1
|
Hao K, Chen F, Xu S, Xiong Y, Xu R, Huang H, Shu C, Wang H, Wang G, Reynolds GP. The role of SIRT3 in mediating the cognitive deficits and neuroinflammatory changes associated with a developmental animal model of schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2024; 130:110914. [PMID: 38122862 DOI: 10.1016/j.pnpbp.2023.110914] [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: 08/11/2023] [Revised: 11/30/2023] [Accepted: 12/10/2023] [Indexed: 12/23/2023]
Abstract
The neuroinflammatory state may contribute to the pathogenesis of many mental disorders including schizophrenia. Nicotinamide adenine dinucleotide (NAD+) is an essential cofactor for activation of proteins involved in mitochondria quality control, such as Sirtuin3 (SIRT3). Our previous study has found that NAD+ supplement could rescue early life stress (ELS)-induced neuroinflammation and down-regulation of SIRT3 in adult offspring. However, it is unclear whether SIRT3 is the key to the neuroprotective effects of NAD+ supplement in this animal model of schizophrenia. The present study used 24 h maternal separation (MS) as ELS to Wistar rat pups on the postnatal day (PND) 9. Schizophrenia-like behaviors and memory impairments were detected by behavioral tests. Microglial activation, pro-inflammatory cytokine expression, and NAD+/SIRT3 expression were detected in the prefrontal cortex and hippocampus. Meanwhile, NAM (a precursor of NAD+), and the SIRT3 activator Honokiol (HNK), and the SIRT3 inhibitor 3-TYP were used as an intervention in vivo. Our results showed that ELS could induce schizophrenia-like behaviors and M1 microglial activation, NAD+ decline, lower expression of SIRT3, and increased acetylated superoxide dismutase 2 expression at the adult stage. NAD+ supplement or HNK administration could block this process and normalize the behavioral alterations of the MS animals. 3-TYP administration in the control group and the NAM-treated MS rats caused M1 microglial activation and cognitive deficits. Our results demonstrated that SIRT3 mediated the stabilizing effect of NAD+ on normalizing M1 microglial activation and behavioral phenotypes in MS rats.
Collapse
Affiliation(s)
- Keke Hao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Fashuai Chen
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Shilin Xu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Ying Xiong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Rui Xu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Huan Huang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Chang Shu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Huiling Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China.
| | - Gaohua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China; Hubei Institute of Neurology and Psychiatry Research, Wuhan 430060, China.
| | - Gavin P Reynolds
- Biomolecular Sciences Research Centre, Sheffield Hallam University, Sheffield, United Kingdom
| |
Collapse
|
2
|
Hofmeister M, Clement F, Patten S, Li J, Dowsett LE, Farkas B, Mastikhina L, Egunsola O, Diaz R, Cooke NCA, Taylor VH. The effect of interventions targeting gut microbiota on depressive symptoms: a systematic review and meta-analysis. CMAJ Open 2021; 9:E1195-E1204. [PMID: 34933877 PMCID: PMC8695538 DOI: 10.9778/cmajo.20200283] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Despite their popularity, the efficacy of interventions targeting gut microbiota to improve depressive symptoms is unknown. Our objective is to summarize the effect of microbiome-targeting interventions on depressive symptoms. METHODS We conducted a systematic review and meta-analysis. We searched MEDLINE, Embase, PsycINFO, Database of Abstracts of Reviews of Effects, Cochrane Database of Systematic Reviews and the Cochrane Controlled Register of Trials from inception to Mar. 5, 2021. We included studies that evaluated probiotic, prebiotic, synbiotic, paraprobiotic or fecal microbiota transplant interventions in an adult population (age ≥ 18 yr) with an inactive or placebo comparator (defined by the absence of active intervention). Studies must have measured depressive symptoms with a validated scale, and used a randomized controlled trial study design. We conducted a random effects meta-analysis of change scores, using standardized mean difference as the measure of effect. RESULTS Sixty-two studies formed the final data set, with 50 included in the meta-analysis. Probiotic, prebiotic, and synbiotic interventions on depressive symptoms showed statistically significant benefits. In the single studies evaluating each of fecal microbiota transplant and paraprobiotic interventions, neither showed a statistically significant benefit. INTERPRETATION Despite promising findings of benefit of probiotic, prebiotic and synbiotic interventions for depressive symptoms in study populations, there is not yet strong enough evidence to favour inclusion of these interventions in treatment guidelines for depression. Critical questions about species administered, dosage and timing relative to other antidepressant medications remain to be answered. STUDY REGISTRATION PROSPERO no. 143178.
