Serotonin uptake and imipramine binding in rat platelets after chronic dexamethasone and amitriptyline treatment

Effects of aging and glucocorticoid treatment on monoamine oxidase subtypes in rat cerebral cortex: therapeutic implications

Dysregulation of the hypothalamus-pituitary-adrenal (HPA) axis is more common in elderly depression than in younger cohorts, resulting in elevated glucocorticoid levels. Effectiveness of antidepressant drugs is also impaired in these patients. We evaluated the effects of continuous infusions of dexamethasone on monoamine oxidase (MAO) subtypes in aged rat brain to determine whether unique interactions of glucocorticoids and aging could contribute to abnormal transmitter disposition. Aged rats given dexamethasone showed robust induction of both MAO A (threefold increase) and B (30% increase) in the frontal/parietal cortex, effects in the opposite direction from those seen in young rats treated with glucocorticoids. Our results support the view that depression in the elderly may have biologically discrete components that make it differ from depression in younger people. These distinctions may influence the etiology and therapy of depression, while at the same time providing potential biomarkers (such as platelet MAO) that may serve to predict successful treatment outcome in patient subpopulations.

Glucocorticoid-targeting of the adenylyl cyclase signaling pathway in the cerebellum of young vs. aged rats

Glucocorticoids exacerbate aging-induced cell death, but relatively little is known about other CNS effects in senescence. We examined noradrenergic/adenylyl cyclase signaling in the cerebellum, which is a brain region that is susceptible to deterioration of synaptic function in aging. Aged control rats had increased total cyclase catalytic activity, but showed deficits in basal adenylyl cyclase. Deficits resolved when G-proteins were stimulated with GTP, GTP and fluoride, or GTP and isoproterenol, despite reductions in beta-receptors. In young rats, long-term dexamethasone infusions evoked the same types of changes that had been seen in aging, including induction of cyclase catalytic activity and enhanced G-protein responsiveness. The same dexamethasone regimens given to aged rats failed to cause stimulation of these processes in the cerebellum, but did so in a peripheral tissue (kidney). These data indicate homology between the cellular events involved in noradrenergic signaling during aging and after glucocorticoid administration to young animals; the absence of glucocorticoid effects in the elderly cohort supports a convergent mechanism with aging. Given the high incidence of HPA axis dysregulation in the elderly, and particularly in elderly depression, effects of glucocorticoids on cell signaling may contribute to disrupted function and to altered drug reactivity.

Serotonin transporter expression in rat brain regions and blood platelets: aging and glucocorticoid effects

Hyperactivity of the hypothalamus-pituitary-adrenal axis is more common in elderly depression than in younger cohorts and glucocorticoids are known to influence serotonergic systems. The current study explores the interaction of glucocorticoids with aging on serotonin transporter expression and function. Continuous infusions of dexamethasone (26 days) reduced transporter expression in the aged brain but the ability of imipramine to inhibit synaptosomal [3H]serotonin uptake was unimpaired. These effects were unique to aged animals, as prior work with young adults found no effects of dexamethasone on transporter expression. In contrast to the effects in the brain, there were no differences in platelet transporter expression between young and old rats nor did dexamethasone treatment affect the values in the aged group: thus, the platelet may not reliably model these aspects of CNS function. The results suggest that there are basic biologic differences in the effects of glucocorticoids in aged vs. young brain that could contribute to lowered effectiveness to antidepressants in elderly depression; if transport capacity is already reduced by the effects of increased glucocorticoids, further inhibition of transport by antidepressants would have proportionally less impact on synaptic serotonin concentrations.

