg alterations, intestinal barrier damage, and bacterial translocation. Methods: 30 MDD patients and 20 healthy controls were studied. The levels of circulating CD25FoxP3+ Tregs and their distribution on the naïve (TN), effector (TE), central (TCM), and effector memory(TEM) differentiation/activation stages were analyzed using polychromatic flow cytometry. Chemokine receptors (CCR) 2, 5, and 6, and the intracytoplasmic IL-10 expression by the Tregs were also analyzed. The serum IL-10 was measured using Luminex. The serum levels of zonulin and the intestinal fatty acid-binding protein (I-FABP), both markers of gut barrier function, and the LPS-binding protein (LBP), a marker of bacterial translocation, were measured using an enzyme-linked immunosorbent assay. Results: MDD patients had increased number of circulating Tregs cells with enhanced number of Tregs at the TN, TE, TCM, and TEM stages. The percentage of Tregs cells at TN stage was significantly higher in MDD patients. The percentage of Tregs that expressed CCR2 and CCR6 was increased as well as those expressing IL-10. MDD patients had significantly increased levels of circulating I-FABP and LBP. MDD patients with high LBP levels had a significant reduction in the number of circulating Tregs compared to normal-LBP MDD patients. Conclusions: MDD patients showed an expansion of circulating Tregs and their CD25highFoxP3+ and CD25lowFoxP3+ subsets throughout the different stages of CD4+ T lymphocyte differentiation/activation. Tregs also showed an increased frequency of cells expressing CCR6 and CCR2. IL-10 Treg production was also enhanced in MDD patients that concurrently had increased serum IL-10 levels. However, this Treg expansion was blunted in MDD patients with gut barrier damage and increased bacterial translocation.
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Affiliation(s)
- Miguel Angel Alvarez-Mon
- Department of Psychiatry and Medical Psychology, University Clinic of Navarra, Pamplona, Spain.,Department of Medicine and Medical Specialities, University of Alcala, Alcala de Henares, Spain.,Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Ana Maria Gomez-Lahoz
- Department of Medicine and Medical Specialities, University of Alcala, Alcala de Henares, Spain
| | - Arantxa Orozco
- Department of Psychiatry, University Hospital "Principe de Asturias", Alcalá de Henares, Spain
| | - Guillermo Lahera
- Department of Medicine and Medical Specialities, University of Alcala, Alcala de Henares, Spain.,Department of Psychiatry, University Hospital "Principe de Asturias", Alcalá de Henares, Spain.,CIBERSAM (Biomedical Research Networking Centre in Mental Health), Madrid, Spain
| | - M Dolores Sosa-Reina
- Department of Medicine and Medical Specialities, University of Alcala, Alcala de Henares, Spain
| | - David Diaz
- Department of Medicine and Medical Specialities, University of Alcala, Alcala de Henares, Spain
| | - Agustin Albillos
- Department of Medicine and Medical Specialities, University of Alcala, Alcala de Henares, Spain.,Department of Gastroenterology, University Hospital Ramon y Cajal, Madrid, Spain.,Institute Ramon y Cajal for Health Research (IRYCIS), Madrid, Spain.,Biomedical Institute for Liver and Gut Diseases (CIBEREHD), Madrid, Spain
| | - Javier Quintero
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, Madrid, Spain.,Department of Legal and Psychiatry, Complutense University, Madrid, Spain
| | - Patricio Molero
- Department of Psychiatry and Medical Psychology, University Clinic of Navarra, Pamplona, Spain
| | - Jorge Monserrat
- Department of Medicine and Medical Specialities, University of Alcala, Alcala de Henares, Spain
| | - Melchor Alvarez-Mon
- Department of Medicine and Medical Specialities, University of Alcala, Alcala de Henares, Spain.,Institute Ramon y Cajal for Health Research (IRYCIS), Madrid, Spain.,Biomedical Institute for Liver and Gut Diseases (CIBEREHD), Madrid, Spain.,Service of Internal Medicine and Rheumatology, Autoimmune Diseases University Hospital "Principe de Asturias", Madrid, Spain
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Sahin Ozkartal C, Tuzun E, Kucukali CI, Ulusoy C, Giris M, Aricioglu F. Antidepressant-like effects of agmatine and NOS inhibitors in chronic unpredictable mild stress model of depression in rats: The involvement of NLRP inflammasomes. Brain Res 2019; 1725:146438. [DOI: 10.1016/j.brainres.2019.146438] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 08/27/2019] [Accepted: 09/05/2019] [Indexed: 12/15/2022]
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Zhou J, Zhang C, Wu X, Xie Q, Li L, Chen Y, Yan H, Ren P, Huang X. Identification of genes and pathways related to atherosclerosis comorbidity and depressive behavior via RNA-seq and bioinformation analysis in ApoE -/- mice. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:733. [PMID: 32042749 DOI: 10.21037/atm.2019.11.118] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Background Depression is an independent risk factor for atherosclerosis (AS), which can increase the risk of death and disability from AS. However, the mechanism of AS comorbidity with depression is complex. Methods ApoE-/- and C57BL/6J mice were fed with a high-fat diet (model group, N=12 ♂) and a normal diet (control group, N=12 ♂). During the 15-week experimental period, the following tests were performed: coat color score, body weight, and sucrose preference tests (every 2 weeks); open-field test (1st, 7th, and 15th weeks); and light/dark and tail suspension tests (15th week). Oil Red O and hematoxylin and eosin (HE) stainings were used to assess the area of atherosclerotic status. The levels of triglyceride and total and low-density lipoprotein cholesterol in the serum and secretion of pro-inflammatory cytokines were determined using the enzyme-linked immunosorbent assay. The differentially expressed genes (DEGs) in the hippocampus and prefrontal cortex were screened by RNA-sequencing (RNA-seq) and analyzed using the Gene Ontology (GO) annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) annotations. Results Our findings showed that compared with C57 mice in the control group, ApoE-/- mice in the model group gradually developed depression-like behavioral changes with elevated blood lipid concentrations, serum inflammatory factor levels, and atherosclerotic plaque formation in the thoracic aorta. Consequently, in the RNA-seq and bioinformatics analysis, the high expression of inflammatory chemokine genes was found in the hippocampus and prefrontal cortex area. The regulation of movement, feeding, and reproduction of the gene expression decreased. Conclusions These results indicate that when ApoE-/- mice were fed a high-fat diet for 15 weeks, depression-like behavioral changes occurred with the formation of atherosclerotic lesions. The RNA-seq, combined with bioinformatics analysis, showed that this AS comorbidity with depressive behavior was associated with the high expression of inflammation-related genes and pathways in the hippocampus and prefrontal cortex.
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Affiliation(s)
- Junjie Zhou
- Institute of TCM-related Comorbid Depression, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Chunjie Zhang
- Institute of TCM-related Comorbid Depression, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Xiaoyun Wu
- Medical College, Xiamen University, Xiamen 361102, China
| | - Qi Xie
- Institute of TCM-related Comorbid Depression, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Lan Li
- Institute of TCM-related Comorbid Depression, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Ying Chen
- Institute of TCM-related Comorbid Depression, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Hongbin Yan
- Institute of TCM-related Comorbid Depression, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Ping Ren
- Institute of TCM-related Comorbid Depression, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Xi Huang
- Institute of TCM-related Comorbid Depression, Nanjing University of Chinese Medicine, Nanjing 210023, China
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Nowak W, Grendas LN, Sanmarco LM, Estecho IG, Arena ÁR, Eberhardt N, Rodante DE, Aoki MP, Daray FM, Carrera Silva EA, Errasti AE. Pro-inflammatory monocyte profile in patients with major depressive disorder and suicide behaviour and how ketamine induces anti-inflammatory M2 macrophages by NMDAR and mTOR. EBioMedicine 2019; 50:290-305. [PMID: 31753725 PMCID: PMC6921226 DOI: 10.1016/j.ebiom.2019.10.063] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 09/17/2019] [Accepted: 10/31/2019] [Indexed: 12/24/2022] Open
Abstract
Background Depression is a highly prevalent disorder that is one of the leading causes of disability worldwide. Despite an unknown aetiology, evidence suggests that the innate and adaptive immune systems play a significant role in the development and maintenance of major depressive disorder (MDD). The non-competitive glutamatergic N-methyl-D-aspartate receptor (NMDAR) antagonist, (R,S)-ketamine (ketamine), has demonstrated rapid and robust efficacy as an antidepressant when administered at sub-anaesthetic doses. Methods Our goal was to characterize the pro-inflammatory profile of patients with MDD by measuring pro-inflammatory cytokines in plasma and circulating monocyte subsets and to understand how ketamine induces an anti-inflammatory program in monocyte and macrophages in vitro and vivo. Finding Our results show that patients with MDD without other comorbidities (N = 33) exhibited significantly higher levels of pro-inflammatory IL-12 and IL-6 in plasma and that these cytokines were associated with increased numbers of non-classical (CD11b+CD16brightCD14neg) monocytes and increased activation state (CD40+CD86+) of classical monocytes in circulation. Remarkably, we have demonstrated that sub-anaesthetic doses of ketamine programs human monocytes into M2c-like macrophages by inducing high levels of CD163 and MERTK with intermediate levels of CD64 and stimulating mTOR-associated gene expression in vitro. The NMDAR antagonist MK-801, but not the α-amino-3‑hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) antagonist, NBQX, also polarizes macrophages to an M2c-like phenotype, but this phenotype disappears upon mTOR pathway inhibition. Sub-anaesthetic doses (10 mg/kg) of ketamine administration in mice both promote reduction of circulating classical pro-inflammatory monocytes and increase of alternative M2 macrophage subtypes in the spleen and CNS. Interpretation Our results suggest an anti-inflammatory property of ketamine that can skew macrophages to an M2-like phenotype, highlighting potential therapeutic implications not only for patients with MDD but also other inflammatory-based diseases. Funding This study was supported by grants from the Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) and Agencia Nacional de Promoción Científica y Tecnológica (ANPCyT-FONCYT).