Collapse
Affiliation(s)
- Mark Hofmeister
- Department of Community Health Sciences (Hofmeister, Clement, Patten, Li, Dowsett, Farkas, Mastikhina, Egunsola, Diaz), and O'Brien Institute for Public Health (Hofmeister, Clement, Patten, Li, Dowsett, Farkas, Mastikhina, Egunsola, Diaz), and Departments of Psychiatry (Patten, Taylor) and Biochemistry and Molecular Biology (Cooke), Teaching Research and Wellness Building, University of Calgary, Calgary, Alta
| | - Fiona Clement
- Department of Community Health Sciences (Hofmeister, Clement, Patten, Li, Dowsett, Farkas, Mastikhina, Egunsola, Diaz), and O'Brien Institute for Public Health (Hofmeister, Clement, Patten, Li, Dowsett, Farkas, Mastikhina, Egunsola, Diaz), and Departments of Psychiatry (Patten, Taylor) and Biochemistry and Molecular Biology (Cooke), Teaching Research and Wellness Building, University of Calgary, Calgary, Alta
| | - Scott Patten
- Department of Community Health Sciences (Hofmeister, Clement, Patten, Li, Dowsett, Farkas, Mastikhina, Egunsola, Diaz), and O'Brien Institute for Public Health (Hofmeister, Clement, Patten, Li, Dowsett, Farkas, Mastikhina, Egunsola, Diaz), and Departments of Psychiatry (Patten, Taylor) and Biochemistry and Molecular Biology (Cooke), Teaching Research and Wellness Building, University of Calgary, Calgary, Alta
| | - Joyce Li
- Department of Community Health Sciences (Hofmeister, Clement, Patten, Li, Dowsett, Farkas, Mastikhina, Egunsola, Diaz), and O'Brien Institute for Public Health (Hofmeister, Clement, Patten, Li, Dowsett, Farkas, Mastikhina, Egunsola, Diaz), and Departments of Psychiatry (Patten, Taylor) and Biochemistry and Molecular Biology (Cooke), Teaching Research and Wellness Building, University of Calgary, Calgary, Alta
| | - Laura E Dowsett
- Department of Community Health Sciences (Hofmeister, Clement, Patten, Li, Dowsett, Farkas, Mastikhina, Egunsola, Diaz), and O'Brien Institute for Public Health (Hofmeister, Clement, Patten, Li, Dowsett, Farkas, Mastikhina, Egunsola, Diaz), and Departments of Psychiatry (Patten, Taylor) and Biochemistry and Molecular Biology (Cooke), Teaching Research and Wellness Building, University of Calgary, Calgary, Alta
| | - Brenlea Farkas
- Department of Community Health Sciences (Hofmeister, Clement, Patten, Li, Dowsett, Farkas, Mastikhina, Egunsola, Diaz), and O'Brien Institute for Public Health (Hofmeister, Clement, Patten, Li, Dowsett, Farkas, Mastikhina, Egunsola, Diaz), and Departments of Psychiatry (Patten, Taylor) and Biochemistry and Molecular Biology (Cooke), Teaching Research and Wellness Building, University of Calgary, Calgary, Alta
| | - Liza Mastikhina
- Department of Community Health Sciences (Hofmeister, Clement, Patten, Li, Dowsett, Farkas, Mastikhina, Egunsola, Diaz), and O'Brien Institute for Public Health (Hofmeister, Clement, Patten, Li, Dowsett, Farkas, Mastikhina, Egunsola, Diaz), and Departments of Psychiatry (Patten, Taylor) and Biochemistry and Molecular Biology (Cooke), Teaching Research and Wellness Building, University of Calgary, Calgary, Alta
| | - Oluwaseun Egunsola
- Department of Community Health Sciences (Hofmeister, Clement, Patten, Li, Dowsett, Farkas, Mastikhina, Egunsola, Diaz), and O'Brien Institute for Public Health (Hofmeister, Clement, Patten, Li, Dowsett, Farkas, Mastikhina, Egunsola, Diaz), and Departments of Psychiatry (Patten, Taylor) and Biochemistry and Molecular Biology (Cooke), Teaching Research and Wellness Building, University of Calgary, Calgary, Alta
| | - Ruth Diaz
- Department of Community Health Sciences (Hofmeister, Clement, Patten, Li, Dowsett, Farkas, Mastikhina, Egunsola, Diaz), and O'Brien Institute for Public Health (Hofmeister, Clement, Patten, Li, Dowsett, Farkas, Mastikhina, Egunsola, Diaz), and Departments of Psychiatry (Patten, Taylor) and Biochemistry and Molecular Biology (Cooke), Teaching Research and Wellness Building, University of Calgary, Calgary, Alta
| | - Noah C A Cooke
- Department of Community Health Sciences (Hofmeister, Clement, Patten, Li, Dowsett, Farkas, Mastikhina, Egunsola, Diaz), and O'Brien Institute for Public Health (Hofmeister, Clement, Patten, Li, Dowsett, Farkas, Mastikhina, Egunsola, Diaz), and Departments of Psychiatry (Patten, Taylor) and Biochemistry and Molecular Biology (Cooke), Teaching Research and Wellness Building, University of Calgary, Calgary, Alta
| | - Valerie H Taylor
- Department of Community Health Sciences (Hofmeister, Clement, Patten, Li, Dowsett, Farkas, Mastikhina, Egunsola, Diaz), and O'Brien Institute for Public Health (Hofmeister, Clement, Patten, Li, Dowsett, Farkas, Mastikhina, Egunsola, Diaz), and Departments of Psychiatry (Patten, Taylor) and Biochemistry and Molecular Biology (Cooke), Teaching Research and Wellness Building, University of Calgary, Calgary, Alta.
| |
Collapse
|
3
|
Bechter K. The Challenge of Assessing Mild Neuroinflammation in Severe Mental Disorders. Front Psychiatry 2020; 11:773. [PMID: 32973573 PMCID: PMC7469926 DOI: 10.3389/fpsyt.2020.00773] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 07/21/2020] [Indexed: 12/13/2022] Open
Abstract
Recent psychoneuroimmunology research has provided new insight into the etiology and pathogenesis of severe mental disorders (SMDs). The mild encephalitis (ME) hypothesis was developed with the example of human Borna disease virus infection years ago and proposed, that a subgroup SMD patients, mainly from the broad schizophrenic and affective spectrum, could suffer from mild neuroinflammation, which remained undetected because hard to diagnose with available diagnostic methods. Recently, in neurology an emerging new subgroup of autoimmune encephalitis (AE) cases suffering from various neurological syndromes was described in context with the discovery of an emerging list of Central Nervous System (CNS) autoantibodies. Similarly in psychiatry, consensus criteria of autoimmune psychosis (AP) were developed for patients presenting with CNS autoantibodies together with isolated psychiatric symptoms and paraclinical findings of (mild) neuroinflammation, which in fact match also the previously proposed ME criteria. Nevertheless, identifying mild neuroinflammation in vivo in the individual SMD case remains still a major clinical challenge and the possibility that further cases of ME remain still under diagnosed appears an plausible possibility. In this paper a critical review of recent developments and remaining challenges in the research and clinical diagnosis of mild neuroinflammation in SMDs and in general and in transdisciplinary perspective to psycho-neuro-immunology and neuropsychiatry is given. Present nosological classifications of neuroinflammatory disorders are reconsidered with regard to findings from experimental and clinical research. A refined grading list of clinical states including "classical" encephalitis, AE, AP/ME,and newly proposed terms like parainflammation, stress-induced parainflammation and neuroprogression, and their respective relation to neurodegeneration is presented, which may be useful for further research on the possible causative role of mild neuroinflammation in SMDs. Beyond, an etiology-focused subclassification of ME subtypes, like autoimmune ME or infectious ME, appears to be required for differential diagnosis and individualized treatment. The present status of the clinical diagnosis of mild neuroinflammatory mechanisms involved in SMDs is outlined with the example of actual diagnosis and therapy in AP. Ideas for future research to unravel the contribution of mild neuroinflammation in the causality of SMDs and the difficulties expected to come to novel immune modulatory, anti-infectious or anti-inflammatory therapeutic principles in the sense of precision medicine are discussed.
