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Walton NL, Antonoudiou P, Maguire JL. Neurosteroid influence on affective tone. Neurosci Biobehav Rev 2023; 152:105327. [PMID: 37499891 PMCID: PMC10528596 DOI: 10.1016/j.neubiorev.2023.105327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 07/07/2023] [Accepted: 07/23/2023] [Indexed: 07/29/2023]
Abstract
Affective disorders such as depression and anxiety are among the most prevalent psychiatric illnesses and causes of disability worldwide. The recent FDA-approval of a novel antidepressant treatment, ZULRESSO® (Brexanolone), a synthetic neurosteroid has fueled interest into the role of neurosteroids in the pathophysiology of depression as well as the mechanisms mediating the antidepressant effects of these compounds. The majority of studies examining the impact of neurosteroids on affective states have relied on the administration of exogenous neurosteroids; however, neurosteroids can also be synthesized endogenously from cholesterol or steroid hormone precursors. Despite the well-established influence of exogenous neurosteroids on affective states, we still lack an understanding of the role of endogenous neurosteroids in modulating affective tone. This review aims to summarize the current literature supporting the influence of neurosteroids on affective states in clinical and preclinical studies, as well as recent evidence suggesting that endogenous neurosteroids may set a baseline affective tone.
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Affiliation(s)
- Najah L Walton
- Program of Neuroscience, Graduate School of Biomedical Sciences, Tufts University School of Medicine, Boston, MA, USA; Department of Neuroscience, Graduate School of Biomedical Sciences, Tufts University School of Medicine, Boston, MA, USA
| | - Pantelis Antonoudiou
- Program of Neuroscience, Graduate School of Biomedical Sciences, Tufts University School of Medicine, Boston, MA, USA; Department of Neuroscience, Graduate School of Biomedical Sciences, Tufts University School of Medicine, Boston, MA, USA
| | - Jamie L Maguire
- Program of Neuroscience, Graduate School of Biomedical Sciences, Tufts University School of Medicine, Boston, MA, USA; Department of Neuroscience, Graduate School of Biomedical Sciences, Tufts University School of Medicine, Boston, MA, USA.
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Petelin DS, Bairamova SP, Akhapkin RV, Kudryashov NV, Sorokina OY, Semin SA, Volel BA. [A role of neurosteroids in the pathogenesis of psychiatric disorders]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:31-36. [PMID: 37084362 DOI: 10.17116/jnevro202312304131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Abstract
Despite the proven importance of neurosteroids in many physiological processes, their role in the pathogenesis of the most of psychiatric disorders remains relatively understudied. This article reviews the current clinical evidence on the effects of neurosteroids on the formation and treatment of anxiety disorder, depression, bipolar disorder, and schizophrenia. In particular, the article points out the ambivalent nature of the effects of neurosteroids on GABAA- and other receptors. We are especially interested in the anxiolytic and anxiogenic effects of some neurosteroids, the antidepressant effect of allopregnanolone in treating postpartum and other forms of depression, and the nature of short- and long-term mechanisms of antidepressant effects of neurosteroids of different types. The currently unproven hypothesis about the effect of changes in the level of neurosteroids on the course of bipolar disorder is also discussed, with an analysis of the scientific evidence on the development of schizophrenic symptomatology in relation to changing neurosteroid levels in the context of positive and cognitive symptoms.
