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Chen CY, Wang YF, Lei L, Zhang Y. Impacts of microbiota and its metabolites through gut-brain axis on pathophysiology of major depressive disorder. Life Sci 2024; 351:122815. [PMID: 38866215 DOI: 10.1016/j.lfs.2024.122815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/21/2024] [Accepted: 06/04/2024] [Indexed: 06/14/2024]
Abstract
Major depressive disorder (MDD) is characterized by a high rate of recurrence and disability, which seriously affects the quality of life of patients. That's why a deeper understanding of the mechanisms of MDD pathology is an urgent task, and some studies have found that intestinal symptoms accompany people with MDD. The microbiota-gut-brain axis is the bidirectional communication between the gut microbiota and the central nervous system, which was found to have a strong association with the pathogenesis of MDD. Previous studies have focused more on the communication between the gut and the brain through neuroendocrine, neuroimmune and autonomic pathways, and the role of gut microbes and their metabolites in depression is unclear. Metabolites of intestinal microorganisms (e.g., tryptophan, kynurenic acid, indole, and lipopolysaccharide) can participate in the pathogenesis of MDD through immune and inflammatory pathways or by altering the permeability of the gut and blood-brain barrier. In addition, intestinal microbes can communicate with intestinal neurons and glial cells to affect the integrity and function of intestinal nerves. However, the specific role of gut microbes and their metabolites in the pathogenesis of MDD is not well understood. Hence, the present review summarizes how gut microbes and their metabolites are directly or indirectly involved in the pathogenesis of MDD.
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Affiliation(s)
- Cong-Ya Chen
- Department of Anatomy, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing 102488, China
| | - Yu-Fei Wang
- Department of Anatomy, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing 102488, China
| | - Lan Lei
- Department of Anatomy, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing 102488, China
| | - Yi Zhang
- Department of Anatomy, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing 102488, China.
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Liu B, Wang C, Liu R, Xiang W, Yang C, Li D. Function and mechanism exploring of icariin in schizophrenia through network pharmacology. Brain Res 2024; 1835:148931. [PMID: 38604555 DOI: 10.1016/j.brainres.2024.148931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 04/04/2024] [Accepted: 04/08/2024] [Indexed: 04/13/2024]
Abstract
This study aims to explore the therapeutic effect and possible mechanisms of icariin in schizophrenia. SD rats were divided into five groups, a control group, a MK801-induced schizophrenia model group, and three icariin treatment groups, with twelve rats in each group. Morris water maze and open field were used to observe the spatial learning and memory ability of rats. Compared with the control group, rats in the MK801-induced model group showed an increase in stereotypic behavior score, distance of spontaneous activities, escape latency, malondialdehyde (MDA) content, and IL-6, IL-1β, TNF-α expression, but a decrease in platform crossing times and superoxide dismutase (SOD) activity (P < 0.05). Furthermore, all the above changes of the model group were reversed after icariin treatment in a dose-dependent manner (P < 0.05). Network pharmacology found that icariin can exert anti-schizophrenic effects through some signaling pathways, such as relaxin, estrogen, and TNF signaling pathways. MAPK1, MAPK3, FOS, RELA, TNF, and JUN were the key targets of icariin on schizophrenia, and their expression was detected in animal models, which was consistent with the predicted results of network pharmacology. Icariin treatment may improve the spatial learning and memory ability of schizophrenic rats through TNF signaling pathway.
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Affiliation(s)
- Bing Liu
- Department of Psychiatry, Wuhan Wudong Hospital, Wuhan 430084, Hubei, China
| | - Chengqiang Wang
- Department of Epidemiology and Statistics, School of Public Health, Guilin Medical University, Guilin 541199, Guangxi, China
| | - Ruyuan Liu
- Department of Epidemiology and Statistics, School of Public Health, Guilin Medical University, Guilin 541199, Guangxi, China
| | - Weilai Xiang
- Department of Epidemiology and Statistics, School of Public Health, Guilin Medical University, Guilin 541199, Guangxi, China
| | - Chang Yang
- Department of Epidemiology and Statistics, School of Public Health, Guilin Medical University, Guilin 541199, Guangxi, China.
| | - Di Li
- Department of Epidemiology and Statistics, School of Public Health, Guilin Medical University, Guilin 541199, Guangxi, China.