Collapse
Affiliation(s)
- Karl Bechter
- Department for Psychiatry and Psychotherapy II, Ulm University, Bezirkskrankenhaus Günzburg, Günzburg, Germany
| |
Collapse
|
4
|
Noronha C, Figueiredo G, Pinheiro C, Carvalho E, Calheiros A, Pires MM, Taipa R. Brain biopsy in suspected non-neoplastic neurological disease. Acta Neurochir (Wien) 2019; 161:1139-1147. [PMID: 31016453 DOI: 10.1007/s00701-019-03910-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 04/10/2019] [Indexed: 12/18/2022]
Abstract
Brain biopsy has a well-established role in the diagnosis of CNS neoplasia. Nevertheless, despite being essential for the diagnosis of some benign neurological diseases, little consensus exists regarding its indications for disease diagnosis and patient orientation. Our aim was to assess brain biopsy diagnostic yield in patients with neurological deterioration of unknown etiology, to identify the clinical characteristics associated with an increased likelihood of achieving a diagnostic biopsy as well as the characteristics linked to a particular diagnosis. METHODS A retrospective analysis of 62 consecutive brain biopsies performed at a single tertiary care center between January 2004 and December 2015 for suspected non-neoplastic neurological disease was performed. The clinical presentation, imaging, and laboratory results were collected and compared between diagnostic groups. RESULTS Sixty-eight percent of the biopsies led to a definitive diagnosis. The most common histological diagnosis was central nervous system lymphoma (eight cases), followed by astrocytoma, demyelinating disease, and progressive multifocal leukoencephalopathy (four cases each). No clinical characteristics were found to predict a diagnostic biopsy or to correlate with a specific diagnosis. Importantly, a distinct diagnosis from the initially suspected was achieved in 52% of cases and biopsy findings led to a change of therapeutic orientation in 78% of the cases. CONCLUSIONS Our results suggest that brain biopsies have a significant impact on patient management and should be considered early in selected cases in which less invasive testing was unable to reach a definitive diagnosis.
Collapse
Affiliation(s)
- Carolina Noronha
- Neurosurgery Department, Hospital Santo Antonio, Centro Hospitalar e Universitario do Porto, Largo Prof Abel Salazar, Porto, 4099-001, Portugal.
- i3s Institute for Research and Innovation in Health, Universidade do Porto, Porto, Portugal.
| | - Gonçalo Figueiredo
- Neurosurgery Department, Hospital Santo Antonio, Centro Hospitalar e Universitario do Porto, Largo Prof Abel Salazar, Porto, 4099-001, Portugal
| | - Célia Pinheiro
- Neurosurgery Department, Hospital Santo Antonio, Centro Hospitalar e Universitario do Porto, Largo Prof Abel Salazar, Porto, 4099-001, Portugal
| | - Ernesto Carvalho
- Neurosurgery Department, Hospital Santo Antonio, Centro Hospitalar e Universitario do Porto, Largo Prof Abel Salazar, Porto, 4099-001, Portugal
| | - Alfredo Calheiros
- Neurosurgery Department, Hospital Santo Antonio, Centro Hospitalar e Universitario do Porto, Largo Prof Abel Salazar, Porto, 4099-001, Portugal
| | - Manuel Melo Pires
- Neuropathology Unit, Hospital de Santo Antonio, Centro Hospitalar e Universitario do Porto, Porto, Portugal
| | - Ricardo Taipa
- Neuropathology Unit, Hospital de Santo Antonio, Centro Hospitalar e Universitario do Porto, Porto, Portugal
| |
Collapse
|
5
|
Gong H, Su WJ, Cao ZY, Lian YJ, Peng W, Liu YZ, Zhang Y, Liu LL, Wu R, Wang B, Zhang T, Wang YX, Jiang CL. Hippocampal Mrp8/14 signaling plays a critical role in the manifestation of depressive-like behaviors in mice. J Neuroinflammation 2018; 15:252. [PMID: 30180864 PMCID: PMC6122683 DOI: 10.1186/s12974-018-1296-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 08/29/2018] [Indexed: 12/17/2022] Open
Abstract
Background Depression is one of the most common mental disorders characterized mainly by low mood and loss of interest or pleasure. About a third of patients with depression do not respond to classic antidepressant treatments. Recent evidence suggests that Mrp8/14 (myeloid-related protein 8/14) plays a crucial role in cognitive dysfunction and neuroinflammatory diseases, yet its role in mood regulation remains largely uninvestigated. In the present work, we explored the potential role of Mrp8/14 in the progression of depression. Methods After 4 weeks of chronic unpredictable mild stress (CUMS), depressive-like symptoms and Mrp8/14 were determined. To verify the effects of Mrp8/14 on depressive-like behaviors, the inhibitor TAK-242 and recombinant Mrp8/14 were used. Furthermore, the molecular mechanisms in Mrp8/14-induced behavioral and biological changes were examined in vivo and ex vivo. Results Four-week CUMS contributed to the development of depressive symptoms. Mrp8 and Mrp14 were upregulated in the hippocampus and serum after exposure to CUMS. Pharmacological inhibition of Mrp14 attenuated CUMS-induced TLR4/NF-κB signaling activation and depressive-like behaviors. Furthermore, central administration of recombinant Mrp8, Mrp14, and Mrp8/14 resulted in neuroinflammation and depressive-like behaviors. Mrp8/14-provoked proinflammatory effects and depressive-like behaviors were improved by pretreatment with a TLR4 inhibitor. Moreover, pharmacological inhibition of TLR4 reduced the release of nitric oxide and reactive oxygen species in Mrp8/14-activated BV2 microglia. Conclusions These data suggest that the hippocampal Mrp8/14-TLR4-mediated neuroinflammation contributes to the development of depressive-like behaviors. Targeting the Mrp8/14 may be a novel promising antidepressant approach. Electronic supplementary material The online version of this article (10.1186/s12974-018-1296-0) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Hong Gong
- Department of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, 200433, People's Republic of China.,Hainan Branch of Chinese PLA General Hospital, Sanya, 572013, People's Republic of China
| | - Wen-Jun Su
- Department of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Zhi-Yong Cao
- Department of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, 200433, People's Republic of China.,Department of Psychiatry, The 102nd Hospital of PLA, Changzhou, 213003, People's Republic of China
| | - Yong-Jie Lian
- Department of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Wei Peng
- Department of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Yun-Zi Liu
- Department of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Yi Zhang
