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Tamimou R, Montout C, Mura T, Conejero I, Evrard A, Courtet P, Bonilla-Escribano P, Riaza C, Vaquero-Lorenzo C, Baca-Garcia E, Jollant F, Lumbroso S, Mouzat K, Lopez-Castroman J. Genetic association of the kynurenine pathway to suicidal behavior. Brain Behav Immun Health 2024; 42:100903. [PMID: 39650284 PMCID: PMC11625281 DOI: 10.1016/j.bbih.2024.100903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 07/21/2024] [Accepted: 10/27/2024] [Indexed: 12/11/2024] Open
Abstract
Suicidal behavior has been associated with dysfunctions in the kynurenine pathway, including alterations in the levels of neuroprotective and neurotoxic metabolites. Changes in the catalytic activity of enzymes within the pathway may contribute significantly. Variations in the genes encoding enzymes within the pathway can significantly affect their catalytic activity, playing a crucial role in the process. To explore this possibility, we hypothesized that these genetic variations would occur more frequently in patients with a history of suicidal behavior compared to non-suicidal individuals. Thus, we investigated the relationship between a history of suicide attempts and five single nucleotide polymorphisms (SNPs) within genes involved in the kynurenine pathway: IDO1 (rs7820268), IDO2 (rs10109853), KMO (rs1053230), KAT1 (rs10988134), and ACSMD (rs2121337). Our sample comprised 849 subjects: 325 individuals who had attempted suicide in their lifetime (SAs), 99 individuals with a history of major depression disorder but no previous suicide attempts (non-SAs), and 425 non-psychiatric controls (CTRL). We performed SNP association analyses using codominant, dominant, and recessive models. Adjustment for sex and multiple comparisons was applied. After adjustment, the analysis revealed that SAs showed a significantly higher frequency of T alleles and TT genotypes of the rs1053230 SNP compared to CTRL across nearly all models. Furthermore, in the recessive model, non-SAs displayed a higher prevalence of the TT genotype of the rs10109853 SNP compared to CTRL. The rs1053230 and rs10109853 SNPs could play a role in the previously observed metabolic dysregulation among SAs and non-SAs, respectively. To validate our findings, it is crucial to conduct functional analyses to investigate the impact of rs10109853 and rs1053230 SNPs on the expression and/or catalytic activity of the corresponding enzymes.
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Affiliation(s)
- Rabah Tamimou
- Department of Psychiatry, Nîmes University Hospital, Nîmes, France
- IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
| | - Christine Montout
- Department of Biostatistics, Epidemiology, Public Health and Innovation in Methodology, CHU Nîmes, University of Montpellier, Nîmes, France
| | - Thibault Mura
- Department of Biostatistics, Epidemiology, Public Health and Innovation in Methodology, CHU Nîmes, University of Montpellier, Nîmes, France
| | - Ismael Conejero
- Department of Psychiatry, Nîmes University Hospital, Nîmes, France
- IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
| | - Alexandre Evrard
- Laboratory of Biochemistry and Molecular Biology, Nimes University Hospital and INSERM U1194, Institute of Cancer Research of Montpellier, Montpellier, France
| | - Philippe Courtet
- IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
| | | | - Carlos Riaza
- Hospital universitario Ramon y Cajal, Servicio de Psiquiatría, Madrid, Spain
| | - Concepción Vaquero-Lorenzo
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Department of Biology, University Institute of Molecular Biology, Autonomous University of Madrid, Spain
| | - Enrique Baca-Garcia
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Department of Psychiatry, University Hospital Jimenez Diaz Foundation, Madrid, Spain
- Department of Psychiatry, University Hospital Rey Juan Carlos, Mostoles, Spain
- Department of Psychiatry, General Hospital of Villalba, Madrid, Spain
- Department of Psychiatry, University Hospital Infanta Elena, Valdemoro, Spain
- Department of Psychiatry, Madrid Autonomous University, Madrid, Spain
| | - Fabrice Jollant
- Department of Psychiatry, Nîmes University Hospital, Nîmes, France
- Facultéé de méédecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France & Service de psychiatrie et addictologie, Hôpital Paul-Brousse, APHP, Villejuif, France
- Department of psychiatry and McGill Group for suicide studies, McGill University, Montréal, Canada
| | - Serge Lumbroso
- Laboratory of Biochemistry and Molecular Biology, Nimes University Hospital, INM, University of Montpellier, INSERM, Montpellier, France
| | - Kevin Mouzat
- Laboratory of Biochemistry and Molecular Biology, Nimes University Hospital, INM, University of Montpellier, INSERM, Montpellier, France
| | - Jorge Lopez-Castroman
- Department of Psychiatry, Nîmes University Hospital, Nîmes, France
- IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Spain
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Contella L, Farrell CL, Boccuto L, Litwin A, Snyder ML. Gene Variant Frequencies of IDO1, IDO2, TDO, and KMO in Substance Use Disorder Cohorts. Genes (Basel) 2024; 15:1388. [PMID: 39596587 PMCID: PMC11594152 DOI: 10.3390/genes15111388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2024] [Revised: 10/24/2024] [Accepted: 10/25/2024] [Indexed: 11/28/2024] Open
Abstract
BACKGROUND Substance use disorder in the United States represents a complex and growing public health crisis, marked by increasing rates of overdose deaths and the misuse of prescription medications. There is a critical need for furthering the understanding of the molecular and genetic mechanisms that can lead to substance use disorder. Identifying significant variants in the kynurenine pathway could help identify therapeutic targets for intervention. METHODS The All of Us cohort builder evaluated the frequency of variants of four genes, TDO2, IDO1, IDO2, and KMO, encoding enzymes in the kynurenine pathway. The samples were broken into six cohorts: alcohol, cannabis, cocaine, opioid, other use disorder, and control. Using Chi-square analysis, the frequency of at least one copy of a variant allele was calculated. RESULTS Chi-square analysis showed a significant variation in genetic frequency (p-value < 0.005) in 14 of 18 polymorphisms analyzed. The cocaine cohort had the most significant variants (13), cannabis had 11, opioids had 3, other use disorders had 2, and alcohol had 1 significant variant. CONCLUSIONS This study found associations of polymorphisms in the TDO2, IDO1, IDO2, and KMO genes of individuals with a substance use disorder. These results provide evidence of potential predictors of increased susceptibility to substance use disorder.
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Affiliation(s)
- Lindsey Contella
- Healthcare Genetics and Genomics, School of Nursing, Clemson University, 605 Grove Rd., Greenville, SC 29605, USA
- Luxor Scientific, LLC, 1327 Miller Rd., Greenville, SC 29607, USA
| | - Christopher L. Farrell
- Healthcare Genetics and Genomics, School of Nursing, Clemson University, 605 Grove Rd., Greenville, SC 29605, USA
| | - Luigi Boccuto
- Healthcare Genetics and Genomics, School of Nursing, Clemson University, 605 Grove Rd., Greenville, SC 29605, USA
| | - Alain Litwin
- School of Health Research, Clemson University, Clemson, SC 29631, USA
- Department of Medicine, Prisma Health, 701 Grove Rd., Greenville, SC 29605, USA
- Department of Medicine, University of South Carolina School of Medicine, 876 W Faris Rd., Greenville, SC 29605, USA
| | - Marion L. Snyder
- Luxor Scientific, LLC, 1327 Miller Rd., Greenville, SC 29607, USA
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Pocivavsek A, Schwarcz R, Erhardt S. Neuroactive Kynurenines as Pharmacological Targets: New Experimental Tools and Exciting Therapeutic Opportunities. Pharmacol Rev 2024; 76:978-1008. [PMID: 39304346 PMCID: PMC11549936 DOI: 10.1124/pharmrev.124.000239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2024] [Revised: 09/08/2024] [Accepted: 09/10/2024] [Indexed: 09/22/2024] Open
Abstract
Both preclinical and clinical studies implicate functional impairments of several neuroactive metabolites of the kynurenine pathway (KP), the major degradative cascade of the essential amino acid tryptophan in mammals, in the pathophysiology of neurologic and psychiatric diseases. A number of KP enzymes, such as tryptophan 2,3-dioxygenase (TDO2), indoleamine 2,3-dioxygenases (IDO1 and IDO2), kynurenine aminotransferases (KATs), kynurenine 3-monooxygenase (KMO), 3-hydroxyanthranilic acid oxygenase (3-HAO), and quinolinic acid phosphoribosyltransferase (QPRT), control brain KP metabolism in health and disease and are therefore increasingly considered to be promising targets for the treatment of disorders of the nervous system. Understanding the distribution, cellular expression, and regulation of KP enzymes and KP metabolites in the brain is therefore critical for the conceptualization and implementation of successful therapeutic strategies. SIGNIFICANCE STATEMENT: Studies have implicated the kynurenine pathway of tryptophan in the pathophysiology of neurologic and psychiatric diseases. Key enzymes of the kynurenine pathway regulate brain metabolism in both health and disease, making them promising targets for treating these disorders. Therefore, understanding the distribution, cellular expression, and regulation of these enzymes and metabolites in the brain is critical for developing effective therapeutic strategies. This review endeavors to describe these processes in detail.
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Affiliation(s)
- Ana Pocivavsek
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, South Carolina (A.P.); Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland (R.S.); and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (S.E.)
| | - Robert Schwarcz
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, South Carolina (A.P.); Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland (R.S.); and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (S.E.)
| | - Sophie Erhardt
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, South Carolina (A.P.); Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland (R.S.); and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (S.E.)
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Chen H, Huang X, Zeng C, Sun D, Liu F, Zhang J, Liao Q, Luo S, Xu W, Xiao Y, Zeng D, Song M, Tian F. The role of indoleamine 2,3-dioxygenase 1 in early-onset post-stroke depression. Front Immunol 2023; 14:1125634. [PMID: 36911716 PMCID: PMC9998486 DOI: 10.3389/fimmu.2023.1125634] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/13/2023] [Indexed: 03/14/2023] Open
Abstract
Background The immune-inflammatory response has been widely considered to be involved in the pathogenesis of post-stroke depression (PSD), but there is ambiguity about the mechanism underlying such association. Methods According to Diagnostic and Statistical Manual of Mental Disorders (5th edition), depressive symptoms were assessed at 2 weeks after stroke onset. 15 single nucleotide polymorphisms (SNPs) in genes of indoleamine 2,3-dioxygenase (IDO, including IDO1 and IDO2) and its inducers (including pro-inflammatory cytokines interferon [IFN]-γ, tumor necrosis factor [TNF]-α, interleukin [IL]-1β, IL-2 and IL-6) were genotyped using SNPscan™ technology, and serum IDO1 levels were detected by double-antibody sandwich enzyme-linked immune-sorbent assay. Results Fifty-nine patients (31.72%) were diagnosed with depression at 2 weeks after stroke onset (early-onset PSD). The IDO1 rs9657182 T/T genotype was independently associated with early-onset PSD (adjusted odds ratio [OR] = 3.008, 95% confidence interval [CI] 1.157-7.822, p = 0.024) and the frequency of rs9657182 T allele was significantly higher in patients with PSD than that in patients with non-PSD (χ2 = 4.355, p = 0.037), but these results did not reach the Bonferroni significance threshold (p > 0.003). Serum IDO1 levels were also independently linked to early-onset PSD (adjusted OR = 1.071, 95% CI 1.002-1.145, p = 0.044) and patients with PSD had higher serum IDO1 levels than patients with non-PSD in the presence of the rs9657182 T allele but not homozygous C allele (t = -2.046, p = 0.043). Stroke patients with the TNF-α rs361525 G/G genotype had higher serum IDO1 levels compared to those with the G/A genotype (Z = -2.451, p = 0.014). Conclusions Our findings provided evidence that IDO1 gene polymorphisms and protein levels were involved in the development of early-onset PSD and TNF-α polymorphism was associated with IDO1 levels, supporting that IDO1 which underlie strongly regulation by cytokines may be a specific pathway for the involvement of immune-inflammatory mechanism in the pathophysiology of PSD.
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Affiliation(s)
- Hengshu Chen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Xia Huang
- Department of Critical Care Medicine, The First People's Hospital of Huaihua, Huaihua, China
| | - Chang Zeng
- Health Management Center, Xiangya Hospital, Central South University, Changsha, China
| | - Dongren Sun
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Fan Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Jingyuan Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Qiao Liao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Shihang Luo
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Weiye Xu
- Department of Human Anatomy and Neurobiology, School of Basic Medical Sciences, Central South University, Changsha, China
| | - Yeqing Xiao
- Department of Neurology, Hengyang Central Hospital, Hengyang, China
| | - Danfeng Zeng
- Department of Neurology, Xiangtan Central Hospital, Xiangtan, China
| | - Mingyu Song
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.,Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China
| | - Fafa Tian
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
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Tanaka M, Szabó Á, Spekker E, Polyák H, Tóth F, Vécsei L. Mitochondrial Impairment: A Common Motif in Neuropsychiatric Presentation? The Link to the Tryptophan-Kynurenine Metabolic System. Cells 2022; 11:2607. [PMID: 36010683 PMCID: PMC9406499 DOI: 10.3390/cells11162607] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/14/2022] [Accepted: 08/19/2022] [Indexed: 02/07/2023] Open
Abstract
Nearly half a century has passed since the discovery of cytoplasmic inheritance of human chloramphenicol resistance. The inheritance was then revealed to take place maternally by mitochondrial DNA (mtDNA). Later, a number of mutations in mtDNA were identified as a cause of severe inheritable metabolic diseases with neurological manifestation, and the impairment of mitochondrial functions has been probed in the pathogenesis of a wide range of illnesses including neurodegenerative diseases. Recently, a growing number of preclinical studies have revealed that animal behaviors are influenced by the impairment of mitochondrial functions and possibly by the loss of mitochondrial stress resilience. Indeed, as high as 54% of patients with one of the most common primary mitochondrial diseases, mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) syndrome, present psychiatric symptoms including cognitive impairment, mood disorder, anxiety, and psychosis. Mitochondria are multifunctional organelles which produce cellular energy and play a major role in other cellular functions including homeostasis, cellular signaling, and gene expression, among others. Mitochondrial functions are observed to be compromised and to become less resilient under continuous stress. Meanwhile, stress and inflammation have been linked to the activation of the tryptophan (Trp)-kynurenine (KYN) metabolic system, which observably contributes to the development of pathological conditions including neurological and psychiatric disorders. This review discusses the functions of mitochondria and the Trp-KYN system, the interaction of the Trp-KYN system with mitochondria, and the current understanding of the involvement of mitochondria and the Trp-KYN system in preclinical and clinical studies of major neurological and psychiatric diseases.