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Chaves C, Dursun SM, Tusconi M, Hallak JEC. Neuroinflammation and schizophrenia - is there a link? Front Psychiatry 2024; 15:1356975. [PMID: 38389990 PMCID: PMC10881867 DOI: 10.3389/fpsyt.2024.1356975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 01/30/2024] [Indexed: 02/24/2024] Open
Affiliation(s)
- Cristiano Chaves
- NeuroMood Lab, School of Medicine and Kingston Health Sciences Center (KHSC), Department of Psychiatry, Queen's University, Kingston, ON, Canada
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
- National Institute for Translational Medicine (INCT-TM), CNPq, São Paulo, Brazil
| | - Serdar M Dursun
- National Institute for Translational Medicine (INCT-TM), CNPq, São Paulo, Brazil
- Department of Psychiatry (Neurochemical Research Unit) and Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
| | - Massimo Tusconi
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Jaime E C Hallak
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
- National Institute for Translational Medicine (INCT-TM), CNPq, São Paulo, Brazil
- Department of Psychiatry (Neurochemical Research Unit) and Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
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Wei Y, Gao H, Luo Y, Feng J, Li G, Wang T, Xu H, Yin L, Ma J, Chen J. Systemic inflammation and oxidative stress markers in patients with unipolar and bipolar depression: A large-scale study. J Affect Disord 2024; 346:154-166. [PMID: 37924985 DOI: 10.1016/j.jad.2023.10.156] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 10/26/2023] [Accepted: 10/30/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVE Numerous studies have demonstrated that neutrophil/HDL ratio (NHR), lymphocyte/HDL ratio (LHR), monocyte/HDL (MHR) ratio, platelet/HDL ratio (PHR), neutrophil/ALB ratio (NAR) and platelet/ALB ratio (PAR) can serve as systemic inflammation and oxidative stress markers in a variety of diseases. However, few studies have estimated the associations of these markers with unipolar depression (UD) and bipolar depression (BD), as well as psychotic symptoms in UD and BD. METHODS 6297 UD patients, 1828 BD patients and 7630 healthy subjects were recruited. The differences in these indicators among different groups were compared, and the influencing factors for the occurrence of UD or BD and psychotic symptoms were analyzed. RESULTS These ratios displayed unique variation patterns across different diagnostic groups. BD group exhibited higher NHR, LHR, MHR, NAR and lower PAR than UD and HC groups, UD group showed higher MHR than HC group. The psychotic UD group had higher NHR, LHR, MHR and NAR than non-psychotic UD group. Higher LHR, MHR, NAR and lower PAR were risk factors in BD when compared to UD group. CONCLUSIONS Our study demonstrated differences in inflammation and oxidative stress profile between UD and BD patients, as well as between subjects with or without psychotic symptom exist, highlighting the role of inflammation and oxidative stress in the pathophysiology of UD and BD.
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Affiliation(s)
- Yanyan Wei
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing 100096, China.
| | - Huanqin Gao
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing 100096, China
| | - Yanhong Luo
- School of Mental Health, Bengbu Medical College, Bengbu, Anhui 233030, China
| | - Junhui Feng
- Jining Psychiatric Hospital, Jidai Road 1#, Jining 272000, Shandong, China
| | - Guoguang Li
- The Fourth People's Hospital of Liaocheng, Liaocheng, Shandong 252000, China
| | - Tingting Wang
- School of Mental Health, Bengbu Medical College, Bengbu, Anhui 233030, China
| | - Haiting Xu
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing 100096, China
| | - Lu Yin
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing 100096, China
| | - Jinbao Ma
- Beijing Tongren Hospital, Dongjiaomin Road 1#, Beijing 100000, China.
| | - Jingxu Chen
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing 100096, China.
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Lamanna-Rama N, Romero-Miguel D, Casquero-Veiga M, MacDowell KS, Santa-Marta C, Torres-Sánchez S, Berrocoso E, Leza JC, Desco M, Soto-Montenegro ML. THC improves behavioural schizophrenia-like deficits that CBD fails to overcome: a comprehensive multilevel approach using the Poly I:C maternal immune activation. Psychiatry Res 2024; 331:115643. [PMID: 38064909 DOI: 10.1016/j.psychres.2023.115643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 11/07/2023] [Accepted: 11/26/2023] [Indexed: 01/02/2024]
Abstract
Prenatal infections and cannabis use during adolescence are well-recognized risk factors for schizophrenia. As inflammation and oxidative stress (OS) contribute to this disorder, anti-inflammatory drugs have been proposed as potential therapies. This study aimed to evaluate the association between delta-9-tetrahydrocannabinol (THC) and schizophrenia-like abnormalities in a maternal immune activation (MIA) model. Additionally, we assessed the preventive effect of cannabidiol (CBD), a non-psychotropic/anti-inflammatory cannabinoid. THC and/or CBD were administered to Saline- and MIA-offspring during periadolescence. At adulthood, THC-exposed MIA-offspring showed significant improvements in sensorimotor gating deficits. Structural and metabolic brain changes were evaluated by magnetic resonance imaging, revealing cortical shrinkage in Saline- and enlargement in MIA-offspring after THC-exposure. Additionally, MIA-offspring displayed enlarged ventricles and decreased hippocampus, which were partially reverted by both cannabinoids. CBD prevented THC-induced reduction in the corpus callosum, despite affecting white matter structure. Post-mortem studies revealed detrimental effects of THC, including increased inflammation and oxidative stress. CBD partially reverted these pro-inflammatory alterations and modulated THC's effects on the endocannabinoid system. In conclusion, contrary to expectations, THC exhibited greater behavioural and morphometric benefits, despite promoting a pro-inflammatory state that CBD partially reverted. Further research is needed to elucidate the underlying mechanisms involved in the observed benefits of THC.
