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Ali-Sisto T, Tolmunen T, Kraav SL, Mäntyselkä P, Valkonen-Korhonen M, Honkalampi K, Ruusunen A, Velagapudi V, Lehto SM. Serum levels of carnosine may be associated with the duration of MDD episodes. J Affect Disord 2023; 320:647-655. [PMID: 36208690 DOI: 10.1016/j.jad.2022.09.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 09/09/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a recurrent disorder that incurs a high societal burden. However, the etiology of MDD remains unclear. The functioning of several systems associated with the etiopathogenesis of MDD, such as inflammatory and stress systems, is partially modulated by the dipeptide carnosine. METHODS The study comprised 99 MDD patients and 253 non-depressed controls aged 20-71 years. Fasting serum samples were analyzed using ultra-performance liquid chromatography coupled to mass spectrometry to determine the serum levels of carnosine and its constituent, histidine. We compared these metabolites in three different settings: 1) MDD patients vs. non-depressed controls and 2) remitted vs. non-remitted MDD patients, as well as 3) changes in the metabolite levels during the follow-up period within a) the remitted group and b) the non-remitted group. In addition, we assessed the possible effect of medications on the measured metabolites. RESULTS We observed higher serum levels of carnosine in the MDD group compared to the control group at baseline (OR = 1.895, 95%CI = 1.223-2.937, p = 0.004). Elevated serum levels of carnosine were also associated with a longer duration of the depressive episode (Z = 0.406, p = 0.001). However, the use of any antipsychotic medication (n = 36) was associated with lowered carnosine levels (p = 0.010 for use vs. non-use). At the follow-up, remitted and non-remitted participants displayed no significant differences in their carnosine levels (Z = -0.14, p = 0.891) or histidine (Z = -1.39 p = 0.164). CONCLUSIONS An increase in circulating carnosine may characterize depressive episodes and may represent a protective homeostatic reaction against MDD-related oxidative stress and inflammation.
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Affiliation(s)
- Toni Ali-Sisto
- Institute of Clinical Medicine, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland.
| | - Tommi Tolmunen
- Institute of Clinical Medicine, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland; Department of Psychiatry, Kuopio University Hospital, KYS, P.O. Box 100, 70029, Finland
| | - Siiri-Liisi Kraav
- Institute of Clinical Medicine, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland; Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
| | - Pekka Mäntyselkä
- Primary Health Care Unit, University of Eastern Finland and Kuopio University Hospital, P.O. Box 1627, 70211 Kuopio, Finland
| | - Minna Valkonen-Korhonen
- Institute of Clinical Medicine, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland; Department of Psychiatry, Kuopio University Hospital, KYS, P.O. Box 100, 70029, Finland
| | - Kirsi Honkalampi
- Department of Education and Psychology, University of Eastern Finland, P.O. Box 111, 80101 Joensuu, Finland
| | - Anu Ruusunen
- Department of Psychiatry, Kuopio University Hospital, KYS, P.O. Box 100, 70029, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland; Deakin University, iMPACT Institute, School of Medicine, P.O. Box 281, Geelong 3220, Australia
| | - Vidya Velagapudi
- Metabolomics Unit, Institute for Molecular Medicine Finland FIMM, University of Helsinki, P.O. Box 20, 00014, Finland
| | - Soili M Lehto
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; R&D department, Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway; Department of Psychiatry, University of Helsinki, Helsinki, Finland
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Ali-Sisto T, Tolmunen T, Viinamäki H, Mäntyselkä P, Valkonen-Korhonen M, Koivumaa-Honkanen H, Honkalampi K, Ruusunen A, Nandania J, Velagapudi V, Lehto SM. Global arginine bioavailability ratio is decreased in patients with major depressive disorder. J Affect Disord 2018; 229:145-151. [PMID: 29310063 DOI: 10.1016/j.jad.2017.12.030] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 12/11/2017] [Accepted: 12/24/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is characterized by increased oxidative and nitrosative stress. We compared nitric oxide metabolism, i.e., the global arginine bioavailability ratio (GABR) and related serum amino acids, between MDD patients and non-depressed controls, and between remitted and non-remitted MDD patients. METHODS Ninety-nine MDD patients and 253 non-depressed controls, aged 20-71 years, provided background data via questionnaires. Fasting serum samples were analyzed using ultra-performance liquid chromatography coupled to mass spectrometry to determine the serum levels of ornithine, arginine, citrulline, and symmetric and asymmetric dimethylarginine. GABR was calculated as arginine divided by the sum of ornithine plus citrulline. We compared the above measures between: 1) MDD patients and controls, 2) remitted (n=33) and non-remitted (n = 45) MDD patients, and 3) baseline and follow-up within the remitted and non-remitted groups. RESULTS Lower arginine levels (OR 0.98, 95% CI 0.97-0.99) and lower GABR (OR 0.13, 95% CI 0.03-0.50) were associated with the MDD vs. the non-depressed group after adjustments for potential confounders. The remitted group showed a decrease in GABR, arginine, and symmetric dimethylarginine, and an increase in ornithine after the follow-up compared with within-group baseline values. The non-remitted group displayed an increase in arginine and ornithine levels and a decrease in GABR. No significant differences were recorded between the remitted and non-remitted groups. LIMITATIONS The MDD group was not medication-free. CONCLUSIONS Arginine bioavailability may be decreased in MDD. This could impair the production of nitric oxide, and thus add to oxidative stress in the central nervous system.
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Affiliation(s)
- Toni Ali-Sisto
- Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland.
| | - Tommi Tolmunen
- Department of Psychiatry, Kuopio University Hospital, P.O. Box 100, 70029 KYS, Finland
| | - Heimo Viinamäki
- Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland; Department of Psychiatry, Kuopio University Hospital, P.O. Box 100, 70029 KYS, Finland
| | - Pekka Mäntyselkä
- Primary Health Care Unit, University of Eastern Finland and Kuopio University Hospital, P.O. Box 1627, 70211 Kuopio, Finland
| | - Minna Valkonen-Korhonen
- Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland; Department of Psychiatry, Kuopio University Hospital, P.O. Box 100, 70029 KYS, Finland
| | - Heli Koivumaa-Honkanen
- Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland; Department of Psychiatry, Kuopio University Hospital, P.O. Box 100, 70029 KYS, Finland; Departments of Psychiatry, South-Savonia Hospital District, Mikkeli, Finland; Departments of Psychiatry, North Karelia Central Hospital, Joensuu, Finland; Departments of Psychiatry, SOTE, Iisalmi, Finland; Departments of Psychiatry, Lapland Hospital District, Rovaniemi, Finland
| | - Kirsi Honkalampi
- Department of Education and Psychology, University of Eastern Finland, P.O. Box 111, 80101 Joensuu, Finland
| | - Anu Ruusunen
- Department of Psychiatry, Kuopio University Hospital, P.O. Box 100, 70029 KYS, Finland; Deakin University, Geelong, IMPACT Strategic Research Centre, VIC, Australia
| | - Jatin Nandania
- Metabolomics Unit, Institute for Molecular Medicine Finland FIMM, University of Helsinki, P.O. Box 20, 00014, Finland
| | - Vidya Velagapudi
- Metabolomics Unit, Institute for Molecular Medicine Finland FIMM, University of Helsinki, P.O. Box 20, 00014, Finland
| | - Soili M Lehto
- Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland; Department of Psychiatry, Kuopio University Hospital, P.O. Box 100, 70029 KYS, Finland; Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, P.O. Box 9, 00014, Finland
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