- Department of Psychiatry, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Lin-Lin Liu
- Department of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Ran Wu
- Department of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Bo Wang
- Department of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Ting Zhang
- Department of Navy Medicine, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Yun-Xia Wang
- Department of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Chun-Lei Jiang
- Department of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, 200433, People's Republic of China.
| |
Collapse
|
6
|
Najjar S, Steiner J, Najjar A, Bechter K. A clinical approach to new-onset psychosis associated with immune dysregulation: the concept of autoimmune psychosis. J Neuroinflammation 2018; 15:40. [PMID: 29433523 PMCID: PMC5809809 DOI: 10.1186/s12974-018-1067-y] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 01/15/2018] [Indexed: 12/19/2022] Open
Abstract
Growing data point to the overlap between psychosis and pathological processes associated with immunological dysregulation as well as inflammation. Notably, the recent discovery of antibodies against synaptic and neuronal cell membrane proteins such as anti-N-methyl-d-aspartate receptor provides more direct evidence of the etiological connection between autoimmunity and subsequent hazard of psychosis. Here, we advocate the use of term “autoimmune psychosis,” as this term suggests that autoimmune disorders can masquerade as drug-resistant primary psychosis, and this subtype of psychosis has anatomical and immunological footprints in the brain, despite the frequent absence of structural abnormalities on conventional brain MRI. Furthermore, this term might serve as a reminder not to overlook appropriate neurological workup such as neuroimaging and EEG testing, as well as CSF analysis, for cases with acute or subacute atypical onset of neuropsychiatric presentations including those dominated by acute psychotic symptoms. We propose etiologically and serologically oriented subclassification as well as multi-modal diagnostic approach to address some of the challenges inherent to early diagnosis of patients presenting with atypical and refractory new-onset psychotic symptoms of autoimmune origin. This is particularly relevant to the diagnosis of seronegative but probable autoimmune psychosis (SPAP) that might masquerade as antipsychotic drug-resistant primary psychotic disorder. This distinction is therapeutically important as autoimmune-related psychotic symptomatology can frequently respond well to timely treatment with proper immune modulatory therapies.
Collapse
Affiliation(s)
- Souhel Najjar
- Department of Neurology, Zucker School of Medicine at Hofstra/Northwell, 8 Black Hall, 130 E 77th Street, New York, NY, 10075, USA.
| | - Johann Steiner
- Department of Psychiatry, University of Magdeburg, Leipziger Str. 44, D-39120, Magdeburg, Germany
| | - Amanda Najjar
- Department of Neurology, Lenox Hill Hospital, 8 Black Hall, 130 E 77th Street, New York, NY, 10075, USA
| | - Karl Bechter
- Ulm University, Ludwig-Heilmeyer-Str. 4, D-89312, Günzburg, Germany
| |
Collapse
|
7
|
Bechter K. Encephalitis, Mild Encephalitis, Neuroprogression, or Encephalopathy-Not Merely a Question of Terminology. Front Psychiatry 2018; 9:782. [PMID: 30787887 PMCID: PMC6372546 DOI: 10.3389/fpsyt.2018.00782] [Citation(s) in RCA: 12] [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: 08/23/2018] [Accepted: 12/28/2018] [Indexed: 12/17/2022] Open
Abstract
Background: Psychoneuroimmunology research has presented emerging evidence of the involvement of inflammatory and immune mechanisms in the pathogenesis of severe mental disorders. In this context, new terms with increasing clinical relevance have been proposed, challenging the existing terms, and requiring consensus definitions of the new ones. Method: From a perspective of longstanding personal involvement in clinical settings and research in psychoneuroimmunology, the new and the existing terms are critically reconsidered. Results: Meningoencephalitis and encephalitis are comparably well defined clinical terms in neuropsychiatry, although in the individual case approach diagnosis can be difficult, for example in some cases of encephalitis that are described with normal cerebrospinal fluid findings, or often in chronic encephalitis. Encephalopathy is also a widely accepted term, however, with a surprisingly broad meaning with regard to the assigned underlying pathophysiology, ranging from one-hit traumatic encephalopathy to inflammatory encephalopathy, the latter term addressing a type of brain dysfunction secondary to acute systemic inflammation without proven brain autochthonus inflammation (neuroinflammation). However, this latter assumption and term may be wrong as neuroinflammation is difficult to prove in vivo. With emerging insights into prevailing inflammatory and neuroinflammatory mechanisms that are involved in the pathogenesis of severe mental disorders, the interdependent aspects of sensitive assessment and potential clinical relevance of mild neuroinflammation are becoming more apparent and of increasing clinical interest. The new terms "mild encephalitis," "parainflammation," and "neuroprogression" show considerable overlap in addition to gaps and hardly defined borders. However, details are hard to discuss as available studies use many biomarkers, but most of these are done without an established categorical attribution to exclusive terms. Most important, the three new concepts (neruoprogression, parainflammation, and mild encephalitis) are not mutually exclusive, even at the individual case level, and therefore will require state-related individual assessment approaches beyond large confirmatory studies. Conclusion: The newly proposed terms of mild encephalitis, parainflammation, and neuroprogression have an emerging clinical relevance, but respective borders, gaps and overlap in between them remain unclear, and these concepts may even be seen as complementary. Categorical delineation of the new and reconsideration of the existing terms with respect to individualized psychiatric treatment is required for better clinical use, eventually requiring a consensus approach. Here, a critique based on available data and a focus on clinical perspective was outlined, which may help to enhance fruitful discussion. The idea followed here is in line with pillar number six as proposed for the Research Diagnostic Domains, i.e., to provide and follow new concepts in psychiatric research.