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Affiliation(s)
- Wanda Nowak
- Instituto de Farmacología, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, 9th floor, Buenos Aires 1121, Argentina
| | - Leandro Nicolás Grendas
- Instituto de Farmacología, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, 9th floor, Buenos Aires 1121, Argentina
| | - Liliana María Sanmarco
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Ivana Gisele Estecho
- Instituto de Farmacología, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, 9th floor, Buenos Aires 1121, Argentina
| | - Ángeles Romina Arena
- Instituto de Farmacología, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, 9th floor, Buenos Aires 1121, Argentina
| | - Natalia Eberhardt
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Demián Emanuel Rodante
- Instituto de Farmacología, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, 9th floor, Buenos Aires 1121, Argentina
| | - María Pilar Aoki
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Federico Manuel Daray
- Instituto de Farmacología, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, 9th floor, Buenos Aires 1121, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.
| | - Eugenio Antonio Carrera Silva
- Instituto de Medicina Experimental (IMEX), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Academia Nacional de Medicina, Pacheco de Melo 3081, Buenos Aires 1425, Argentina.
| | - Andrea Emilse Errasti
- Instituto de Farmacología, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, 9th floor, Buenos Aires 1121, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.
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Alvarez-Mon MA, Gómez AM, Orozco A, Lahera G, Sosa MD, Diaz D, Auba E, Albillos A, Monserrat J, Alvarez-Mon M. Abnormal Distribution and Function of Circulating Monocytes and Enhanced Bacterial Translocation in Major Depressive Disorder. Front Psychiatry 2019; 10:812. [PMID: 31803077 PMCID: PMC6873610 DOI: 10.3389/fpsyt.2019.00812] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 10/14/2019] [Indexed: 12/16/2022] Open
Abstract
Introduction: Major depressive disorder (MDD) patients experience a systemic inflammatory stage. Monocytes play an important role in innate inflammatory responses and may be modulated by bacterial translocation. Our aim was to investigate the subset distribution and function of circulating monocytes, levels of proinflammatory cytokines, gut barrier damage, and bacterial translocation in MDD patients. Methods: Twenty-two MDD patients without concomitant diseases and 14 sex- and age-matched healthy controls were studied. The levels of circulating CD14++CD16- (classical), CD14++CD16++ (intermediate) and CD14-CD16++ (nonclassical) monocytes and the intracytoplasmic tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, and IL-10 expression in the presence or absence of lipopolysaccharide (LPS) stimulation were analyzed by polychromatic flow cytometry. The serum TNF-α, IL-1β, IL-6, and IL-10 levels were measured by Luminex. LPS-binding protein (LBP), intestinal fatty acid-binding protein (I-FABP), and zonulin were measured by enzyme-linked immunosorbent assay (ELISA). Results: MDD patients had a significant increase in the frequency of intermediate monocytes and a significant decrease in the frequency of classical monocytes compared to those in the healthy controls. MDD patients had a significantly increased percentage of classical monocytes that expressed IL-1β, intermediate monocytes that expressed IL-1β and IL6 and nonclassical monocytes that expressed IL-1β, and decreased levels of nonclassical monocytes that expressed IL6 compared to those in the healthy controls. MDD patients had significantly increased levels of circulating TNF-α, IL-1β, LBP, and I-FABP compared to those in the healthy controls. MDD patients with high LBP levels had a significant reduction in the number of circulating monocytes compared to that in the normal-LBP MDD patients, which can be mainly ascribed to a decrease in the number of intermediate and nonclassical monocytes. Conclusions: We have demonstrated that compared to the healthy controls, MDD patients show a marked alteration in circulating monocytes, with an expansion of the intermediate subset with increased frequency of IL-1β and IL-6 producing cells. These patients also exhibited a systemic proinflammatory state, which was characterized by the enhanced serum TNF-α and IL-1β levels compared to those in the healthy controls. Furthermore, MDD patients showed increased LBP and I-FABP levels compared to those in healthy controls, indicating increased bacterial translocation and gut barrier damage.
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Affiliation(s)
- Miguel Angel Alvarez-Mon
- Department of Psychiatry and Medical Psychology, Clinica Universidad de Navarra, Pamplona, Spain
| | - Ana Maria Gómez
- Department of Medicine and Medical Specialties, University of Alcalá, Madrid, Spain
- Institute Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
| | - Arancha Orozco
- Division of Psychiatry, University Hospital “Principe de Asturias”, Alcalá de Henares, Spain
| | - Guillermo Lahera
- Department of Medicine and Medical Specialties, University of Alcalá, Madrid, Spain
- Institute Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- Biomedical Research Centre for Mental Health Network (CIBERSAM), Madrid, Spain
| | - Maria Dolores Sosa
- Department of Medicine and Medical Specialties, University of Alcalá, Madrid, Spain
- Institute Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
| | - David Diaz
- Department of Medicine and Medical Specialties, University of Alcalá, Madrid, Spain
- Institute Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- Biomedical Institute for Liver and Gut Diseases (CIBEREHD), Instituto de Salud Carlos III, Madrid, Spain
| | - Enrique Auba
- Department of Psychiatry and Medical Psychology, Clinica Universidad de Navarra, Pamplona, Spain
| | - Agustín Albillos
- Department of Medicine and Medical Specialties, University of Alcalá, Madrid, Spain
- Institute Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- Biomedical Institute for Liver and Gut Diseases (CIBEREHD), Instituto de Salud Carlos III, Madrid, Spain
- Service of Gastroenterology, University Hospital Ramón 80 y Cajal, Madrid, Spain
| | - Jorge Monserrat
- Department of Medicine and Medical Specialties, University of Alcalá, Madrid, Spain
- Institute Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- Biomedical Institute for Liver and Gut Diseases (CIBEREHD), Instituto de Salud Carlos III, Madrid, Spain
| | - Melchor Alvarez-Mon
- Department of Medicine and Medical Specialties, University of Alcalá, Madrid, Spain
- Institute Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- Biomedical Institute for Liver and Gut Diseases (CIBEREHD), Instituto de Salud Carlos III, Madrid, Spain
- Immune System Diseases and Oncology, Internal Medicine Service, University Hospital “Príncipe de Asturias”, Alcalá de Henares, Spain
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Alshammari TK, Alghamdi H, Green TA, Niazy A, Alkahdar L, Alrasheed N, Alhosaini K, Alswayyed M, Elango R, Laezza F, Alshammari MA, Yacoub H. Assessing the role of toll-like receptor in isolated, standard and enriched housing conditions. PLoS One 2019; 14:e0222818. [PMID: 31647818 PMCID: PMC6812767 DOI: 10.1371/journal.pone.0222818] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 09/06/2019] [Indexed: 12/27/2022] Open
Abstract
Depression is a common psychiatric disorder that has been poorly understood. Consequently, current antidepressant agents have clinical limitations. Until today, most have exhibited the slow onset of therapeutic action and, more importantly, their effect on remission has been minimal. Thus, the need to find new forms of therapeutic intervention is urgent. The inflammation hypothesis of depression is widely acknowledged and is one that theories the relationship between the function of the immune system and its contribution to the neurobiology of depression. In this research, we utilized an environmental isolation (EI) approach as a valid animal model of depression, employing biochemical, molecular, and behavioral studies. The aim was to investigate the anti-inflammatory effect of etanercept, a tumor necrosis factor-α inhibitor on a toll-like receptor 7 (TLR 7) signaling pathway in a depressive rat model, and compare these actions to fluoxetine, a standard antidepressant agent. The behavioral analysis indicates that depression-related symptoms are reduced after acute administration of fluoxetine and, to a lesser extent, etanercept, and are prevented by enriched environment (EE) housing conditions. Experimental studies were conducted by evaluating immobility time in the force swim test and pleasant feeling in the sucrose preference test. The mRNA expression of the TLR 7 pathway in the hippocampus showed that TLR 7, MYD88, and TRAF6 were elevated in isolated rats compared to the standard group, and that acute treatment with an antidepressant and anti-inflammatory drugs reversed these effects. This research indicates that stressful events have an impact on behavioral well-being, TLR7 gene expression, and the TLR7 pathway. We also found that peripheral administration of etanercept reduces depressive-like behaviour in isolated rats: this could be due to the indirect modulation of the TLR7 pathway and other TLRs in the brain. Furthermore, fluoxetine treatment reversed depressive-like behaviour and molecularly modulated the expression of TLR7, suggesting that fluoxetine exerts antidepressant effects partially by modulating the TLR7 signaling pathway.
