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Gale SD, Farrer TJ, Erbstoesser R, MacLean S, Hedges DW. Human Cytomegalovirus Infection and Neurocognitive and Neuropsychiatric Health. Pathogens 2024; 13:417. [PMID: 38787269 PMCID: PMC11123947 DOI: 10.3390/pathogens13050417] [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: 04/23/2024] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024] Open
Abstract
A common infection, human cytomegalovirus (HCMV) has been associated with a variety of human diseases, including cardiovascular disease and possibly certain cancers. HCMV has also been associated with cognitive, psychiatric, and neurological conditions. Children with congenital or early-life HCMV are at risk for microcephaly, cerebral palsy, and sensorineural hearing loss, although in many cases sensorineural loss may resolve. In addition, HCMV can be associated with neurodevelopmental impairment, which may improve with time. In young, middle-aged, and older adults, HCMV has been adversely associated with cognitive function in some but not in all studies. Research has linked HCMV to Alzheimer's and vascular dementia, but again not all findings consistently support these associations. In addition, HCMV has been associated with depressive disorder, bipolar disorder, anxiety, and autism-spectrum disorder, although the available findings are likewise inconsistent. Given associations between HCMV and a variety of neurocognitive and neuropsychiatric disorders, additional research investigating reasons for the considerable inconsistencies in the currently available findings is needed. Additional meta-analyses and more longitudinal studies are needed as well. Research into the effects of antiviral medication on cognitive and neurological outcomes and continued efforts in vaccine development have potential to lower the neurocognitive, neuropsychiatric, and neurological burden of HCMV infection.
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Affiliation(s)
- Shawn D. Gale
- The Department of Psychology, Brigham Young University, Provo, UT 84602, USA; (S.M.); (D.W.H.)
- The Neuroscience Center, Brigham Young University, Provo, UT 84602, USA
| | - Thomas J. Farrer
- Idaho WWAMI Medical Education Program, University of Idaho, Moscow, ID 83844, USA;
| | - Reagan Erbstoesser
- The Department of Biology, Brigham Young University, Provo, UT 84602, USA;
| | - Scott MacLean
- The Department of Psychology, Brigham Young University, Provo, UT 84602, USA; (S.M.); (D.W.H.)
| | - Dawson W. Hedges
- The Department of Psychology, Brigham Young University, Provo, UT 84602, USA; (S.M.); (D.W.H.)
- The Neuroscience Center, Brigham Young University, Provo, UT 84602, USA
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2
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Zerekidze A, Li M, Refisch A, Shameya J, Sobanski T, Walter M, Wagner G. Impact of Toxoplasma gondii and Human Microbiome on Suicidal Behavior: A Systematic Review. J Clin Med 2024; 13:593. [PMID: 38276099 PMCID: PMC10816148 DOI: 10.3390/jcm13020593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/10/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Suicide remains a persistent global health challenge, resisting widespread prevention efforts. According to previous findings, toxoplasmosis is particularly associated with altered decision making, which could lead to risk-taking behavior, thereby increasing the likelihood for suicidal behavior (SB). In addition, discussion about the role of microbiome in psychiatric disorders has emerged lately, which also makes it relevant to investigate its role in the context of SB. Therefore, two systematic reviews are integrated in this paper, and the existing knowledge is comprehensively summarized regarding the association between microbial pathogens and SB. METHODS We conducted a systematic search with keywords including SB and Toxoplasma gondii (Suicid* AND Toxoplasm*) and microbiome (Suicid* AND Microbiome AND Microbiota) throughout PubMed and Scopus to retrieve related studies up to 9 November 2023, identifying 24 eligible records. The subjects of the included studies had to have fulfilled the criteria of an SB disorder as defined by DSM-5, and death cases needed to have been defined as suicide. RESULTS Most studies reported significant association between toxoplasmosis and SB, suggesting a higher likelihood of SB in the infected population. Regarding the microbiome, only very few studies investigated an association between SB and alterations in the microbiome. Based on six included studies, there were some indications of a link between changes in the microbiome and SB. CONCLUSION The cognitive aspects of decision making in T. gondii-infected individuals with SB should be further investigated to unravel the underlying mechanisms. Further sufficiently powered studies are needed to establish a link between SB and alterations in the microbiome.
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Affiliation(s)
- Ani Zerekidze
- Department of Psychiatry and Psychotherapy, Jena Center for Mental Health, Jena University Hospital, 07743 Jena, Germany
| | - Meng Li
- Department of Psychiatry and Psychotherapy, Jena Center for Mental Health, Jena University Hospital, 07743 Jena, Germany
- Circuits Underlying Mental Health (C-I-R-C), Jena-Magdeburg-Halle, 07743 Jena, Germany
| | - Alexander Refisch
- Department of Psychiatry and Psychotherapy, Jena Center for Mental Health, Jena University Hospital, 07743 Jena, Germany
- Circuits Underlying Mental Health (C-I-R-C), Jena-Magdeburg-Halle, 07743 Jena, Germany
| | - Justina Shameya
- Department of Psychiatry and Psychotherapy, Jena Center for Mental Health, Jena University Hospital, 07743 Jena, Germany
| | - Thomas Sobanski
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Center for Mental Health, Thueringen-Kliniken “Georgius Agricola”, 07318 Saalfeld, Germany;
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, Jena Center for Mental Health, Jena University Hospital, 07743 Jena, Germany
- Circuits Underlying Mental Health (C-I-R-C), Jena-Magdeburg-Halle, 07743 Jena, Germany
- German Center for Mental Health (DZPG), Partner Site Jena, 07743 Jena, Germany