Collapse
Affiliation(s)
- Karl Bechter
- Department Psychiatry and Psychotherapy II, Bezirkskrankenhaus Günzburg, Ulm University, Ulm, Germany
| |
Collapse
|
8
|
Bogerts B, Winopal D, Schwarz S, Schlaaff K, Dobrowolny H, Mawrin C, Frodl T, Steiner J. Evidence of neuroinflammation in subgroups of schizophrenia and mood disorder patients: A semiquantitative postmortem study of CD3 and CD20 immunoreactive lymphocytes in several brain regions. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.npbr.2016.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
9
|
Wang L, Hiller H, Smith JA, de Kloet AD, Krause EG. Angiotensin type 1a receptors in the paraventricular nucleus of the hypothalamus control cardiovascular reactivity and anxiety-like behavior in male mice. Physiol Genomics 2016; 48:667-76. [PMID: 27468749 PMCID: PMC5111882 DOI: 10.1152/physiolgenomics.00029.2016] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 07/13/2016] [Indexed: 01/19/2023] Open
Abstract
This study tested the hypothesis that deletion of angiotensin type 1a receptors (AT1a) from the paraventricular nucleus of hypothalamus (PVN) attenuates anxiety-like behavior, hypothalamic-pituitary-adrenal (HPA) axis activity, and cardiovascular reactivity. We used the Cre/LoxP system to generate male mice with AT1a specifically deleted from the PVN. Deletion of the AT1a from the PVN reduced anxiety-like behavior as indicated by increased time spent in the open arms of the elevated plus maze. In contrast, PVN AT1a deletion had no effect on HPA axis activation subsequent to an acute restraint challenge but did reduce hypothalamic mRNA expression for corticotropin-releasing hormone (CRH). To determine whether PVN AT1a deletion inhibits cardiovascular reactivity, we measured systolic blood pressure, heart rate, and heart rate variability (HRV) using telemetry and found that PVN AT1a deletion attenuated restraint-induced elevations in systolic blood pressure and elicited changes in HRV indicative of reduced sympathetic nervous activity. Consistent with the decreased HRV, PVN AT1a deletion also decreased adrenal weight, suggestive of decreased adrenal sympathetic outflow. Interestingly, the altered stress responsivity of mice with AT1a deleted from the PVN was associated with decreased hypothalamic microglia and proinflammatory cytokine expression. Collectively, these results suggest that deletion of AT1a from the PVN attenuates anxiety, CRH gene transcription, and cardiovascular reactivity and reduced brain inflammation may contribute to these effects.
Collapse
Affiliation(s)
- Lei Wang
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, Florida; and
| | - Helmut Hiller
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, Florida; and
| | - Justin A Smith
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, Florida; and
| | - Annette D de Kloet
- Department of Physiology and Functional Genomics, College of Medicine, University of Florida, Gainesville, Florida
| | - Eric G Krause
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, Florida; and
| |
Collapse
|
10
|
Gururajan A, Clarke G, Dinan TG, Cryan JF. Molecular biomarkers of depression. Neurosci Biobehav Rev 2016; 64:101-33. [DOI: 10.1016/j.neubiorev.2016.02.011] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 01/11/2016] [Accepted: 02/12/2016] [Indexed: 12/22/2022]
|
11
|
Disruption in the Blood-Brain Barrier: The Missing Link between Brain and Body Inflammation in Bipolar Disorder? Neural Plast 2015; 2015:708306. [PMID: 26075104 PMCID: PMC4444594 DOI: 10.1155/2015/708306] [Citation(s) in RCA: 129] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 02/02/2015] [Accepted: 02/05/2015] [Indexed: 01/01/2023] Open
Abstract
The blood-brain barrier (BBB) regulates the transport of micro- and macromolecules between the peripheral blood and the central nervous system (CNS) in order to maintain optimal levels of essential nutrients and neurotransmitters in the brain. In addition, the BBB plays a critical role protecting the CNS against neurotoxins. There has been growing evidence that BBB disruption is associated with brain inflammatory conditions such as Alzheimer's disease and multiple sclerosis. Considering the increasing role of inflammation and oxidative stress in the pathophysiology of bipolar disorder (BD), here we propose a novel model wherein transient or persistent disruption of BBB integrity is associated with decreased CNS protection and increased permeability of proinflammatory (e.g., cytokines, reactive oxygen species) substances from the peripheral blood into the brain. These events would trigger the activation of microglial cells and promote localized damage to oligodendrocytes and the myelin sheath, ultimately compromising myelination and the integrity of neural circuits. The potential implications for research in this area and directions for future studies are discussed.