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Affiliation(s)
- Tahani K. Alshammari
- Department of Pharmacology and Toxicology, Pharmacy College, King Saud University, Riyadh, Saudi Arabia
- * E-mail:
| | - Hajar Alghamdi
- Pharmacology & Toxicology Graduate Program, Pharmacy College, King Saud University, Riyadh, Saudi Arabia
| | - Thomas A. Green
- Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX, United States of America
| | - Abdurahman Niazy
- Prince Naïf Bin Abdul-Aziz Health Research Center, King Saud University, Riyadh, Saudi Arabia
| | - Lama Alkahdar
- Department of Pharmacology and Toxicology, Pharmacy College, King Saud University, Riyadh, Saudi Arabia
| | - Nouf Alrasheed
- Department of Pharmacology and Toxicology, Pharmacy College, King Saud University, Riyadh, Saudi Arabia
| | - Khalid Alhosaini
- Department of Pharmacology and Toxicology, Pharmacy College, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Alswayyed
- Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Ramesh Elango
- Stem Cell Unit, Department of Anatomy, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fernanda Laezza
- Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX, United States of America
| | - Musaad A. Alshammari
- Department of Pharmacology and Toxicology, Pharmacy College, King Saud University, Riyadh, Saudi Arabia
| | - Hazar Yacoub
- Department of Pharmacology and Toxicology, Pharmacy College, King Saud University, Riyadh, Saudi Arabia
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73
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Lisitsyna TA, Veltishchev DY, Lila AM, Nasonov EL. Interleukin 6 as a pathogenic factor mediating clinical manifestations and a therapeutic target for rheumatic diseases and depressive disorders. RHEUMATOLOGY SCIENCE AND PRACTICE 2019. [DOI: 10.14412/1995-4484-2019-318-327] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The review summarizes current idea on the key role of interleukin 6 (IL-6) in the pathogenesis of rheumatic diseases (RDs) and depressive disorders. It considers in detail the mechanisms by which IL6 induces the clinical and laboratory manifestations of RDs and depression; the influence of precipitating and predisposing stress factors, including childhood mental traumas, which increase the risk of RDs and depression, on IL-6 production. Particular attention is paid to the consideration of prospects for using IL-6 inhibitors in the therapy of depression.
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Affiliation(s)
| | - D. Yu. Veltishchev
- Moscow Research Institute of Psychiatry, Branch, V.P. Serbsky National Medical Research Center of Psychiatry and Narcology, Ministry of Health of Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
| | - A. M. Lila
- V.A. Nasonova Research Institute of Rheumatology
| | - E. L. Nasonov
- V.A. Nasonova Research Institute of Rheumatology; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
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74
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Zhang K, Wang X, Tu J, Rong H, Werz O, Chen X. The interplay between depression and tuberculosis. J Leukoc Biol 2019; 106:749-757. [PMID: 31254317 DOI: 10.1002/jlb.mr0119-023r] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/19/2019] [Accepted: 06/07/2019] [Indexed: 02/06/2023] Open
Abstract
Depression is a major mental health condition and is expected be the most debilitating and widespread health disorder by 2030. Tuberculosis (TB) is also a leading cause of morbidity and mortality worldwide and interestingly, is a common comorbidity of depression. As such, much attention has been paid to the association between these 2 pathologies. Based on clinical reports, the association between TB and depression seems to be bidirectional, with a substantial overlap in symptoms between the 2 conditions. TB infection or reactivation may precipitate depression, likely as a consequence of the host's inflammatory response and/or dysregulation of the hypothalamic-pituitary-adrenal axis. Nevertheless, few studies have considered whether patients with depression are at a higher risk for TB. In this review, we discuss the hypotheses on the association between depression and TB, highlighting the immuno-inflammatory response and lipid metabolism as potential mechanisms. Improving our understanding of the interplay between these 2 disorders should help guide TB clinical care and prevention both in patients with comorbid depression and in the general population.
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Affiliation(s)
- Kehong Zhang
- Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Department of Pathogen Biology, Shenzhen University School of Medicine, Shenzhen, China.,Department of Pharmaceutical/Medicinal Chemistry, Institute of Pharmacy, Friedrich-Schiller-University Jena, Jena, Germany
| | - Xin Wang
- Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Department of Pathogen Biology, Shenzhen University School of Medicine, Shenzhen, China
| | - Jie Tu
- The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institutes of Advanced Technology, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, Chinese Academy of Sciences, Shenzhen, China
| | - Han Rong
- Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
| | - Oliver Werz
- Department of Pharmaceutical/Medicinal Chemistry, Institute of Pharmacy, Friedrich-Schiller-University Jena, Jena, Germany
| | - Xinchun Chen
- Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Department of Pathogen Biology, Shenzhen University School of Medicine, Shenzhen, China
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Aricioglu F, Ozkartal CS, Bastaskin T, Tüzün E, Kandemir C, Sirvanci S, Kucukali CI, Utkan T. Antidepressant-like Effects Induced by Chronic Blockade of the Purinergic 2X7 Receptor through Inhibition of Non-like Receptor Protein 1 Inflammasome in Chronic Unpredictable Mild Stress Model of Depression in Rats. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2019; 17:261-272. [PMID: 30905126 PMCID: PMC6478084 DOI: 10.9758/cpn.2019.17.2.261] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 07/11/2018] [Accepted: 07/23/2018] [Indexed: 02/06/2023]
Abstract
Objective Purinergic 2X7 receptor (P2X7R) activation is known to be involved in pathogenesis of depression. Our aims were to investigate P2X7R-activated inflammasome pathways in parallel with induction of depression and to test the antidepressant-like effects of the selective P2X7R antagonist Brilliant Blue G (BBG) in a rat model of chronic unpredictable mild stress (CUMS). Methods Male Wistar albino rats were divided into control, CUMS, CUMS+BBG25 (25 mg/kg/day) and CUMS+BBG50 (50 mg/kg/day) groups (n=10 for each group). Various stressors were applied to rats for 6 weeks to establish the CUMS model and daily BBG treatment was started at the end of 3rd week. Sucrose preference test and forced swim test (FST) were performed to assess antidepressant-like effects. Brain samples were obtained for real-time polymerase chain reaction and immunohistochemistry analysis. Results In FST, duration of immobility was reduced in the CUMS+BBG50 group. Also, BBG treatment significantly enhanced sucrose preference. While NLRP3 gene expression levels were unchanged in rats exposed to the CUMS protocol, expression levels of other inflammasome pathway factors NLRP1, caspase-1, ASC, NF-κB, IL-1β, IL-6 and P2X7R were increased. BBG treatment reduced expression levels of these factors. Likewise, Iba-1 and GFAP immunoreactivities were enhanced by the CUMS protocol and this action was reversed by BBG treatment. Conclusion Chronic administration of BBG in CUMS model results in antidepressant-like activity in a dose dependent manner. Molecular and histological results show that these effects might be at least partially related to the suppression of inflammasome-related neuroinflammatory responses and suggest involvement of NLRP1 in depression.
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Affiliation(s)
- Feyza Aricioglu
- Department of Pharmacology and Psychopharmacology Research Unit, Marmara University School of Pharmacy
| | - Ceren Sahin Ozkartal
- Department of Pharmacology and Psychopharmacology Research Unit, Marmara University School of Pharmacy
| | - Tugce Bastaskin
- Department of Pharmacology and Psychopharmacology Research Unit, Marmara University School of Pharmacy
| | - Erdem Tüzün
- Department of Neuroscience, Aziz Sancar Institute of Experimental Medical Research, Istanbul University
| | - Cansu Kandemir
- Department of Histology and Embryology, Marmara University School of Medicine
| | - Serap Sirvanci
- Department of Histology and Embryology, Marmara University School of Medicine
| | - Cem Ismail Kucukali
- Department of Neuroscience, Aziz Sancar Institute of Experimental Medical Research, Istanbul University
| | - Tijen Utkan
- Department of Pharmacology, Kocaeli University School of Medicine
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76
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Kang HR, Hong SH, Ha SY, Kim TB, Lee EK. Differences in the risk of mood disorders in patients with asthma-COPD overlap and in patients with COPD alone: a nationwide population-based retrospective cohort study in Korea. Respir Res 2019; 20:80. [PMID: 31039780 PMCID: PMC6492426 DOI: 10.1186/s12931-019-1039-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 04/01/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Although feelings of anxiety and depression are common in patients with chronic obstructive pulmonary disease (COPD), little is known about the estimates of their incidence in patients with asthma-COPD overlap (ACO), which has been described and acknowledged as a distinct clinical entity. We aimed to estimate the risk of depression and anxiety among patients with ACO and compare it with the risk among those with COPD alone in the general population. METHODS We conducted a nationwide population-based retrospective cohort study using the Korean National Sample Cohort database between 1 January, 2002, and 31 December, 2013. Patients who were diagnosed with COPD (International Classification of Diseases, 10th revision [ICD-10] codes J42-J44) at least twice and prescribed COPD medications at least once between 2003 and 2011 were classified into two categories: patients who were diagnosed with asthma (ICD-10 codes J45-J46) more than twice and at least once prescribed asthma medications comprised the ACO group, and the remaining COPD patients comprised the COPD alone group. Patients who had been diagnosed with depression or anxiety within a year before the index date were excluded. We defined the outcome as time to first diagnosis with depression and anxiety. Matched Cox regression models were used to compare the risk of depression and anxiety among patients with ACO and patients with COPD alone after propensity score matching with a 1:1 ratio. RESULTS After propensity score estimation and matching in a 1:1 ratio, the cohort used in the analysis included 15,644 patients. The risk of depression during the entire study period was higher for patients with ACO than for patients with COPD alone (adjusted hazard ratio, 1.10; 95% confidence interval, 1.03-1.18; P value = 0.0039), with an elevated risk in patients aged 40-64 years (1.21; 1.10-1.34; 0.0001) and in women (1.18; 1.07-1.29; 0.0005). The risk of anxiety was higher for patients with ACO than for patients with COPD alone (1.06; 1.01-1.12; 0.0272), with a higher risk in patients aged 40-64 years (1.08; 1.00-1.17; 0.0392); however, the risk was not significant when stratified by sex. CONCLUSIONS This population-based study revealed a higher incidence of depression and anxiety in patients with ACO than in patients with COPD alone.