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Affiliation(s)
- Masaru Tanaka
- ELKH-SZTE Neuroscience Research Group, Danube Neuroscience Research Laboratory, Eötvös Loránd Research Network, University of Szeged (ELKH-SZTE), Tisza Lajos krt. 113, H-6725 Szeged, Hungary
| | - Ágnes Szabó
- Department of Neurology, Albert Szent-Györgyi Medical School, University of Szeged, Semmelweis u. 6, H-6725 Szeged, Hungary
- Doctoral School of Clinical Medicine, University of Szeged, Korányi fasor 6, H-6720 Szeged, Hungary
| | - Eleonóra Spekker
- ELKH-SZTE Neuroscience Research Group, Danube Neuroscience Research Laboratory, Eötvös Loránd Research Network, University of Szeged (ELKH-SZTE), Tisza Lajos krt. 113, H-6725 Szeged, Hungary
| | - Helga Polyák
- Department of Neurology, Albert Szent-Györgyi Medical School, University of Szeged, Semmelweis u. 6, H-6725 Szeged, Hungary
- Doctoral School of Clinical Medicine, University of Szeged, Korányi fasor 6, H-6720 Szeged, Hungary
| | - Fanni Tóth
- ELKH-SZTE Neuroscience Research Group, Danube Neuroscience Research Laboratory, Eötvös Loránd Research Network, University of Szeged (ELKH-SZTE), Tisza Lajos krt. 113, H-6725 Szeged, Hungary
| | - László Vécsei
- ELKH-SZTE Neuroscience Research Group, Danube Neuroscience Research Laboratory, Eötvös Loránd Research Network, University of Szeged (ELKH-SZTE), Tisza Lajos krt. 113, H-6725 Szeged, Hungary
- Department of Neurology, Albert Szent-Györgyi Medical School, University of Szeged, Semmelweis u. 6, H-6725 Szeged, Hungary
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Gonçalves de Andrade E, González Ibáñez F, Tremblay MÈ. Microglia as a Hub for Suicide Neuropathology: Future Investigation and Prevention Targets. Front Cell Neurosci 2022; 16:839396. [PMID: 35663424 PMCID: PMC9158339 DOI: 10.3389/fncel.2022.839396] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 02/22/2022] [Indexed: 12/27/2022] Open
Abstract
Suicide is a complex public health challenge associated worldwide with one death every 40 s. Research advances in the neuropathology of suicidal behaviors (SB) have defined discrete brain changes which may hold the key to suicide prevention. Physiological differences in microglia, the resident immune cells of the brain, are present in post-mortem tissue samples of individuals who died by suicide. Furthermore, microglia are mechanistically implicated in the outcomes of important risk factors for SB, including early-life adversity, stressful life events, and psychiatric disorders. SB risk factors result in inflammatory and oxidative stress activities which could converge to microglial synaptic remodeling affecting susceptibility or resistance to SB. To push further this perspective, in this Review we summarize current areas of opportunity that could untangle the functional participation of microglia in the context of suicide. Our discussion centers around microglial state diversity in respect to morphology, gene and protein expression, as well as function, depending on various factors, namely brain region, age, and sex.
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Affiliation(s)
- Elisa Gonçalves de Andrade
- Neuroscience Graduate Program, Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | - Fernando González Ibáñez
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
- Axe Neurosciences, Centre de Recherche du CHU de Québec, Université Laval, Québec City, QC, Canada
| | - Marie-Ève Tremblay
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
- Axe Neurosciences, Centre de Recherche du CHU de Québec, Université Laval, Québec City, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
- Department of Molecular Medicine, Université Laval, Québec City, QC, Canada
- Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, BC, Canada
- Centre for Advanced Materials and Related Technology (CAMTEC), University of Victoria, Victoria, BC, Canada
- *Correspondence: Marie-Ève Tremblay,
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Huang Y, Zhao M, Chen X, Zhang R, Le A, Hong M, Zhang Y, Jia L, Zang W, Jiang C, Wang J, Fan X, Wang J. Tryptophan Metabolism in Central Nervous System Diseases: Pathophysiology and Potential Therapeutic Strategies. Aging Dis 2022; 14:858-878. [PMID: 37191427 DOI: 10.14336/ad.2022.0916] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 09/16/2022] [Indexed: 11/19/2022] Open
Abstract
The metabolism of L-tryptophan (TRP) regulates homeostasis, immunity, and neuronal function. Altered TRP metabolism has been implicated in the pathophysiology of various diseases of the central nervous system. TRP is metabolized through two main pathways, the kynurenine pathway and the methoxyindole pathway. First, TRP is metabolized to kynurenine, then kynurenic acid, quinolinic acid, anthranilic acid, 3-hydroxykynurenine, and finally 3-hydroxyanthranilic acid along the kynurenine pathway. Second, TRP is metabolized to serotonin and melatonin along the methoxyindole pathway. In this review, we summarize the biological properties of key metabolites and their pathogenic functions in 12 disorders of the central nervous system: schizophrenia, bipolar disorder, major depressive disorder, spinal cord injury, traumatic brain injury, ischemic stroke, intracerebral hemorrhage, multiple sclerosis, Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, and Huntington's disease. Furthermore, we summarize preclinical and clinical studies, mainly since 2015, that investigated the metabolic pathway of TRP, focusing on changes in biomarkers of these neurologic disorders, their pathogenic implications, and potential therapeutic strategies targeting this metabolic pathway. This critical, comprehensive, and up-to-date review helps identify promising directions for future preclinical, clinical, and translational research on neuropsychiatric disorders.
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Krupa A, Kowalska I. The Kynurenine Pathway-New Linkage between Innate and Adaptive Immunity in Autoimmune Endocrinopathies. Int J Mol Sci 2021; 22:9879. [PMID: 34576041 PMCID: PMC8469440 DOI: 10.3390/ijms22189879] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 12/18/2022] Open
Abstract
The kynurenine pathway (KP) is highly regulated in the immune system, where it promotes immunosuppression in response to infection or inflammation. Indoleamine 2,3-dioxygenase 1 (IDO1), the main enzyme of KP, has a broad spectrum of activity on immune cells regulation, controlling the balance between stimulation and suppression of the immune system at sites of local inflammation, relevant to a wide range of autoimmune and inflammatory diseases. Various autoimmune diseases, among them endocrinopathies, have been identified to date, but despite significant progress in their diagnosis and treatment, they are still associated with significant complications, morbidity, and mortality. The precise cellular and molecular mechanisms leading to the onset and development of autoimmune disease remain poorly clarified so far. In breaking of tolerance, the cells of the innate immunity provide a decisive microenvironment that regulates immune cells' differentiation, leading to activation of adaptive immunity. The current review provided a comprehensive presentation of the known role of IDO1 and KP activation in the regulation of the innate and adaptive arms of the immune system. Significant attention has been paid to the immunoregulatory role of IDO1 in the most prevalent, organ-specific autoimmune endocrinopathies-type 1 diabetes mellitus (T1DM) and autoimmune thyroiditis.
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Affiliation(s)
- Anna Krupa
- Department of Internal Medicine and Metabolic Diseases, Medical University of Bialystok, M. Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland
| | - Irina Kowalska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Bialystok, M. Sklodowskiej-Curie 24A, 15-276 Bialystok, Poland
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Marszalek-Grabska M, Walczak K, Gawel K, Wicha-Komsta K, Wnorowska S, Wnorowski A, Turski WA. Kynurenine emerges from the shadows – Current knowledge on its fate and function. Pharmacol Ther 2021; 225:107845. [DOI: 10.1016/j.pharmthera.2021.107845] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/29/2021] [Indexed: 12/12/2022]
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10
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The kynurenine pathway and bipolar disorder: intersection of the monoaminergic and glutamatergic systems and immune response. Mol Psychiatry 2021; 26:4085-4095. [PMID: 31732715 PMCID: PMC7225078 DOI: 10.1038/s41380-019-0589-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 10/21/2019] [Accepted: 10/30/2019] [Indexed: 12/19/2022]
Abstract
Dysfunction in a wide array of systems-including the immune, monoaminergic, and glutamatergic systems-is implicated in the pathophysiology of depression. One potential intersection point for these three systems is the kynurenine (KYN) pathway. This study explored the impact of the prototypic glutamatergic modulator ketamine on the endogenous KYN pathway in individuals with bipolar depression (BD), as well as the relationship between response to ketamine and depression-related behavioral and peripheral inflammatory markers. Thirty-nine participants with treatment-resistant BD (23 F, ages 18-65) received a single ketamine infusion (0.5 mg/kg) over 40 min. KYN pathway analytes-including plasma concentrations of indoleamine 2,3-dioxygenase (IDO), KYN, kynurenic acid (KynA), and quinolinic acid (QA)-were assessed at baseline (pre-infusion), 230 min, day 1, and day 3 post-ketamine. General linear models with restricted maximum likelihood estimation and robust sandwich variance estimators were implemented. A repeated effect of time was used to model the covariance of the residuals with an unstructured matrix. After controlling for age, sex, and body mass index (BMI), post-ketamine IDO levels were significantly lower than baseline at all three time points. Conversely, ketamine treatment significantly increased KYN and KynA levels at days 1 and 3 versus baseline. No change in QA levels was observed post-ketamine. A lower post-ketamine ratio of QA/KYN was observed at day 1. In addition, baseline levels of proinflammatory cytokines and behavioral measures predicted KYN pathway changes post ketamine. The results suggest that, in addition to having rapid and sustained antidepressant effects in BD participants, ketamine also impacts key components of the KYN pathway.
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Mithaiwala MN, Santana-Coelho D, Porter GA, O’Connor JC. Neuroinflammation and the Kynurenine Pathway in CNS Disease: Molecular Mechanisms and Therapeutic Implications. Cells 2021; 10:1548. [PMID: 34205235 PMCID: PMC8235708 DOI: 10.3390/cells10061548] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/13/2021] [Accepted: 06/15/2021] [Indexed: 12/16/2022] Open
Abstract
Diseases of the central nervous system (CNS) remain a significant health, social and economic problem around the globe. The development of therapeutic strategies for CNS conditions has suffered due to a poor understanding of the underlying pathologies that manifest them. Understanding common etiological origins at the cellular and molecular level is essential to enhance the development of efficacious and targeted treatment options. Over the years, neuroinflammation has been posited as a common link between multiple neurological, neurodegenerative and neuropsychiatric disorders. Processes that precipitate neuroinflammatory conditions including genetics, infections, physical injury and psychosocial factors, like stress and trauma, closely link dysregulation in kynurenine pathway (KP) of tryptophan metabolism as a possible pathophysiological factor that 'fuel the fire' in CNS diseases. In this study, we aim to review emerging evidence that provide mechanistic insights between different CNS disorders, neuroinflammation and the KP. We provide a thorough overview of the different branches of the KP pertinent to CNS disease pathology that have therapeutic implications for the development of selected and efficacious treatment strategies.
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Affiliation(s)
- Mustafa N. Mithaiwala
- Integrated Biomedical Sciences Program, Graduate School of Biomedical Sciences, UT Health San Antonio, San Antonio, TX 78229, USA; (M.N.M.); (D.S.-C.); (G.A.P.)
- Department of Pharmacology, Long School of Medicine, UT Health San Antonio, Mail Code 8864, San Antonio, TX 78229, USA
| | - Danielle Santana-Coelho
- Integrated Biomedical Sciences Program, Graduate School of Biomedical Sciences, UT Health San Antonio, San Antonio, TX 78229, USA; (M.N.M.); (D.S.-C.); (G.A.P.)
- Department of Pharmacology, Long School of Medicine, UT Health San Antonio, Mail Code 8864, San Antonio, TX 78229, USA
| | - Grace A. Porter
- Integrated Biomedical Sciences Program, Graduate School of Biomedical Sciences, UT Health San Antonio, San Antonio, TX 78229, USA; (M.N.M.); (D.S.-C.); (G.A.P.)
- Department of Pharmacology, Long School of Medicine, UT Health San Antonio, Mail Code 8864, San Antonio, TX 78229, USA
| | - Jason C. O’Connor
- Integrated Biomedical Sciences Program, Graduate School of Biomedical Sciences, UT Health San Antonio, San Antonio, TX 78229, USA; (M.N.M.); (D.S.-C.); (G.A.P.)
- Department of Pharmacology, Long School of Medicine, UT Health San Antonio, Mail Code 8864, San Antonio, TX 78229, USA
- Department of Research, Audie L. Murphy VA Hospital, South Texas Veterans Heath System, San Antonio, TX 78229, USA
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12
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Fang C, Hayashi S, Du X, Cai X, Deng B, Zheng H, Ishido S, Tsutsui H, Sheng J. Caffeine protects against stress-induced murine depression through activation of PPARγC1α-mediated restoration of the kynurenine pathway in the skeletal muscle. Sci Rep 2021; 11:7287. [PMID: 33790369 PMCID: PMC8012704 DOI: 10.1038/s41598-021-86659-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 02/01/2021] [Indexed: 02/05/2023] Open
Abstract
Exercise prevents depression through peroxisome proliferator-activated receptor-gamma coactivator 1α (PGC-1α)-mediated activation of a particular branch of the kynurenine pathway. From kynurenine (KYN), two independent metabolic pathways produce neurofunctionally different metabolites, mainly in somatic organs: neurotoxic intermediate metabolites via main pathway and neuroprotective end product, kynurenic acid (KYNA) via the branch. Elevated levels of KYN have been found in patients with depression. Herein, we investigated whether and how caffeine prevents depression, focusing on the kynurenine pathway. Mice exposed to chronic mild stress (CMS) exhibited depressive-like behaviours with an increase and decrease in plasma levels of pro-neurotoxic KYN and neuroprotective KYNA, respectively. However, caffeine rescued CMS-exposed mice from depressive-like behaviours and restored the plasma levels of KYN and KYNA. Concomitantly, caffeine induced a key enzyme converting KYN into KYNA, namely kynurenine aminotransferase-1 (KAT1), in murine skeletal muscle. Upon caffeine stimulation murine myotubes exhibited KAT1 induction and its upstream PGC-1α sustainment. Furthermore, a proteasome inhibitor, but not translational inhibitor, impeded caffeine sustainment of PGC-1α, suggesting that caffeine induced KAT1 by inhibiting proteasomal degradation of PGC-1α. Thus, caffeine protection against CMS-induced depression may be associated with sustainment of PGC-1α levels and the resultant KAT1 induction in skeletal muscle, and thereby consumption of pro-neurotoxic KYN.
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Affiliation(s)
- Chongye Fang
- Yunnan Research Center for Advanced Tea Processing, College of Pu-erh Tea, Yunnan Agricultural University, Kunming, 650201, China
| | - Shuhei Hayashi
- Department of Microbiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Xiaocui Du
- Yunnan Research Center for Advanced Tea Processing, College of Pu-erh Tea, Yunnan Agricultural University, Kunming, 650201, China
| | - Xianbin Cai
- Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
- Department of Gastroenterology, First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Bin Deng
- Yunnan Rural Science and Technology Service Center, Kunming, Yunnan, China
| | - Hongmei Zheng
- Yunnan Rural Science and Technology Service Center, Kunming, Yunnan, China
| | - Satoshi Ishido
- Department of Microbiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Hiroko Tsutsui
- Department of Microbiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
| | - Jun Sheng
- Yunnan Research Center for Advanced Tea Processing, College of Pu-erh Tea, Yunnan Agricultural University, Kunming, 650201, China.