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Affiliation(s)
- D S Petelin
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - S P Bairamova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - R V Akhapkin
- Serbsky National Medical Research Center of Psychiatry and Narcology, Moscow, Russia
| | - N V Kudryashov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Zakusov Institute of Pharmacology, Moscow, Russia
| | - O Yu Sorokina
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - S A Semin
- «Spasenie» Clinic, LLC, Moscow, Russia
| | - B A Volel
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Mental Health Research Center, Moscow, Russia
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Junker J, Kamp F, Winkler E, Steiner H, Bracher F, Müller C. Effective sample preparation procedure for the analysis of free neutral steroids, free steroid acids and sterol sulfates in different tissues by GC-MS. J Steroid Biochem Mol Biol 2021; 211:105880. [PMID: 33757894 DOI: 10.1016/j.jsbmb.2021.105880] [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: 10/02/2020] [Revised: 03/11/2021] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Abstract
Steroids play an important role in cell regulation and homeostasis. Many diseases like Alzheimer's disease or Smith-Lemli-Opitz syndrome are known to be associated with deviations in the steroid profile. Most published methods only allow the analysis of small subgroups of steroids and cannot give an overview of the total steroid profile. We developed and validated a method that allows the analysis of free neutral steroids, including intermediates of cholesterol biosynthesis, free oxysterols, C19 and C21 steroids, free steroid acids, including bile acids, and sterol sulfates using gas chromatography-mass spectrometry. Samples were analyzed in scan mode for screening purposes and in dynamic multiple reaction monitoring mode for highly sensitive quantitative analysis. The method was validated for mouse brain and liver tissue and consists of sample homogenization, lipid extraction, steroid group separation, deconjugation, derivatization and gas chromatography-mass spectrometry analysis. We applied the method on brain and liver samples of mice (10 months and 3 weeks old) and cultured N2a cells and report the endogenous concentrations of 29 physiological steroids.
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Affiliation(s)
- Julia Junker
- Department of Pharmacy - Center for Drug Research, Ludwig-Maximilians University-Munich, Butenandtstraße 5-13, 81377, Munich, Germany
| | - Frits Kamp
- Biomedical Center (BMC), Metabolic Biochemistry, Ludwig-Maximilians University-Munich, Feodor-Lynen-Straße 17, 81377, Munich, Germany
| | - Edith Winkler
- Biomedical Center (BMC), Metabolic Biochemistry, Ludwig-Maximilians University-Munich, Feodor-Lynen-Straße 17, 81377, Munich, Germany
| | - Harald Steiner
- Biomedical Center (BMC), Metabolic Biochemistry, Ludwig-Maximilians University-Munich, Feodor-Lynen-Straße 17, 81377, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Feodor-Lynen-Straße 17, 81377, Munich, Germany
| | - Franz Bracher
- Department of Pharmacy - Center for Drug Research, Ludwig-Maximilians University-Munich, Butenandtstraße 5-13, 81377, Munich, Germany
| | - Christoph Müller
- Department of Pharmacy - Center for Drug Research, Ludwig-Maximilians University-Munich, Butenandtstraße 5-13, 81377, Munich, Germany.
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Carta MG, Preti A, Akiskal HS. Coping with the New Era: Noise and Light Pollution, Hperactivity and Steroid Hormones. Towards an Evolutionary View of Bipolar Disorders. Clin Pract Epidemiol Ment Health 2018. [PMID: 29541149 PMCID: PMC5838624 DOI: 10.2174/1745017901814010033] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Human population is increasing in immense cities with millions of inhabitants, in which life is expected to run 24 hours a day for seven days a week (24/7). Noise and light pollution are the most reported consequences, with a profound impact on sleep patterns and circadian biorhythms. Disruption of sleep and biorhythms has severe consequences on many metabolic pathways. Suppression of melatonin incretion at night and the subsequent effect on DNA methylation may increase the risk of prostate and breast cancer. A negative impact of light pollution on neurosteroids may also affect mood. People who carry the genetic risk of bipolar disorder may be at greater risk of full-blown bipolar disorder because of the impact of noise and light pollution on sleep patterns and circadian biorhythms. However, living in cities may also offers opportunities and might be selective for people with hyperthymic temperament, who may find themselves advantaged by increased energy prompted by increased stimulation produced by life in big cities. This might result in the spreading of the genetic risk of bipolar disorder in the coming decades. In this perspective the burden of poor quality of life, increased disability adjusted life years and premature mortality due to the increases of mood disorders is the negative side of a phenomenon that in its globality also shows adaptive aspects. The new lifestyle also influences those who adapt and show behaviors, reactions and responses that might resemble the disorder, but are on the adaptive side.