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Affiliation(s)
- Hye-Rim Kang
- School of Pharmacy, Sungkyunkwan University, 2066, Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do, 16419, South Korea
| | - Sung-Hyun Hong
- School of Pharmacy, Sungkyunkwan University, 2066, Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do, 16419, South Korea
| | - So-Young Ha
- School of Pharmacy, Sungkyunkwan University, 2066, Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do, 16419, South Korea
| | - Tae-Bum Kim
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Eui-Kyung Lee
- School of Pharmacy, Sungkyunkwan University, 2066, Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do, 16419, South Korea.
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77
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Liu CH, Zhang GZ, Li B, Li M, Woelfer M, Walter M, Wang L. Role of inflammation in depression relapse. J Neuroinflammation 2019; 16:90. [PMID: 30995920 PMCID: PMC6472093 DOI: 10.1186/s12974-019-1475-7] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 04/01/2019] [Indexed: 12/13/2022] Open
Abstract
Major depressive disorder (MDD) is a leading cause of disability worldwide. After the first episode, patients with remitted MDD have a 60% chance of experiencing a second episode. Consideration of therapy continuation should be viewed in terms of the balance between the adverse effects of medication and the need to prevent a possible relapse. Relapse during the early stages of MDD could be prevented more efficiently by conducting individual risk assessments and providing justification for continuing therapy. Our previous work established the neuroimaging markers of relapse by comparing patients with recurrent major depressive disorder (rMDD) in depressive and remitted states. However, it is not known which of these markers are trait markers that present before initial relapse and, consequently, predict disease course. Here, we first describe how inflammation can be translated to subtype-specific clinical features and suggest how this could be used to facilitate clinical diagnosis and treatment. Next, we address the central and peripheral functional state of the immune system in patients with MDD. In addition, we emphasize the important link between the number of depressive episodes and rMDD and use neuroimaging to propose a model for the latter. Last, we address how inflammation can affect brain circuits, providing a possible mechanism for rMDD. Our review suggests a link between inflammatory processes and brain region/circuits in rMDD.
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Affiliation(s)
- Chun-Hong Liu
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, 100010, China
| | - Guang-Zhong Zhang
- Dermatological Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Bin Li
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Meng Li
- Clinical Affective Neuroimaging Laboratory (CANLAB), Otto-von-Guericke-University Magdeburg, Magdeburg, 39120, Germany
| | - Marie Woelfer
- Clinical Affective Neuroimaging Laboratory (CANLAB), Otto-von-Guericke-University Magdeburg, Magdeburg, 39120, Germany.,Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, 07102, USA
| | - Martin Walter
- Clinical Affective Neuroimaging Laboratory (CANLAB), Otto-von-Guericke-University Magdeburg, Magdeburg, 39120, Germany.,Department of Psychiatry and Psychotherapy, University of Tuebingen, Tubeingen, 72074, Germany.,Leibniz Institute for Neurobiology, Magdeburg, 39118, Germany
| | - Lihong Wang
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, 06030, USA.
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Woelfer M, Kasties V, Kahlfuss S, Walter M. The Role of Depressive Subtypes within the Neuroinflammation Hypothesis of Major Depressive Disorder. Neuroscience 2019; 403:93-110. [DOI: 10.1016/j.neuroscience.2018.03.034] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 01/25/2018] [Accepted: 03/20/2018] [Indexed: 12/21/2022]
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79
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He S, Zeng D, Xu F, Zhang J, Zhao N, Wang Q, Shi J, Lin Z, Yu W, Li H. Baseline Serum Levels of Beclin-1, but Not Inflammatory Factors, May Predict Antidepressant Treatment Response in Chinese Han Patients With MDD: A Preliminary Study. Front Psychiatry 2019; 10:378. [PMID: 31244689 PMCID: PMC6563849 DOI: 10.3389/fpsyt.2019.00378] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 05/13/2019] [Indexed: 01/08/2023] Open
Abstract
Currently, the choice of medical treatment for major depressive disorder (MDD) is primarily based on a trial-and-error process. Thus, identification of individual factors capable of predicting treatment response is of great clinical relevance. Recent work points towards beclin-1 and inflammatory factors as potential biomarkers of antidepressant treatment response. The primary aim of the study was to investigate whether pre-treatment serum levels of beclin-1 and inflammatory factors could predict antidepressant treatment response in Chinese Han patients with MDD. Forty patients with MDD were treated with either a selective serotonin reuptake inhibitor (SSRI) (paroxetine in 20 cases) or a serotonin-norepinephrine reuptake inhibitor (SNRI) (duloxetine in 13 cases and venlafaxine in 7 cases). Depression scores and serum levels of beclin-1 were measured at the baseline and after 8 weeks of antidepressant treatment. Serum C-reactive protein (CRP), interleukin (IL)-1B, and IL-6 levels were determined using enzyme-linked immunosorbent assay kits at the baseline. Twenty-seven patients were identified as treatment responders, whereas 13 were identified as non-responders after 8 weeks of antidepressant treatment. Baseline serum beclin-1 levels were significantly higher in non-responders than in responders (p = 0.001), whereas no differences were found in baseline serum CRP, IL-1B, or IL-6 levels between responders and non-responders. There were no significant correlations between baseline levels of beclin-1 and baseline IL-1β, IL-6, and CRP levels-neither in the total sample nor in responder and non-responder groups. Moreover, logistic regression models and a random forest model showed that baseline serum beclin-1, but not inflammatory factors, was an independent and the most important predictor for antidepressant treatment response. Furthermore, serum beclin-1 levels were significantly increased in responders (p = 0.027) but not in non-responders after 8 weeks of treatment (p = 0.221). Baseline serum beclin-1 levels may be a predictive biomarker of antidepressant response in patients with MDD. Moreover, beclin-1 may be involved in the therapeutic effect of antidepressant drugs.
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Affiliation(s)
- Shen He
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Duan Zeng
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Feikang Xu
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianping Zhang
- Psychiatry Research, Zucker Hillside Hospital, Northwell Health System, Glen Oaks, NY, United States
| | - Nan Zhao
- Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
| | - Qiang Wang
- Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
| | - Jiali Shi
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiguang Lin
- Biochemistry Laboratory, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenjuan Yu
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huafang Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Romay-Tallon R, Kulhawy E, Brymer KJ, Allen J, Rivera-Baltanas T, Olivares JM, Kalynchuk LE, Caruncho HJ. Changes in Membrane Protein Clustering in Peripheral Lymphocytes in an Animal Model of Depression Parallel Those Observed in Naïve Depression Patients: Implications for the Development of Novel Biomarkers of Depression. Front Pharmacol 2018; 9:1149. [PMID: 30374301 PMCID: PMC6196231 DOI: 10.3389/fphar.2018.01149] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 09/24/2018] [Indexed: 12/27/2022] Open
Abstract
Naïve depression patients show alterations in serotonin transporter (SERT) and serotonin 2A (5HT2A) receptor clustering in peripheral lymphocytes, and these alterations have been proposed as a biomarker of therapeutic efficacy in major depression. Repeated corticosterone (CORT) induces a consistent depression-like phenotype and has been widely used as an animal model to study neurobiological alterations underlying the depressive symptoms. In this experiment, we used the CORT paradigm to evaluate whether depression-like behavior is associated with similar changes in the pattern of SERT and 5HT2A membrane protein clustering as those observed in depression patients. We also analyzed the clustering of other proteins expressed in lipid rafts in lymphocytes. Rats received daily CORT or vehicle injections for 21 consecutive days. Afterward they underwent the forced swim test to evaluate depression-like behavior, and isolated lymphocytes were analyzed by immunocytochemistry coupled to image-analysis to study clustering parameters of the SERT, 5HT2A receptor, dopamine transporter (DAT), Beta2 adrenergic receptor (β2AR), NMDA 2B receptor (NR2B), Pannexin 1 (Pnx1), and prion cellular protein (PrPc). Our results showed that CORT increases the size of protein clusters for all proteins with the exception of β 2AR, which is decreased. CORT also increased the number of clusters for Pnx1 and PrPc only. Overall, these results indicate that alterations in SERT and 5HT2A protein clustering in naïve depression patients are paralleled by changes seen in an animal model of depression. The CORT paradigm may be a useful screen for examining additional proteins in lymphocytes as a preliminary step prior to their analysis as biomarkers of depression in human blood samples.