Do glucocorticoids contribute to the abnormalities in serotonin transporter expression and function seen in depression? An animal model

Adrenocorticosteroids and serotonergic neurons exert reciprocal regulatory actions, and both are abnormal in depression. We evaluated whether glucocorticoids influence the serotonin transporter in rat platelets and brain by infusing dexamethasone for 26 days, sufficient for replacement of the entire platelet population. Effectiveness was verified by measurement of plasma dexamethasone levels, adrenal atrophy, and growth inhibition. At the end of the infusion, we examined [3H]paroxetine binding to platelet, hippocampal, and cerebrocortical membranes, and [3H]serotonin uptake into platelets and synaptosomes. Dexamethasone slightly reduced platelet [3H]paroxetine binding (12%) and had no effect on binding in brain. Platelet [3H]serotonin uptake was unaffected, but synaptosomal uptake was significantly reduced. In neither platelets nor synaptosomes did dexamethasone alter imipramine's ability to inhibit uptake. Thus, elevated glucocorticoids are not responsible for reduced platelet serotonin transporter expression in depression, nor for resistance to imipramine's effect in platelets in elderly depression; however, reduced synaptosomal [3H]serotonin uptake indicates that glucocorticoids can affect transport efficiency, even when the number of transporter molecules is unaltered.

Expression of mRNA coding for the serotonin transporter in aged vs. young rat brain: differential effects of glucocorticoids

Serotonin transporter mRNA expression in midbrain of young and aged rats was measured after long-term infusion of dexamethasone (0.01 and 0.05 mg/kg/day). Aging alone had no effect. Dexamethasone significantly decreased expression in both young and old rats but the effect was greater in the aged group. Adrenocortical dysregulation is common in elderly depression; our results suggest that glucocorticoids interact with aging to exacerbate abnormalities of serotonergic function, contributing to reduced antidepressant effectiveness.

Alteration of platelet serotonergic mechanisms and monoamine oxidase activity in premenstrual syndrome

Platelet uptake and content of 5-hydroxytryptamine (5-HT), platelet monoamine oxidase (MAO) activity, and plasma free and total tryptophan levels were determined in patients diagnosed with premenstrual syndrome (PMS) and in control subjects. The Vmax of 5-HT uptake and 5-HT content in platelets of PMS patients were significantly decreased during the premenstrual phase (cycle days -9 to -1) compared to control subjects. Platelet MAO activity was significantly lower postmenstrually (cycle days 5-9) in PMS patients compared to the premenstrual phase. There were no differences in plasma free and total tryptophan levels between PMS patients and control subjects during either interval. As platelets are believed to be a peripheral model for central serotonergic neurons, the results suggest that PMS symptomatology may be related to alterations in serotonergic neuronal mechanisms.

Uptake of serotonin into rat platelets and synaptosomes: comparative structure-activity relationships, energetics and evaluation of the effects of acute and chronic nortriptyline administration

In order to establish whether the uptake systems in platelets and synaptosomes are equivalent, the structure-activity relationships for drug-induced inhibition of serotonin uptake were examined in vitro. The rank order for potency of inhibitors was the same in platelets as in synaptosomes, namely imipramine greater than nortriptyline greater than desmethylimipramine much much greater than norepinephrine greater than histamine; in addition, serotonin uptake was clearly distinguishable from the norepinephrine synaptic uptake mechanism, which displayed a different rank order. The synaptosomal uptake of serotonin was, however, much more dependent upon maintenance of Na+-K+-ATPase activity for its energy source than was the platelet uptake mechanism. Acute administration of nortriptyline produced substantial inhibition of platelet serotonin uptake and a smaller degree of inhibition of synaptosomal uptake; inhibition was detectable even after extensive washing of the platelet and synaptosome preparations, and was associated with persistent binding of the drug to the organelles. Chronic infusion of nortriptyline (20 mg/kg for 21 days, followed by a 24 hr washout period to dissipate persistent binding) did not alter the uptake capacity of synaptosomal or platelet preparations, but did cause a shift in the drug specificity of inhibitors. The latter effect was in opposite directions in platelets vs. synaptosomes. These data indicate that the platelet uptake mechanism does bear some resemblance to that seen in serotonergic neurons, but that the energy source for transport differs and the two mechanisms respond differently to prolonged drug administration in vivo. The use of uptake as a marker during the course of antidepressant administration is likely to be confounded by persistent direct drug effects on these organelles.