- Key Laboratory of Pu-erh Tea Science, The Ministry of Education, Yunnan Agricultural University, Kunming, 650201, China.
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13
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Suneson K, Lindahl J, Chamli Hårsmar S, Söderberg G, Lindqvist D. Inflammatory Depression-Mechanisms and Non-Pharmacological Interventions. Int J Mol Sci 2021; 22:1640. [PMID: 33561973 PMCID: PMC7915869 DOI: 10.3390/ijms22041640] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 02/08/2023] Open
Abstract
Treatment of depression is hampered by the failure to identify distinct symptom profiles with distinct pathophysiologies that differentially respond to distinct treatments. We posit that inflammatory depression is a meaningful depression subtype associated with specific symptoms and biological abnormalities. We review several upstream, potentially causative, mechanisms driving low-grade inflammation in this subtype of depression. We also discuss downstream mechanisms mediating the link between inflammation and symptoms of depression, including alterations in dopaminergic neurotransmission and tryptophan metabolism. Finally, we review evidence for several non-pharmacological interventions for inflammatory depression, including probiotics, omega-3 fatty acids, and physical exercise interventions. While some evidence suggests that these interventions may be efficacious in inflammatory depression, future clinical trials should consider enriching patient populations for inflammatory markers, or stratify patients by inflammatory status, to confirm or refute this hypothesis.
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Affiliation(s)
- Klara Suneson
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, 221 85 Lund, Sweden; (J.L.); (G.S.); (D.L.)
- Office for Psychiatry and Habilitation, Psychiatric Clinic Helsingborg, Region Skåne, 252 23 Helsingborg, Sweden
| | - Jesper Lindahl
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, 221 85 Lund, Sweden; (J.L.); (G.S.); (D.L.)
- Office for Psychiatry and Habilitation, Psychiatric Clinic Lund, Region Skåne, 221 85 Lund, Sweden;
| | - Simon Chamli Hårsmar
- Office for Psychiatry and Habilitation, Psychiatric Clinic Lund, Region Skåne, 221 85 Lund, Sweden;
| | - Gustav Söderberg
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, 221 85 Lund, Sweden; (J.L.); (G.S.); (D.L.)
| | - Daniel Lindqvist
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, 221 85 Lund, Sweden; (J.L.); (G.S.); (D.L.)
- Office for Psychiatry and Habilitation, Psychiatry Research Skåne, Region Skåne, 221 85 Lund, Sweden
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14
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Li P, Xu W, Liu F, Zhu H, Zhang L, Ding Z, Liang H, Song J. The emerging roles of IDO2 in cancer and its potential as a therapeutic target. Biomed Pharmacother 2021; 137:111295. [PMID: 33550042 DOI: 10.1016/j.biopha.2021.111295] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 01/10/2021] [Accepted: 01/18/2021] [Indexed: 01/03/2023] Open
Abstract
During the past decades, tryptophan metabolism disorder was discovered to play a vital and complex role in the development of cancer. Indoleamine 2,3-dioxygenase 2 (IDO2) is one of the initial and rate-limiting enzymes of the kynurenine pathway of tryptophan catabolism. Increasing evidence indicates that IDO2 is upregulated in some tumors and plays a role in the development of cancer. In spite of the growing body of research, few reviews focused on the role of IDO2 in cancer. Here, we review the emerging knowledge on the roles of IDO2 in cancer and its potential as a therapeutic target. Firstly, the main biological features and regulatory mechanisms are reviewed, after which we focus on the expression and roles of IDO2 in cancer. Finally, we discuss the potential of IDO2 as a therapeutic target for cancer treatment.
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Affiliation(s)
- Pengcheng Li
- Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weiqi Xu
- Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Furong Liu
- Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - He Zhu
- Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lu Zhang
- Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zeyang Ding
- Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Huifang Liang
- Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Jia Song
- Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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15
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Zhang P, Huang H, Gao X, Jiang J, Xi C, Wu L, Fu Y, Lai J, Hu S. Involvement of Kynurenine Metabolism in Bipolar Disorder: An Updated Review. Front Psychiatry 2021; 12:677039. [PMID: 34381386 PMCID: PMC8349985 DOI: 10.3389/fpsyt.2021.677039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 07/01/2021] [Indexed: 01/23/2023] Open
Abstract
Bipolar disorder (BD) is a severe affective disorder, mainly characterized by alternative depressive and manic or hypomanic episodes, yet the pathogenesis of BD has not been fully elucidated. Recent researches have implicated the altered kynurenine (KYN) metabolism involved in the neurobiology of BD. Excessive activation of the immune system also occurs in patients with BD, which further accelerates the KYN pathway for tryptophan metabolism. Changes of the KYN metabolites have effects on neuronal receptors and are involved in neuroendocrine transmissions. Interactions between KYN metabolism and the immune system may contribute to the neuropathogenesis of BD. Various studies have shown that alterations of the KYN metabolites were associated with mood, psychotic symptoms, and cognitive functions in patients with BD. In this review, we briefly introduce the KYN pathway and describe the immune dysregulation in BD as well as their interactions. We then focus on the research advances on the KYN metabolism in BD, which hold promise for identifying novel treatment targets in patients stricken with this disorder.
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Affiliation(s)
- Peifen Zhang
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | | | - Xingle Gao
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiajun Jiang
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Caixi Xi
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lingling Wu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yaoyang Fu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianbo Lai
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.,The Key Laboratory of Mental Disorder's Management in Zhejiang Province, Hangzhou, China.,Brain Research Institute of Zhejiang University, Hangzhou, China
| | - Shaohua Hu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.,The Key Laboratory of Mental Disorder's Management in Zhejiang Province, Hangzhou, China.,Brain Research Institute of Zhejiang University, Hangzhou, China
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16
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Evrensel A, Ünsalver BÖ, Ceylan ME, Tarhan N. Vaccination and Immunotherapy for Major Depression. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1305:503-513. [PMID: 33834415 DOI: 10.1007/978-981-33-6044-0_25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Depression is a very common disease with increasing incidence resulting from complex interactions of genetic, environmental, and immunological processes. To this day, the etiopathogenesis and treatment of depression unfortunately seem to be stuck in the synaptic gap. Despite highly potent antidepressants, the treatment rate cannot reach 100%, the treatment resistant group cannot be eliminated, and relapse cannot be prevented. These problems lead researchers to further and different research to understand and treat psychopathology. Immune dysfunction and neuroinflammation have been one of the main issues that psychiatry has focused on in recent years and helps us to understand depression. Extraneuronal components of all neuropsychiatric disorders, especially depression, have begun to be revealed in detail thanks to a better understanding of the immune system and an increase in experimental and technological possibilities. There is increasing evidence of a causal relationship between the etiopathogenesis of major depression and low-level chronic neuroinflammation. In this article, the role of neuroinflammation in the etiopathogenesis of depression and the possibilities of vaccination and immunotherapy are discussed.
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Affiliation(s)
- Alper Evrensel
- Department of Psychiatry, NP Brain Hospital, Saray Mah. Ahmet Tevfik İleri Cad. No: 18 PK:34768 Umraniye, Uskudar University, Istanbul, Turkey.
| | - Barış Önen Ünsalver
- Vocational School of Health Services, Department of Medical Documentation and Secretariat, Uskudar University, Istanbul, Turkey
| | - Mehmet Emin Ceylan
- Departments of Psychology and Philosophy, Uskudar University, Istanbul, Turkey
| | - Nevzat Tarhan
- Department of Psychiatry, Uskudar University, Istanbul, Turkey
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17
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Silva ACPE, Dos Santos MJ, Góes Gitaí DL, de Miranda Coelho JAP, de Andrade TG. Depression and anxiety symptoms correlate with diurnal preference, sleep habits, and Per3 VNTR polymorphism (rs57875989) in a non-clinical sample. J Affect Disord 2020; 277:260-270. [PMID: 32841827 DOI: 10.1016/j.jad.2020.07.138] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/29/2020] [Accepted: 07/31/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Evidences suggest that alterations in circadian rhythms trigger the development of mental disorders. Eveningness, sleep behavior, and circadian genes polymorphisms have been associated with depression and anxiety symptomatology. However, the mechanism underlying these interactions is not well understood. We investigated the contribution of diurnal preference, sleep habits, and PER3 VNTR polymorphism (rs57875989) to depression and anxiety symptoms in a Northeast sample from the Brazilian population. METHODS Eight hundred and four young adults completed the Morningness-Eveningness (MEQ), Munich Chronotype (MCTQ), Center for Epidemiologic Studies - Depression (CES-D), and Beck Anxiety Inventory (BAI) questionnaires. All participants were genotyped and linear regression was performed to test the interactions between the genetic /behavioral variants and depression/ anxiety symptoms. RESULTS Eveningness and sleep behaviors (bedtime, wake-up time, sleep duration, and midpoint of sleep) were correlated with depression symptomatology, specifically in somatic factors of the CES-D questionnaire. No correlation was found between diurnal preference/sleep habits with anxiety symptoms for both BAI total score and its factors. However, women with PER34/4 genotype showed less interpesonal affect in depression symptomatology and more anxiety symptoms in four factors of the BAI questionnaire. LIMITATIONS Mainly because this study was based on self-report questionnaires and was limited to undergraduate students aging 18 to 30 years old. CONCLUSION These results reinforce a role for sleep and diurnal preference in depression, and PER3 VNTR polymorphism in anxiety symptomatology, particularly in women.
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Affiliation(s)
| | | | | | | | - Tiago Gomes de Andrade
- Circadian Medicine Center, Faculty of Medicine, Federal University of Alagoas, Maceió, Brazil.
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18
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Biernacki T, Sandi D, Bencsik K, Vécsei L. Kynurenines in the Pathogenesis of Multiple Sclerosis: Therapeutic Perspectives. Cells 2020; 9:cells9061564. [PMID: 32604956 PMCID: PMC7349747 DOI: 10.3390/cells9061564] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 12/11/2022] Open
Abstract
Over the past years, an increasing amount of evidence has emerged in support of the kynurenine pathway’s (KP) pivotal role in the pathogenesis of several neurodegenerative, psychiatric, vascular and autoimmune diseases. Different neuroactive metabolites of the KP are known to exert opposite effects on neurons, some being neuroprotective (e.g., picolinic acid, kynurenic acid, and the cofactor nicotinamide adenine dinucleotide), while others are toxic to neurons (e.g., 3-hydroxykynurenine, quinolinic acid). Not only the alterations in the levels of the metabolites but also disturbances in their ratio (quinolinic acid/kynurenic acid) have been reported in several diseases. In addition to the metabolites, the enzymes participating in the KP have been unearthed to be involved in modulation of the immune system, the energetic upkeep of neurons and have been shown to influence redox processes and inflammatory cascades, revealing a sophisticated, intertwined system. This review considers various methods through which enzymes and metabolites of the kynurenine pathway influence the immune system, the roles they play in the pathogenesis of neuroinflammatory diseases based on current evidence with a focus on their involvement in multiple sclerosis, as well as therapeutic approaches.
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Affiliation(s)
- Tamás Biernacki
- Department of Neurology, Faculty of General Medicine, Albert Szent-Györgyi Clinical Centre, University of Szeged, H-6725 Szeged, Hungary; (T.B.); (D.S.); (K.B.)
| | - Dániel Sandi
- Department of Neurology, Faculty of General Medicine, Albert Szent-Györgyi Clinical Centre, University of Szeged, H-6725 Szeged, Hungary; (T.B.); (D.S.); (K.B.)
| | - Krisztina Bencsik
- Department of Neurology, Faculty of General Medicine, Albert Szent-Györgyi Clinical Centre, University of Szeged, H-6725 Szeged, Hungary; (T.B.); (D.S.); (K.B.)
| | - László Vécsei
- Department of Neurology, Faculty of General Medicine, Albert Szent-Györgyi Clinical Centre, University of Szeged, H-6725 Szeged, Hungary; (T.B.); (D.S.); (K.B.)
- MTA—SZTE Neuroscience Research Group, H-6725 Szeged, Hungary
- Interdisciplinary Excellence Center, University of Szeged, H-6720 Szeged, Hungary
- Correspondence: ; Tel.: +36-62-545-356; Fax: +36-62-545-597
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Tryptophan metabolism as a common therapeutic target in cancer, neurodegeneration and beyond. Nat Rev Drug Discov 2019; 18:379-401. [PMID: 30760888 DOI: 10.1038/s41573-019-0016-5] [Citation(s) in RCA: 848] [Impact Index Per Article: 169.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
L-Tryptophan (Trp) metabolism through the kynurenine pathway (KP) is involved in the regulation of immunity, neuronal function and intestinal homeostasis. Imbalances in Trp metabolism in disorders ranging from cancer to neurodegenerative disease have stimulated interest in therapeutically targeting the KP, particularly the main rate-limiting enzymes indoleamine-2,3-dioxygenase 1 (IDO1), IDO2 and tryptophan-2,3-dioxygenase (TDO) as well as kynurenine monooxygenase (KMO). However, although small-molecule IDO1 inhibitors showed promise in early-stage cancer immunotherapy clinical trials, a phase III trial was negative. This Review summarizes the physiological and pathophysiological roles of Trp metabolism, highlighting the vast opportunities and challenges for drug development in multiple diseases.
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Boros FA, Vécsei L. Immunomodulatory Effects of Genetic Alterations Affecting the Kynurenine Pathway. Front Immunol 2019; 10:2570. [PMID: 31781097 PMCID: PMC6851023 DOI: 10.3389/fimmu.2019.02570] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 10/16/2019] [Indexed: 12/15/2022] Open
Abstract
Several enzymes and metabolites of the kynurenine pathway (KP) have immunomodulatory effects. Modulation of the activities and levels of these molecules might be of particular importance under disease conditions when the amelioration of overreacting immune responses is desired. Results obtained by the use of animal and tissue culture models indicate that by eliminating or decreasing activities of key enzymes of the KP, a beneficial shift in disease outcome can be attained. This review summarizes experimental data of models in which IDO, TDO, or KMO activity modulation was achieved by interventions affecting enzyme production at a genomic level. Elimination of IDO activity was found to improve the outcome of sepsis, certain viral infections, chronic inflammation linked to diabetes, obesity, aorta aneurysm formation, and in anti-tumoral processes. Similarly, lack of TDO activity was advantageous in the case of anti-tumoral immunity, while KMO inhibition was found to be beneficial against microorganisms and in the combat against tumors, as well. On the other hand, the complex interplay among KP metabolites and immune function in some cases requires an increase in a particular enzyme activity for the desired immune response modulation, as was shown by the exacerbation of liver fibrosis due to the elimination of IDO activity and the detrimental effects of TDO inhibition in a mouse model of autoimmune gastritis. The relevance of these studies concerning possible human applications are discussed and highlighted. Finally, a brief overview is presented on naturally occurring genetic variants affecting immune functions via modulation of KP enzyme activity.