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Affiliation(s)
| | - Erin Kulhawy
- Innovate-Calgary, University of Calgary, Calgary, AB, Canada
| | - Kyle J Brymer
- Department of Psychology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Josh Allen
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | | | - Jose M Olivares
- Division of Psychiatry, Hospital Alvaro Cunqueiro, CHUVI, Vigo, Spain
| | - Lisa E Kalynchuk
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | - Hector J Caruncho
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
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81
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Liu Y, Tang X. Depressive Syndromes in Autoimmune Disorders of the Nervous System: Prevalence, Etiology, and Influence. Front Psychiatry 2018; 9:451. [PMID: 30319458 PMCID: PMC6168717 DOI: 10.3389/fpsyt.2018.00451] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 08/30/2018] [Indexed: 12/20/2022] Open
Abstract
Autoimmune diseases of the nervous system (ADNS) consist of a group of severely disabling disorders characterized by abnormal immune attack against protein components of the nervous system. This type of attack behavior may occur in the central or peripheral nervous system, and in the neuromuscular junction, resulting in neuronal damage, axonal injury, demyelination or destruction of the neuromuscular junction. While the neurological deficits of patients with ADNS have received significant research attention, the manifestation of depression tends to be ignored. In fact, depressive manifestation is common in ADNS and adds significant burden upon patients suffering from this disease. Here, we systematically reviewed the current literature to highlight the prevalence, etiology and influence of depressive manifestation in ADNS. Most autoimmune diseases of the nervous system are discussed in this paper, from multiple sclerosis, acute disseminated encephalomyelitis and autoimmune encephalitis to acute myelitis, neuromyelitis optica, Guillain-Barré syndrome and myasthenia gravis. Depressive symptoms usually develop as a comorbidity during the course of disease, but sometimes exist as a primary presentation of the disease. Psychosocial factors, long periods of disablement and chronic pain are the three most common causes of depressive symptoms in many chronic conditions, particularly in peripheral neuropathy. Furthermore, the higher prevalence of depressive symptoms in ADNS suggests that immunological dysregulation may contribute to the elevated morbidity of depression. Finally, structural lesions of the brain, and some medications for ADNS, are also thought to precipitate depressive states in ADNS.
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Affiliation(s)
| | - Xiangqi Tang
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China
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82
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Dey A, Hankey Giblin PA. Insights into Macrophage Heterogeneity and Cytokine-Induced Neuroinflammation in Major Depressive Disorder. Pharmaceuticals (Basel) 2018; 11:E64. [PMID: 29941796 PMCID: PMC6160985 DOI: 10.3390/ph11030064] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 06/21/2018] [Accepted: 06/22/2018] [Indexed: 12/13/2022] Open
Abstract
Over 350 million individuals suffer from depression, a psychiatric illness classified as major depressive disorder (MDD) with symptoms that include a loss of interest or pleasure in life accompanied by depressed mood. The present understanding of major depressive disorder does not encompass a systematic characterization of the neurobiological processes that drive the behavioral physiology in patients diagnosed with major depressive disorder. Psychiatric illness is a complex intersection between genetics, physiology, immunology and environmental stress. The increased attention to the relevance of depression has led to new discoveries that highlight the biological significance of ‘neuroinflammation’ and immunity underlying a spectrum of psychiatric illnesses. The process of neuroinflammation involves sentinel immune cells in the central nervous system (CNS). The activation and polarization of microglia, CNS-resident macrophages, modulates the production and secretion of pro-inflammatory cytokines implicated in the etiology of major depressive disorder, and this phenomenon has been aptly titled the ‘macrophage theory of depression’. Of particular interest are three hallmark cytokines, IL-6, TNFα and IL-1β, which have been studied extensively in basic research, cell-receptor signaling and drug development. The field of inflammasome-mediated neuroinflammation is an emerging area of MDD research that is providing new cellular insight into how macrophages mechanistically support cytokine-associated neuropathology, particularly in the case of IL-1β-associated inflammation in MDD. With the increasing number of individuals identified with depression, a comprehensive understanding of macrophage-cytokine signaling pathways in the CNS in depression is necessary for developing effective anti-depressant therapeutics.
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Affiliation(s)
- Adwitia Dey
- Center for Molecular Immunology and Infectious Diseases, The Pennsylvania State University, University Park, State College, PA 16802, USA.
- Department of Veterinary and Biomedical Sciences, The Pennsylvania State University, University Park, State College, PA 16802, USA.
| | - Pamela A Hankey Giblin
- Center for Molecular Immunology and Infectious Diseases, The Pennsylvania State University, University Park, State College, PA 16802, USA.
- Department of Veterinary and Biomedical Sciences, The Pennsylvania State University, University Park, State College, PA 16802, USA.
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83
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Crider A, Feng T, Pandya CD, Davis T, Nair A, Ahmed AO, Baban B, Turecki G, Pillai A. Complement component 3a receptor deficiency attenuates chronic stress-induced monocyte infiltration and depressive-like behavior. Brain Behav Immun 2018; 70. [PMID: 29518530 PMCID: PMC5967612 DOI: 10.1016/j.bbi.2018.03.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Major depressive disorder (MDD) is one of the most common and debilitating neuropsychiatric illnesses. Accumulating evidence suggests a potential role of the immune system in the pathophysiology of MDD. The complement system represents one of the major effector mechanisms of the innate immune system, and plays a critical role in inflammation. However, the role of complement components in MDD is not well understood. Here, we found significant increase in component 3 (C3) expression in the prefrontal cortex (PFC) of depressed suicide subjects. We tested the role of altered C3 expression in mouse model of depression and found that increased C3 expression in PFC as a result of chronic stress causes depressive-like behavior. Conversely, mice lacking C3 were resilient to stress-induced depressive-like behavior. Moreover, selective overexpression of C3 in PFC was sufficient to cause depressive-like behavior in mice. We found that C3a (activated product of C3) receptor, C3aR+ monocytes were infiltrated into PFC following chronic stress. However, C3aR knockout mice displayed significantly reduced monocyte recruitment into PFC and reduced levels of the proinflammatory cytokine IL-1β in PFC after chronic stress. In addition, C3aR knockout mice did not exhibit chronic stress-induced behavior despair. Similarly, chronic stress-induced increases in C3aR+ monocytes and IL-1β in PFC, and depressive-like behavior were attenuated by myeloid cell depletion. These postmortem and preclinical studies identify C3aR signaling as a key factor in MDD pathophysiology.
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Affiliation(s)
- Amanda Crider
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA 30912
| | - Tami Feng
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA 30912
| | - Chirayu D. Pandya
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA 30912
| | - Talisha Davis
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA 30912
| | - Ashwati Nair
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA 30912,Institute of Pharmacy, Nirma University, Ahmedabad, India
| | - Anthony O Ahmed
- Department of Psychiatry, Weill Cornell Medical College, 1300 York Ave, New York, NY 10065
| | - Babak Baban
- Department of Oral Biology, Dental College of Georgia, Department of Neurology, Augusta University, Augusta, GA 30912
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Depressive Disorders Program, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Anilkumar Pillai
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States.
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84
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Differences in immunomodulatory properties between venlafaxine and paroxetine in patients with major depressive disorder. Psychoneuroendocrinology 2018; 87:108-118. [PMID: 29055264 DOI: 10.1016/j.psyneuen.2017.10.009] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 09/03/2017] [Accepted: 10/10/2017] [Indexed: 01/24/2023]
Abstract
Inflammatory processes play a crucial role in the pathophysiology of depression, and identifying the specific cytokines targeted by different antidepressants is important for personalized treatment. The aims of this study were to examine whether venlafaxine and paroxetine cause different immunomodulatory effects when used to treat patients with major depression and to clarify the relationships between plasma cytokine levels and the therapeutic effectiveness of these drugs. A total of 91 Han Chinese patients with major depression completed the 8-week paroxetine or venlafaxine treatment and 90 healthy controls were recruited. A multiplex assay was used to measure cytokines levels in patients with major depression before and after an 8-week venlafaxine and paroxetine treatment. Cytokine levels were measured in healthy controls at the baseline. The 21-item Hamilton Depression Rating Scale was used to assess the changes in psychopathological symptoms from the baseline to the end point in each patient. Venlafaxine treatment caused greater decreases in the levels of interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), interleukin 4 (IL-4), IL-5, IL-1β, and IL-8 than did paroxetine. Paroxetine treatment increased the levels of proinflammatory cytokines IFN-γ, TNF-α, and IL-6 and decreased Th2 cytokine levels. After paroxetine treatment, IL-6 levels increased more in the non-remitter group than in the remitter group. In the remitter group, IL-4 and IL-5 levels decreased to values seen in the healthy controls. After venlafaxine treatment in both the remitter and non-remitter groups, IL-1β levels decreased to values seen in the healthy controls. Our results suggest that venlafaxine and paroxetine have different immunomodulatory properties and that venlafaxine has greater anti-inflammatory effects than paroxetine.
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85
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Hoggard M, Nocera A, Biswas K, Taylor MW, Douglas RG, Bleier BS. The sinonasal microbiota, neural signaling, and depression in chronic rhinosinusitis. Int Forum Allergy Rhinol 2017; 8:394-405. [PMID: 29278464 DOI: 10.1002/alr.22074] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 12/04/2017] [Accepted: 12/05/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND The complex relationships between the human microbiota, the immune system, and the brain play important roles in both health and disease, and have been of increasing interest in the study of chronic inflammatory mucosal conditions. We hypothesized that the sinonasal microbiota may act as a modifier of interkingdom neural signaling and, subsequently, mental health, in the upper respiratory inflammatory condition chronic rhinosinusitis (CRS). In this study we investigated associations between the sinonasal microbiota; local concentrations of the neurotransmitters serotonin, dopamine, and γ-aminobutyric acid (GABA); and depression severity in a cohort of 14 CRS patients and 12 healthy controls. METHODS Subject demographics, clinical severity scores, depression index scores, and sinonasal swab and mucus samples were collected at the time of surgery. Bacterial communities were characterized from swabs by 16S rRNA gene-targeted sequencing and quantified by quantitative polymerase chain reaction. Mucus concentrations of the neurotransmitters serotonin, dopamine, and GABA were quantified by enzyme-linked immunosorbent assay. RESULTS Several commonly "health-associated" sinonasal bacterial taxa were positively associated with higher neurotransmitter concentrations and negatively associated with depression severity. In contrast, several taxa commonly associated with an imbalanced sinonasal microbiota negatively associated with neurotransmitters and positively with depression severity. Few significant differences were identified when comparing between control and CRS subject groups, including neurotransmitter concentrations, depression scores, or sinonasal microbiota composition or abundance. CONCLUSION The findings obtained lend support to the potential for downstream effects of the sinonasal microbiota on neural signaling and, subsequently, brain function and behavior.