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Affiliation(s)
- Nicolás Lamanna-Rama
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.; Departamento de Bioingeniería, Universidad Carlos III de Madrid, Leganés (Madrid) 28911, Spain
| | | | | | - Karina S MacDowell
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain; Department of Pharmacology & Toxicology, School of Medicine, Universidad Complutense (UCM), IIS Imas12, IUIN, 28040 - Madrid, Spain
| | | | - Sonia Torres-Sánchez
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain; Neuropsychopharmacology & Psychobiology Research Group, Department of Neuroscience, Universidad de Cádiz, Spain; Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Esther Berrocoso
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain; Neuropsychopharmacology & Psychobiology Research Group, Department of Neuroscience, Universidad de Cádiz, Spain; Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Juan C Leza
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain; Department of Pharmacology & Toxicology, School of Medicine, Universidad Complutense (UCM), IIS Imas12, IUIN, 28040 - Madrid, Spain
| | - Manuel Desco
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.; Departamento de Bioingeniería, Universidad Carlos III de Madrid, Leganés (Madrid) 28911, Spain; CIBER de Salud Mental (CIBERSAM), Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.
| | - María Luisa Soto-Montenegro
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.; CIBER de Salud Mental (CIBERSAM), Madrid, Spain; High Performance Research Group in Physiopathology and Pharmacology of the Digestive System (NeuGut-URJC), URJC, Alcorcón, Spain.
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Yang Z, Yang L, Sun Z, Rong Y, Bai C, Dong Q, Jian L. miRNA-660-3p inhibits malignancy in glioblastoma via negative regulation of APOC1-TGFβ2 signaling pathway. Cancer Biol Ther 2023; 24:2281459. [PMID: 37981873 PMCID: PMC10783846 DOI: 10.1080/15384047.2023.2281459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 11/06/2023] [Indexed: 11/21/2023] Open
Abstract
Glioblastoma as the most common and aggressive central nervous system tumor in adults. Its prognosis and therapeutic outcome are poor due to the limited understanding of its molecular mechanism. Apolipoprotein C-1 (APOC1) as a member of the apolipoprotein family that acts as a tumor promoter in various cancers. MicroRNA (miRNA) can silence gene expression and suppress tumor progression. However, the role of APOC1 and its upstream miRNA has not been explored in glioblastoma. Two glioblastoma cell lines (U87 and U251) were used to explore the role of APOC1 and its upstream miRNA-660-3p in glioblastoma tumorigenesis in vitro. Cells with APOC1/miRNA-660-3p overexpression or knockdown were assessed for their proliferation, migration, and invasion in vitro, and tumorigenesis in vivo. Gene and protein expression was assessed by qRT-PCR and western blot, respectively. Cell proliferation was assessed by the MTT assay and the EdU and Ki67 staining. Cell migration and invasion were assessed by the transwell assay. Tumorigenesis in vivo was assessed in U87 cells with a xenograft mouse model. APOC1 was overexpressed in glioblastoma compared with normal peritumoral tissue and was inversely related to patient prognosis. APOC1 overexpression promotes cell proliferation, migration, and invasion in vitro. APOC1 inhibition reduced tumor growth in vivo. miRNA-660-3p inhibits tumorigenesis by directly targeting APOC1. Mechanistically, APOC1 drives the malignancy of glioblastoma by activating the TGFβ2 signaling pathway. miRNA-660-3p suppresses tumorigenesis by targeting APOC1. Therefore, miRNA-660-3p/APOC1 axis can serve as potential intervention targets in managing glioblastoma progression.