Collapse
|
12
|
Brown JA, Sherrod SD, Goodwin CR, Brewer B, Yang L, Garbett KA, Li D, McLean JA, Wikswo JP, Mirnics K. Metabolic consequences of interleukin-6 challenge in developing neurons and astroglia. J Neuroinflammation 2014; 11:183. [PMID: 25374324 PMCID: PMC4233071 DOI: 10.1186/s12974-014-0183-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 10/11/2014] [Indexed: 02/02/2023] Open
Abstract
Background Maternal immune activation and subsequent interleukin-6 (IL-6) induction disrupt normal brain development and predispose the offspring to developing autism and schizophrenia. While several proteins have been identified as having some link to these developmental disorders, their prevalence is still small and their causative role, if any, is not well understood. However, understanding the metabolic consequences of environmental predisposing factors could shed light on disorders such as autism and schizophrenia. Methods To gain a better understanding of the metabolic consequences of IL-6 exposure on developing central nervous system (CNS) cells, we separately exposed developing neuron and astroglia cultures to IL-6 for 2 hours while collecting effluent from our gravity-fed microfluidic chambers. By coupling microfluidic technologies to ultra-performance liquid chromatography-ion mobility-mass spectrometry (UPLC-IM-MS), we were able to characterize the metabolic response of these CNS cells to a narrow window of IL-6 exposure. Results Our results revealed that 1) the use of this technology, due to its superb media volume:cell volume ratio, is ideally suited for analysis of cell-type-specific exometabolome signatures; 2) developing neurons have low secretory activity at baseline, while astroglia show strong metabolic activity; 3) both neurons and astroglia respond to IL-6 exposure in a cell type-specific fashion; 4) the astroglial response to IL-6 stimulation is predominantly characterized by increased levels of metabolites, while neurons mostly depress their metabolic activity; and 5) disturbances in glycerophospholipid metabolism and tryptophan/kynurenine metabolite secretion are two putative mechanisms by which IL-6 affects the developing nervous system. Conclusions Our findings are potentially critical for understanding the mechanism by which IL-6 disrupts brain function, and they provide information about the molecular cascade that links maternal immune activation to developmental brain disorders. Electronic supplementary material The online version of this article (doi:10.1186/s12974-014-0183-6) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Jacquelyn A Brown
- Department of Psychiatry, 465 21st Avenue South, Vanderbilt University, Nashville, TN, 37232, USA. .,Vanderbilt Institute for Integrative Biosystems Research and Education, 6809 Stevenson Center, Vanderbilt University, Nashville, TN, 37235, USA.
| | - Stacy D Sherrod
- Vanderbilt Institute for Integrative Biosystems Research and Education, 6809 Stevenson Center, Vanderbilt University, Nashville, TN, 37235, USA. .,Department of Physics and Astronomy, 6301 Stevenson Center, Vanderbilt University, Nashville, TN, 37235, USA.
| | - Cody R Goodwin
- Vanderbilt Institute for Integrative Biosystems Research and Education, 6809 Stevenson Center, Vanderbilt University, Nashville, TN, 37235, USA. .,Department of Chemistry, 5421 Stevenson Center, Vanderbilt University, Nashville, TN, 37235, USA.
| | - Bryson Brewer
- Department of Mechanical Engineering, 333 Olin Hall, Vanderbilt University, Nashville, TN, 37235, USA.
| | - Lijie Yang
- Department of Mechanical Engineering, 333 Olin Hall, Vanderbilt University, Nashville, TN, 37235, USA.
| | - Krassimira A Garbett
- Department of Psychiatry, 465 21st Avenue South, Vanderbilt University, Nashville, TN, 37232, USA.
| | - Deyu Li
- Vanderbilt Institute for Integrative Biosystems Research and Education, 6809 Stevenson Center, Vanderbilt University, Nashville, TN, 37235, USA. .,Department of Mechanical Engineering, 333 Olin Hall, Vanderbilt University, Nashville, TN, 37235, USA.
| | - John A McLean
- Vanderbilt Institute for Integrative Biosystems Research and Education, 6809 Stevenson Center, Vanderbilt University, Nashville, TN, 37235, USA. .,Department of Chemistry, 5421 Stevenson Center, Vanderbilt University, Nashville, TN, 37235, USA.
| | - John P Wikswo
- Vanderbilt Institute for Integrative Biosystems Research and Education, 6809 Stevenson Center, Vanderbilt University, Nashville, TN, 37235, USA. .,Department of Physics and Astronomy, 6301 Stevenson Center, Vanderbilt University, Nashville, TN, 37235, USA. .,Department of Biomedical Engineering, 5824 Stevenson Center, Vanderbilt University, Nashville, 37235, TN, USA. .,Department of Molecular Physiology and Biophysics, 702 Light Hall, Vanderbilt University, Nashville, TN, 37232, USA.
| | - Károly Mirnics
- Department of Psychiatry, 465 21st Avenue South, Vanderbilt University, Nashville, TN, 37232, USA. .,Vanderbilt Institute for Integrative Biosystems Research and Education, 6809 Stevenson Center, Vanderbilt University, Nashville, TN, 37235, USA. .,Vanderbilt Kennedy Center for Research on Human Development, 110 Magnolia Circle, Vanderbilt University, Nashville, TN, 37203, USA. .,Department of Psychiatry, University of Szeged, 6725, Szeged, Hungary.