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Affiliation(s)
- Fanni A. Boros
- Department of Neurology, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - László Vécsei
- Department of Neurology, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
- MTA-SZTE Neuroscience Research Group of the Hungarian Academy of Sciences, University of Szeged, Szeged, Hungary
- Department of Neurology, Interdisciplinary Excellence Centre, University of Szeged, Szeged, Hungary
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Azevedo BP, Farias PCS, Pastor AF, Davi CCM, Neco HVPDC, Lima RED, Acioli-Santos B. AAIDO1Variant Genotype (G2431A, rs3739319) Is Associated with Severe Dengue Risk Development in a DEN-3 Brazilian Cohort. Viral Immunol 2019; 32:296-301. [DOI: 10.1089/vim.2018.0149] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
| | - Pablo Cantalice S. Farias
- Department of Virology, Aggeu Magalhães Institute, Oswaldo Cruz Foundation (FIOCRUZ). Recife/PE, Brazil
| | - André Filipe Pastor
- Institute of Education, Science, and Technology of Sertão Pernambucano (IFSertão-PE), Floresta, Pernambuco, Brazil
| | | | | | - Raul Emídio de Lima
- Department of Virology, Aggeu Magalhães Institute, Oswaldo Cruz Foundation (FIOCRUZ). Recife/PE, Brazil
| | - Bartolomeu Acioli-Santos
- Department of Virology, Aggeu Magalhães Institute, Oswaldo Cruz Foundation (FIOCRUZ). Recife/PE, Brazil
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The IDO genetic polymorphisms and postpartum depressive symptoms: an association study in Chinese parturients who underwent cesarean section. Arch Womens Ment Health 2019; 22:339-348. [PMID: 30121843 DOI: 10.1007/s00737-018-0898-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 07/29/2018] [Indexed: 10/28/2022]
Abstract
Postpartum depressive symptoms (PDS) are not an uncommon mood disorder in postpartum women. Our previous research indicated a role for increased tryptophan (TRP) metabolism along the kynurenine pathway (KP) in the pathogenesis of PDS. Accordingly, this study was going to investigate the association of indoleamine-2,3-dioxygenase (IDO, a key enzyme of KP) genetic polymorphisms with PDS. Seven hundred twenty-five women receiving cesarean section were enrolled in this study. PDS was determined by an Edinburgh Postnatal Depression Scale (EPDS) score ≥ 13. Subsequently, 48 parturients with PDS and 48 parturients without PDS were selected for investigation of perinatal serum concentrations of TRP, kynurenine (KYN), and KYN/TRP ratio, the latter is the representative of IDO activity. In addition, seven single nucleotide polymorphisms of the IDO gene were examined. Following this genotyping, 50 parturients carrying the IDO rs10108662 AA genotype and 50 parturients carrying the IDO rs10108662 AC + CC genotype were selected for comparisons of TRP, KYN, and KYN/TRP ratio levels. This study showed the PDS incidence of 6.9% in the Chinese population, with PDS characterized by increased IDO activity (p < 0.05), versus women without PDS. We also found that the variations of IDO1 gene rs10108662 were significantly related to PDS incidence (p < 0.05). Furthermore, there was a significant difference in IDO activity between the IDO rs10108662 CA + AA, versus CC, genotypes. Our findings indicate a role of the kynurenine pathway in the development of PDS, rs10108662 genetic polymorphism resulting in changes of IDO activity might contribute to PDS pathogenesis.
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Mondanelli G, Iacono A, Carvalho A, Orabona C, Volpi C, Pallotta MT, Matino D, Esposito S, Grohmann U. Amino acid metabolism as drug target in autoimmune diseases. Autoimmun Rev 2019; 18:334-348. [DOI: 10.1016/j.autrev.2019.02.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 10/30/2018] [Indexed: 12/14/2022]
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Boros FA, Klivényi P, Toldi J, Vécsei L. Indoleamine 2,3-dioxygenase as a novel therapeutic target for Huntington’s disease. Expert Opin Ther Targets 2018; 23:39-51. [DOI: 10.1080/14728222.2019.1549231] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Fanni A. Boros
- Department of Neurology, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Péter Klivényi
- Department of Neurology, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - József Toldi
- Department of Physiology, Anatomy and Neuroscience, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
- MTA-SZTE Neuroscience Research Group of the Hungarian Academy of Sciences and the University of Szeged, Szeged, Hungary
| | - László Vécsei
- Department of Neurology, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary
- MTA-SZTE Neuroscience Research Group of the Hungarian Academy of Sciences and the University of Szeged, Szeged, Hungary
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Correlations of indoleamine 2,3-dioxygenase, interferon-λ3, and anti-HBs antibodies in hemodialysis patients. Vaccine 2018; 36:4454-4461. [DOI: 10.1016/j.vaccine.2018.06.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 06/04/2018] [Accepted: 06/14/2018] [Indexed: 01/11/2023]
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26
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Orabona C, Mondanelli G, Pallotta MT, Carvalho A, Albini E, Fallarino F, Vacca C, Volpi C, Belladonna ML, Berioli MG, Ceccarini G, Esposito SM, Scattoni R, Verrotti A, Ferretti A, De Giorgi G, Toni S, Cappa M, Matteoli MC, Bianchi R, Matino D, Iacono A, Puccetti M, Cunha C, Bicciato S, Antognelli C, Talesa VN, Chatenoud L, Fuchs D, Pilotte L, Van den Eynde B, Lemos MC, Romani L, Puccetti P, Grohmann U. Deficiency of immunoregulatory indoleamine 2,3-dioxygenase 1in juvenile diabetes. JCI Insight 2018; 3:96244. [PMID: 29563329 DOI: 10.1172/jci.insight.96244] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 02/13/2018] [Indexed: 12/23/2022] Open
Abstract
A defect in indoleamine 2,3-dioxygenase 1 (IDO1), which is responsible for immunoregulatory tryptophan catabolism, impairs development of immune tolerance to autoantigens in NOD mice, a model for human autoimmune type 1 diabetes (T1D). Whether IDO1 function is also defective in T1D is still unknown. We investigated IDO1 function in sera and peripheral blood mononuclear cells (PBMCs) from children with T1D and matched controls. These children were further included in a discovery study to identify SNPs in IDO1 that might modify the risk of T1D. T1D in children was characterized by a remarkable defect in IDO1 function. A common haplotype, associated with dysfunctional IDO1, increased the risk of developing T1D in the discovery and also confirmation studies. In T1D patients sharing such a common IDO1 haplotype, incubation of PBMCs in vitro with tocilizumab (TCZ) - an IL-6 receptor blocker - would, however, rescue IDO1 activity. In an experimental setting with diabetic NOD mice, TCZ was found to restore normoglycemia via IDO1-dependent mechanisms. Thus, functional SNPs of IDO1 are associated with defective tryptophan catabolism in human T1D, and maneuvers aimed at restoring IDO1 function would be therapeutically effective in at least a subgroup of T1D pediatric patients.
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Affiliation(s)
- Ciriana Orabona
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Giada Mondanelli
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Maria T Pallotta
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Agostinho Carvalho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Elisa Albini
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | | | - Carmine Vacca
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Claudia Volpi
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Maria L Belladonna
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Maria G Berioli
- Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
| | - Giulia Ceccarini
- Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy.,Pediatric Clinic of S. Maria della Misericordia Hospital, Perugia, Italy
| | - Susanna Mr Esposito
- Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy.,Pediatric Clinic of S. Maria della Misericordia Hospital, Perugia, Italy
| | - Raffaella Scattoni
- Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy.,Pediatric Clinic of S. Maria della Misericordia Hospital, Perugia, Italy
| | - Alberto Verrotti
- Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy.,Pediatric Clinic of S. Maria della Misericordia Hospital, Perugia, Italy
| | | | - Giovanni De Giorgi
- Pediatric Clinic of S. Maria della Misericordia Hospital, Perugia, Italy
| | - Sonia Toni
- Juvenile Diabetes Center, Anna Meyer Children's Hospital, Florence, Italy
| | - Marco Cappa
- Unit of Endocrinology and Diabetes, 'Bambino Gesù' Children's Hospital, Rome, Italy
| | - Maria C Matteoli
- Unit of Endocrinology and Diabetes, 'Bambino Gesù' Children's Hospital, Rome, Italy
| | - Roberta Bianchi
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Davide Matino
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Alberta Iacono
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Matteo Puccetti
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Cristina Cunha
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Silvio Bicciato
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Cinzia Antognelli
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Vincenzo N Talesa
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Lucienne Chatenoud
- INSERM U1013, Hôpital Necker-Enfants Malades and Université Paris Descartes, Paris, France
| | - Dietmar Fuchs
- Division of Biological Chemistry, Biocenter, Medical University, Innsbruck, Austria
| | - Luc Pilotte
- Ludwig Institute for Cancer Research, Walloon Excellence in Life Sciences and Biotechnology and.,De Duve Institute, Université Catholique de Louvain, Brussels, Belgium
| | - Benoît Van den Eynde
- Ludwig Institute for Cancer Research, Walloon Excellence in Life Sciences and Biotechnology and.,De Duve Institute, Université Catholique de Louvain, Brussels, Belgium
| | - Manuel C Lemos
- CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Luigina Romani
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Paolo Puccetti
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Ursula Grohmann
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
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Boros FA, Bohár Z, Vécsei L. Genetic alterations affecting the genes encoding the enzymes of the kynurenine pathway and their association with human diseases. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2018; 776:32-45. [PMID: 29807576 DOI: 10.1016/j.mrrev.2018.03.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 03/12/2018] [Accepted: 03/13/2018] [Indexed: 01/15/2023]
Abstract
Tryptophan is metabolized primarily via the kynurenine pathway (KP), which involves several enzymes, including indoleamine 2,3-dioxygenase, tryptophan 2,3 dioxygenase (TDO), kynurenine aminotransferases (KATs), kynurenine monooxygenase (KMO) etc. The majority of metabolites are neuroactive: some of them, such as kynurenic acid, show neuroprotective effects, while others contribute to free radical production, leading to neurodegeneration. Imbalance of the pathway is assumed to contribute to the development of several neurodegenerative diseases, psychiatric disorders, migraine and multiple sclerosis. Our aim was to summarize published data on genetic alterations of enzymes involved in the KP leading to disturbances of the pathway that can be related to different diseases. To achieve this, a PubMed literature search was performed for publications on genetic alterations of the KP enzymes upto April 2017. Several genetic alterations of the KP have been identified and have been proposed to be associated with diseases. Here we must emphasize that despite the large number of recognized genetic alterations, the number of firmly established causal relations with specific diseases is still small. The realization of this by those interested in the field is very important and finding such connections should be a major focus of related research. Polymorphisms of the genes encoding the enzymes of the KP have been associated with autism, multiple sclerosis and schizophrenia, and were shown to affect the immune response of patients with bacterial meningitis, just to mention a few. To our knowledge, this is the first comprehensive review of the genetic alterations of the KP enzymes. We believe that the identification of genetic alterations underlying diseases has great value regarding both treatment and diagnostics in precision medicine, as this work can promote the understanding of pathological mechanisms, and might facilitate medicinal chemistry approaches to substitute missing components or correct the disturbed metabolite balance of KP.
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Affiliation(s)
- Fanni A Boros
- Department of Neurology, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Zsuzsanna Bohár
- Department of Neurology, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary; MTA-SZTE Neuroscience Research Group, Szeged, Hungary
| | - László Vécsei
- Department of Neurology, Albert Szent-Györgyi Clinical Center, Faculty of Medicine, University of Szeged, Szeged, Hungary; MTA-SZTE Neuroscience Research Group, Szeged, Hungary.
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28
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Regan T, Gill AC, Clohisey SM, Barnett MW, Pariante CM, Harrison NA, Hume DA, Bullmore ET, Freeman TC. Effects of anti-inflammatory drugs on the expression of tryptophan-metabolism genes by human macrophages. J Leukoc Biol 2018; 103:681-692. [PMID: 29377288 PMCID: PMC5918594 DOI: 10.1002/jlb.3a0617-261r] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 11/04/2017] [Accepted: 11/27/2017] [Indexed: 12/17/2022] Open
Abstract
Several lines of evidence link macrophage activation and inflammation with (monoaminergic) nervous systems in the etiology of depression. IFN treatment is associated with depressive symptoms, whereas anti‐TNFα therapies elicit positive mood. This study describes the actions of 2 monoaminergic antidepressants (escitalopram, nortriptyline) and 3 anti‐inflammatory drugs (indomethacin, prednisolone, and anti‐TNFα antibody) on the response of human monocyte‐derived macrophages (MDMs) from 6 individuals to LPS or IFN‐α. Expression profiling revealed robust changes in the MDM transcriptome (3294 genes at P < 0.001) following LPS challenge, whereas a more limited subset of genes (499) responded to IFNα. Contrary to published reports, administered at nontoxic doses, neither monoaminergic antidepressant significantly modulated the transcriptional response to either inflammatory challenge. Each anti‐inflammatory drug had a distinct impact on the expression of inflammatory cytokines and on the profile of inducible gene expression—notably on the regulation of enzymes involved in metabolism of tryptophan. Inter alia, the effect of anti‐TNFα antibody confirmed a predicted autocrine stimulatory loop in human macrophages. The transcriptional changes were predictive of tryptophan availability and kynurenine synthesis, as analyzed by targeted metabolomic studies on cellular supernatants. We suggest that inflammatory processes in the brain or periphery could impact on depression by altering the availability of tryptophan for serotonin synthesis and/or by increasing production of neurotoxic kynurenine.