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Affiliation(s)
- Zelin Yang
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, China
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Liang Yang
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, China
| | - Zhenkai Sun
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yuxi Rong
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, China
| | - Chenglian Bai
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Qiaoxiang Dong
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, China
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Lin Jian
- Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, China
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Zhang MZ, Shi JX, Li H, Chen R, Zheng MB, Yan LJ, Wu NJ, He QQ. The impact of educational lifestyle intervention on body weight and psychological health among overweight/obese patients with severe mental disorders. J Affect Disord 2023; 343:71-76. [PMID: 37741469 DOI: 10.1016/j.jad.2023.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 08/29/2023] [Accepted: 09/18/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND There was a high prevalence of overweight/obesity among patients with severe mental disorders (SMD). However, studies on the lifestyle-based interventions in patients with SMD are limited. OBJECTIVE To examine the effects of an educational lifestyle intervention on body weight and psychological health among Chinese community-dwelling overweight/obese patients with SMD. METHODS Community-dwelling overweight/obese patients with SMD was recruited from Shenzhen, China in October 2020. They were randomly allocated into intervention group (IG) and control group (CG). Participants in IG received a 12-month educational lifestyle intervention, while the CG was exposed to routine care. A generalized estimating equation model was used to assess the effect of the intervention over time. RESULTS A total of 176 subjects (88 in IG and 88 in CG) aged 42.2 ± 10.9 years were included in this study. After adjusting for potential confounders, body weight (p = 0.001), body mass index (BMI, p = 0.001), and waist circumference (p = 0.027) in IG significantly decreased compared with CG after 12 months. Besides, IG had significantly higher life satisfaction than CG after intervention (p = 0.026), whereas significant reductions in depressive symptoms were observed in IG from 26.1 % at baseline to 13.6 % after the intervention (p = 0.027), and the between-group differences were marginally significant (p = 0.086). CONCLUSION An educational lifestyle intervention can effectively reduce body weight parameters and improve psychological health in overweight/obese patients with SMD.
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Affiliation(s)
- Min-Zhe Zhang
- School of Public Health, Wuhan University, Wuhan, PR China
| | - Jun-Xia Shi
- Center of Prevention and Control of Pingshan, Shenzhen, PR China
| | - Hui Li
- Medical Department, Taixing People's Hospital, Jiangsu, PR China
| | - Rui Chen
- School of Public Health, Wuhan University, Wuhan, PR China
| | - Miao-Bing Zheng
- School of Nutrition and Exercise, Deakin University, Melbourne, Australia
| | - Li-Jing Yan
- Global Health Research Center, Duke Kunshan University, Suzhou, PR China
| | - Neng-Jian Wu
- Center of Prevention and Control of Pingshan, Shenzhen, PR China
| | - Qi-Qiang He
- School of Public Health, Wuhan University, Wuhan, PR China; Hubei Biomass-Resource Chemistry and Environmental Biotechnology Key Laboratory, Wuhan University, Wuhan, PR China.
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Ellermann M. Emerging mechanisms by which endocannabinoids and their derivatives modulate bacterial populations within the gut microbiome. ADVANCES IN DRUG AND ALCOHOL RESEARCH 2023; 3:11359. [PMID: 38389811 PMCID: PMC10880783 DOI: 10.3389/adar.2023.11359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 11/28/2023] [Indexed: 02/24/2024]
Abstract
Bioactive lipids such as endocannabinoids serve as important modulators of host health and disease through their effects on various host functions including central metabolism, gut physiology, and immunity. Furthermore, changes to the gut microbiome caused by external factors such as diet or by disease development have been associated with altered endocannabinoid tone and disease outcomes. These observations suggest the existence of reciprocal relationships between host lipid signaling networks and bacterial populations that reside within the gut. Indeed, endocannabinoids and their congeners such as N-acylethanolamides have been recently shown to alter bacterial growth, functions, physiology, and behaviors, therefore introducing putative mechanisms by which these bioactive lipids directly modulate the gut microbiome. Moreover, these potential interactions add another layer of complexity to the regulation of host health and disease pathogenesis that may be mediated by endocannabinoids and their derivatives. This mini review will summarize recent literature that exemplifies how N-acylethanolamides and monoacylglycerols including endocannabinoids can impact bacterial populations in vitro and within the gut microbiome. We also highlight exciting preclinical studies that have engineered gut bacteria to synthesize host N-acylethanolamides or their precursors as potential strategies to treat diseases that are in part driven by aberrant lipid signaling, including obesity and inflammatory bowel diseases.