| | - Gerd Wagner
- Department of Psychiatry and Psychotherapy, Jena Center for Mental Health, Jena University Hospital, 07743 Jena, Germany
- Circuits Underlying Mental Health (C-I-R-C), Jena-Magdeburg-Halle, 07743 Jena, Germany
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3
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Zheng H, Webster MJ, Weickert CS, Beasley CL, Paulus MP, Yolken RH, Savitz J. Cytomegalovirus antibodies are associated with mood disorders, suicide, markers of neuroinflammation, and microglia activation in postmortem brain samples. Mol Psychiatry 2023; 28:5282-5292. [PMID: 37391529 PMCID: PMC10756933 DOI: 10.1038/s41380-023-02162-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 06/13/2023] [Accepted: 06/22/2023] [Indexed: 07/02/2023]
Abstract
Cytomegalovirus (CMV) is a common, neurotrophic herpesvirus that can be reactivated by inflammation and cause central nervous system disease. We hypothesize that CMV may contribute to the neuroinflammation that underlies some psychiatric disorders by (1) exacerbating inflammation through the induction of anti-viral immune responses, and (2) translating peripheral inflammation into neuroinflammation. We investigated whether the presence of anti-CMV antibodies in blood were associated with mental illness, suicide, neuroinflammation, and microglial density in the dorsolateral prefrontal cortex (DLPFC) in postmortem samples. Data (n = 114 with schizophrenia; n = 78 with bipolar disorder; n = 87 with depression; n = 85 controls) were obtained from the Stanley Medical Research Institute. DLPFC gene expression data from a subset of 82 samples were categorized into "high" (n = 30), and "low" (n = 52) inflammation groups based on a recursive two-step cluster analysis using expression data for four inflammation-related genes. Measurements of the ratio of non-ramified to ramified microglia, a proxy of microglial activation, were available for a subset of 49 samples. All analyses controlled for age, sex, and ethnicity, as well as postmortem interval, and pH for gene expression and microglial outcomes. CMV seropositivity significantly increased the odds of a mood disorder diagnosis (bipolar disorder: OR = 2.45; major depression: OR = 3.70) and among the psychiatric samples, of suicide (OR = 2.09). Samples in the upper tercile of anti-CMV antibody titers were more likely to be members of the "high" inflammation group (OR = 4.41, an effect driven by schizophrenia and bipolar disorder samples). CMV positive samples also showed an increased ratio of non-ramified to ramified microglia in layer I of the DLPFC (Cohen's d = 0.81) as well as a non-significant increase in this ratio for the DLPFC as a whole (d = 0.56). The results raise the possibility that the reactivation of CMV contributes to the neuroinflammation that underlies some cases of psychiatric disorders.
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Affiliation(s)
- Haixia Zheng
- Laureate Institute for Brain Research, Tulsa, OK, USA.
- Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK, USA.
| | - Maree J Webster
- Laboratory of Brain Research, Stanley Medical Research Institute, 9800 Medical Center Drive, Rockville, MD, USA
| | - Cynthia Shannon Weickert
- Department of Neuroscience & Physiology, Upstate Medical University, Syracuse, NY, 13210, USA
- Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick, NSW, 2031, Australia
| | - Clare L Beasley
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Martin P Paulus
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK, USA
| | - Robert H Yolken
- Stanley Division of Developmental Neurovirology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Jonathan Savitz
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK, USA
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Neupane SP, Daray FM, Ballard ED, Galfalvy H, Itzhaky L, Segev A, Shelef A, Tene O, Rizk MM, Mann JJ, Zalsman G. Immune-related biomarkers and suicidal behaviors: A meta-analysis. Eur Neuropsychopharmacol 2023; 75:15-30. [PMID: 37356288 DOI: 10.1016/j.euroneuro.2023.05.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 06/27/2023]
Abstract
Biomarkers that can differentiate between psychiatric disorders with and without suicidal behavior history from each other and from healthy volunteers may explain part of the pathogenesis of suicidal behavior. We conducted the hitherto largest meta-analysis comparing immune biomarkers between subjects with and without suicide attempt history or death by suicide. The study protocol was registered with PROSPERO, CRD42020212841. Standardized mean differences (SMD) were pooled with random-effects models. Heterogeneity between studies was assessed with the I2-statistic and publication bias was evaluated by the Egger test and funnel plots. Data were based on 36 studies including 2679 persons with suicidal behaviors and 6839 comparison subjects, and four immune-related biomarkers (CRP, IL-6, TNF-α and IL-1β). Suicidal behavior was associated with higher CRP blood levels compared with: healthy controls (SMD [95%CI] = 1.42[0.85-1.98]); patients with depression alone (SMD [95%CI] = 1.23[0.20-2.26]); and patients with any psychiatric disorders (SMD [95%CI] = 0.39[0.22-0.55]). IL-6 blood level was higher in patients with suicidal behaviors compared with healthy controls (SMD [95%CI] = 1.13[0.45-1.82]) and when compared with psychiatric patients without suicidal behaviors (SMD [95%CI] = 0.22 [0.11-0.33]). Meta-regression and subgroup analyses revealed that increased CRP in suicidal behavior is primarily driven by recent suicidal behavior. These results implicate the immune system and inflammatory response in suicidal behavior independent of a relationship to major psychiatric disorders, and that these biological measures are predominantly state-dependent markers. Future studies are needed to determine the cause-and-effect relationship of these immune system biomarkers with suicidal behavior, and their potential predictive properties.
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Affiliation(s)
- Sudan Prasad Neupane
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Sognsvannsveien 21, Building 12, 2nd floor. N-0372 Oslo, Norway.