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Affiliation(s)
- Tim Regan
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Edinburgh, Scotland, UK
| | - Andrew C Gill
- School of Chemistry, Joseph Banks Laboratories, University of Lincoln, Green Lane, Lincoln, Lincolnshire, UK
| | - Sara M Clohisey
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Edinburgh, Scotland, UK
| | - Mark W Barnett
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Edinburgh, Scotland, UK
| | - Carmine M Pariante
- Stress, Psychiatry and Immunology Department of Psychological Medicine, Institute of Psychiatry, Kings College London, London, UK
| | - Neil A Harrison
- Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | | | - David A Hume
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Edinburgh, Scotland, UK
| | - Edward T Bullmore
- Department of Psychiatry, University of Cambridge, Cambridge, UK.,Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK.,ImmunoPsychiatry, Immuno-Inflammation Therapeutic Area Unit, GlaxoSmithKline R&D, Stevenage, UK
| | - Tom C Freeman
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Edinburgh, Scotland, UK
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Smith R, Alkozei A, Killgore WDS, Lane RD. Nested positive feedback loops in the maintenance of major depression: An integration and extension of previous models. Brain Behav Immun 2018; 67:374-397. [PMID: 28943294 DOI: 10.1016/j.bbi.2017.09.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 09/18/2017] [Accepted: 09/19/2017] [Indexed: 12/15/2022] Open
Abstract
Several theories of Major Depressive Disorder (MDD) have previously been proposed, focusing largely on either a psychological (i.e., cognitive/affective), biological, or neural/computational level of description. These theories appeal to somewhat distinct bodies of work that have each highlighted separate factors as being of considerable potential importance to the maintenance of MDD. Such factors include a range of cognitive/attentional information-processing biases, a range of structural and functional brain abnormalities, and also dysregulation within the autonomic, endocrine, and immune systems. However, to date there have been limited efforts to integrate these complimentary perspectives into a single multi-level framework. Here we review previous work in each of these MDD research domains and illustrate how they can be synthesized into a more comprehensive model of how a depressive episode is maintained. In particular, we emphasize how plausible (but insufficiently studied) interactions between the various MDD-related factors listed above can lead to a series of nested positive feedback loops, which are each capable of maintaining an individual in a depressive episode. We also describe how these different feedback loops could be active to different degrees in different individual cases, potentially accounting for heterogeneity in both depressive symptoms and treatment response. We conclude by discussing how this integrative model might extend understanding of current treatment mechanisms, and also potentially guide the search for markers to inform treatment selection in individual cases.
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Affiliation(s)
- Ryan Smith
- Department of Psychiatry, University of Arizona, Tucson, AZ, USA.
| | - Anna Alkozei
- Department of Psychiatry, University of Arizona, Tucson, AZ, USA
| | | | - Richard D Lane
- Department of Psychiatry, University of Arizona, Tucson, AZ, USA
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30
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Huang X, Liu X, Yu Y. Depression and Chronic Liver Diseases: Are There Shared Underlying Mechanisms? Front Mol Neurosci 2017; 10:134. [PMID: 28533742 PMCID: PMC5420567 DOI: 10.3389/fnmol.2017.00134] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Accepted: 04/20/2017] [Indexed: 12/15/2022] Open
Abstract
The occurrence of depression is higher in patients with chronic liver disease (CLD) than that in the general population. The mechanism described in previous studies mainly focused on inflammation and stress, which not only exists in CLD, but also emerges in common chronic diseases, leaving the specific mechanism unknown. This review was to summarize the prevalence and risk factors of depression in CLD including chronic hepatitis B, chronic hepatitis, alcoholic liver disease, and non-alcoholic fatty liver disease, and to point out the possible underlying mechanism of this potential link. Clarifying the origins of this common comorbidity (depression and CLD) may provide more information to understand both diseases.
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Affiliation(s)
- Xiaoqin Huang
- Department of Psychiatry, The First Affiliated Hospital of Anhui Medical UniversityHefei, China
| | - Xiaoyun Liu
- Department of Psychiatry, The First Affiliated Hospital of Anhui Medical UniversityHefei, China
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical UniversityHefei, China
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31
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Chiu WC, Su YP, Su KP, Chen PC. Recurrence of depressive disorders after interferon-induced depression. Transl Psychiatry 2017; 7:e1026. [PMID: 28170005 PMCID: PMC5438022 DOI: 10.1038/tp.2016.274] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 10/31/2016] [Accepted: 11/28/2016] [Indexed: 01/14/2023] Open
Abstract
Interferon alpha (IFN-α)-treated patients commonly develop depression during the therapy period. Although most IFN-α-induced depressive disorders achieve remission after IFN-α therapy, no studies have examined the long-term mood effects of IFN-α treatment. We conducted a 12-year population-based cohort study of hepatitis C virus (HCV)-infected patients who were older than 20 years and had received IFN-α therapy. The sample was obtained from the Taiwan National Health Insurance Research Database. The cohort included patients with and without IFN-α-induced depression, matched randomly by age, sex and depression history, at a ratio of 1:10. The follow-up started after the last administration of IFN-α and was designed to determine the incidence of recurrent depressive disorder after IFN-α therapy. A total of 156 subjects were identified as having IFN-α-induced depression and achieving full remission after IFN-α therapy. The overall incidence of recurrent depressive disorders among patients with and without IFN-α-induced depression was 56.8 (95% confidence interval (CI), 42.4-76.1) and 4.1 (95% CI, 2.9-5.8) cases, respectively, per 100 000 person-years, P<0.001. The adjusted hazard ratios for recurrent depressive disorder were 13.5 (95% CI, 9.9-18.3) in the IFN-α-treated cohort and 22.2 (95% CI, 11.2-44.2) in the matched cohort for IFN-α-induced depression patients after adjusting for age, sex, income, urbanization and comorbid diseases. IFN-α-induced depression was associated with a high risk of recurrent depression. It was not a transient disease and might be considered an episode of depressive disorder. Continuation therapy might be considered, and further research is needed.
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Affiliation(s)
- W-C Chiu
- Department of Psychiatry, Cathay General Hospital, Taipei, Taiwan,School of Medicine, Fu Jen Catholic University, Taipei, Taiwan
| | - Y-P Su
- Department of Psychiatry, Cathay General Hospital, Taipei, Taiwan,School of Medicine, Fu Jen Catholic University, Taipei, Taiwan
| | - K-P Su
- Graduate Institute of Neural and Cognitive Sciences, China Medical University, Taichung, Taiwan,Department of Psychiatry and Mind-Body Interface Laboratory, China Medical University Hospital, Taichung, Taiwan
| | - P-C Chen
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan,Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan,Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan,Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, 17 Syujhou Road, Taipei 10055, Taiwan. E-mail:
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32
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Frydecka D, Pawłowski T, Pawlak D, Małyszczak K. Functional Polymorphism in the Interleukin 6 (IL6) Gene with Respect to Depression Induced in the Course of Interferon-α and Ribavirin Treatment in Chronic Hepatitis Patients. Arch Immunol Ther Exp (Warsz) 2017; 64:169-175. [PMID: 28083615 PMCID: PMC5334377 DOI: 10.1007/s00005-016-0441-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 11/18/2016] [Indexed: 12/30/2022]
Abstract
Interleukin (IL)-6 is a multifactorial cytokine known to be increased in patients with chronic hepatitis C (CHC) and to be predictive of depression incidence. The aim of the study was to explore the association between IL6 gene C-174G polymorphism and depressive symptom severity in the longitudinal study design following the course of pegylated interferon/ribavirin treatment in CHC patients. In our study, we included 62 CHC subjects. They were assessed using present state examination, Beck Depression Inventory (BDI) and Montgomery Åsberg Depression Rating Scale (MADRS) at weeks 0, 3, 5, 9, 13, 24 and 24 weeks after the end of treatment. The risk of depression was associated with higher baseline MADRS score and BDI score. Interestingly, when stratified by IL6 C-174G polymorphism, higher baseline depressive symptom severity measured by MADRS and BDI predicted higher risk of depression in the course of antiviral treatment only in high IL-6 producers-G allele carriers (patients with GG and CG genotypes) (p = 0.004, p = 0.00008, respectively). There is interaction between severity of baseline depressive symptoms at the beginning of antiviral therapy and IL6 gene C-174G polymorphism leading to increased risk for the development of depressive episode in CHC patients in the course of antiviral treatment.
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Affiliation(s)
- Dorota Frydecka
- Department and Clinic of Psychiatry, Wroclaw Medical University, Pasteura 10, 50-367, Wroclaw, Poland.
| | - Tomasz Pawłowski
- Department and Clinic of Psychiatry, Wroclaw Medical University, Pasteura 10, 50-367, Wroclaw, Poland
| | - Dariusz Pawlak
- Department of Pharmacodynamics, Medical University in Bialystok, Białystok, Poland
| | - Krzysztof Małyszczak
- Department and Clinic of Psychiatry, Wroclaw Medical University, Pasteura 10, 50-367, Wroclaw, Poland
- Division of Psychotherapy and Psychosomatic Medicine, Department and Clinic of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
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Strasser B, Becker K, Fuchs D, Gostner JM. Kynurenine pathway metabolism and immune activation: Peripheral measurements in psychiatric and co-morbid conditions. Neuropharmacology 2017; 112:286-296. [DOI: 10.1016/j.neuropharm.2016.02.030] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 02/17/2016] [Accepted: 02/23/2016] [Indexed: 12/14/2022]
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34
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Genetic Contributions of Inflammation to Depression. Neuropsychopharmacology 2017; 42:81-98. [PMID: 27555379 PMCID: PMC5143493 DOI: 10.1038/npp.2016.169] [Citation(s) in RCA: 164] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 08/04/2016] [Accepted: 08/08/2016] [Indexed: 01/05/2023]
Abstract
This paper describes the effects of immune genes genetic variants and mRNA expression on depression's risk, severity, and response to antidepressant treatment, through a systematic review on all papers published between 2000 and 2016. Our results, based largely on case-control studies, suggest that common genetic variants and gene-expression pathways are involved in both immune activation and depression. The most replicated and relevant genetic variants include polymorphisms in the genes for interleukin (IL)-1β, IL-6, IL-10, monocyte chemoattractant protein-1, tumor necrosis factor-alpha, C-reactive protein, and phospholipase A2. Moreover, increased blood cytokines mRNA expression (especially of IL-1β) identifies patients that are less likely to respond to conventional antidepressants. However, even for the most replicated findings there are inconsistent results, not only between studies, but also between the immune effects of the genetic variants and the resulting effects on depression. We find evidence that these discrepant findings may be explained, at least in part, by the heterogeneity of the depression immunophenotype, by environmental influences and gene × environment interactions, and by the complex interfacing of genetic variants with gene expression. Indeed, some of the most robust findings have been obtained in patients developing depression in the context of treatment with interferon-alpha, a widely used model to mimic depression in the context of inflammation. Further 'omics' approaches, through GWAS and transcriptomics, will finally shed light on the interaction between immune genes, their expression, and the influence of the environment, in the pathogenesis of depression.
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Sherchand S, Ibana JA, Quayle AJ, Aiyar A. Cell Intrinsic Factors Modulate the Effects of IFNγ on the Development of Chlamydia trachomatis. ACTA ACUST UNITED AC 2016; 7. [PMID: 27695641 DOI: 10.4172/2155-9597.1000282] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Chlamydia trachomatis is an obligate intracellular bacterial pathogen that cannot synthesize several amino acids, including tryptophan. Rather, C. trachomatis acquires these essential metabolites from its human host cell. Chlamydial dependence on host-provided tryptophan underlies a major host defense mechanism against the bacterium; namely, the induction of the host tryptophan-catabolizing enzyme, indoleamine 2,3- dioxygenase (IDO1) by interferon gamma (IFNγ), which leads to eradication of C. trachomatis by tryptophan starvation. For this reason, IFNγ is proposed to be the major host protective cytokine against genital C. trachomatis infections. The protective effect of IFNγ against C. trachomatis can be recapitulated in vitro using epithelial cell-lines such as the cervical carcinoma derived cell-line Hela, the Hela subclone HEp-2, and the cervical carcinoma derived cell-line ME180. Addition of IFNγ to these cells infected with C. trachomatis results in a strong bactericidal or bacteriostatic effect dependent on the concentration of IFNγ administered. Unlike Hela, HEp-2, and ME180, there are other human epithelial, or epithelial-like cell-lines where administration of IFNγ does not affect chlamydial replication, although they express the IFNγ receptor (IFNGR). In this report, we have characterized the mechanisms that underlie this dichotomy using the cell-lines C33A and 293. Akin to Hela, C33A is derived from a human cervical carcinoma, while 293 cells were produced by transfection of adenovirus type 5 DNA into embryonic kidney cells. We demonstrate that although IFNGR is expressed at high levels in C33A cells, its ligation by IFNγ does not result in STAT1 phosphorylation, an essential step for activation of the IDO1 promoter. Our results indicate that although the IFNγ-dependent signaling cascade is intact in 293 cells; the IDO1 promoter is not activated in these cells because it is epigenetically silenced, most likely by DNA methylation. Because polymorphisms in IFNγ, IFNGR, and the IDO1 promoter are known to affect other human infections or diseased states, our results indicate that the effect of allelic differences in these genes and the pathways they activate should be evaluated for their effect on C. trachomatis pathology.
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Affiliation(s)
- Shardulendra Sherchand
- Department of Microbiology, Immunology & Parasitology, LSU Health Sciences Center, New Orleans, LA, USA
| | - Joyce A Ibana
- Institute of Biology, University of the Philippines, Diliman, Quezon City, Philippines, USA
| | - Alison J Quayle
- Department of Microbiology, Immunology & Parasitology, LSU Health Sciences Center, New Orleans, LA, USA
| | - Ashok Aiyar
- Department of Microbiology, Immunology & Parasitology, LSU Health Sciences Center, New Orleans, LA, USA
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Yirmiya R, Rimmerman N, Reshef R. Depression as a microglial disease. Trends Neurosci 2016; 38:637-658. [PMID: 26442697 DOI: 10.1016/j.tins.2015.08.001] [Citation(s) in RCA: 598] [Impact Index Per Article: 74.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 08/10/2015] [Accepted: 08/11/2015] [Indexed: 12/12/2022]
Abstract
Despite decades of intensive research, the biological mechanisms that causally underlie depression are still unclear, and therefore the development of novel effective antidepressant treatments is hindered. Recent studies indicate that impairment of the normal structure and function of microglia, caused by either intense inflammatory activation (e.g., following infections, trauma, stroke, short-term stress, autoimmune or neurodegenerative diseases) or by decline and senescence of these cells (e.g., during aging, Alzheimer's disease, or chronic unpredictable stress exposure), can lead to depression and associated impairments in neuroplasticity and neurogenesis. Accordingly, some forms of depression can be considered as a microglial disease (microgliopathy), which should be treated by a personalized medical approach using microglial inhibitors or stimulators depending on the microglial status of the depressed patient.