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Affiliation(s)
- M G Carta
- Department of Health Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - A Preti
- Department of Health Sciences and Public Health, University of Cagliari, Cagliari, Italy
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Abstract
Electroencephalography (EEG) studies in patients with bipolar disorder have revealed lower amplitudes in brain oscillations. The aim of this review is to describe lithium-induced EEG changes in bipolar disorder and to discuss potential underlying factors. A literature survey about lithium-induced EEG changes in bipolar disorder was performed. Lithium consistently enhances magnitudes of brain oscillations in slow frequencies (delta and theta) in both resting-state EEG studies as well as event-related oscillations studies. Enhancement of magnitudes of beta oscillations is specific to event-related oscillations. Correlation between serum lithium levels and brain oscillations has been reported. Lithium-induced changes in brain oscillations might correspond to lithium-induced alterations in neurotransmitters, signaling cascades, plasticity, brain structure, or biophysical properties of lithium. Therefore, lithium-induced changes in brain oscillations could be promising biomarkers to assess the molecular mechanisms leading to variability in efficacy. Since the variability of lithium response in bipolar disorder is due to the genetic differences in the mechanisms involving lithium, it would be highly promising to assess the lithium-induced EEG changes as biomarkers in genetic studies.
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Affiliation(s)
- Murat İlhan Atagün
- Department of Psychiatry, Yıldırım Beyazıt University Medical School, Cankaya, Ankara, Turkey
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Sabunciyan S, Maher B, Bahn S, Dickerson F, Yolken RH. Association of DNA Methylation with Acute Mania and Inflammatory Markers. PLoS One 2015; 10:e0132001. [PMID: 26147665 PMCID: PMC4492496 DOI: 10.1371/journal.pone.0132001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 06/09/2015] [Indexed: 11/18/2022] Open
Abstract
In order to determine whether epigenetic changes specific to the manic mood state can be detected in peripheral blood samples we assayed DNA methylation levels genome-wide in serum samples obtained from 20 patients hospitalized for mania and 20 unaffected controls using the Illumina 450K methylation arrays. We identified a methylation locus in the CYP11A1 gene, which is regulated by corticotropin, that is hypo-methylated in individuals hospitalized for mania compared with unaffected controls. DNA methylation levels at this locus appear to be state related as levels in follow-up samples collected from mania patients six months after hospitalization were similar to those observed in controls. In addition, we found that methylation levels at the CYP11A1 locus were significantly correlated with three inflammatory markers in serum in acute mania cases but not in unaffected controls. We conclude that mania is associated with alterations in levels of DNA methylation and inflammatory markers. Since epigenetic markers are potentially malleable, a better understanding of the role of epigenetics may lead to new methods for the prevention and treatment of mood disorders.
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Affiliation(s)
- Sarven Sabunciyan
- Department of Pediatrics, Johns Hopkins University, Baltimore, MD, United States of America
- * E-mail: (SS); (RHY)
| | - Brion Maher
- Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD, United States of America
| | - Sabine Bahn
- Department of Chemical Engineering & Biotechnology, University of Cambridge, Cambridge, United Kingdom
| | - Faith Dickerson
- Sheppard Pratt Health System, Baltimore, MD, United States of America
| | - Robert H. Yolken
- Department of Pediatrics, Johns Hopkins University, Baltimore, MD, United States of America
- * E-mail: (SS); (RHY)
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Youssef NA, Bradford DW, Kilts JD, Szabo ST, Naylor JC, Allen TB, Strauss JL, Hamer RM, Brunca M, Shampine LJ, Marx CE. Exploratory Investigation of Biomarker Candidates for Suicide in Schizophrenia and Bipolar Disorder. CRISIS 2015; 36:46-54. [DOI: 10.1027/0227-5910/a000280] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Clozapine and lithium increase neurosteroids in rodents, and both drugs demonstrate antisuicidal actions. We therefore hypothesized that neurosteroid levels may be reduced in patients with schizophrenia or bipolar disorder who completed suicide. Aims: To investigate neurosteroid levels in the parietal cortex and posterior cingulate in schizophrenia and bipolar patients who died by suicide, and compare them with patients with these disorders who died of other causes. Method: Neurosteroid levels were quantified by gas chromatography/mass spectrometry in the parietal cortex and posterior cingulate. Mann–Whitney analyses were conducted in exploratory post hoc analyses to investigate neurosteroids as possible biomarker candidates for suicide. Results: The study showed that pregnenolone was significantly decreased in the parietal cortex in the combined group of patients with schizophrenia or bipolar disorder who died by suicide (n = 13) compared with patients with these disorders who died of other causes (n = 17, p = .02). Pregnenolone levels were also lower in the parietal cortex in the individual group of schizophrenia patients who died by suicide (n = 4) compared with schizophrenia patients who died of other causes (n = 11) p = .04). Conclusion: Pregnenolone alterations may be relevant to the neurobiology of suicide in schizophrenia and bipolar disorder.
