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Sani G, Margoni S, Brugnami A, Ferrara OM, Bernardi E, Simonetti A, Monti L, Mazza M, Janiri D, Moccia L, Kotzalidis GD, Chieffo DPR, Janiri L. The Nrf2 Pathway in Depressive Disorders: A Systematic Review of Animal and Human Studies. Antioxidants (Basel) 2023; 12:antiox12040817. [PMID: 37107192 PMCID: PMC10135298 DOI: 10.3390/antiox12040817] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/12/2023] [Accepted: 03/14/2023] [Indexed: 03/30/2023] Open
Abstract
There is increasing interest in the involvement of antioxidative systems in protecting from depression. Among these, Nrf2 occupies a central place. We aimed to review the role of Nrf2 in depression. For this reason, we conducted a PubMed search using as search strategy (psychiatr*[ti] OR schizo*[ti] OR psychot*[ti] OR psychos*[ti] OR depress*[ti] OR MDD[ti] OR BD[ti] OR bipolar[ti] OR Anxiety[ti] OR antidepress*[ti] OR panic[ti] OR obsess*[ti] OR compulsio*[ti] OR “mood disord*”[ti] OR phobi*[ti] OR agoraphob*[ti] OR anorex*[ti] OR anorect*[ti] OR bulimi*[ti] OR “eating disorder*”[ti] OR neurodevelopm*[ti] OR retardation[ti] OR autism[ti] OR autistic[ti] OR ASM[ti] OR adhd[ti] OR “attention-deficit”[ti]) AND nrf2, which on the 9th of March produced 208 results of which 89 were eligible for our purposes. Eligible articles were studies reporting data of Nrf2 manipulations or content by any treatment in human patients or animals with any animal model of depression. Most studies were on mice only (N = 58), 20 on rats only, and three on both rats and mice. There were two studies on cell lines (in vitro) and one each on nematodes and fish. Only four studies were conducted in humans, one of which was post mortem. Most studies were conducted on male animals; however, human studies were carried out on both men and women. The results indicate that Nrf2 is lower in depression and that antidepressant methods (drugs or other methods) increase it. Antioxidant systems and plasticity-promoting molecules, such as those in the Nrf2–HO-1, BDNF–TrkB, and cyclic AMP–CREB pathways, could protect from depression, while glycogen synthase kinase-3β and nuclear factor κB oppose these actions, thus increasing depressive-like behaviours. Since Nrf2 is also endowed with tumorigenic and atherogenic potential, the balance between benefits and harms must be taken into account in designing novel drugs aiming at increasing the intracellular content of Nrf2.
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Affiliation(s)
- Gabriele Sani
- Institute of Psychiatry, Department of Neuroscience, Catholic University of the Sacred Hearth, Rome, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Psychiatry, Department of Neuroscience, Head, Neck and Thorax, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 1, 00168 Rome, Italy
- Correspondence:
| | - Stella Margoni
- Institute of Psychiatry, Department of Neuroscience, Catholic University of the Sacred Hearth, Rome, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Andrea Brugnami
- Institute of Psychiatry, Department of Neuroscience, Catholic University of the Sacred Hearth, Rome, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Ottavia Marianna Ferrara
- Institute of Psychiatry, Department of Neuroscience, Catholic University of the Sacred Hearth, Rome, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Evelina Bernardi
- Institute of Psychiatry, Department of Neuroscience, Catholic University of the Sacred Hearth, Rome, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Alessio Simonetti
- Institute of Psychiatry, Department of Neuroscience, Catholic University of the Sacred Hearth, Rome, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Psychiatry, Department of Neuroscience, Head, Neck and Thorax, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 1, 00168 Rome, Italy
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA
- Centro Lucio Bini, Via Crescenzio 42, 00193 Rome, Italy
| | - Laura Monti
- UOS Clinical Psychology, Clinical Government, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 1, 00168 Rome, Italy
| | - Marianna Mazza
- Institute of Psychiatry, Department of Neuroscience, Catholic University of the Sacred Hearth, Rome, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Psychiatry, Department of Neuroscience, Head, Neck and Thorax, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 1, 00168 Rome, Italy
| | - Delfina Janiri
- Institute of Psychiatry, Department of Neuroscience, Catholic University of the Sacred Hearth, Rome, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Psychiatry, Department of Neuroscience, Head, Neck and Thorax, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 1, 00168 Rome, Italy
| | - Lorenzo Moccia
- Institute of Psychiatry, Department of Neuroscience, Catholic University of the Sacred Hearth, Rome, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Psychiatry, Department of Neuroscience, Head, Neck and Thorax, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 1, 00168 Rome, Italy
| | - Georgios D. Kotzalidis
- Institute of Psychiatry, Department of Neuroscience, Catholic University of the Sacred Hearth, Rome, Largo Francesco Vito 1, 00168 Rome, Italy
- NESMOS Department, Faculty of Medicine and Psychology, Sant’Andrea University Hospital, University of Rome La Sapienza, Via di Grottarossa, 1035-1039, 00189 Rome, Italy
| | - Daniela Pia Rosaria Chieffo
- UOS Clinical Psychology, Clinical Government, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 1, 00168 Rome, Italy
| | - Luigi Janiri
- Institute of Psychiatry, Department of Neuroscience, Catholic University of the Sacred Hearth, Rome, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Psychiatry, Department of Neuroscience, Head, Neck and Thorax, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 1, 00168 Rome, Italy
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Zhang Y, Ding J, Liang J. Associations of Dietary Vitamin A and Beta-Carotene Intake With Depression. A Meta-Analysis of Observational Studies. Front Nutr 2022; 9:881139. [PMID: 35548582 PMCID: PMC9083456 DOI: 10.3389/fnut.2022.881139] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 03/24/2022] [Indexed: 12/04/2022] Open
Abstract
Objective To clarify the associations of dietary vitamin A and beta-carotene intake with depression based on a meta-analysis of observational studies. Methods An extensive literature search on February 2022 (PubMed, Web of Science and Embase) was employed to identify observational studies on the associations of dietary vitamin A and beta-carotene intake with depression. The pooled relative risk (RR) of depression for the highest vs. lowest dietary vitamin A and beta-carotene intake category, and the standard mean difference (SMD) of dietary vitamin A and beta-carotene intake for depression vs. control subjects, were calculated. Results A total of 25 observational studies (100,955 participants), which included 24 cross-sectional/case-control and 1 prospective cohort study, were included in this study. The overall multi-variable adjusted RR demonstrated that dietary vitamin A intake was inversely associated with depression (RR = 0.83, 95%CI: 0.70–1.00; P = 0.05). In addition, the combined SMD showed that the dietary vitamin A intake in depression was also lower than that in control subjects (SMD = −0.13, 95%CI: −0.18 to −0.07; P < 0.001). On the other hand, the overall multi-variable adjusted RR indicated that dietary beta-carotene intake was negatively associated with depression (RR = 0.63, 95%CI: 0.55–0.72; P < 0.001). The combined SMD showed that the dietary beta-carotene intake in depression was also lower than that in control subjects (SMD = −0.34, 95%CI: −0.48 to −0.20; P < 0.001). Conclusion Our results suggest that both dietary vitamin A and beta-carotene intake is inversely associated with depression. However, due to the limited evidence, further prospective cohort studies are still needed.
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Affiliation(s)
- Yi Zhang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jun Ding
- Changsha Social Work College, Changsha, China
| | - Jieyu Liang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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