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Affiliation(s)
- Raz Yirmiya
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem 91905, Israel.
| | - Neta Rimmerman
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem 91905, Israel
| | - Ronen Reshef
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem 91905, Israel
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Genetic variations in immunomodulatory pathways to predict survival in patients with locoregional gastric cancer. THE PHARMACOGENOMICS JOURNAL 2016; 17:528-534. [PMID: 27241062 DOI: 10.1038/tpj.2016.46] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 03/01/2016] [Accepted: 05/02/2016] [Indexed: 12/19/2022]
Abstract
Immunomodulator-targeting therapies are under development in gastric cancer (GC). However, the role of genes modulating anti-tumor immunity in GC remains poorly understood. We investigated the association of variations in genes involved in immunomodulatory pathways with overall survival (OS) in locoregional GC patients. Extracted genomic DNA was analyzed for 35 functional single-nucleotide polymorphisms in genes, PDCD1, CD274, CTLA4, FOXP3, LAG3, ADORA2A, NT5E and IDO1, in 162 Japanese patients as discovery set and 277 US patients as validation set. The C allele of PDCD1 rs10204525 had univariate and multivariable associations with shorter OS in Japanese cohort (P=0.015, P=0.043, respectively). In US cohort the C allele predicted worse OS (P=0.007). Univariate and multivariable analyses revealed IDO1 rs9657182 associated with OS in the Japanese cohort; moreover, the association was confirmed in the US cohort. Genetic predisposition of the host in the immunomodulators may serve as a prognostic biomarker in patients with locoregional GC.
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Interactions between inflammatory mediators and corticosteroids regulate transcription of genes within the Kynurenine Pathway in the mouse hippocampus. J Neuroinflammation 2016; 13:98. [PMID: 27142940 PMCID: PMC4855471 DOI: 10.1186/s12974-016-0563-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 04/26/2016] [Indexed: 11/24/2022] Open
Abstract
Background Increased tryptophan metabolism towards the production of kynurenine via indoleamine/tryptophan-2,3-dioxygenases (DOs: Ido1, Ido2, and Tdo2) is strongly associated with the prevalence of major depressive disorder in patients and the induction of depression-like behaviors in animal models. Several studies have suggested that activation of the immune system or elevated corticosteroids drive DO expression; however, mechanisms linking cytokines, corticosteroids, and DOs to psychiatric diseases remain unclear. Various attempts have been made to correlate DO gene expression within the brain to behavior, but disparate results have been obtained. We believe that discrepancies arise as a result of the under-recognized existence of multiple mRNA transcripts for each DO. Unfortunately, there are no reports regarding how the multiple transcripts are distributed or regulated. Here, we used organotypic hippocampal slice cultures (OHSCs) to directly test the ability of inflammatory and stress mediators to differentially regulate DO transcripts. Methods OHSCs were treated with pro-inflammatory mediators (interferon-gamma (IFNγ), lipopolysaccharide (LPS), and polyinosine-polycytidylic acid (pI:C)) with or without corticosteroids (dexamethasone (Dex: glucocorticoid receptor (GR) agonist), aldosterone (Aldo: mineralocorticoid receptor (MR) agonist), or corticosterone (Cort: GR/MR agonist)). Results IFNγ induced Ido1-full length (FL) and Ido1-variant (v) expression, and surprisingly, Dex, Cort, and Aldo interacted with IFNγ to further elevate expression of Ido1, importantly, in a transcript dependent manner. IFNγ, LPS, and pI:C increased expression of Ido2-v1 and Ido2-v3 transcripts, whereas only IFNγ increased expression of Ido2-v2. Overall Ido2 transcripts were relatively unaffected by GR or MR activation. Naïve mouse brain expresses multiple Tdo2 transcripts. Dex and Cort induced expression of only one of the three Tdo2 transcripts (Tdo2-FL) in OHSCs. Conclusions These results establish that multiple transcripts for all three DOs are expressed within the mouse hippocampus, under the control of distinct regulatory pathways. These data identify a previously unrecognized interaction between corticosteroid receptor activation and inflammatory signals on DO gene expression, which suggest that corticosteroids act to differentially enhance gene expression of Ido1, Ido2, and Tdo2.
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Udina M, Navinés R, Egmond E, Oriolo G, Langohr K, Gimenez D, Valdés M, Gómez-Gil E, Grande I, Gratacós M, Kapczinski F, Artigas F, Vieta E, Solà R, Martín-Santos R. Glucocorticoid Receptors, Brain-Derived Neurotrophic Factor, Serotonin and Dopamine Neurotransmission are Associated with Interferon-Induced Depression. Int J Neuropsychopharmacol 2016; 19:pyv135. [PMID: 26721949 PMCID: PMC4851270 DOI: 10.1093/ijnp/pyv135] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 11/24/2015] [Accepted: 12/11/2015] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The role of inflammation in mood disorders has received increased attention. There is substantial evidence that cytokine therapies, such as interferon alpha (IFN-alpha), can induce depressive symptoms. Indeed, proinflammatory cytokines change brain function in several ways, such as altering neurotransmitters, the glucocorticoid axis, and apoptotic mechanisms. This study aimed to evaluate the impact on mood of initiating IFN-alpha and ribavirin treatment in a cohort of patients with chronic hepatitis C. We investigated clinical, personality, and functional genetic variants associated with cytokine-induced depression. METHODS We recruited 344 Caucasian outpatients with chronic hepatitis C, initiating IFN-alpha and ribavirin therapy. All patients were euthymic at baseline according to DSM-IV-R criteria. Patients were assessed at baseline and 4, 12, 24, and 48 weeks after treatment initiation using the Patient Health Questionnaire (PHQ), the Hospital Anxiety and Depression Scale (HADS), and the Temperament and Character Inventory (TCI). We genotyped several functional polymorphisms of interleukin-28 (IL28B), indoleamine 2,3-dioxygenase (IDO-1), serotonin receptor-1A (HTR1A), catechol-O-methyl transferase (COMT), glucocorticoid receptors (GCR1 and GCR2), brain-derived neurotrophic factor (BDNF), and FK506 binding protein 5 (FKBP5) genes. A survival analysis was performed, and the Cox proportional hazards model was used for the multivariate analysis. RESULTS The cumulative incidence of depression was 0.35 at week 24 and 0.46 at week 48. The genotypic distributions were in Hardy-Weinberg equilibrium. Older age (p = 0.018, hazard ratio [HR] per 5 years = 1.21), presence of depression history (p = 0.0001, HR = 2.38), and subthreshold depressive symptoms at baseline (p = 0.005, HR = 1.13) increased the risk of IFN-induced depression. So too did TCI personality traits, with high scores on fatigability (p = 0.0037, HR = 1.17), impulsiveness (p = 0.0200 HR = 1.14), disorderliness (p = 0.0339, HR = 1.11), and low scores on extravagance (p = 0.0040, HR = 0.85). An interaction between HTR1A and COMT genes was found. Patients carrying the G allele of HTR1A plus the Met substitution of the COMT polymorphism had a greater risk for depression during antiviral treatment (HR = 3.83) than patients with the CC (HTR1A) and Met allele (COMT) genotypes. Patients carrying the HTR1A CC genotype and the COMT Val/Val genotype (HR = 3.25) had a higher risk of depression than patients with the G allele (HTR1A) and the Val/Val genotype. Moreover, functional variants of the GCR1 (GG genotype: p = 0.0436, HR = 1.88) and BDNF genes (Val/Val genotype: p = 0.0453, HR = 0.55) were associated with depression. CONCLUSIONS The results of the study support the theory that IFN-induced depression is associated with a complex pathophysiological background, including serotonergic and dopaminergic neurotransmission as well as glucocorticoid and neurotrophic factors. These findings may help to improve the management of patients on antiviral treatment and broaden our understanding of the pathogenesis of mood disorders.
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MESH Headings
- Adult
- Antiviral Agents/therapeutic use
- Brain-Derived Neurotrophic Factor/genetics
- Catechol O-Methyltransferase/genetics
- Depression/chemically induced
- Depression/epidemiology
- Depression/genetics
- Depression/immunology
- Female
- Genetic Predisposition to Disease
- Hepatitis C, Chronic/drug therapy
- Hepatitis C, Chronic/epidemiology
- Hepatitis C, Chronic/genetics
- Hepatitis C, Chronic/psychology
- Humans
- Incidence
- Indoleamine-Pyrrole 2,3,-Dioxygenase/genetics
- Interferon-alpha/adverse effects
- Interferon-alpha/therapeutic use
- Interferons
- Interleukins/genetics
- Male
- Middle Aged
- Polymorphism, Single Nucleotide
- Prospective Studies
- Receptor, Serotonin, 5-HT1A/genetics
- Receptors, Glucocorticoid/genetics
- Ribavirin/therapeutic use
- Tacrolimus Binding Proteins/genetics
- Treatment Outcome
- White People/genetics
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Affiliation(s)
- M Udina
- Department of Psychiatry, Hospital Clínic, Institut d'Investigacions Biomèdiques de Barcelona (IDIBAPS), Spain (Drs Udina, Navinés, Egmond, Oriolo, Valdés, Gómez-Gil, Grande, Vieta, and Martín-Santos); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain (Drs Navinés, Grande, Artigas, Vieta, and Martín-Santos); Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain (Drs Oriolo, Valdés, Vieta, and Martín-Santos); Liver Section, Parc de Salut Mar, UAB, Barcelona, Spain (Drs Navinés, Gimenez, and Solà); Department of Clinical and Health Psychology, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain (Egmond); Departament d'Estadística, Investigació Operativa, Universitat Politècnica de Catalunya and Research programme in Neurosciences, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain (Dr Langohr); Center of Genomic Regulation, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain (Dr Gratacós); National Institute for Translational Medicine, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (Dr Kapczinski); Department of Neurochemistry and Neuropharmacology, Institute d'Investigacions Biomèdiques de Barcelona (IBB-CSIC-IDIBAPS), Spain (Dr Artigas)
| | - R Navinés
- Department of Psychiatry, Hospital Clínic, Institut d'Investigacions Biomèdiques de Barcelona (IDIBAPS), Spain (Drs Udina, Navinés, Egmond, Oriolo, Valdés, Gómez-Gil, Grande, Vieta, and Martín-Santos); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain (Drs Navinés, Grande, Artigas, Vieta, and Martín-Santos); Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain (Drs Oriolo, Valdés, Vieta, and Martín-Santos); Liver Section, Parc de Salut Mar, UAB, Barcelona, Spain (Drs Navinés, Gimenez, and Solà); Department of Clinical and Health Psychology, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain (Egmond); Departament d'Estadística, Investigació Operativa, Universitat Politècnica de Catalunya and Research programme in Neurosciences, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain (Dr Langohr); Center of Genomic Regulation, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain (Dr Gratacós); National Institute for Translational Medicine, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (Dr Kapczinski); Department of Neurochemistry and Neuropharmacology, Institute d'Investigacions Biomèdiques de Barcelona (IBB-CSIC-IDIBAPS), Spain (Dr Artigas)
| | - E Egmond
- Department of Psychiatry, Hospital Clínic, Institut d'Investigacions Biomèdiques de Barcelona (IDIBAPS), Spain (Drs Udina, Navinés, Egmond, Oriolo, Valdés, Gómez-Gil, Grande, Vieta, and Martín-Santos); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain (Drs Navinés, Grande, Artigas, Vieta, and Martín-Santos); Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain (Drs Oriolo, Valdés, Vieta, and Martín-Santos); Liver Section, Parc de Salut Mar, UAB, Barcelona, Spain (Drs Navinés, Gimenez, and Solà); Department of Clinical and Health Psychology, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain (Egmond); Departament d'Estadística, Investigació Operativa, Universitat Politècnica de Catalunya and Research programme in Neurosciences, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain (Dr Langohr); Center of Genomic Regulation, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain (Dr Gratacós); National Institute for Translational Medicine, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (Dr Kapczinski); Department of Neurochemistry and Neuropharmacology, Institute d'Investigacions Biomèdiques de Barcelona (IBB-CSIC-IDIBAPS), Spain (Dr Artigas)
| | - G Oriolo
- Department of Psychiatry, Hospital Clínic, Institut d'Investigacions Biomèdiques de Barcelona (IDIBAPS), Spain (Drs Udina, Navinés, Egmond, Oriolo, Valdés, Gómez-Gil, Grande, Vieta, and Martín-Santos); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain (Drs Navinés, Grande, Artigas, Vieta, and Martín-Santos); Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain (Drs Oriolo, Valdés, Vieta, and Martín-Santos); Liver Section, Parc de Salut Mar, UAB, Barcelona, Spain (Drs Navinés, Gimenez, and Solà); Department of Clinical and Health Psychology, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain (Egmond); Departament d'Estadística, Investigació Operativa, Universitat Politècnica de Catalunya and Research programme in Neurosciences, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain (Dr Langohr); Center of Genomic Regulation, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain (Dr Gratacós); National Institute for Translational Medicine, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (Dr Kapczinski); Department of Neurochemistry and Neuropharmacology, Institute d'Investigacions Biomèdiques de Barcelona (IBB-CSIC-IDIBAPS), Spain (Dr Artigas)
| | - K Langohr
- Department of Psychiatry, Hospital Clínic, Institut d'Investigacions Biomèdiques de Barcelona (IDIBAPS), Spain (Drs Udina, Navinés, Egmond, Oriolo, Valdés, Gómez-Gil, Grande, Vieta, and Martín-Santos); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain (Drs Navinés, Grande, Artigas, Vieta, and Martín-Santos); Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain (Drs Oriolo, Valdés, Vieta, and Martín-Santos); Liver Section, Parc de Salut Mar, UAB, Barcelona, Spain (Drs Navinés, Gimenez, and Solà); Department of Clinical and Health Psychology, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain (Egmond); Departament d'Estadística, Investigació Operativa, Universitat Politècnica de Catalunya and Research programme in Neurosciences, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain (Dr Langohr); Center of Genomic Regulation, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain (Dr Gratacós); National Institute for Translational Medicine, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (Dr Kapczinski); Department of Neurochemistry and Neuropharmacology, Institute d'Investigacions Biomèdiques de Barcelona (IBB-CSIC-IDIBAPS), Spain (Dr Artigas)
| | - D Gimenez
- Department of Psychiatry, Hospital Clínic, Institut d'Investigacions Biomèdiques de Barcelona (IDIBAPS), Spain (Drs Udina, Navinés, Egmond, Oriolo, Valdés, Gómez-Gil, Grande, Vieta, and Martín-Santos); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain (Drs Navinés, Grande, Artigas, Vieta, and Martín-Santos); Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain (Drs Oriolo, Valdés, Vieta, and Martín-Santos); Liver Section, Parc de Salut Mar, UAB, Barcelona, Spain (Drs Navinés, Gimenez, and Solà); Department of Clinical and Health Psychology, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain (Egmond); Departament d'Estadística, Investigació Operativa, Universitat Politècnica de Catalunya and Research programme in Neurosciences, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain (Dr Langohr); Center of Genomic Regulation, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain (Dr Gratacós); National Institute for Translational Medicine, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (Dr Kapczinski); Department of Neurochemistry and Neuropharmacology, Institute d'Investigacions Biomèdiques de Barcelona (IBB-CSIC-IDIBAPS), Spain (Dr Artigas)