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Affiliation(s)
- Nagy A. Youssef
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
- Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC) and Durham VA Medical Center, Durham, NC, USA
| | - Daniel W. Bradford
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
- Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC) and Durham VA Medical Center, Durham, NC, USA
| | - Jason D. Kilts
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
- Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC) and Durham VA Medical Center, Durham, NC, USA
| | - Steven T. Szabo
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
- Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC) and Durham VA Medical Center, Durham, NC, USA
| | - Jennifer C. Naylor
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
- Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC) and Durham VA Medical Center, Durham, NC, USA
| | - Trina B. Allen
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
- Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC) and Durham VA Medical Center, Durham, NC, USA
| | - Jennifer L. Strauss
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
- Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC) and Durham VA Medical Center, Durham, NC, USA
- Center for Health Services Research in Primary Care, Durham, NC, USA
| | - Robert M. Hamer
- Department of Psychiatry, University of North Carolina at Chapel Hill, NC, USA
| | - Mira Brunca
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
- Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC) and Durham VA Medical Center, Durham, NC, USA
| | - Lawrence J. Shampine
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
- Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC) and Durham VA Medical Center, Durham, NC, USA
| | - Christine E. Marx
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
- Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC) and Durham VA Medical Center, Durham, NC, USA
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Ritsner MS, Bawakny H, Kreinin A. Pregnenolone treatment reduces severity of negative symptoms in recent-onset schizophrenia: an 8-week, double-blind, randomized add-on two-center trial. Psychiatry Clin Neurosci 2014; 68:432-40. [PMID: 24548129 DOI: 10.1111/pcn.12150] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 12/05/2013] [Accepted: 12/12/2013] [Indexed: 11/26/2022]
Abstract
AIMS Management of recent-onset schizophrenia (SZ) and schizoaffective disorder (SA) is challenging owing to frequent insufficient response to antipsychotic agents. This study aimed to test the efficacy and safety of the neurosteroid pregnenolone in patients with recent-onset SZ/SA. METHODS Sixty out- and inpatients who met DSM-IV criteria for SZ/SA, with suboptimal response to antipsychotics were recruited for an 8-week, double-blind, randomized, placebo-controlled, two-center add-on trial, that was conducted between 2008 and 2011. Participants were randomized to receive either pregnenolone (50 mg/day) or placebo added on to antipsychotic medications. The primary outcome measures were the Positive and Negative Symptoms Scale and the Assessment of Negative Symptoms scores. Secondary outcomes included assessments of functioning, and side-effects. RESULTS Analysis was by linear mixed model. Fifty-two participants (86.7%) completed the trial. Compared to placebo, adjunctive pregnenolone significantly reduced Positive and Negative Symptoms Scale negative symptom scores with moderate effect sizes (d = 0.79). Significant improvement was observed in weeks 6 and 8 of pregnenolone therapy among patients who were not treated with concomitant mood stabilizers (arms × visit × mood stabilizers; P = 0.010). Likewise, pregnenolone significantly reduced Assessment of Negative Symptoms scores compared to placebo (d = 0.57), especially on blunted affect, avolition and anhedonia domain scores. Other symptoms, functioning, and side-effects were not significantly affected by adjunctive pregnenolone. Antipsychotic agents, benzodiazepines and sex did not associate with pregnenolone augmentation. Pregnenolone was well tolerated. CONCLUSIONS Thus, add-on pregnenolone reduces the severity of negative symptoms in recent-onset schizophrenia and schizoaffective disorder, especially among patients who are not treated with concomitant mood stabilizers. Further studies are warranted.