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Affiliation(s)
- Melissa Ellermann
- Department of Biological Sciences, University of South Carolina, Columbia, SC, United States
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Reece AS, Hulse GK. Perturbation of 3D nuclear architecture, epigenomic aging and dysregulation, and cannabinoid synaptopathy reconfigures conceptualization of cannabinoid pathophysiology: part 2-Metabolome, immunome, synaptome. Front Psychiatry 2023; 14:1182536. [PMID: 37854446 PMCID: PMC10579598 DOI: 10.3389/fpsyt.2023.1182536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 09/11/2023] [Indexed: 10/20/2023] Open
Abstract
The second part of this paper builds upon and expands the epigenomic-aging perspective presented in Part 1 to describe the metabolomic and immunomic bases of the epigenomic-aging changes and then considers in some detail the application of these insights to neurotoxicity, neuronal epigenotoxicity, and synaptopathy. Cannabinoids are well-known to have bidirectional immunomodulatory activities on numerous parts of the immune system. Immune perturbations are well-known to impact the aging process, the epigenome, and intermediate metabolism. Cannabinoids also impact metabolism via many pathways. Metabolism directly impacts immune, genetic, and epigenetic processes. Synaptic activity, synaptic pruning, and, thus, the sculpting of neural circuits are based upon metabolic, immune, and epigenomic networks at the synapse, around the synapse, and in the cell body. Many neuropsychiatric disorders including depression, anxiety, schizophrenia, bipolar affective disorder, and autistic spectrum disorder have been linked with cannabis. Therefore, it is important to consider these features and their complex interrelationships in reaching a comprehensive understanding of cannabinoid dependence. Together these findings indicate that cannabinoid perturbations of the immunome and metabolome are important to consider alongside the well-recognized genomic and epigenomic perturbations and it is important to understand their interdependence and interconnectedness in reaching a comprehensive appreciation of the true nature of cannabinoid pathophysiology. For these reasons, a comprehensive appreciation of cannabinoid pathophysiology necessitates a coordinated multiomics investigation of cannabinoid genome-epigenome-transcriptome-metabolome-immunome, chromatin conformation, and 3D nuclear architecture which therefore form the proper mechanistic underpinning for major new and concerning epidemiological findings relating to cannabis exposure.
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Affiliation(s)
- Albert Stuart Reece
- Division of Psychiatry, University of Western Australia, Crawley, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Gary Kenneth Hulse
- Division of Psychiatry, University of Western Australia, Crawley, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
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Bresciani G, Manai F, Davinelli S, Tucci P, Saso L, Amadio M. Novel potential pharmacological applications of dimethyl fumarate-an overview and update. Front Pharmacol 2023; 14:1264842. [PMID: 37745068 PMCID: PMC10512734 DOI: 10.3389/fphar.2023.1264842] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 08/18/2023] [Indexed: 09/26/2023] Open
Abstract
Dimethyl fumarate (DMF) is an FDA-approved drug for the treatment of psoriasis and multiple sclerosis. DMF is known to stabilize the transcription factor Nrf2, which in turn induces the expression of antioxidant response element genes. It has also been shown that DMF influences autophagy and participates in the transcriptional control of inflammatory factors by inhibiting NF-κB and its downstream targets. DMF is receiving increasing attention for its potential to be repurposed for several diseases. This versatile molecule is indeed able to exert beneficial effects on different medical conditions through a pleiotropic mechanism, in virtue of its antioxidant, immunomodulatory, neuroprotective, anti-inflammatory, and anti-proliferative effects. A growing number of preclinical and clinical studies show that DMF may have important therapeutic implications for chronic diseases, such as cardiovascular and respiratory pathologies, cancer, eye disorders, neurodegenerative conditions, and systemic or organ specific inflammatory and immune-mediated diseases. This comprehensive review summarizes and highlights the plethora of DMF's beneficial effects and underlines its repurposing opportunities in a variety of clinical conditions.
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Affiliation(s)
- Giorgia Bresciani
- Section of Pharmacology, Department of Drug Sciences, University of Pavia, Pavia, Italy
| | - Federico Manai
- Department of Biology and Biotechnology L. Spallanzani, University of Pavia, Pavia, Italy
| | - Sergio Davinelli
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy
| | - Paolo Tucci
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Luciano Saso
- Department of Physiology and Pharmacology Vittorio Erspamer, Sapienza University, Rome, Italy
| | - Marialaura Amadio
- Section of Pharmacology, Department of Drug Sciences, University of Pavia, Pavia, Italy
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Zhu X, Li R, Zhu Y, Zhou J, Huang J, Zhou Y, Tong J, Zhang P, Luo X, Chen S, Li Y, Tian B, Tan SP, Wang Z, Han X, Tian L, Li CSR, Tan YL. Changes in Inflammatory Biomarkers in Patients with Schizophrenia: A 3-Year Retrospective Study. Neuropsychiatr Dis Treat 2023; 19:1597-1604. [PMID: 37465565 PMCID: PMC10350427 DOI: 10.2147/ndt.s411028] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/19/2023] [Indexed: 07/20/2023] Open
Abstract
Objective Accumulating evidence suggested that immune system activation might be involved in the pathophysiology of schizophrenia. The neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) can measure inflammation. This study aimed to investigate the inflammatory state in patients with schizophrenia by using these indicators. Methods In this study, the complete blood count data for 187 continuing hospitalized patients with schizophrenia and 187 age- and sex-matched healthy participants was collected annually from 2017 to 2019. Platelet (PLT), lymphocyte (LYM), monocyte (MON) and neutrophil (NEU) counts were aggregated and NLR, MLR, PLR, and SII were calculated. Using a generalized linear mixed model, we assessed the impact of age, sex, diagnosis, and sampling year on the above indicators and evaluated the interaction between the factors. Results According to the estimation results of the generalized linear mixed model, the NLR increased by 0.319 (p = 0.004), the MLR increased by 0.037 (p < 0.001), and the SII increased by 57.858 (p = 0.018) in patients with schizophrenia. Data after two years of continuous antipsychotic treatment showed that the NLR and MLR were higher in patients with schizophrenia than those in healthy controls, while the PLT and LYM counts were decreased in patients with schizophrenia. The schizophrenia diagnosis was correlated to the MON and LYM count, NLR, MLR, and SII (p < 0.05). Conclusion The differences in these markers were stable and cannot be eliminated by a full course of treatment. This study provides impetus for the inflammatory hypothesis of schizophrenia.