| |
Collapse
|
13
|
Zahr NM, Alt C, Mayer D, Rohlfing T, Manning-Bog A, Luong R, Sullivan EV, Pfefferbaum A. Associations between in vivo neuroimaging and postmortem brain cytokine markers in a rodent model of Wernicke's encephalopathy. Exp Neurol 2014; 261:109-19. [PMID: 24973622 PMCID: PMC4194214 DOI: 10.1016/j.expneurol.2014.06.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 06/13/2014] [Accepted: 06/17/2014] [Indexed: 02/03/2023]
Abstract
Thiamine (vitamin B1) deficiency, associated with a variety of conditions, including chronic alcoholism and bariatric surgery for morbid obesity, can result in the neurological disorder Wernicke's encephalopathy (WE). Recent work building upon early observations in animal models of thiamine deficiency has demonstrated an inflammatory component to the neuropathology observed in thiamine deficiency. The present, multilevel study including in vivo magnetic resonance imaging (MRI) and spectroscopy (MRS) and postmortem quantification of chemokine and cytokine proteins sought to determine whether a combination of these in vivo neuroimaging tools could be used to characterize an in vivo MR signature for neuroinflammation. Thiamine deficiency for 12days was used to model neuroinflammation; glucose loading in thiamine deficiency was used to accelerate neurodegeneration. Among 38 animals with regional brain tissue assayed postmortem for cytokine/chemokine protein levels, three groups of rats (controls+glucose, n=6; pyrithiamine+saline, n=5; pyrithiamine+glucose, n=13) underwent MRI/MRS at baseline (time 1), after 12days of treatment (time 2), and 3h after challenge (glucose or saline, time 3). In the thalamus of glucose-challenged, thiamine deficient animals, correlations between in vivo measures of pathology (lower levels of N-acetyle aspartate and higher levels of lactate) and postmortem levels of monocyte chemotactic protein-1 (MCP-1, also known as chemokine ligand 2, CCL2) support a role for this chemokine in thiamine deficiency-related neurodegeneration, but do not provide a unique in vivo signature for neuroinflammation.
Collapse
Affiliation(s)
- Natalie M Zahr
- Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd., Stanford, CA 94305, USA; Neuroscience Program, SRI International, Menlo Park, CA 94025, USA.
| | - Carsten Alt
- Immunology Program, SRI International, Menlo Park, CA 94025, USA; Palo Alto Institute for Research and Education, Palo Alto, CA 94304, USA
| | - Dirk Mayer
- Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd., Stanford, CA 94305, USA; Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD 21201, USA
| | - Torsten Rohlfing
- Neuroscience Program, SRI International, Menlo Park, CA 94025, USA
| | - Amy Manning-Bog
- Neuroscience Program, SRI International, Menlo Park, CA 94025, USA
| | - Richard Luong
- Department of Comparative Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Edwards R321, Stanford, CA 94305, USA
| | - Edith V Sullivan
- Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd., Stanford, CA 94305, USA
| | - Adolf Pfefferbaum
- Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd., Stanford, CA 94305, USA; Neuroscience Program, SRI International, Menlo Park, CA 94025, USA
| |
Collapse
|
14
|
Blood levels of S-100 calcium-binding protein B, high-sensitivity C-reactive protein, and interleukin-6 for changes in depressive symptom severity after coronary artery bypass grafting: prospective cohort nested within a randomized, controlled trial. PLoS One 2014; 9:e111110. [PMID: 25329583 PMCID: PMC4203837 DOI: 10.1371/journal.pone.0111110] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 09/28/2014] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Cross-sectional and retrospective studies have associated major depressive disorder with glial activation and injury as well as blood-brain barrier disruption, but these associations have not been assessed prospectively. Here, we aimed to determine the relationship between changes in depressive symptom severity and in blood levels of S-100 calcium-binding protein B (S-100B), high-sensitivity C-reactive protein, and interleukin-6 following an inflammatory challenge. METHODS Fifty unselected participants were recruited from a randomized, controlled trial comparing coronary artery bypass grafting procedures performed with versus without cardiopulmonary bypass for the risk of neurocognitive decline. Depressive symptom severity was measured at baseline, discharge, and six-month follow-up using the Beck Depression Inventory II (BDI-II). The primary outcome of the present biomarker study was acute change in depressive symptom severity, defined as the intra-subject difference between baseline and discharge BDI-II scores. Blood biomarker levels were determined at baseline and 2 days postoperative. RESULTS Changes in S-100B levels correlated positively with acute changes in depressive symptom severity (Spearman ρ, 0.62; P = 0.0004) and accounted for about one-fourth of their observed variance (R2, 0.23; P = 0.0105). This association remained statistically significant after adjusting for baseline S-100B levels, age, weight, body-mass index, or β-blocker use, but not baseline BDI-II scores (P = 0.064). There was no statistically significant association between the primary outcome and baseline S-100B levels, baseline high-sensitivity C-reactive protein or interleukin-6 levels, or changes in high-sensitivity C-reactive protein or interleukin-6 levels. Among most participants, levels of all three biomarkers were normal at baseline and markedly elevated at 2 days postoperative. CONCLUSIONS Acute changes in depressive symptom severity were specifically associated with incremental changes in S-100B blood levels, largely independent of covariates associated with either. These findings support the hypothesis that glial activation and injury and blood-brain barrier disruption can be mechanistically linked to acute exacerbation of depressive symptoms in some individuals.