| | - Federico M Daray
- Institute of Pharmacology, School of Medicine, University of Buenos Aires, Paraguay 2155, Piso9, Ciudad Autónoma de Buenos Aires, C1121ABG, Argentina
| | - Elizabeth D Ballard
- Section on the Neurobiology and Treatment of Mood Disorders, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Hanga Galfalvy
- Departments of Psychiatry and Biostatistics, Columbia University, New York, NY, United States of America
| | - Liat Itzhaky
- Department of Psychiatry, Columbia University, New York, NY, United States of America; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States
| | - Aviv Segev
- Shalvata Mental Health Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Assaf Shelef
- Lev-Hasharon Mental Health Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Oren Tene
- Psychiatric Division, Tel Aviv Sourasky Medical Center, Tel-Aviv University, Tel Aviv, Israel
| | - Mina M Rizk
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States
| | - J John Mann
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, 10032, NY, United States of America; Division of Molecular Imaging & Neuropathology, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 42, New York, 10032, NY, United States of America; Department of Radiology, Columbia University, 622 West 168th St, New York, 10032, NY, United States of America
| | - Gil Zalsman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University NY, NY, United States of America
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Wang Q, Zhong Y, Chen N, Chen J. From the immune system to mood disorders especially induced by Toxoplasma gondii: CD4+ T cell as a bridge. Front Cell Infect Microbiol 2023; 13:1078984. [PMID: 37077528 PMCID: PMC10106765 DOI: 10.3389/fcimb.2023.1078984] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 03/23/2023] [Indexed: 04/05/2023] Open
Abstract
Toxoplasma gondii (T. gondii), a ubiquitous and obligatory intracellular protozoa, not only alters peripheral immune status, but crosses the blood-brain barrier to trigger brain parenchymal injury and central neuroinflammation to establish latent cerebral infection in humans and other vertebrates. Recent findings underscore the strong correlation between alterations in the peripheral and central immune environment and mood disorders. Th17 and Th1 cells are important pro-inflammatory cells that can drive the pathology of mood disorders by promoting neuroinflammation. As opposed to Th17 and Th1, regulatory T cells have inhibitory inflammatory and neuroprotective functions that can ameliorate mood disorders. T. gondii induces neuroinflammation, which can be mediated by CD4+ T cells (such as Tregs, Th17, Th1, and Th2). Though the pathophysiology and treatment of mood disorder have been currently studied, emerging evidence points to unique role of CD4+ T cells in mood disorder, especially those caused by T. gondii infection. In this review, we explore some recent studies that extend our understanding of the relationship between mood disorders and T. gondii.
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Abstract
There is increasingly compelling evidence that microorganisms may play an etiological role in the emergence of mental illness in a subset of the population. Historically, most work has focused on the neurotrophic herpesviruses, herpes simplex virus type 1 (HSV-1), cytomegalovirus (CMV), and Epstein-Barr virus (EBV) as well as the protozoan, Toxoplasma gondii. In this chapter, we provide an umbrella review of this literature and additionally highlight prospective studies that allow more mechanistic conclusions to be drawn. Next, we focus on clinical trials of anti-microbial medications for the treatment of psychiatric disorders. We critically evaluate six trials that tested the impact of anti-herpes medications on inflammatory outcomes in the context of a medical disorder, nine clinical trials utilizing anti-herpetic medications for the treatment of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) or schizophrenia, and four clinical trials utilizing anti-parasitic medications for the treatment of schizophrenia. We then turn our attention to evidence for a gut dysbiosis and altered microbiome in psychiatric disorders, and the potential therapeutic effects of probiotics, including an analysis of more than 10 randomized controlled trials of probiotics in the context of schizophrenia, bipolar disorder (BD), and major depressive disorder (MDD).
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Toffol E, Miola A, Magnolfi G, Trevisan G, Scocco P. High hs-CRP levels after an attempted suicide: A matched case-control study. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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8
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Effect of Cytomegalovirus on the Immune System: Implications for Aging and Mental Health. Curr Top Behav Neurosci 2022; 61:181-214. [PMID: 35871707 DOI: 10.1007/7854_2022_376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Human cytomegalovirus (HCMV) is a major modulator of the immune system leading to long-term changes in T-lymphocytes, macrophages, and natural killer (NK) cells among others. Perhaps because of this immunomodulatory capacity, HCMV infection has been linked with a host of deleterious effects including accelerated immune aging (premature mortality, increased expression of immunosenescence-linked markers, telomere shortening, speeding-up of epigenetic "clocks"), decreased vaccine immunogenicity, and greater vulnerability to infectious diseases (e.g., tuberculosis) or infectious disease-associated pathology (e.g., HIV). Perhaps not surprisingly given the long co-evolution between HCMV and humans, the virus has also been associated with beneficial effects, such as increased vaccine responsiveness, heterologous protection against infections, and protection against relapse in the context of leukemia. Here, we provide an overview of this literature. Ultimately, we focus on one other deleterious effect of HCMV, namely the emerging literature suggesting that HCMV plays a pathophysiological role in psychiatric illness, particularly depression and schizophrenia. We discuss this literature through the lens of psychological stress and inflammation, two well-established risk factors for psychiatric illness that are also known to predispose to reactivation of HCMV.
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Zheng H, Savitz J. Effect of Cytomegalovirus Infection on the Central Nervous System: Implications for Psychiatric Disorders. Curr Top Behav Neurosci 2022; 61:215-241. [PMID: 35505056 DOI: 10.1007/7854_2022_361] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Cytomegalovirus (CMV) is a common herpesvirus that establishes lifelong latent infections and interacts extensively with the host immune system, potentially contributing to immune activation and inflammation. Given its proclivity for infecting the brain and its reactivation by inflammatory stimuli, CMV is well known for causing central nervous system complications in the immune-naïve (e.g., in utero) and in the immunocompromised (e.g., in neonates, individuals receiving transplants or cancer chemotherapy, or people living with HIV). However, its potentially pathogenic role in diseases that are characterized by more subtle immune dysregulation and inflammation such as psychiatric disorders is still a matter of debate. In this chapter, we briefly summarize the pathogenic role of CMV in immune-naïve and immunocompromised populations and then review the evidence (i.e., epidemiological studies, serological studies, postmortem studies, and recent neuroimaging studies) for a link between CMV infection and psychiatric disorders with a focus on mood disorders and schizophrenia. Finally, we discuss the potential mechanisms through which CMV may cause CNS dysfunction in the context of mental disorders and conclude with a summary of the current state of play as well as potential future research directions in this area.