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Affiliation(s)
- Michael S Ritsner
- Sha'ar Menashe Mental Health Center, Hadera, Israel; The Rappaport Faculty of Medicine, Technion, Haifa, Israel
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Carta MG, Bhat KM, Preti A. GABAergic neuroactive steroids: a new frontier in bipolar disorders? Behav Brain Funct 2012; 8:61. [PMID: 23253178 PMCID: PMC3573983 DOI: 10.1186/1744-9081-8-61] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 11/30/2012] [Indexed: 01/27/2023] Open
Abstract
Neurosteroids are synthesized in the brain and modulate brain excitability. There is increasing evidence of their sedative, anesthetic and antiseizure properties, as well as their influence on mood. Currently neurosteroids are classified as pregnane neurosteroids (allopregnanolone and allotetrahydrodeoxycorticosterone), androstane neurosteroids (androstanediol and etiocholanone) or sulfated neurosteroids (pregnenolone sulfate and dehydroepiandrosterone sulfate). Both preclinical and clinical findings indicate that progesterone derivative neurosteroids such as allopregnanolone and allotetrahydrodeoxycorticosterone play a role in mood disorders. Clozapine and olanzapine, which were shown to be effective in stabilizing bipolar disorder, elevate pregnenolone levels in rat hippocampus, cerebral cortex, and serum. In lithium-treated mice, the blood levels of allopregnanolone and pregnenolone were elevated compared to control levels. Women diagnosed with bipolar disorder typically show symptomatic exacerbation in relation to the menstrual cycle, and show vulnerability to the onset or recurrence of mood disorders immediately after giving birth, when the levels of neurosteroid derivatives of progesterone drop. Whereas in women who had recovered from bipolar disorder, the plasma concentration of allopregnanolone was elevated compared to either healthy controls or women with major depressive disorder during the premenstrual period. During depressive episodes, blood level of allopregnanolone is low. Treatment with fluoxetine tends to stabilize the levels of neurosteroids in depression. These findings converge to suggest that these steroids have significant mood-stabilizing effect. This hypothesis is consistent with the observation that a number of anticonvulsants are effective therapies for bipolar disorder, a finding also consistent with the antiseizure properties of neurosteroids. Further exploration of action of neuroactive steroids is likely to open new frontiers in the investigation of the etiology and treatment of mood disorders, particularly bipolar disorders.
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Affiliation(s)
- Mauro Giovanni Carta
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari and Center for Consultation-Liaison Psychiatry and Psychosomatics University Hospital of Cagliari, Cagliari, Italy.