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Affiliation(s)
- Xiaoyu Zhu
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Ran Li
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Yu Zhu
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Jia Zhou
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Junchao Huang
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Yanfang Zhou
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Jinghui Tong
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Ping Zhang
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Xingguang Luo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Song Chen
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Yanli Li
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Baopeng Tian
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Shu-Ping Tan
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Zhiren Wang
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Xiaole Han
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Li Tian
- Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Yun-Long Tan
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
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12
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Anderson G, Almulla AF, Reiter RJ, Maes M. Redefining Autoimmune Disorders' Pathoetiology: Implications for Mood and Psychotic Disorders' Association with Neurodegenerative and Classical Autoimmune Disorders. Cells 2023; 12:cells12091237. [PMID: 37174637 PMCID: PMC10177037 DOI: 10.3390/cells12091237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/28/2023] [Accepted: 04/18/2023] [Indexed: 05/15/2023] Open
Abstract
Although previously restricted to a limited number of medical conditions, there is a growing appreciation that 'autoimmune' (or immune-mediated) processes are important aspects of a wide array of diverse medical conditions, including cancers, neurodegenerative diseases and psychiatric disorders. All of these classes of medical conditions are associated with alterations in mitochondrial function across an array of diverse cell types. Accumulating data indicate the presence of the mitochondrial melatonergic pathway in possibly all body cells, with important consequences for pathways crucial in driving CD8+ T cell and B-cell 'autoimmune'-linked processes. Melatonin suppression coupled with the upregulation of oxidative stress suppress PTEN-induced kinase 1 (PINK1)/parkin-driven mitophagy, raising the levels of the major histocompatibility complex (MHC)-1, which underpins the chemoattraction of CD8+ T cells and the activation of antibody-producing B-cells. Many factors and processes closely associated with autoimmunity, including gut microbiome/permeability, circadian rhythms, aging, the aryl hydrocarbon receptor, brain-derived neurotrophic factor (BDNF) and its receptor tyrosine receptor kinase B (TrkB) all interact with the mitochondrial melatonergic pathway. A number of future research directions and novel treatment implications are indicated for this wide collection of poorly conceptualized and treated medical presentations. It is proposed that the etiology of many 'autoimmune'/'immune-mediated' disorders should be conceptualized as significantly determined by mitochondrial dysregulation, with alterations in the mitochondrial melatonergic pathway being an important aspect of these pathoetiologies.
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Affiliation(s)
- George Anderson
- CRC Scotland & London, Eccleston Square, London SW1V 1PG, UK
| | - Abbas F Almulla
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
- Medical Laboratory Technology Department, College of Medical Technology, The Islamic University, Najaf 54001, Iraq
| | - Russel J Reiter
- Department of Cell Systems and Anatomy, UT Health Long School of Medicine, San Antonio, TX 78229, USA
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
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13
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Misiak B, Bielawski T, Samochowiec J, Samochowiec A, Fleszar MG, Fortuna P, Kosyk B, Frydecka D. Activation of the endocannabinoid system in schizophrenia: A compensatory mechanism of subclinical inflammation? Schizophr Res 2023; 252:67-68. [PMID: 36628871 DOI: 10.1016/j.schres.2022.12.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/14/2022] [Accepted: 12/30/2022] [Indexed: 01/11/2023]
Affiliation(s)
- Błażej Misiak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Tomasz Bielawski
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Agnieszka Samochowiec
- Department of Clinical Psychology, Institute of Psychology, University of Szczecin, Poland
| | - Mariusz G Fleszar
- Department of Medical Biochemistry, Wroclaw Medical University, Wroclaw, Poland
| | - Paulina Fortuna
- Department of Medical Biochemistry, Wroclaw Medical University, Wroclaw, Poland
| | - Bogna Kosyk
- Institute of Soil Science and Environmental Protection, Wroclaw, Poland; University of Environmental and Life Sciences, Wroclaw, Poland
| | - Dorota Frydecka
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland.