| | - M Valdés
- Department of Psychiatry, Hospital Clínic, Institut d'Investigacions Biomèdiques de Barcelona (IDIBAPS), Spain (Drs Udina, Navinés, Egmond, Oriolo, Valdés, Gómez-Gil, Grande, Vieta, and Martín-Santos); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain (Drs Navinés, Grande, Artigas, Vieta, and Martín-Santos); Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain (Drs Oriolo, Valdés, Vieta, and Martín-Santos); Liver Section, Parc de Salut Mar, UAB, Barcelona, Spain (Drs Navinés, Gimenez, and Solà); Department of Clinical and Health Psychology, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain (Egmond); Departament d'Estadística, Investigació Operativa, Universitat Politècnica de Catalunya and Research programme in Neurosciences, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain (Dr Langohr); Center of Genomic Regulation, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain (Dr Gratacós); National Institute for Translational Medicine, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (Dr Kapczinski); Department of Neurochemistry and Neuropharmacology, Institute d'Investigacions Biomèdiques de Barcelona (IBB-CSIC-IDIBAPS), Spain (Dr Artigas)
| | - E Gómez-Gil
- Department of Psychiatry, Hospital Clínic, Institut d'Investigacions Biomèdiques de Barcelona (IDIBAPS), Spain (Drs Udina, Navinés, Egmond, Oriolo, Valdés, Gómez-Gil, Grande, Vieta, and Martín-Santos); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain (Drs Navinés, Grande, Artigas, Vieta, and Martín-Santos); Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain (Drs Oriolo, Valdés, Vieta, and Martín-Santos); Liver Section, Parc de Salut Mar, UAB, Barcelona, Spain (Drs Navinés, Gimenez, and Solà); Department of Clinical and Health Psychology, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain (Egmond); Departament d'Estadística, Investigació Operativa, Universitat Politècnica de Catalunya and Research programme in Neurosciences, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain (Dr Langohr); Center of Genomic Regulation, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain (Dr Gratacós); National Institute for Translational Medicine, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (Dr Kapczinski); Department of Neurochemistry and Neuropharmacology, Institute d'Investigacions Biomèdiques de Barcelona (IBB-CSIC-IDIBAPS), Spain (Dr Artigas)
| | - I Grande
- Department of Psychiatry, Hospital Clínic, Institut d'Investigacions Biomèdiques de Barcelona (IDIBAPS), Spain (Drs Udina, Navinés, Egmond, Oriolo, Valdés, Gómez-Gil, Grande, Vieta, and Martín-Santos); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain (Drs Navinés, Grande, Artigas, Vieta, and Martín-Santos); Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain (Drs Oriolo, Valdés, Vieta, and Martín-Santos); Liver Section, Parc de Salut Mar, UAB, Barcelona, Spain (Drs Navinés, Gimenez, and Solà); Department of Clinical and Health Psychology, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain (Egmond); Departament d'Estadística, Investigació Operativa, Universitat Politècnica de Catalunya and Research programme in Neurosciences, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain (Dr Langohr); Center of Genomic Regulation, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain (Dr Gratacós); National Institute for Translational Medicine, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (Dr Kapczinski); Department of Neurochemistry and Neuropharmacology, Institute d'Investigacions Biomèdiques de Barcelona (IBB-CSIC-IDIBAPS), Spain (Dr Artigas)
| | - M Gratacós
- Department of Psychiatry, Hospital Clínic, Institut d'Investigacions Biomèdiques de Barcelona (IDIBAPS), Spain (Drs Udina, Navinés, Egmond, Oriolo, Valdés, Gómez-Gil, Grande, Vieta, and Martín-Santos); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain (Drs Navinés, Grande, Artigas, Vieta, and Martín-Santos); Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain (Drs Oriolo, Valdés, Vieta, and Martín-Santos); Liver Section, Parc de Salut Mar, UAB, Barcelona, Spain (Drs Navinés, Gimenez, and Solà); Department of Clinical and Health Psychology, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain (Egmond); Departament d'Estadística, Investigació Operativa, Universitat Politècnica de Catalunya and Research programme in Neurosciences, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain (Dr Langohr); Center of Genomic Regulation, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain (Dr Gratacós); National Institute for Translational Medicine, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (Dr Kapczinski); Department of Neurochemistry and Neuropharmacology, Institute d'Investigacions Biomèdiques de Barcelona (IBB-CSIC-IDIBAPS), Spain (Dr Artigas)
| | - F Kapczinski
- Department of Psychiatry, Hospital Clínic, Institut d'Investigacions Biomèdiques de Barcelona (IDIBAPS), Spain (Drs Udina, Navinés, Egmond, Oriolo, Valdés, Gómez-Gil, Grande, Vieta, and Martín-Santos); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain (Drs Navinés, Grande, Artigas, Vieta, and Martín-Santos); Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain (Drs Oriolo, Valdés, Vieta, and Martín-Santos); Liver Section, Parc de Salut Mar, UAB, Barcelona, Spain (Drs Navinés, Gimenez, and Solà); Department of Clinical and Health Psychology, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain (Egmond); Departament d'Estadística, Investigació Operativa, Universitat Politècnica de Catalunya and Research programme in Neurosciences, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain (Dr Langohr); Center of Genomic Regulation, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain (Dr Gratacós); National Institute for Translational Medicine, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (Dr Kapczinski); Department of Neurochemistry and Neuropharmacology, Institute d'Investigacions Biomèdiques de Barcelona (IBB-CSIC-IDIBAPS), Spain (Dr Artigas)
| | - F Artigas
- Department of Psychiatry, Hospital Clínic, Institut d'Investigacions Biomèdiques de Barcelona (IDIBAPS), Spain (Drs Udina, Navinés, Egmond, Oriolo, Valdés, Gómez-Gil, Grande, Vieta, and Martín-Santos); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain (Drs Navinés, Grande, Artigas, Vieta, and Martín-Santos); Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain (Drs Oriolo, Valdés, Vieta, and Martín-Santos); Liver Section, Parc de Salut Mar, UAB, Barcelona, Spain (Drs Navinés, Gimenez, and Solà); Department of Clinical and Health Psychology, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain (Egmond); Departament d'Estadística, Investigació Operativa, Universitat Politècnica de Catalunya and Research programme in Neurosciences, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain (Dr Langohr); Center of Genomic Regulation, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain (Dr Gratacós); National Institute for Translational Medicine, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (Dr Kapczinski); Department of Neurochemistry and Neuropharmacology, Institute d'Investigacions Biomèdiques de Barcelona (IBB-CSIC-IDIBAPS), Spain (Dr Artigas)
| | - E Vieta
- Department of Psychiatry, Hospital Clínic, Institut d'Investigacions Biomèdiques de Barcelona (IDIBAPS), Spain (Drs Udina, Navinés, Egmond, Oriolo, Valdés, Gómez-Gil, Grande, Vieta, and Martín-Santos); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain (Drs Navinés, Grande, Artigas, Vieta, and Martín-Santos); Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain (Drs Oriolo, Valdés, Vieta, and Martín-Santos); Liver Section, Parc de Salut Mar, UAB, Barcelona, Spain (Drs Navinés, Gimenez, and Solà); Department of Clinical and Health Psychology, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain (Egmond); Departament d'Estadística, Investigació Operativa, Universitat Politècnica de Catalunya and Research programme in Neurosciences, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain (Dr Langohr); Center of Genomic Regulation, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain (Dr Gratacós); National Institute for Translational Medicine, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (Dr Kapczinski); Department of Neurochemistry and Neuropharmacology, Institute d'Investigacions Biomèdiques de Barcelona (IBB-CSIC-IDIBAPS), Spain (Dr Artigas)
| | - R Solà
- Department of Psychiatry, Hospital Clínic, Institut d'Investigacions Biomèdiques de Barcelona (IDIBAPS), Spain (Drs Udina, Navinés, Egmond, Oriolo, Valdés, Gómez-Gil, Grande, Vieta, and Martín-Santos); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain (Drs Navinés, Grande, Artigas, Vieta, and Martín-Santos); Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain (Drs Oriolo, Valdés, Vieta, and Martín-Santos); Liver Section, Parc de Salut Mar, UAB, Barcelona, Spain (Drs Navinés, Gimenez, and Solà); Department of Clinical and Health Psychology, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain (Egmond); Departament d'Estadística, Investigació Operativa, Universitat Politècnica de Catalunya and Research programme in Neurosciences, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain (Dr Langohr); Center of Genomic Regulation, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain (Dr Gratacós); National Institute for Translational Medicine, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (Dr Kapczinski); Department of Neurochemistry and Neuropharmacology, Institute d'Investigacions Biomèdiques de Barcelona (IBB-CSIC-IDIBAPS), Spain (Dr Artigas)
| | - R Martín-Santos
- Department of Psychiatry, Hospital Clínic, Institut d'Investigacions Biomèdiques de Barcelona (IDIBAPS), Spain (Drs Udina, Navinés, Egmond, Oriolo, Valdés, Gómez-Gil, Grande, Vieta, and Martín-Santos); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain (Drs Navinés, Grande, Artigas, Vieta, and Martín-Santos); Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain (Drs Oriolo, Valdés, Vieta, and Martín-Santos); Liver Section, Parc de Salut Mar, UAB, Barcelona, Spain (Drs Navinés, Gimenez, and Solà); Department of Clinical and Health Psychology, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain (Egmond); Departament d'Estadística, Investigació Operativa, Universitat Politècnica de Catalunya and Research programme in Neurosciences, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain (Dr Langohr); Center of Genomic Regulation, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain (Dr Gratacós); National Institute for Translational Medicine, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (Dr Kapczinski); Department of Neurochemistry and Neuropharmacology, Institute d'Investigacions Biomèdiques de Barcelona (IBB-CSIC-IDIBAPS), Spain (Dr Artigas)
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Probable involvement of p11 with interferon alpha induced depression. Sci Rep 2016; 6:17029. [PMID: 26821757 PMCID: PMC4731785 DOI: 10.1038/srep17029] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 10/23/2015] [Indexed: 12/16/2022] Open
Abstract
Depression is one of the major side effects of interferon alpha (IFN-α) treatment, but the molecular mechanism underlying IFN-α-induced depression remains unclear. Several studies have shown that the serotonin receptors 5-HTR1b and 5-HTR4 play key roles in the anti-depression effects associated with p11 (S100A10). We investigated the effects of IFN-α on the regulation of p11, 5-HTR1b and 5-HTR4 in mice and human neuroblastoma cells (SH-sy5y). We found that intraperitoneal injection with IFN-α in Balb/c mice resulted in an increased immobility in FST and TST, and potently lowered the protein levels of p11, 5-HTR1b and 5-HTR4 in the hippocampus or cingulate gyrus. IFN-α significantly down-regulated the protein levels of p11, 5-HTR1b and 5-HTR4 in SH-sy5y cells, in a time- and dose-dependent manner. Our study revealed that over-expression of p11 could prevent the IFN-α-induced down-regulation of 5-HTR1b and 5-HTR4. The results indicated that IFN-α treatment resulted in p11 down-regulation, which subsequently decreased 5-HTR1b and 5-HTR4 in vitro or in vivo. Our findings suggested that p11 might be a potential regulator on 5-HTR1b and 5-HTR4 as well as a predictor of or a therapeutic target for IFN-α-induced depression.
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Sickness: From the focus on cytokines, prostaglandins, and complement factors to the perspectives of neurons. Neurosci Biobehav Rev 2015; 57:30-45. [PMID: 26363665 DOI: 10.1016/j.neubiorev.2015.07.015] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 07/06/2015] [Accepted: 07/31/2015] [Indexed: 12/29/2022]
Abstract
Systemic inflammation leads to a variety of physiological (e.g. fever) and behavioral (e.g. anorexia, immobility, social withdrawal, depressed mood, disturbed sleep) responses that are collectively known as sickness. While these phenomena have been studied for the past few decades, the neurobiological mechanisms by which sickness occurs remain unclear. In this review, we first revisit how the body senses and responds to infections and injuries by eliciting systemic inflammation. Next, we focus on how peripheral inflammatory molecules such as cytokines, prostaglandins, and activated complement factors communicate with the brain to trigger neuroinflammation and sickness. Since depression also involves inflammation, we further elaborate on the interrelationship between sickness and depression. Finally, we discuss how immune activation can modulate neurons in the brain, and suggest future perspectives to help unravel how changes in neuronal functions relate to sickness responses.
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Vollmer-Conna U, Cvejic E, Granville Smith I, Hadzi-Pavlovic D, Parker G. Characterising acute coronary syndrome-associated depression: Let the data speak. Brain Behav Immun 2015; 48:19-28. [PMID: 25770081 DOI: 10.1016/j.bbi.2015.03.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 02/24/2015] [Accepted: 03/02/2015] [Indexed: 12/12/2022] Open
Abstract
Depression in the context of acute coronary syndrome (ACS) is understood to confer increased morbidity and mortality risk. The pathophysiological mechanisms underlying this association remain poorly understood, although several candidates including inflammation, cardiac autonomic dysregulation, and behavioural factors are viewed as of key importance. No single bio-behavioural explanatory model of ACS-associated depression has emerged, likely due the substantial heterogeneity across both conditions. We studied 344 patients with ACS; 45 fulfilled diagnostic (DSM-IV) criteria for a major depressive episode occurring within 1-month of ACS, and 13 had ongoing major depression that pre-dated ACS and continued through to 1 month post-ACS. We employed two statistical methods (multinomial logistic regression; and latent class analysis) and a range of immunological, autonomic and nutritional markers in an attempt to characterise a biological basis for ACS-associated depression. Regression modelling failed to accurately predict categorical group membership of ACS-associated depression. An alternative data-driven approach produced a three-class solution, with the derived classes differing on measure of C-reactive protein, vitamin D, omega-6:omega-3 ratio, heart rate variability, and age (all p⩽0.004). The majority of participants with ACS-associated and ongoing depression were members of the class characterised by the greatest biological disturbance. Patients with depression differed from those without depression on a range of psychological trait and state variables; additionally reporting poorer sleep quality, higher levels of social isolation, and functional impairment, but had similar biological profiles. Patients with ongoing depression generally had higher scores on these psychological/behavioural measures. Our novel analytic approach identified a combination of biomarkers suggestive of a role for immune, autonomic, and nutritional pathways in the manifestation of depression during ACS, in the context of additional psychosocial and behavioural vulnerabilities. Further studies are required to confirm the causal role of these factors in perpetuating depression and increasing risk of poor-health outcomes.