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Marx C, Bradford D, Hamer R, Naylor J, Allen T, Lieberman J, Strauss J, Kilts J. Pregnenolone as a novel therapeutic candidate in schizophrenia: emerging preclinical and clinical evidence. Neuroscience 2011; 191:78-90. [DOI: 10.1016/j.neuroscience.2011.06.076] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Revised: 05/30/2011] [Accepted: 06/28/2011] [Indexed: 10/18/2022]
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A new era for CNS Spectrums. CNS Spectr 2009; 14:232-3. [PMID: 19407720 DOI: 10.1017/s1092852900025359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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12
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Porcu P, O'Buckley TK, Alward SE, Marx CE, Shampine LJ, Girdler SS, Morrow AL. Simultaneous quantification of GABAergic 3alpha,5alpha/3alpha,5beta neuroactive steroids in human and rat serum. Steroids 2009; 74:463-73. [PMID: 19171160 PMCID: PMC2832187 DOI: 10.1016/j.steroids.2008.12.015] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2008] [Revised: 12/17/2008] [Accepted: 12/29/2008] [Indexed: 11/29/2022]
Abstract
The 3alpha,5alpha- and 3alpha,5beta-reduced derivatives of progesterone, deoxycorticosterone, dehydroepiandrosterone and testosterone enhance GABAergic neurotransmission and produce inhibitory neurobehavioral and anti-inflammatory effects. Despite substantial information on the progesterone derivative (3alpha,5alpha)-3-hydroxypregnan-20-one (3alpha,5alpha-THP, allopregnanolone), the physiological significance of the other endogenous GABAergic neuroactive steroids has remained elusive. Here, we describe the validation of a method using gas chromatography-mass spectrometry to simultaneously identify serum levels of the eight 3alpha,5alpha- and 3alpha,5beta-reduced derivatives of progesterone, deoxycorticosterone, dehydroepiandrosterone and testosterone. The method shows specificity, sensitivity and enhanced throughput compared to other methods already available for neuroactive steroid quantification. Administration of pregnenolone to rats and progesterone to women produced selective effects on the 3alpha,5alpha- and 3alpha,5beta-reduced neuroactive steroids, indicating differential regulation of their biosynthetic pathways. Pregnenolone administration increased serum levels of 3alpha,5alpha-THP (+1488%, p<0.001), (3alpha,5alpha)-3,21-dihydroxypregnan-20-one (3alpha,5alpha-THDOC, +205%, p<0.01), (3alpha,5alpha)-3-hydroxyandrostan-17-one (3alpha,5alpha-A, +216%, p<0.001), (3alpha,5alpha,17beta)-androstane-3,17-diol (3alpha,5alpha-A-diol, +190%, p<0.01). (3alpha,5beta)-3-hydroxypregnan-20-one (3alpha,5beta-THP) and (3alpha,5beta)-3-hydroxyandrostan-17-one (3alpha,5beta-A) were not altered, while (3alpha,5beta)-3,21-dihydroxypregnan-20-one (3alpha,5beta-THDOC) and (3alpha,5beta,17beta)-androstane-3,17-diol (3alpha,5beta-A-diol) were increased from undetectable levels to 271+/-100 and 2.4+/-0.9 pg+/-SEM, respectively (5/8 rats). Progesterone administration increased serum levels of 3alpha,5alpha-THP (+1806%, p<0.0001), 3alpha,5beta-THP (+575%, p<0.001), 3alpha,5alpha-THDOC (+309%, p<0.001). 3alpha,5beta-THDOC levels were increased by 307%, although this increase was not significant because this steroid was detected only in 3/16 control subjects. Levels of 3alpha,5alpha-A, 3alpha,5beta-A and pregnenolone were not altered. This method can be used to investigate the physiological and pathological role of neuroactive steroids and to develop biomarkers and new therapeutics for neurological and psychiatric disorders.
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Affiliation(s)
- Patrizia Porcu
- Department of Psychiatry and Bowles Center for Alcohol Studies, University of North Carolina School of Medicine, Chapel Hill, NC, 27599-7178, USA
| | - Todd K. O'Buckley
- Department of Psychiatry and Bowles Center for Alcohol Studies, University of North Carolina School of Medicine, Chapel Hill, NC, 27599-7178, USA
| | - Sarah E. Alward
- Department of Psychiatry and Bowles Center for Alcohol Studies, University of North Carolina School of Medicine, Chapel Hill, NC, 27599-7178, USA
| | - Christine E. Marx
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center and Department of Veterans Affairs Medical Center, Durham, NC, 27705, USA
| | - Lawrence J. Shampine
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center and Department of Veterans Affairs Medical Center, Durham, NC, 27705, USA
| | - Susan S. Girdler
- Departments of Psychiatry and Psychology, University of North Carolina School of Medicine, Chapel Hill, NC, 27599-7178, USA
| | - A. Leslie Morrow
- Department of Psychiatry and Bowles Center for Alcohol Studies, University of North Carolina School of Medicine, Chapel Hill, NC, 27599-7178, USA
- Department of Pharmacology, University of North Carolina School of Medicine, Chapel Hill, NC, 27599-7178, USA
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