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Affiliation(s)
- Haixia Zheng
- Laureate Institute for Brain Research, Tulsa, OK, USA.
| | - Jonathan Savitz
- Laureate Institute for Brain Research, Tulsa, OK, USA.,Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK, USA
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10
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Fernández-Sevillano J, González-Ortega I, MacDowell K, Zorrilla I, López MP, Courtet P, Gabilondo A, Martínez-Cengotitabengoa M, Leza JC, Sáiz P, González-Pinto A. Inflammation biomarkers in suicide attempts and their relation to abuse, global functioning and cognition. World J Biol Psychiatry 2022; 23:307-317. [PMID: 34730074 DOI: 10.1080/15622975.2021.1988703] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES To explore the link between cytokines and suicide attempts and their relationship with the psychological aspects of this complex multifactorial phenomenon. METHODS 96 participants, including 20 patients with a recent suicide attempt and diagnosis of Major Depression Disorder (MDD), 33 MDD patients with a lifetime history of suicide attempt, 23 non-attempter MDD patients, and 20 healthy controls underwent an assessment on depressive symptoms, global functioning, aggressive behaviour, presence of abuse and attention performance. Additionally, all participants had a blood extraction for IL-2, IL2-R, IL-4, IL-6, and TNF-α plasma levels analysis. RESULTS IL-6 levels were significantly different across groups (F(3,89)=3.690; p = 0.015), with higher concentrations in both recent (p = 0.04) and distant (p = 0.015) attempt in comparison to MDD non-attempters. IL-6 was associated with adult physical abuse (B = 2.591; p = 0.021), lower global functioning score (B = -0.512; p = 0.011), and poorer performance on attention (B = -0.897; p = 0.011). CONCLUSIONS Recent and distant suicidal behaviour is associated with elevated IL-6 levels, which may be influenced by stressful and traumatic experiences. Elevated concentrations of IL-6 could have a negative impact on attention, increasing suicide risk. More research is needed to clarify the role of cytokines in suicide-related features to explore novel treatments and more effective preventive interventions.
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Affiliation(s)
- Jessica Fernández-Sevillano
- Department of Neuroscience, University of the Basque Country UPV/EHU, Leioa, Spain.,Bioaraba Research Institute, Severe Mental Disorder Research Group, Vitoria-Gasteiz, Spain.,Department of Psychiatry, Araba University Hospital, OSIARABA, Osakidetza, Vitoria-Gasteiz, Spain.,Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
| | - Itxaso González-Ortega
- Bioaraba Research Institute, Severe Mental Disorder Research Group, Vitoria-Gasteiz, Spain.,Department of Psychiatry, Araba University Hospital, OSIARABA, Osakidetza, Vitoria-Gasteiz, Spain.,Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
| | - Karina MacDowell
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain.,Department of Pharmacology & Toxicology, Faculty of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain.,Instituto de Investigación Hospital 12 de Octubre (i + 12), IUIN-UCM, Madrid, Spain
| | - Iñaki Zorrilla
- Department of Neuroscience, University of the Basque Country UPV/EHU, Leioa, Spain.,Bioaraba Research Institute, Severe Mental Disorder Research Group, Vitoria-Gasteiz, Spain.,Department of Psychiatry, Araba University Hospital, OSIARABA, Osakidetza, Vitoria-Gasteiz, Spain.,Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
| | - María Purificación López
- Department of Neuroscience, University of the Basque Country UPV/EHU, Leioa, Spain.,Bioaraba Research Institute, Severe Mental Disorder Research Group, Vitoria-Gasteiz, Spain.,Department of Psychiatry, Araba University Hospital, OSIARABA, Osakidetza, Vitoria-Gasteiz, Spain.,Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
| | - Philippe Courtet
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, University of Montpellier, Montpellier, France
| | - Andrea Gabilondo
- Mental Health and Psychiatric Care Research Unit, BioDonostia Health Research Institute, Donostia-San Sebastián, Spain.,Outpatient Mental Health Network, Osakidetza, Donostia-San Sebastián, Spain
| | - Mónica Martínez-Cengotitabengoa
- Department of Neuroscience, University of the Basque Country UPV/EHU, Leioa, Spain.,Psychology Clinic of East Anglia, Norwich, United Kingdom
| | - Juan Carlos Leza
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain.,Department of Pharmacology & Toxicology, Faculty of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain.,Instituto de Investigación Hospital 12 de Octubre (i + 12), IUIN-UCM, Madrid, Spain
| | - Pilar Sáiz
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain.,Department of Psychiatry, Universidad de Oviedo. Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - Ana González-Pinto
- Department of Neuroscience, University of the Basque Country UPV/EHU, Leioa, Spain.,Bioaraba Research Institute, Severe Mental Disorder Research Group, Vitoria-Gasteiz, Spain.,Department of Psychiatry, Araba University Hospital, OSIARABA, Osakidetza, Vitoria-Gasteiz, Spain.,Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
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11
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Fanelli G, Sokolowski M, Wasserman D, Kasper S, Zohar J, Souery D, Montgomery S, Albani D, Forloni G, Ferentinos P, Rujescu D, Mendlewicz J, De Ronchi D, Serretti A, Fabbri C. Polygenic risk scores for neuropsychiatric, inflammatory, and cardio-metabolic traits highlight possible genetic overlap with suicide attempt and treatment-emergent suicidal ideation. Am J Med Genet B Neuropsychiatr Genet 2022; 189:74-85. [PMID: 35191176 PMCID: PMC9305542 DOI: 10.1002/ajmg.b.32891] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 10/01/2021] [Accepted: 01/31/2022] [Indexed: 12/11/2022]
Abstract
Suicide is the second cause of death among youths. Genetics may contribute to suicidal phenotypes and their co-occurrence in other neuropsychiatric and medical conditions. Our study aimed to investigate the association of polygenic risk scores (PRSs) for 24 neuropsychiatric, inflammatory, and cardio-metabolic traits/diseases with suicide attempt (SA) or treatment-worsening/emergent suicidal ideation (TWESI). PRSs were computed based on summary statistics of genome-wide association studies. Regression analyses were performed between PRSs and SA or TWESI in four clinical cohorts. Results were then meta-analyzed across samples, including a total of 688 patients with SA (Neff = 2,258) and 214 with TWESI (Neff = 785). Stratified genetic covariance analyses were performed to investigate functionally cross-phenotype PRS associations. After Bonferroni correction, PRS for major depressive disorder (MDD) was associated with SA (OR = 1.24; 95% CI = 1.11-1.38; p = 1.73 × 10-4 ). Nominal associations were shown between PRSs for coronary artery disease (CAD) (p = 4.6 × 10-3 ), loneliness (p = .009), or chronic pain (p = .016) and SA, PRSs for MDD or CAD and TWESI (p = .043 and p = .032, respectively). Genetic covariance between MDD and SA was shown in 86 gene sets related to drugs having antisuicidal effects. A higher genetic liability for MDD may underlie a higher SA risk. Further, but milder, possible modulatory factors are genetic risk for loneliness and CAD.