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Affiliation(s)
- Michael Hoggard
- School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Angela Nocera
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
| | - Kristi Biswas
- School of Medicine, University of Auckland, Auckland, New Zealand
| | - Michael W Taylor
- School of Biological Sciences, University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre for Molecular Biodiscovery, University of Auckland, Auckland, New Zealand
| | | | - Benjamin S Bleier
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
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86
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Sild M, Ruthazer ES, Booij L. Major depressive disorder and anxiety disorders from the glial perspective: Etiological mechanisms, intervention and monitoring. Neurosci Biobehav Rev 2017; 83:474-488. [DOI: 10.1016/j.neubiorev.2017.09.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 08/08/2017] [Accepted: 09/11/2017] [Indexed: 12/12/2022]
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87
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Colpo GD, Leboyer M, Dantzer R, Trivedi MH, Teixeira AL. Immune-based strategies for mood disorders: facts and challenges. Expert Rev Neurother 2017; 18:139-152. [PMID: 29179585 DOI: 10.1080/14737175.2018.1407242] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Inflammation seems to play a role in the pathophysiology of mood disorders, including major depressive disorder (MDD) and bipolar disorder (BD). In the last years several studies have shown increased levels of inflammatory and/or immune markers in patients with mood disorders. Accordingly, the immune system has become a target of interest for the development of biomarkers and therapeutics for mood disorders. Areas covered: Here, we review the evidence showing low-grade inflammation in mood disorders and the studies evaluating immune-based strategies for the treatment of these conditions. Expert commentary: Clinical trials with non-steroidal anti-inflammatory drugs, polyunsaturated acids, N-acetylcysteine, anti-cytokines, physical activity and probiotics have provided promising results in terms of antidepressant efficacy in patients with MDD and BD. Regarding stem cells, only studies with animal models have been performed so far with interesting pre-clinical results. Due to the preliminary nature of the results, most of the clinical studies need to be replicated and/or confirmed in larger clinical settings, embracing the highly heterogeneous pathophysiology of mood disorders.
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Affiliation(s)
- Gabriela D Colpo
- a Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School , The University of Texas Health Science Center at Houston - UT Health , Houston , TX , USA
| | - Marion Leboyer
- b Inserm U 955, Department of Psychiatry, AP-HP, DHU PePSY, Groupe Hosp italier Henri Mondor , Créteil University Paris Est Créteil , Paris , France
| | - Robert Dantzer
- c Division of Internal Medicine, Department of Symptom Research , MD Anderson Cancer Center , Houston , TX , USA
| | - Mahdukar H Trivedi
- d Department of Psychiatry , University of Texas Southwestern Medical Center , Dallas , TX , USA
| | - Antonio L Teixeira
- a Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School , The University of Texas Health Science Center at Houston - UT Health , Houston , TX , USA
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88
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Herkenham M, Kigar SL. Contributions of the adaptive immune system to mood regulation: Mechanisms and pathways of neuroimmune interactions. Prog Neuropsychopharmacol Biol Psychiatry 2017; 79:49-57. [PMID: 27613155 PMCID: PMC5339070 DOI: 10.1016/j.pnpbp.2016.09.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 07/22/2016] [Accepted: 09/05/2016] [Indexed: 12/20/2022]
Abstract
Clinical and basic studies of functional interactions between adaptive immunity, affective states, and brain function are reviewed, and the neural, humoral, and cellular routes of bidirectional communication between the brain and the adaptive immune system are evaluated. In clinical studies of depressed populations, lymphocytes-the principal cells of the adaptive immune system-exhibit altered T cell subtype ratios and CD4+ helper T cell polarization profiles. In basic studies using psychological stress to model depression, T cell profiles are altered as well, consistent with stress effects conveyed by the hypothalamic-pituitary-adrenal axis and sympathetic nervous system. Lymphocytes in turn have effects on behavior and CNS structure and function. CD4+ T cells in particular appear to modify affective behavior and rates of hippocampal dentate gyrus neurogenesis. These observations force the question of how such actions are carried out. CNS effects may occur via cellular and molecular mechanisms whereby effector memory T cells and the cytokine profiles they produce in the blood interact with the blood-brain barrier in ways that remain to be clarified. Understanding the mechanisms by which T cells polarize and interact with the brain to alter mood states is key to advances in the field, and may permit development of therapies that target cells in the periphery, thus bypassing problems associated with bioavailability of drugs within the brain.
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Affiliation(s)
- Miles Herkenham
- Section on Functional Neuroanatomy, Intramural Research Program, National Institute of Mental Health, NIH, Bethesda, MD, USA.
| | - Stacey L Kigar
- Section on Functional Neuroanatomy, Intramural Research Program, National Institute of Mental Health, NIH, Bethesda, MD, USA
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89
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Callaghan CK, Rouine J, O'Mara SM. Exercise prevents IFN-α-induced mood and cognitive dysfunction and increases BDNF expression in the rat. Physiol Behav 2017; 179:377-383. [DOI: 10.1016/j.physbeh.2017.07.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 07/11/2017] [Accepted: 07/11/2017] [Indexed: 02/06/2023]
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90
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Abildgaard A, Elfving B, Hokland M, Lund S, Wegener G. Probiotic treatment protects against the pro-depressant-like effect of high-fat diet in Flinders Sensitive Line rats. Brain Behav Immun 2017; 65:33-42. [PMID: 28450222 DOI: 10.1016/j.bbi.2017.04.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 04/10/2017] [Accepted: 04/23/2017] [Indexed: 12/18/2022] Open
Abstract
Major depressive disorder (MDD) is highly associated with dysmetabolic conditions, such as obesity and diabetes mellitus type 2, and the gut microbiota may interact with both disease entities. We have previously shown that a high-fat diet (HFD) exacerbated depressive-like behaviour uniquely in Flinders Sensitive Line (FSL) rats that inherently present with an increased level of depressive-like behaviour compared with Flinders Resistant Line (FRL) rats. We therefore investigated whether multispecies probiotics possessed anti-depressant-like effect in FSL rats or protected against the pro-depressant-like effect of HFD. We also examined blood and cerebral T cell subsets as well as plasma cytokines. Lastly, we investigated the effect of HFD in outbred Sprague-Dawley (SD) rats to substantiate the association between depressive-like behaviour and any immunological measures affected by HFD. HFD exacerbated the depressive-like behaviour in FSL rats in the forced swim test, whereas SD rats remained unaffected. Probiotic treatment completely precluded the pro-depressant-like effect of HFD, but it did not affect FSL rats on control diet. Cerebral T lymphocyte CD4/8 ratios closely mirrored the behavioural changes, whereas the proportions of Treg and Th17 subsets were unaltered. No association between blood and brain CD4/8 ratios were evident; nor did plasma cytokine levels change as a consequence of HFD of probiotic treatment. Our findings suggest that MDD may hold a dysmetabolic component that responds to probiotic treatment. This finding has wide implications owing to the high metabolic comorbidity in MDD. Furthermore, the close association between depressive-like behaviour and cerebral T cell populations demonstrate lymphocyte-brain interactions as a promising future research area in the field of psychoneuroimmunology.
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Affiliation(s)
- Anders Abildgaard
- Translational Neuropsychiatry Unit, Aarhus University, Skovagervej 2, 8240 Risskov, Denmark; Department of Clinical Biochemistry, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
| | - Betina Elfving
- Translational Neuropsychiatry Unit, Aarhus University, Skovagervej 2, 8240 Risskov, Denmark
| | - Marianne Hokland
- Department of Biomedicine, Aarhus University, Bartholins Allé 6, Build. 1242, 8000 Aarhuc C, Denmark
| | - Sten Lund
- Department of Medical Endocrinology (MEA), Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus C, Denmark
| | - Gregers Wegener
- Translational Neuropsychiatry Unit, Aarhus University, Skovagervej 2, 8240 Risskov, Denmark; Center of Excellence for Pharmaceutical Sciences, North-West University (Potchefstroom Campus), Hoffman Street, Potchefstroom 2520, South Africa
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91
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Dickerson F, Adamos M, Katsafanas E, Khushalani S, Origoni A, Savage C, Schweinfurth L, Stallings C, Sweeney K, Alaedini A, Uhde M, Severance E, Wilcox HC, Yolken R. The association between immune markers and recent suicide attempts in patients with serious mental illness: A pilot study. Psychiatry Res 2017; 255:8-12. [PMID: 28505469 DOI: 10.1016/j.psychres.2017.05.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 04/25/2017] [Accepted: 05/04/2017] [Indexed: 11/28/2022]
Abstract
Previous studies have identified elevations in markers of gastrointestinal inflammation in schizophrenia and mood disorders but studies have not measured the association between these markers and recent suicide attempts. We assessed 210 patients receiving treatment for schizophrenia, bipolar disorder, or major depression. We employed the Columbia Suicide Severity Rating Scale to identify recent and lifetime suicide attempts (actual, aborted, and interrupted). Psychiatric participants and a control group of 72 individuals without a psychiatric disorder had a blood sample drawn from which were measured specific markers of gastrointestinal inflammation and also C-Reactive protein (CRP). A total of 20 (10%) of psychiatric participants had a suicide attempt in the previous one month and 95 (45%) an attempt during their lifetime but not in the previous one month. The recent attempters had significantly elevated levels of antibodies to yeast mannan from Saccharomyces cerevisiae (ASCA), the food antigen gliadin, and bacterial lipopolysaccharide (LPS) compared with the non-psychiatric group when adjusting for demographic and clinical variables. These markers were not elevated in individuals with a past, but not recent, suicide attempt history. Our study indicates that there is evidence of gastrointestinal inflammation in some individuals who have had a recent suicide attempt.