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14
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Fišar Z. Biological hypotheses, risk factors, and biomarkers of schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2023; 120:110626. [PMID: 36055561 DOI: 10.1016/j.pnpbp.2022.110626] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 12/19/2022]
Abstract
Both the discovery of biomarkers of schizophrenia and the verification of biological hypotheses of schizophrenia are an essential part of the process of understanding the etiology of this mental disorder. Schizophrenia has long been considered a neurodevelopmental disease whose symptoms are caused by impaired synaptic signal transduction and brain neuroplasticity. Both the onset and chronic course of schizophrenia are associated with risk factors-induced disruption of brain function and the establishment of a new homeostatic setpoint characterized by biomarkers. Different risk factors and biomarkers can converge to the same symptoms of schizophrenia, suggesting that the primary cause of the disease can be highly individual. Schizophrenia-related biomarkers include measurable biochemical changes induced by stress (elevated allostatic load), mitochondrial dysfunction, neuroinflammation, oxidative and nitrosative stress, and circadian rhythm disturbances. Here is a summary of selected valid biological hypotheses of schizophrenia formulated based on risk factors and biomarkers, neurodevelopment, neuroplasticity, brain chemistry, and antipsychotic medication. The integrative neurodevelopmental-vulnerability-neurochemical model is based on current knowledge of the neurobiology of the onset and progression of the disease and the effects of antipsychotics and psychotomimetics and reflects the complex and multifactorial nature of schizophrenia.
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Affiliation(s)
- Zdeněk Fišar
- Charles University and General University Hospital in Prague, First Faculty of Medicine, Department of Psychiatry, Czech Republic.
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15
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Advances in the gut microbiome and mood disorders. Curr Opin Psychiatry 2023; 36:1-7. [PMID: 36131643 DOI: 10.1097/yco.0000000000000829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The gut microbiome is in constant bidirectional communication with the brain through the microbiota-gut-brain-axis. Mood disorders are among the most common psychiatric disorders and include major depressive disorder and bipolar disorder. The gut microbiome is altered in individuals with mood disorders and has a role in its inflammatory pathophysiology. In this article, we performed a narrative review of clinical studies, randomized controlled trials and meta-analyses addressing advances in gut microbiome research in mood disorders and included articles that were published between 2021 and 2022. RECENT FINDINGS Studies highlight transdiagnostic alterations of microbiota in mood disorders, with reductions of butyrate-producing bacteria. Participants with major depressive disorder showed altered beta-diversity, while participants with bipolar disorder showed reduced alpha-diversity. Both disorders exhibit alterations in the metabolome. Early pilot studies addressed the possibility of using the gut microbiome for the prediction of treatment response and the blood microbiome for the diagnosis of psychiatric disorders. Findings from clinical trials support the use of probiotics as an add-on therapy for major depressive disorder. The second published case report in the literature reported a favourable outcome of a patient with bipolar disorder after faecal microbiota transplantation. SUMMARY Gut microbiome modulations allow new treatment strategies including the use of psychobiotics for the treatment and prevention of mood disorders. Well designed clinical trials aiming for personalized medicine are needed to investigate the efficacy and safety of psychobiotic interventions.
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16
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Chen MY, Zhang Q, Liu YF, Zheng WY, Si TL, Su Z, Cheung T, Jackson T, Li XH, Xiang YT. Schizophrenia and oxidative stress from the perspective of bibliometric analysis. Front Psychiatry 2023; 14:1145409. [PMID: 36923522 PMCID: PMC10008861 DOI: 10.3389/fpsyt.2023.1145409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 02/06/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND A growing number of studies has implicated oxidative stress in the pathophysiology of psychiatric disorders including schizophrenia. The aim of this study was to explore the field of schizophrenia and oxidative stress-related research from a bibliometric perspective. METHODS All relevant publications on schizophrenia and oxidative stress were obtained from Web of Science Core Collection (WOSCC) database from its inception date to November 8, 2022. VOSviewer software was used to examine co-authorships and co-occurring keywords. R software was used to present the main characteristics of publications and cooperation frequency among countries. CiteSpace was used to investigate keywords with the strongest citation bursts. RESULTS A total of 3,510 publications on schizophrenia and oxidative stress were included. The United States had the largest number of publications (26.1%), and international collaborations. University of Melbourne was the most productive institution, while Schizophrenia Research was the most productive journal in this field. Apart from "schizophrenia" and "oxidative stress", the terms "prefrontal cortex", "brain" and "nitric oxide" were among the most frequently used keywords. CONCLUSIONS In conclusion, research on the association between oxidative stress and schizophrenia has received growing attention in the academic literature that is expected to continue its upward trajectory during the next two decades. Existing research suggests there has been a transition from research focused on pathways to animal models, and subsequently to clinical applications. Intervention studies on oxidative stress and schizophrenia are likely to be an important focus of related work in the near future.