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Affiliation(s)
- Giuseppe Fanelli
- Department of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly,Department of Human GeneticsRadboud University Medical Center, Donders Institute for Brain, Cognition and BehaviourNijmegenThe Netherlands
| | - Marcus Sokolowski
- National Centre for Suicide Research and Prevention of Mental Ill‐Health (NASP)Karolinska InstituteStockholmSweden
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill‐Health (NASP)Karolinska InstituteStockholmSweden
| | | | - Siegfried Kasper
- Department of Psychiatry and PsychotherapyMedical University ViennaViennaAustria
| | - Joseph Zohar
- Department of PsychiatrySheba Medical Center, Tel Hashomer, and Sackler School of Medicine, Tel Aviv UniversityTel HashomerIsrael
| | - Daniel Souery
- Laboratoire de Psychologie MédicaleUniversité Libre de Bruxelles and Psy Pluriel, Centre Européen de Psychologie MédicaleBrusselsBelgium
| | | | - Diego Albani
- Laboratory of Biology of Neurodegenerative DisordersDepartment of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCSMilanItaly
| | - Gianluigi Forloni
- Laboratory of Biology of Neurodegenerative DisordersDepartment of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCSMilanItaly
| | | | - Dan Rujescu
- University Clinic for PsychiatryPsychotherapy and Psychosomatic, Martin‐Luther‐University, Halle‐WittenbergGermany
| | | | - Diana De Ronchi
- Department of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly
| | - Chiara Fabbri
- Department of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly,Social, Genetic & Developmental Psychiatry CentreInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
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12
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Vasupanrajit A, Jirakran K, Tunvirachaisakul C, Maes M. Suicide attempts are associated with activated immune-inflammatory, nitro-oxidative, and neurotoxic pathways: A systematic review and meta-analysis. J Affect Disord 2021; 295:80-92. [PMID: 34416621 DOI: 10.1016/j.jad.2021.08.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Suicide attempts (SA) frequently occur in patients with mood disorders and schizophrenia, which are both accompanied by activated immune-inflammatory and nitro-oxidative (IO&NS) pathways. METHODS We searched PubMed, Google Scholar, and Web of Science, for articles published from inception until February 1, 2021. We included studies that compared blood biomarkers in psychiatric patients with (SA+) and without SA (SA-) and heathy controls and we combined different IO&NS biomarkers into immune, inflammatory, and neurotoxic profiles and used meta-analysis (random-effect model with restricted maximum-likelihood) to delineate effect sizes with 95% confidence interval (CI). FINDINGS Our search included 51 studies comprising 4.945 SA+ patients and 24.148 controls. We stratified the control group into healthy controls and SA- patients. SA+ patients showed significantly (p<0.001) increased immune activation (SMD: 1.044; CI: 0.599, 1.489), inflammation (SMD: 1.109; CI: 0.505, 1.714), neurotoxicity (SMD: 0.879; CI: 0.465, 1.293), and lowered neuroprotection (SMD: 0.648; CI: 0.354, 0.941) as compared with healthy controls. When compared with SA- patients, those with SA+ showed significant (p<0.001) immune activation (SMD: 0.290; CI: 0.183, 0.397), inflammation (SMD: 0.311; CI: 0.191, 0.432), and neurotoxicity (SMD: 0.315; CI: 0.198, 0.432), and lowered neuroprotection (SMD: 0.341; CI: 0.167, 0.515). Patients with current, but not lifetime, SA showed significant (p<0.001) levels of inflammation and neurotoxicity as compared with controls. CONCLUSIONS Patients with immune activation are at a higher risk of SA which may be explained by increased neurotoxicity due to inflammation and nitro-oxidative stress. This meta-analysis discovered new biomarkers of SA and therapeutic targets to treat individuals with SA.
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Affiliation(s)
- Asara Vasupanrajit
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Ketsupar Jirakran
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Maximizing Thai Children's Developmental Potential Research Unit, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chavit Tunvirachaisakul
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Cognitive Impairment and Dementia Research Unit, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Cognitive Impairment and Dementia Research Unit, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; IMPACT Strategic Research Center, Deakin University, Geelong, Australia; Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria.
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13
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Virus MA, Ehrhorn EG, Lui LM, Davis PH. Neurological and Neurobehavioral Disorders Associated with Toxoplasma gondii Infection in Humans. J Parasitol Res 2021; 2021:6634807. [PMID: 34712493 PMCID: PMC8548174 DOI: 10.1155/2021/6634807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 09/15/2021] [Indexed: 01/17/2023] Open
Abstract
The intracellular parasite Toxoplasma gondii is estimated to infect up to 30% of the world population, leading to lifelong chronic infection of the brain and muscle tissue. Although most latent T. gondii infections in humans have traditionally been considered asymptomatic, studies in rodents suggest phenotypic neurological changes are possible. Consequently, several studies have examined the link between T. gondii infection and diseases such as schizophrenia, epilepsy, depression, bipolar disorder, dysphoria, Alzheimer's disease, Parkinson's disease, and obsessive-compulsive disorder (OCD). To date, there is varying evidence of the relationship of T. gondii to these human neurological or neurobehavioral disorders. A thorough review of T. gondii literature was conducted to highlight and summarize current findings. We found that schizophrenia was most frequently linked to T. gondii infection, while sleep disruption showed no linkage to T. gondii infection, and other conditions having mixed support for a link to T. gondii. However, infection as a cause of human neurobehavioral disease has yet to be firmly established.