Collapse
|
15
|
Hall JR, Wiechmann AR, Johnson LA, Edwards M, Barber RC, Cunningham R, Singh M, O'Bryant SE. Total cholesterol and neuropsychiatric symptoms in Alzheimer's disease: the impact of total cholesterol level and gender. Dement Geriatr Cogn Disord 2014; 38:300-9. [PMID: 25011444 PMCID: PMC4201880 DOI: 10.1159/000361043] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/04/2014] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD) are a major factor in nursing home placement and a primary cause of stress for caregivers. Elevated cholesterol has been linked to psychiatric disorders and has been shown to be a risk factor for AD and to impact disease progression. The present study investigated the relationship between cholesterol and NPS in AD. METHODS Data on cholesterol and NPS from 220 individuals (144 females, 76 males) with mild-to-moderate AD from the Texas Alzheimer's Research and Care Consortium (TARCC) cohort were analyzed. The total number of NPS and symptoms of hyperactivity, psychosis, affect and apathy were evaluated. Groups based on total cholesterol (TC; ≥200 vs. <200 mg/dl) were compared with regard to NPS. The impact of gender was also assessed. RESULTS Individuals with high TC had lower MMSE scores as well as significantly more NPS and more symptoms of psychosis. When stratified by gender, males with high TC had significantly more NPS than females with high TC or than males or females with low TC. CONCLUSION The role of elevated cholesterol in the occurrence of NPS in AD appears to be gender and symptom specific. A cross-validation of these findings will have implications for possible treatment interventions, especially for males with high TC.
Collapse
Affiliation(s)
- James R. Hall
- Institute of Aging and Alzheimer's Disease Research, University of North Texas Health Science Center, Fort Worth, Texas, USA, Department of Psychiatry and Behavioral Health, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - April R. Wiechmann
- Institute of Aging and Alzheimer's Disease Research, University of North Texas Health Science Center, Fort Worth, Texas, USA, Department of Psychiatry and Behavioral Health, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Leigh A. Johnson
- Institute of Aging and Alzheimer's Disease Research, University of North Texas Health Science Center, Fort Worth, Texas, USA, Department of Internal Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Melissa Edwards
- Department of Psychology, University of North Texas, Denton, Texas, USA
| | - Robert C. Barber
- Institute of Aging and Alzheimer's Disease Research, University of North Texas Health Science Center, Fort Worth, Texas, USA, Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Rebecca Cunningham
- Institute of Aging and Alzheimer's Disease Research, University of North Texas Health Science Center, Fort Worth, Texas, USA, Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Meharvan Singh
- Institute of Aging and Alzheimer's Disease Research, University of North Texas Health Science Center, Fort Worth, Texas, USA, Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Sid E. O'Bryant
- Institute of Aging and Alzheimer's Disease Research, University of North Texas Health Science Center, Fort Worth, Texas, USA, Department of Internal Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | | |
Collapse
|
16
|
ROS and brain diseases: the good, the bad, and the ugly. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2013; 2013:963520. [PMID: 24381719 PMCID: PMC3871919 DOI: 10.1155/2013/963520] [Citation(s) in RCA: 243] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 11/04/2013] [Accepted: 11/05/2013] [Indexed: 12/31/2022]
Abstract
The brain is a major metabolizer of oxygen and yet has relatively feeble protective antioxidant mechanisms. This paper reviews the Janus-faced properties of reactive oxygen species. It will describe the positive aspects of moderately induced ROS but it will also outline recent research findings concerning the impact of oxidative and nitrooxidative stress on neuronal structure and function in neuropsychiatric diseases, including major depression. A common denominator of all neuropsychiatric diseases including schizophrenia and ADHD is an increased inflammatory response of the brain caused either by an exposure to proinflammatory agents during development or an accumulation of degenerated neurons, oxidized proteins, glycated products, or lipid peroxidation in the adult brain. Therefore, modulation of the prooxidant-antioxidant balance provides a therapeutic option which can be used to improve neuroprotection in response to oxidative stress. We also discuss the neuroprotective role of the nuclear factor erythroid 2-related factor (Nrf2) in the aged brain in response to oxidative stressors and nanoparticle-mediated delivery of ROS-scavenging drugs. The antioxidant therapy is a novel therapeutic strategy. However, the available drugs have pleiotropic actions and are not fully characterized in the clinic. Additional clinical trials are needed to assess the risks and benefits of antioxidant therapies for neuropsychiatric disorders.
Collapse
|
17
|
Najjar S, Pearlman DM, Devinsky O, Najjar A, Zagzag D. Neurovascular unit dysfunction with blood-brain barrier hyperpermeability contributes to major depressive disorder: a review of clinical and experimental evidence. J Neuroinflammation 2013; 10:142. [PMID: 24289502 PMCID: PMC4220803 DOI: 10.1186/1742-2094-10-142] [Citation(s) in RCA: 154] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Accepted: 11/15/2013] [Indexed: 12/27/2022] Open
Abstract
About one-third of people with major depressive disorder (MDD) fail at least two antidepressant drug trials at 1 year. Together with clinical and experimental evidence indicating that the pathophysiology of MDD is multifactorial, this observation underscores the importance of elucidating mechanisms beyond monoaminergic dysregulation that can contribute to the genesis and persistence of MDD. Oxidative stress and neuroinflammation are mechanistically linked to the presence of neurovascular dysfunction with blood-brain barrier (BBB) hyperpermeability in selected neurological disorders, such as stroke, epilepsy, multiple sclerosis, traumatic brain injury, and Alzheimer’s disease. In contrast to other major psychiatric disorders, MDD is frequently comorbid with such neurological disorders and constitutes an independent risk factor for morbidity and mortality in disorders characterized by vascular endothelial dysfunction (cardiovascular disease and diabetes mellitus). Oxidative stress and neuroinflammation are implicated in the neurobiology of MDD. More recent evidence links neurovascular dysfunction with BBB hyperpermeability to MDD without neurological comorbidity. We review this emerging literature and present a theoretical integration between these abnormalities to those involving oxidative stress and neuroinflammation in MDD. We discuss our hypothesis that alterations in endothelial nitric oxide levels and endothelial nitric oxide synthase uncoupling are central mechanistic links in this regard. Understanding the contribution of neurovascular dysfunction with BBB hyperpermeability to the pathophysiology of MDD may help to identify novel therapeutic and preventative approaches.
Collapse
Affiliation(s)
- Souhel Najjar
- Department of Neurology, Neuroinflammation Research Group, Epilepsy Center Division, NYU School of Medicine, New York, NY 10016, USA.
| | | | | | | | | |
Collapse
|