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Affiliation(s)
| | - Erin Cvejic
- School of Psychiatry, University of New South Wales, Australia
| | | | | | - Gordon Parker
- School of Psychiatry, University of New South Wales, Australia
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Loftis JM, Janowsky A. Neuroimmune basis of methamphetamine toxicity. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2015; 118:165-97. [PMID: 25175865 DOI: 10.1016/b978-0-12-801284-0.00007-5] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Although it is not known which antigen-specific immune responses (or if antigen-specific immune responses) are relevant or required for methamphetamine's neurotoxic effects, it is apparent that methamphetamine exposure is associated with significant effects on adaptive and innate immunity. Alterations in lymphocyte activity and number, changes in cytokine signaling, impairments in phagocytic functions, and glial activation and gliosis have all been reported. These drug-induced changes in immune response, particularly within the CNS, are now thought to play a critical role in the addiction process for methamphetamine dependence as well as for other substance use disorders. In Section 2, methamphetamine's effects on glial cell (e.g., microglia and astrocytes) activity and inflammatory signaling cascades are summarized, including how alterations in immune cell function can induce the neurotoxic and addictive effects of methamphetamine. Section 2 also describes neurotransmitter involvement in the modulation of methamphetamine's inflammatory effects. Section 3 discusses the very recent use of pharmacological and genetic animal models which have helped elucidate the behavioral effects of methamphetamine's neurotoxic effects and the role of the immune system. Section 4 is focused on the effects of methamphetamine on blood-brain barrier integrity and associated immune consequences. Clinical considerations such as the combined effects of methamphetamine and HIV and/or HCV on brain structure and function are included in Section 4. Finally, in Section 5, immune-based treatment strategies are reviewed, with a focus on vaccine development, neuroimmune therapies, and other anti-inflammatory approaches.
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Affiliation(s)
- Jennifer M Loftis
- Research & Development Service, Portland VA Medical Center, Portland, Oregon, USA; Department of Psychiatry, Oregon Health & Science University, School of Medicine, Portland, Oregon, USA; Methamphetamine Abuse Research Center, Oregon Health & Science University, Portland, Oregon, USA.
| | - Aaron Janowsky
- Research & Development Service, Portland VA Medical Center, Portland, Oregon, USA; Department of Psychiatry, Oregon Health & Science University, School of Medicine, Portland, Oregon, USA; Methamphetamine Abuse Research Center, Oregon Health & Science University, Portland, Oregon, USA; Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, Oregon, USA
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Variations in genes involved in immune response checkpoints and association with outcomes in patients with resected colorectal liver metastases. THE PHARMACOGENOMICS JOURNAL 2015; 15:521-9. [PMID: 25752522 DOI: 10.1038/tpj.2015.14] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 12/05/2014] [Accepted: 01/28/2015] [Indexed: 01/10/2023]
Abstract
In patients with colorectal liver metastases (CLM), liver resection offers the possibility of cure and long-term survival. The liver is a highly immunogenic organ harboring ~80% of the body's tissue macrophages. Emerging data demonstrate a critical role of the immune response for cancer treatment. We investigated variations within genes involved in immune response checkpoints and their association with outcomes in patients with CLM who underwent neoadjuvant chemotherapy including bevacizumab and liver resection. Single-nucleotide polymorphisms (SNPs) in nine genes (CCL2, CCR2, LAG3, NT5E, PDCD1, CD274, IDO1, CTLA4 and CD24) were analyzed in genomic DNA from 149 patients with resected bevacizumab-pretreated CLM by direct Sanger DNA sequencing, and correlated with response, recurrence-free survival (RFS), overall survival (OS), probability of cure and recurrence patterns. IDO1 (indoleamine 2, 3-dioxygenase) rs3739319 G>A and CD24 rs8734 G>A showed a significant difference in 3-year OS rates. In addition, IDO1 rs3739319 G>A was significantly associated with extrahepatic recurrence. Recursive partitioning analyses revealed that IDO1 rs3739319 G>A was the dominant SNP predicting RFS and OS. Our data suggest that variants within genes involved in immune response checkpoints are associated with outcomes in patients with resected CLM and might lead to improved treatment strategies modulating anti-tumor immune response by targeting novel immune checkpoints.
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Fonseka TM, McIntyre RS, Soczynska JK, Kennedy SH. Novel investigational drugs targeting IL-6 signaling for the treatment of depression. Expert Opin Investig Drugs 2015; 24:459-75. [PMID: 25585966 DOI: 10.1517/13543784.2014.998334] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Elevated levels of IL-6 have been implicated in the pathophysiology and treatment of major depressive disorder (MDD). Convergent evidence suggests that IL-6 primarily mediates proinflammatory functions via the soluble IL-6 receptor/trans-signaling, and anti-inflammatory functions via a transmembrane receptor (IL-6R). A targeted approach to selectively inhibit IL-6 trans-signaling may offer putative antidepressant effects. AREAS COVERED This review addresses three primary domains. The first focuses on the biological role of IL-6 within inflammation and its signal transduction pathways. The second addresses the potential contributions of IL-6 to the pathophysiology of MDD, and the mechanisms that may mediate these effects. Finally, the article outlines the therapeutic benefits of incorporating anti-inflammatory properties into the pharmacological treatment of MDD, and proposes inhibition of IL-6 signaling as a viable treatment strategy. EXPERT OPINION To improve drug development for the treatment of MDD, there is a critical need to identify promising targets. Target identification will require guidance from a strategic framework such as The Research Domain Criteria, and convincing evidence relating known targets to brain function under both physiological and pathological conditions. Although current evidence provides rationale for administering anti-IL-6 treatments in MDD, further studies confirming safety, target affinity and therapeutic benefits are warranted.
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Affiliation(s)
- Trehani M Fonseka
- University of Toronto, University Health Network, Department of Psychiatry , 200 Elizabeth Street, 8-EN-238, Toronto, M5G 2C4, ON , Canada +1 416 340 3888 ; +1 416 340 4198 ;
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3-Hydroxykynurenic Acid and Type 2 Diabetes: Implications for Aging, Obesity, Depression, Parkinson’s Disease, and Schizophrenia. TRYPTOPHAN METABOLISM: IMPLICATIONS FOR BIOLOGICAL PROCESSES, HEALTH AND DISEASE 2015. [DOI: 10.1007/978-3-319-15630-9_8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Hoyo-Becerra C, Schlaak JF, Hermann DM. Insights from interferon-α-related depression for the pathogenesis of depression associated with inflammation. Brain Behav Immun 2014; 42:222-31. [PMID: 25066466 DOI: 10.1016/j.bbi.2014.06.200] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 06/26/2014] [Accepted: 06/27/2014] [Indexed: 02/06/2023] Open
Abstract
Interferon-α (IFN-α) is a pleiotropic cytokine that is administered as a therapeutic in highly prevalent medical conditions such as chronic hepatitis C and B virus infection, melanoma and lymphoma. IFN-α induces, to a clinically relevant degree, concentration, memory, drive and mood disturbances in almost half of all patients. For this reason, IFN-α is increasingly being replaced by more specifically acting drugs. In the past decades, IFN-α has offered a valuable insight into the pathogenesis of major depression, particularly in settings associated with inflammation. IFN-α triggers immune responses, hypothalamo-pituitary-adrenal axis abnormalities and disturbances of brain metabolism resembling those in other depression states. IFN-α stimulates indoleamine-2,3 dioxygenase-1, activating the kynurenine pathway with reduced formation of the neurotransmitters serotonin and dopamine, excessive formation of the NMDA agonist quinolinic acid, and reduced formation of the NMDA antagonist kynurenic acid. In addition, IFN-α disturbs neurotrophic signaling and impedes neurite outgrowth, synaptic plasticity, endogenous neurogenesis and neuronal survival. Consequently, IFN-α-related depression may represent a model for the neurodegenerative changes that are noticed in late-life major depression. Indeed, the observation that brain responses in IFN-α-related depression resemble idiopathic depression is supported by the existence of common genetic signatures, among which of note, a number of neuronal survival and plasticity genes have been identified. In view of the high incidence of depressive symptoms, IFN-α-related depression is an attractive model for studying links between neuronal plasticity, neurodegeneration and depression. We predict that in the latter areas new targets for anti-depressant therapies could be identified, which may deepen our understanding of idiopathic major depression.
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Affiliation(s)
| | - Joerg F Schlaak
- Department of Gastroenterology and Hepatology, University Hospital Essen, Germany
| | - Dirk M Hermann
- Department of Neurology, University Hospital Essen, Germany.
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Inflammatory cytokine-associated depression. Brain Res 2014; 1617:113-25. [PMID: 25003554 DOI: 10.1016/j.brainres.2014.06.032] [Citation(s) in RCA: 122] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 06/23/2014] [Accepted: 06/26/2014] [Indexed: 02/07/2023]
Abstract
Inflammatory cytokines can sometimes trigger depression in humans, are often associated with depression, and can elicit some behaviors in animals that are homologous to major depression. Moreover, these cytokines can affect monoaminergic and glutamatergic systems, supporting an overlapping pathoetiology with major depression. This suggests that there could be a specific major depression subtype, inflammatory cytokine-associated depression (ICAD), which may require different therapeutic approaches. However, most people do not develop depression, even when exposed to sustained elevations in inflammatory cytokines. Thus several vulnerabilities and sources of resilience to inflammation-associated depression have been identified. These range from genetic differences in neurotrophic and serotonergic systems to sleep quality and omega-3 fatty acid levels. Replicating these sources of resilience as treatments could be one approach for preventing "ICAD". This article is part of a Special Issue entitled SI: Neuroimmunology in Health And Disease.
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Inamdar A, Merlo-Pich E, Gee M, Makumi C, Mistry P, Robertson J, Steinberg E, Zamuner S, Learned S, Alexander R, Ratti E. Evaluation of antidepressant properties of the p38 MAP kinase inhibitor losmapimod (GW856553) in Major Depressive Disorder: Results from two randomised, placebo-controlled, double-blind, multicentre studies using a Bayesian approach. J Psychopharmacol 2014; 28:570-81. [PMID: 24699061 DOI: 10.1177/0269881114529377] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Pro-inflammatory cytokines (PICs) may play important pathophysiological roles in some forms of Major Depressive Disorder (MDD). The p38 MAPK inhibitor losmapimod (GW856553) attenuates the pro-inflammatory response in humans by reducing PIC production. Losmapimod (7.5 mg BD) was administered for 6 weeks in two randomised, placebo-controlled trials in subjects with MDD enriched with symptoms of loss of energy/interest and psychomotor retardation (Studies 574 and 009). Primary efficacy endpoints were the Bech 6-item depression subscale of the HAMD-17 (the 'Bech,') for Study 009; and the Bech, Inventory of Depressive Symptomatology-Clinician Rated (IDS-C), HAMD-17, and Quick Inventory of Depressive Symptomatology (self-rated) (QIDS-SR) for Study 574. Key cytokine biomarker levels were also measured. Study 574 (n=24) was terminated prematurely in light of emerging data from an internal study in rheumatoid arthritis. Efficacy results available at termination favoured losmapimod (Bech, 6 weeks: endpoint drug vs. placebo difference = -4.10; 95% CI, -7.36, -0.83; p=0.017). A subsequent study, Study 009 (n=128), designed using a Bayesian approach based on a prior derived from Study 574, showed no advantage for losmapimod (Bech, 6 weeks: endpoint drug vs. placebo difference = 1.11; 95% credible interval, -0.22, 2.50). Biomarker data showed no significant changes. In conclusion 7.5 mg BID losmapimod was not effective in MDD.
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Affiliation(s)
- Amir Inamdar
- Neurosciences Centre for Excellence in Drug Discovery, GlaxoSmithKline R&D Ltd, Harlow, Essex, UK The first two authors equally contributed to the work here reported Present address: Takeda Development Centre Europe Ltd., London, UK
| | - Emilio Merlo-Pich
- Neurosciences Centre for Excellence in Drug Discovery, GlaxoSmithKline R&D Ltd, Verona, Italy The first two authors equally contributed to the work here reported Present address: Neuroscience DTA, F. Hoffman-la Roche, Basel, Switzerland
| | - Michelle Gee
- Neurosciences Medicines Development Centre, GlaxoSmithKline R&D Ltd, Harlow, Essex, UK
| | - Clare Makumi
- Neurosciences Medicines Development Centre, GlaxoSmithKline R&D Ltd, Durham, NC, USA
| | - Prafull Mistry
- Discovery Biometrics, GlaxoSmithKline R&D Ltd, Harlow, Essex, UK
| | - Jon Robertson
- Discovery Biometrics, GlaxoSmithKline R&D Ltd, Harlow, Essex, UK
| | - Erik Steinberg
- Neurosciences Medicines Development Centre, GlaxoSmithKline R&D Ltd, Durham, NC, USA
| | - Stefano Zamuner
- Clinical Pharmacology Modelling and Simulation, GlaxoSmithKline R&D Ltd, Verona, Italy
| | - Susan Learned
- Neurosciences Centre for Excellence in Drug Discovery, GlaxoSmithKline R&D Ltd, Durham, NC, USA
| | - Robert Alexander
- Neurosciences Centre for Excellence in Drug Discovery, GlaxoSmithKline R&D Ltd, Verona, Italy
| | - Emiliangelo Ratti
- Neurosciences Centre for Excellence in Drug Discovery, GlaxoSmithKline R&D Ltd, Verona, Italy
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Serotonin-1A receptor CC genotype is associated with persistent depression related to interferon-alpha in hepatitis C patients. Gen Hosp Psychiatry 2014; 36:255-60. [PMID: 24462335 DOI: 10.1016/j.genhosppsych.2013.12.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Revised: 12/11/2013] [Accepted: 12/11/2013] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The aim of this study is to investigate the development of depression during interferon-alpha (IFN-α) therapy and the variations in the expression of the serotonin receptor (5-HTR) and transporter (5-HTT) in hepatitis C patients. METHOD Hepatitis C patients (n=277) were given the Mini International Neuropsychiatric Interview at the end of IFN-α therapy. Three polymorphisms were genotyped: the serotonin transporter repeat length polymorphic region [5-HTT gene-linked polymorphic region (5-HTTLPR)], as well as SNPs rs25531 and rs6295, located within the 5-HTTLPR and the transcriptional control region of the 5-HTR1A gene, respectively. RESULTS The diagnosis of current depression, which was associated with IFN-α-related depression (P<.001), demonstrated a statistically significant association with the CC genotype of the 5-HTR1A gene (odds ratio=5.57, 95% confidence interval=1.61-19.24, P=.007). CONCLUSIONS Persistent depression may represent a more specific type of IFN-α-related psychopathology. Future studies need to investigate the genetic risk factors for vulnerability associated with persistent depression. Limitations, such as the study's cross-sectional design, small sample size and retrospective assessment of IFN-α-induced depression diagnosis, must be taken into account while interpreting the results found in this study.
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