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Affiliation(s)
- Maxwell A. Virus
- Department of Biology, University of Nebraska at Omaha, Omaha, Nebraska, USA
| | - Evie G. Ehrhorn
- Department of Biology, University of Nebraska at Omaha, Omaha, Nebraska, USA
| | - LeeAnna M. Lui
- Department of Biology, University of Nebraska at Omaha, Omaha, Nebraska, USA
| | - Paul H. Davis
- Department of Biology, University of Nebraska at Omaha, Omaha, Nebraska, USA
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14
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Alvarado-Esquivel C, Mendoza-Larios LA, García-Dolores F, Sánchez-Anguiano LF, Antuna-Salcido EI, Hernández-Tinoco J, Rocha-Salais A, Segoviano-Mendoza MA, Sifuentes-Álvarez A. Association between Toxoplasma gondii Infection in Brain and a History of Depression in Suicide Decedents: A Cross-Sectional Study. Pathogens 2021; 10:pathogens10101313. [PMID: 34684262 PMCID: PMC8539687 DOI: 10.3390/pathogens10101313] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/30/2021] [Accepted: 10/06/2021] [Indexed: 11/16/2022] Open
Abstract
We assessed the association between Toxoplasma gondii (T. gondii) infection of the central nervous system and suicide correlates in suicide decedents. Eighty-seven decedents who died by suicide received in a forensic setting for medico-legal autopsies in Mexico City were studied. Two samples of brain (amygdala and prefrontal cortex) from each decedent were examined for detection of T. gondii using immunohistochemistry. Correlates of suicide including a history of previous suicide attempts, co-morbid mental disorder, consumption of alcohol or tobacco, irritability and aggression, economic problems, presence of drugs or alcohol in blood and suicide method were obtained and analyzed for their association with T. gondii infection. T. gondii immunohistochemistry was positive in prefrontal cortex sections in 6 decedents and in an amygdala section in one decedent. Thus, the prevalence of T. gondii infection in brain in suicide victims was 8.0% (7/87). Bivariate and logistic regression analysis of suicide correlates showed that only a history of depression was associated with T. gondii infection of the brain in suicide victims (OR: 12.00; 95% CI: 2.26–63.46; p = 0.003). Our results provide evidence that T. gondii infection in brain is associated with a history of depression in suicide decedents.
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Affiliation(s)
- Cosme Alvarado-Esquivel
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juárez University of Durango State, Durango 34000, Mexico; (L.F.S.-A.); (J.H.-T.); (A.R.-S.); (M.A.S.-M.); (A.S.-Á.)
- Correspondence:
| | | | - Fernando García-Dolores
- Amphitheater and Department of Education, Institute of Forensic Sciences, Mexico 06720, Mexico; (L.A.M.-L.); (F.G.-D.)
| | - Luis Francisco Sánchez-Anguiano
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juárez University of Durango State, Durango 34000, Mexico; (L.F.S.-A.); (J.H.-T.); (A.R.-S.); (M.A.S.-M.); (A.S.-Á.)
| | | | - Jesús Hernández-Tinoco
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juárez University of Durango State, Durango 34000, Mexico; (L.F.S.-A.); (J.H.-T.); (A.R.-S.); (M.A.S.-M.); (A.S.-Á.)
| | - Adriana Rocha-Salais
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juárez University of Durango State, Durango 34000, Mexico; (L.F.S.-A.); (J.H.-T.); (A.R.-S.); (M.A.S.-M.); (A.S.-Á.)
| | - Marcela Araceli Segoviano-Mendoza
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juárez University of Durango State, Durango 34000, Mexico; (L.F.S.-A.); (J.H.-T.); (A.R.-S.); (M.A.S.-M.); (A.S.-Á.)
| | - Antonio Sifuentes-Álvarez
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juárez University of Durango State, Durango 34000, Mexico; (L.F.S.-A.); (J.H.-T.); (A.R.-S.); (M.A.S.-M.); (A.S.-Á.)
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15
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A hidden menace? Cytomegalovirus infection is associated with reduced cortical gray matter volume in major depressive disorder. Mol Psychiatry 2021; 26:4234-4244. [PMID: 33223520 PMCID: PMC8140068 DOI: 10.1038/s41380-020-00932-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 10/06/2020] [Accepted: 10/22/2020] [Indexed: 12/14/2022]
Abstract
Human cytomegalovirus (HCMV) infection is associated with neuropathology in patients with impaired immunity and/or inflammatory diseases. However, the association between gray matter volume (GMV) and HCMV has never been examined in major depressive disorder (MDD) despite the presence of inflammation and impaired viral immunity in a subset of patients. We tested this relationship in two independent samples consisting of 179 individuals with MDD and 41 healthy controls (HC) (sample 1) and 124 MDD participants and 148 HCs (sample 2). HCMV positive (HCMV+) and HCMV negative (HCMV-) groups within each sample were balanced on up to 11 different clinical/demographic variables using inverse probability of treatment weighting. GMV of 87 regions was measured with FreeSurfer. There was a main effect of HCMV serostatus but not diagnosis that replicated across samples. Relative to HCMV- subjects, HCMV+ subjects in sample 1 showed a significant reduction of volume in six regions (puncorrected < 0.05). The reductions in GMV of the right supramarginal gyrus (standardized beta coefficient (SBC) = -0.26) and left fusiform gyrus (SBC = -0.25) in sample 1 were replicated in sample 2: right supramarginal gyrus (puncorrected < 0.05, SBC = -0.32), left fusiform gyrus (PFDR < 0.01, SBC = -0.51). Posthoc tests revealed that the effect of HCMV was driven by differences between the HCMV+ and HCMV- MDD subgroups. HCMV IgG level, a surrogate marker of viral activity, was correlated with GMV in the left fusiform gyrus (r = -0.19, Puncorrected = 0.049) and right supramarginal gyrus (r = -0.19, puncorrected = 0.043) in the HCMV+ group of sample 1. Conceivably, HCMV infection may be a treatable source of neuropathology in vulnerable MDD patients.