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Affiliation(s)
- Faith Dickerson
- Stanley Research Program, Sheppard Pratt Health System, Baltimore, MD, USA.
| | - Maria Adamos
- Stanley Research Program, Sheppard Pratt Health System, Baltimore, MD, USA
| | - Emily Katsafanas
- Stanley Research Program, Sheppard Pratt Health System, Baltimore, MD, USA
| | - Sunil Khushalani
- Stanley Research Program, Sheppard Pratt Health System, Baltimore, MD, USA
| | - Andrea Origoni
- Stanley Research Program, Sheppard Pratt Health System, Baltimore, MD, USA
| | - Christina Savage
- Stanley Research Program, Sheppard Pratt Health System, Baltimore, MD, USA
| | - Lucy Schweinfurth
- Stanley Research Program, Sheppard Pratt Health System, Baltimore, MD, USA
| | - Cassie Stallings
- Stanley Research Program, Sheppard Pratt Health System, Baltimore, MD, USA
| | - Kevin Sweeney
- Stanley Research Program, Sheppard Pratt Health System, Baltimore, MD, USA
| | - Armin Alaedini
- Department of Medicine, Columbia University, New York, NY, USA
| | - Melanie Uhde
- Department of Medicine, Columbia University, New York, NY, USA
| | - Emily Severance
- Stanley Neurovirology Laboratory, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Holly C Wilcox
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Robert Yolken
- Stanley Neurovirology Laboratory, Johns Hopkins School of Medicine, Baltimore, MD, USA
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92
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Zhan Y, Zhou S, Li Y, Mu S, Zhang R, Song X, Lin F, Zhang R, Zhang B. Using the BITOLA system to identify candidate molecules in the interaction between oral lichen planus and depression. Behav Brain Res 2017; 320:136-142. [PMID: 27913255 DOI: 10.1016/j.bbr.2016.11.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 11/19/2016] [Accepted: 11/28/2016] [Indexed: 11/29/2022]
Abstract
Exacerbations of oral lichen planus (OLP) have been linked to the periods of psychological stress, anxiety and depression. The specific mechanism of the interaction is unclear. The aim of this study was to explore the candidate genes or molecules that play important roles in the interaction between OLP and depression. The BITOLA system was used to search all intermediate concepts relevant to the "Gene or Gene Product" for OLP and depression, and the gene expression data and tissue-specific gene data along with manual checking were then employed to filter the intermediate concepts. Finally, two genes (NCAM1, neural cell adhesion molecule 1; CD4, CD4 molecule) passed the follow-up inspection. By using the text mining can formulate a new hypothesis: NCAM1 and CD4 were identified as involved or potentially involved in the interaction between OLP and depression. These results offer a new clue for the experimenters and hold promise for developing innovative therapeutic strategies for these two diseases.
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Affiliation(s)
- Yuanbo Zhan
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang, China
| | - Shuang Zhou
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang, China
| | - Ying Li
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang, China
| | - Sen Mu
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang, China
| | - Ruijie Zhang
- Colleges of Bioinformatics Science and Technology, Harbin Medical University, Harbin 150086, China
| | - Xuejing Song
- Department of Stomatology, The Central Hospital of Liaoyang City, Liaoyang 111000, China
| | - Feng Lin
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang, China
| | - Ruimin Zhang
- Department of Periodontology and Oral Mucosa, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China.
| | - Bin Zhang
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang, China; Heilongjiang Academy of Medical Sciences, Harbin 150001, Heilongjiang, China.
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Golden root: A wholesome treat of immunity. Biomed Pharmacother 2017; 87:496-502. [DOI: 10.1016/j.biopha.2016.12.132] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 12/21/2016] [Accepted: 12/31/2016] [Indexed: 12/27/2022] Open
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94
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Biological mechanisms of depression following treatment with interferon for chronic hepatitis C: A critical systematic review. J Affect Disord 2017; 209:235-245. [PMID: 27936453 DOI: 10.1016/j.jad.2016.11.039] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 11/11/2016] [Accepted: 11/25/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND A significant subset of patients infected by the hepatitis C virus (HCV) develops a major depressive episode (MDE) during Interferon-alpha (IFN-α) based immunotherapy. We performed a systematic review of studies which examined biological mechanisms contributing to the onset of a MDE during IFN-α-based immunotherapy for HCV. METHODS Major electronic databases were searched from inception up until 15th February 2016 for peer-reviewed prospective studies that had enrolled HCV infected patients who received IFN-α treatment. A diagnosis of MDE had to be established by means of a standardized diagnostic interview at baseline and endpoint. RESULTS Eight unique references met inclusion criteria. A total of 826 participants with HCV (37.3% females, mean age 46.7 years) were included in this systematic review. The overall MDE incidence rate was 34.8%, with follow-up ranging between 4 and 48 weeks. The methodological quality varied across selected studies. It was observed that Interleukin-6, salivary cortisol, arachidonic acid / eicosapentaenoicacid plus docosahexaenoic acid ratio, and genetic polymorphisms may present variations which are linked to a predisposition to INF-α-induced depression. LIMITATIONS A meta-analysis could not be performed due to the diverse biological mechanisms investigated and the lack of replicated evidence. CONCLUSIONS This systematic review indicates that several potential mechanisms may be implicated in the onset of a MDE following IFN-α-based immunotherapy for chronic HCV. However, replicated evidence is lacking and therefore the mechanisms involved in IFN-α-induced depression in humans remain unclear.
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95
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Batty GD, Russ TC, Stamatakis E, Kivimäki M. Psychological distress in relation to site specific cancer mortality: pooling of unpublished data from 16 prospective cohort studies. BMJ 2017; 356:j108. [PMID: 28122812 PMCID: PMC5266623 DOI: 10.1136/bmj.j108] [Citation(s) in RCA: 211] [Impact Index Per Article: 30.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To examine the role of psychological distress (anxiety and depression) as a potential predictor of site specific cancer mortality. DESIGN Pooling of individual participant data from 16 prospective cohort studies initiated 1994-2008. SETTING Nationally representative samples drawn from the health survey for England (13 studies) and the Scottish health survey (three studies). PARTICIPANTS 163 363 men and women aged 16 or older at study induction, who were initially free of a cancer diagnosis, provided self reported psychological distress scores (based on the general health questionnaire, GHQ-12) and consented to health record linkage. MAIN OUTCOME MEASURE Vital status records used to ascertain death from 16 site specific malignancies; the three Scottish studies also had information on cancer registration (incidence). RESULTS The studies collectively contributed an average of 9.5 years of mortality surveillance during which there were 16 267 deaths (4353 from cancer). After adjustment for age, sex, education, socioeconomic status, body mass index (BMI), and smoking and alcohol intake, and with reverse causality (by left censoring) and missing data (by imputation) taken into account, relative to people in the least distressed group (GHQ-12 score 0-6), death rates in the most distressed group (score 7-12) were consistently raised for cancer of all sites combined (multivariable adjusted hazard ratio 1.32, 95% confidence interval 1.18 to 1.48) and cancers not related to smoking (1.45, 1.23 to 1.71), as well as carcinoma of the colorectum (1.84, 1.21 to 2.78), prostate (2.42, 1.29 to 4.54), pancreas (2.76, 1.47 to 5.19), oesophagus (2.59, 1.34 to 5.00), and for leukaemia (3.86, 1.42 to 10.5). Stepwise associations across the full range of distress scores were observed for colorectal and prostate cancer. CONCLUSION This study contributes to the growing evidence that psychological distress might have some predictive capacity for selected cancer presentations, in addition to other somatic diseases.