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Affiliation(s)
- Meng-Yi Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau, Macao SAR, China.,Centre for Cognitive and Brain Sciences, University of Macau, Macau, Macao SAR, China
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yu-Fei Liu
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau, Macao SAR, China
| | - Wan-Ying Zheng
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau, Macao SAR, China
| | - Tong Leong Si
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau, Macao SAR, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Todd Jackson
- Department of Psychology, University of Macau, Macau, Macao SAR, China
| | - Xiao-Hong Li
- Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau, Macao SAR, China.,Centre for Cognitive and Brain Sciences, University of Macau, Macau, Macao SAR, China
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17
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Domingos LB, Silva NR, Chaves Filho AJM, Sales AJ, Starnawska A, Joca S. Regulation of DNA Methylation by Cannabidiol and Its Implications for Psychiatry: New Insights from In Vivo and In Silico Models. Genes (Basel) 2022; 13:2165. [PMID: 36421839 PMCID: PMC9690868 DOI: 10.3390/genes13112165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/11/2022] [Accepted: 11/16/2022] [Indexed: 12/24/2023] Open
Abstract
Cannabidiol (CBD) is a non-psychotomimetic compound present in cannabis sativa. Many recent studies have indicated that CBD has a promising therapeutic profile for stress-related psychiatric disorders, such as anxiety, schizophrenia and depression. Such a diverse profile has been associated with its complex pharmacology, since CBD can target different neurotransmitter receptors, enzymes, transporters and ion channels. However, the precise contribution of each of those mechanisms for CBD effects is still not yet completely understood. Considering that epigenetic changes make the bridge between gene expression and environment interactions, we review and discuss herein how CBD affects one of the main epigenetic mechanisms associated with the development of stress-related psychiatric disorders: DNA methylation (DNAm). Evidence from in vivo and in silico studies indicate that CBD can regulate the activity of the enzymes responsible for DNAm, due to directly binding to the enzymes and/or by indirectly regulating their activities as a consequence of neurotransmitter-mediated signaling. The implications of this new potential pharmacological target for CBD are discussed in light of its therapeutic and neurodevelopmental effects.
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Affiliation(s)
- Luana B. Domingos
- Department of Biomedicine, Aarhus University, 8000 Aarhus, Denmark
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark
| | - Nicole R. Silva
- Department of Biomedicine, Aarhus University, 8000 Aarhus, Denmark
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark
| | - Adriano J. M. Chaves Filho
- Department of Biomedicine, Aarhus University, 8000 Aarhus, Denmark
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark
| | - Amanda J. Sales
- Department of Pharmacology, School of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto 14049-900, SP, Brazil
| | - Anna Starnawska
- Department of Biomedicine, Aarhus University, 8000 Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, 8000 Aarhus, Denmark
- Center for Genomics and Personalized Medicine, CGPM, Center for Integrative Sequencing, iSEQ, 8000 Aarhus, Denmark
| | - Sâmia Joca
- Department of Biomedicine, Aarhus University, 8000 Aarhus, Denmark
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18
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Inhibiting Endocannabinoid Hydrolysis as Emerging Analgesic Strategy Targeting a Spectrum of Ion Channels Implicated in Migraine Pain. Int J Mol Sci 2022; 23:ijms23084407. [PMID: 35457225 PMCID: PMC9027089 DOI: 10.3390/ijms23084407] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 12/23/2022] Open
Abstract
Migraine is a disabling neurovascular disorder characterized by severe pain with still limited efficient treatments. Endocannabinoids, the endogenous painkillers, emerged, alternative to plant cannabis, as promising analgesics against migraine pain. In this thematic review, we discuss how inhibition of the main endocannabinoid-degrading enzymes, monoacylglycerol lipase (MAGL) and fatty acid amide hydrolase (FAAH), could raise the level of endocannabinoids (endoCBs) such as 2-AG and anandamide in order to alleviate migraine pain. We describe here: (i) migraine pain signaling pathways, which could serve as specific targets for antinociception; (ii) a divergent distribution of MAGL and FAAH activities in the key regions of the PNS and CNS implicated in migraine pain signaling; (iii) a complexity of anti-nociceptive effects of endoCBs mediated by cannabinoid receptors and through a direct modulation of ion channels in nociceptive neurons; and (iv) the spectrum of emerging potent MAGL and FAAH inhibitors which efficiently increase endoCBs levels. The specific distribution and homeostasis of endoCBs in the main regions of the nociceptive system and their generation ‘on demand’, along with recent availability of MAGL and FAAH inhibitors suggest new perspectives for endoCBs-mediated analgesia in migraine pain.
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