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16
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González-Castro TB, Tovilla-Zárate CA, López-Narváez ML, Genis-Mendoza AD, Juárez-Rojop IE. Interleukin-6 Levels in Serum, Plasma, and Cerebral Spinal Fluid in Individuals with Suicide Behavior: Systematic Review and Meta-Analysis with Meta-Regression. J Interferon Cytokine Res 2021; 41:258-267. [PMID: 34280025 DOI: 10.1089/jir.2020.0265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Evidence suggests that interleukin-6 (IL-6) concentrations have an important role in suicide behavior (SB) as they are usually increased in these individuals, although no conclusive outcomes have been attained. The purpose of this study was to evaluate the IL-6 levels in plasma, serum, and cerebral spinal fluid (CSF) to determine through a meta-analysis if these levels are increased in individuals with SB in comparison to a group. We calculated the standardized mean difference and 95% confidence intervals (95% CIs). In the systematic review, 21 studies were included, while in the meta-analysis, we included nine studies. The results of our meta-analysis indicated that individuals with SB had reduced levels of IL-6 in plasma (d - 0.189, 95% CI: -0.274 to -0.103, Z, P (Q) = 0.339, I2 = 7.478), but increased levels of IL-6 in serum (d - 1.14, 95% CI: 0.658 to 1.630, Z, P (Q) = 0.26, I2 = 7.47) and CSF (d 0.64, 95% CI: 0.245 to 1.035, Z, P (Q) = 0.163, I2 = 44.80). The meta-regression analysis showed an association between males and high IL-6 levels in plasma (P = 0.003) and serum (P = 0.010), but not the central nervous system (CNS), while age was not associated with IL-6 levels in any of the samples evaluated (plasma, serum, or CNS). The present meta-analysis indicates that serum and CNS IL-6 levels are increased in individuals with SB, while plasma IL-6 levels are decreased, highlighting the importance of the biological sample at the moment of selecting IL-6 as biomarker. However, we need more studies performed in different populations that measure IL-6 and also consider gender when these measures are performed.
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Affiliation(s)
- Thelma Beatriz González-Castro
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez, México
| | | | | | - Alma Delia Genis-Mendoza
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de México, México
| | - Isela Esther Juárez-Rojop
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, México
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17
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Zheng H, Bergamino M, Ford BN, Kuplicki R, Yeh FC, Bodurka J, Burrows K, Hunt PW, Teague TK, Irwin MR, Yolken RH, Paulus MP, Savitz J. Replicable association between human cytomegalovirus infection and reduced white matter fractional anisotropy in major depressive disorder. Neuropsychopharmacology 2021; 46:928-938. [PMID: 33500556 PMCID: PMC8115597 DOI: 10.1038/s41386-021-00971-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/23/2020] [Accepted: 01/12/2021] [Indexed: 01/30/2023]
Abstract
Major depressive disorder (MDD) is associated with reductions in white matter microstructural integrity as measured by fractional anisotropy (FA), an index derived from diffusion tensor imaging (DTI). The neurotropic herpesvirus, human cytomegalovirus (HCMV), is a major cause of white matter pathology in immunosuppressed populations but its relationship with FA has never been tested in MDD despite the presence of inflammation and weakened antiviral immunity in a subset of depressed patients. We tested the relationship between FA and HCMV infection in two independent samples consisting of 176 individuals with MDD and 44 healthy controls (HC) (Discovery sample) and 88 participants with MDD and 48 HCs (Replication sample). Equal numbers of HCMV positive (HCMV+) and HCMV negative (HCMV-) groups within each sample were balanced on ten different clinical/demographic variables using propensity score matching. Anti-HCMV IgG antibodies were measured using a solid-phase ELISA. In the Discovery sample, significantly lower FA was observed in the right inferior fronto-occipital fasciculus (IFOF) in HCMV+ participants with MDD compared to HCMV- participants with MDD (cluster size 1316 mm3; pFWE < 0.05, d = -0.58). This association was confirmed in the replication sample by extracting the mean FA from this exact cluster and applying the identical statistical model (p < 0.05, d = -0.45). There was no significant effect of diagnosis or interaction between diagnosis and HCMV in either sample. The effect of chronic HCMV infection on white matter integrity may-in at-risk individuals-contribute to the psychopathology of depression. These findings may provide a novel target of intervention for a subgroup of patients with MDD.
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Affiliation(s)
- Haixia Zheng
- Laureate Institute for Brain Research, Tulsa, OK, USA.
| | - Maurizio Bergamino
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Division of Neuroimaging Research, Barrow Neurological Institute, Phoenix, AZ, USA
| | - Bart N Ford
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | | | - Fang-Cheng Yeh
- Department of Neurological Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jerzy Bodurka
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK, USA
| | | | - Peter W Hunt
- Department of Medicine, School of Medicine, The University of California, San Francisco, San Francisco, CA, USA
| | - T Kent Teague
- Department of Surgery, University of Oklahoma School of Community Medicine, Tulsa, OK, USA
- Department of Psychiatry, University of Oklahoma School of Community Medicine, Tulsa, OK, USA
- Department of Biochemistry and Microbiology, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Michael R Irwin
- Cousins Center for Psychoneuroimmunology at UCLA, Los Angeles, CA, USA
- Semel Institute for Neuroscience at UCLA, Los Angeles, CA, USA
- David Geffen School of Medicine, Los Angeles, CA, USA
| | - Robert H Yolken
- Stanley Division of Developmental Neurovirology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Martin P Paulus
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK, USA
| | - Jonathan Savitz
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK, USA
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18
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Shinjyo N, Nakayama H, Li L, Ishimaru K, Hikosaka K, Suzuki N, Yoshida H, Norose K. Hypericum perforatum extract and hyperforin inhibit the growth of neurotropic parasite Toxoplasma gondii and infection-induced inflammatory responses of glial cells in vitro. JOURNAL OF ETHNOPHARMACOLOGY 2021; 267:113525. [PMID: 33129946 DOI: 10.1016/j.jep.2020.113525] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/19/2020] [Accepted: 10/26/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Hypericum perforatum L. has been widely used as a natural antidepressant. However, it is unknown whether it is effective in treating infection-induced neuropsychiatric disorders. AIM OF THE STUDY In order to evaluate the effectiveness of H. perforatum against infection with neurotropic parasite Toxoplasma gondii, which has been linked to neuropsychiatric disorders, this study investigated the anti-Toxoplasma activity using in vitro models. MATERIALS AND METHODS Dried alcoholic extracts were prepared from three Hypericum species: H. perforatum, H. erectum, and H. ascyron. H. perforatum extract was further separated by solvent-partitioning. Hyperforin and hypericin levels in the extracts and fractions were analyzed by high resolution LC-MS. Anti-Toxoplasma activities were tested in vitro, using cell lines (Vero and Raw264), murine primary mixed glia, and primary neuron-glia. Toxoplasma proliferation and stage conversion were analyzed by qPCR. Infection-induced damages to the host cells were analyzed by Sulforhodamine B cytotoxicity assay (Vero) and immunofluorescent microscopy (neurons). Infection-induced inflammatory responses in glial cells were analysed by qPCR and immunofluorescent microscopy. RESULTS Hyperforin was identified only in H. perforatum among the three tested species, whereas hypericin was present in H. perforatum and H. erectum. H. perforatum extract and hyperforin-enriched fraction, as well as hyperforin, exhibited significant anti-Toxoplasma property as well as inhibitory activity against infection-induced inflammatory responses in glial cells. In addition, H. perforatum-derived hyperforin-enriched fraction restored neuro-supportive environment in mixed neuron-glia culture. CONCLUSIONS H. perforatum and its major constituent hyperforin are promising anti-Toxoplasma agents that could potentially protect neurons and glial cells against infection-induced damages. Further study is warranted to establish in vivo efficacy.