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Affiliation(s)
- G David Batty
- Department of Epidemiology and Public Health, University College, London, UK
| | - Tom C Russ
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Emmanuel Stamatakis
- Charles Perkins Centre, Faculty of Health Sciences, University of Sydney, Sydney, Australia
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College, London, UK
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96
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Bevan-Jones WR, Surendranathan A, Passamonti L, Vázquez Rodríguez P, Arnold R, Mak E, Su L, Coles JP, Fryer TD, Hong YT, Williams G, Aigbirhio F, Rowe JB, O'Brien JT. Neuroimaging of Inflammation in Memory and Related Other Disorders (NIMROD) study protocol: a deep phenotyping cohort study of the role of brain inflammation in dementia, depression and other neurological illnesses. BMJ Open 2017; 7:e013187. [PMID: 28064175 PMCID: PMC5223666 DOI: 10.1136/bmjopen-2016-013187] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Inflammation of the central nervous system is increasingly regarded as having a role in cognitive disorders such as dementia and depression, but it is not clear how such inflammation relates to other aspects of neuropathology, structural and functional changes in the brain and symptoms (as assessed via clinical and neuropsychological assessment and MRI). This study will explore these pathophysiological mechanisms using positron emission tomography (PET) which allows in vivo imaging of inflammation, amyloid and τ deposition, together with neuropsychological profiling, MRI and peripheral biomarker analysis. METHODS AND ANALYSIS Using PET imaging of the ligand [11C]PK11195, we will test for increased neuroinflammation in vivo in patients with Alzheimer's disease, Lewy body dementia, frontotemporal dementia, progressive supranuclear palsy, late-onset depression and mild cognitive impairment, when compared to healthy controls. We will assess whether areas of inflammatory change are associated with amyloid and τ deposition (assessed using 11C-labelled Pittsburgh Compound B ([11C]PiB) and 18F-labelled AV-1451, respectively), as well as structural and connectivity markers found on MRI. Inflammatory biomarker analysis and immune-phenotyping of peripheral blood monocytes will determine the correlation between central inflammation and peripheral inflammation. Finally, we will examine whether central inflammatory markers seen on PET imaging are associated with global and domain specific cognitive impairments or predict cognitive decline over 12 months. ETHICS AND DISSEMINATION The study protocol was approved by the local ethics committee, East of England-Cambridge Central Research Ethics Committee (reference: 13/EE/0104). The study is also Administration of Radioactive Substances Advisory Committee (ARSAC) approved as part of this process. Data will be disseminated by presentation at national and international conferences and by publication, predominantly in journals of clinical neuroscience, neurology and psychiatry.
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Affiliation(s)
| | | | - Luca Passamonti
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | | | - Robert Arnold
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Elijah Mak
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Li Su
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Jonathan P Coles
- Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, UK
| | - Tim D Fryer
- Department of Clinical Neurosciences, Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - Young T Hong
- Department of Clinical Neurosciences, Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - Guy Williams
- Department of Clinical Neurosciences, Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - Franklin Aigbirhio
- Department of Clinical Neurosciences, Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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97
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Bortolato B, Hyphantis TN, Valpione S, Perini G, Maes M, Morris G, Kubera M, Köhler CA, Fernandes BS, Stubbs B, Pavlidis N, Carvalho AF. Depression in cancer: The many biobehavioral pathways driving tumor progression. Cancer Treat Rev 2016; 52:58-70. [PMID: 27894012 DOI: 10.1016/j.ctrv.2016.11.004] [Citation(s) in RCA: 174] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 10/15/2016] [Accepted: 11/05/2016] [Indexed: 12/11/2022]
Abstract
Major Depressive Disorder (MDD) is common among cancer patients, with prevalence rates up to four-times higher than the general population. Depression confers worse outcomes, including non-adherence to treatment and increased mortality in the oncology setting. Advances in the understanding of neurobiological underpinnings of depression have revealed shared biobehavioral mechanisms may contribute to cancer progression. Moreover, psychosocial stressors in cancer promote: (1) inflammation and oxidative/nitrosative stress; (2) a decreased immunosurveillance; and (3) a dysfunctional activation of the autonomic nervous system and of the hypothalamic-pituitaryadrenal axis. Consequently, the prompt recognition of depression among patients with cancer who may benefit of treatment strategies targeting depressive symptoms, cognitive dysfunction, fatigue and sleep disturbances, is a public health priority. Moreover, behavioral strategies aiming at reducing psychological distress and depressive symptoms, including addressing unhealthy diet and life-style choices, as well as physical inactivity and sleep dysfunction, may represent important strategies not only to treat depression, but also to improve wider cancer-related outcomes. Herein, we provide a comprehensive review of the intertwined biobehavioral pathways linking depression to cancer progression. In addition, the clinical implications of these findings are critically reviewed.
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Affiliation(s)
| | - Thomas N Hyphantis
- Department of Psychiatry, Division of Medicine, School of Health Sciences, University of Ioannina, Greece
| | - Sara Valpione
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Medical Oncology, The Christie NHS Trust, Manchester, United Kingdom
| | - Giulia Perini
- Department of Neurosciences, University of Padova, Padova, Italy
| | - Michael Maes
- IMPACT Strategic Research Centre, Deakin University, School of Medicine and Barwon Health, Geelong, VIC, Australia; Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Department of Psychiatry, Faculty of Medicine, State University of Londrina, Londrina, Brazil; Department of Psychiatry, Medical University Plovdiv, Plovdiv, Bulgaria; Revitalis, Waalre, The Netherlands
| | - Gerwyn Morris
- Tir Na Nog, Bryn Road Seaside 87, Llanelli SA152LW, Wales, UK
| | - Marta Kubera
- Department of Experimental Neuroendocrinology, Institute of Pharmacology, Polish Academy of Science, Krakow, Poland
| | - Cristiano A Köhler
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Fortaleza, CE, Brazil
| | - Brisa S Fernandes
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, and Barwon Health, Geelong, Australia; Laboratory of Calcium Binding Proteins in the Central Nervous System, Department of Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London Box SE5 8AF, United Kingdom; Faculty of Health, Social Care and Education, Anglia Ruskin University, Bishop Hall Lane, Chelmsford CM1 1SQ, United Kingdom
| | - Nicholas Pavlidis
- Department of Medical Oncology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina 45110, Greece
| | - André F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Fortaleza, CE, Brazil.
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98
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Airagnes G, Lemogne C, Hoertel N, Goldberg M, Limosin F, Zins M. Childhood adversity and depressive symptoms following retirement in the Gazel cohort. J Psychiatr Res 2016; 82:80-90. [PMID: 27471842 DOI: 10.1016/j.jpsychires.2016.07.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 07/07/2016] [Accepted: 07/15/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Only a few studies have examined whether specific moderators may impact the magnitude of the relationship between retirement and depression. The aim of this study was to examine the potential moderating role of adverse childhood life events (ACLE) on changes in depressive symptoms following retirement in the GAZEL cohort. METHODS 9242 participants, followed up since 1989, completed the Center of Epidemiologic Studies Depression scale (CESD) every three years and were asked in 2004 to answer an ACLE questionnaire. Subjects were classed according to 6 clusters by Two-Step Cluster Analysis (no ACLE: cluster 1; increasing material deprivation: clusters 2 to 4; history of early separation: cluster 5 and history of conflicts or violence: cluster 6), and then stratified for sex. Analyses were based on general linear models with the CESD variation between, before and after retirement as dependent variable. All results were adjusted according to age, marital status, occupational status, alcohol consumption, self-rated health and CESD score before retirement. RESULTS The association between exposure to ACLE and changes in depressive symptoms following retirement was significant in both men (F = 6.929; p < 0.001; eta(2) = 0.005) and women (F = 6.890; p < 0.001; eta(2) = 0.016). Exposure to early separation or history of conflicts or violence during childhood was associated with less improvement in both men and women, whereas early exposure to material deprivation only affected results in men. CONCLUSIONS Programs aimed at facilitating retirement transition may focus on subjects at risk of not experiencing the expected benefits of retirement, which is the case for those with a history of ACLE.
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Affiliation(s)
- Guillaume Airagnes
- AP-HP, Hôpitaux Universitaires Paris Ouest, Department of Psychiatry, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Facultéde Médecine, France.
| | - Cédric Lemogne
- AP-HP, Hôpitaux Universitaires Paris Ouest, Department of Psychiatry, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Facultéde Médecine, France; Inserm, U894, Centre Psychiatrie et Neurosciences, Paris, France
| | - Nicolas Hoertel
- AP-HP, Hôpitaux Universitaires Paris Ouest, Department of Psychiatry, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Facultéde Médecine, France; Inserm, U894, Centre Psychiatrie et Neurosciences, Paris, France
| | - Marcel Goldberg
- Inserm, UMS 011, Population-based Epidemiological Cohorts, Villejuif, France; Inserm UMR 1168, VIMA, Villejuif, France
| | - Frédéric Limosin
- AP-HP, Hôpitaux Universitaires Paris Ouest, Department of Psychiatry, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Facultéde Médecine, France; Inserm, U894, Centre Psychiatrie et Neurosciences, Paris, France
| | - Marie Zins
- Inserm, UMS 011, Population-based Epidemiological Cohorts, Villejuif, France; Inserm UMR 1168, VIMA, Villejuif, France
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99
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Stilling RM, van de Wouw M, Clarke G, Stanton C, Dinan TG, Cryan JF. The neuropharmacology of butyrate: The bread and butter of the microbiota-gut-brain axis? Neurochem Int 2016; 99:110-132. [DOI: 10.1016/j.neuint.2016.06.011] [Citation(s) in RCA: 331] [Impact Index Per Article: 41.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 05/30/2016] [Accepted: 06/21/2016] [Indexed: 02/07/2023]
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100
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Sharma A. Editorial (Thematic Selection: Inflammatory and Immune Responses in Depression). Curr Neuropharmacol 2016; 14:663-4. [PMID: 27640516 PMCID: PMC5050396 DOI: 10.2174/1570159x1407160826191654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Abhay Sharma
- CSIR-Institute of Genomics and Integrative Biology Council of Scientific and Industrial Research Sukhdev Vihar, Mathura Road New Delhi 110025
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