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Affiliation(s)
- Noriko Shinjyo
- Department of Infection and Host Defense, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan; School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4, Sakamoto, Nagasaki, 852-8523, Japan.
| | - Hideyuki Nakayama
- Saga Prefectural Institute of Public Health and Pharmaceutical Research, 1-20 Hacchounawate, Saga, 849-0925, Japan
| | - Li Li
- Department of Infection and Host Defense, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Kanji Ishimaru
- Department of Biological Resource Sciences, Faculty of Agriculture, Saga University, 1 Honjo, Saga, 840-8502, Japan
| | - Kenji Hikosaka
- Department of Infection and Host Defense, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Noriyuki Suzuki
- Department of Toxicology and Environmental Health, Graduate School of Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Hiroki Yoshida
- Division of Molecular and Cellular Immunoscience, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Kazumi Norose
- Department of Infection and Host Defense, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
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19
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Wu H, Chen HL. Insufficient evidential basis for the association between Toxoplasma gondii and suicide attempts. Transbound Emerg Dis 2021; 68:2993-2994. [PMID: 33463031 DOI: 10.1111/tbed.13995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/11/2020] [Accepted: 12/14/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Hua Wu
- School of Medicine, Nantong University, Nantong, Jiangsu, PR China
| | - Hong-Lin Chen
- School of Medicine, Nantong University, Nantong, Jiangsu, PR China
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20
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Amouei A, Sarvi S, Mizani A, Nayeri Chegeni T, Daryani A. Response to the Letter to the Editor concerning 'Evolutionary puzzle of Toxoplasma gondii with suicidal ideation and suicide attempts: An updated systematic review and meta-analysis' by Amouei et al. (Transbound Emerg Dis; 2020: Https://doi.org/10.1111/tbed.13550). Transbound Emerg Dis 2021; 68:2990-2992. [PMID: 33462966 DOI: 10.1111/tbed.13994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/11/2021] [Accepted: 01/13/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Afsaneh Amouei
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Parasitology, School of Medicine, Mazandaran University of Medical Science, Sari, Iran
| | - Shahabeddin Sarvi
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Parasitology, School of Medicine, Mazandaran University of Medical Science, Sari, Iran
| | - Azadeh Mizani
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Parasitology, School of Medicine, Mazandaran University of Medical Science, Sari, Iran
| | - Tooran Nayeri Chegeni
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Parasitology, School of Medicine, Mazandaran University of Medical Science, Sari, Iran.,Committee research student, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ahmad Daryani
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Parasitology, School of Medicine, Mazandaran University of Medical Science, Sari, Iran
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21
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Abdoli A, Taghipour A, Pirestani M, Mofazzal Jahromi MA, Roustazadeh A, Mir H, Ardakani HM, Kenarkoohi A, Falahi S, Karimi M. Infections, inflammation, and risk of neuropsychiatric disorders: the neglected role of "co-infection". Heliyon 2020; 6:e05645. [PMID: 33319101 PMCID: PMC7725732 DOI: 10.1016/j.heliyon.2020.e05645] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/18/2020] [Accepted: 11/30/2020] [Indexed: 02/08/2023] Open
Abstract
Neuropsychiatric disorders (NPDs) have multiple etiological factors, mainly genetic background, environmental conditions and immunological factors. The host immune responses play a pivotal role in various physiological and pathophysiological process. In NPDs, inflammatory immune responses have shown to be involved in diseases severity and treatment outcome. Inflammatory cytokines and chemokines are involved in various neurobiological pathways, such as GABAergic signaling and neurotransmitter synthesis. Infectious agents are among the major amplifier of inflammatory reactions, hence, have an indirect role in the pathogenesis of NPDs. As such, some infections directly affect the central nervous system (CNS) and alter the genes that involved in neurobiological pathways and NPDs. Interestingly, the most of infectious agents that involved in NPDs (e.g., Toxoplasma gondii, cytomegalovirus and herpes simplex virus) is latent (asymptomatic) and co-or-multiple infection of them are common. Nonetheless, the role of co-or-multiple infection in the pathogenesis of NPDs has not deeply investigated. Evidences indicate that co-or-multiple infection synergically augment the level of inflammatory reactions and have more severe outcomes than single infection. Hence, it is plausible that co-or-multiple infections can increase the risk and/or pathogenesis of NPDs. Further understanding about the role of co-or-multiple infections can offer new insights about the etiology, treatment and prevention of NPDs. Likewise, therapy based on anti-infective and anti-inflammatory agents could be a promising therapeutic option as an adjuvant for treatment of NPDs.
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Affiliation(s)
- Amir Abdoli
- Department of Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.,Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Ali Taghipour
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Majid Pirestani
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mirza Ali Mofazzal Jahromi
- Department of Advanced Medical Sciences & Technologies, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.,Department of Laboratory Sciences, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.,Research Center for Noncommunicable Diseases, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Abazar Roustazadeh
- Department of Advanced Medical Sciences & Technologies, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.,Research Center for Noncommunicable Diseases, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.,Department of Clinical Biochemistry, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Hamed Mir
- Research Center for Noncommunicable Diseases, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.,Department of Clinical Biochemistry, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Hoda Mirzaian Ardakani
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Azra Kenarkoohi
- Department of Microbiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Shahab Falahi
- Zoonotic Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Mahdi Karimi
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran.,Department of Medical Nanotechnology, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran.,Advances Nanobiotechnology and Nanomedicine Research Group (ANNRG), Iran University of Medical Sciences, Tehran, Iran
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