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Kang HJ, Kim JW, Choi W, Lee JY, Kim SW, Shin IS, Kim JM. Use of Serum Biomarkers to Aid Antidepressant Selection in Depressive Patients. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2024; 22:182-187. [PMID: 38247424 PMCID: PMC10811403 DOI: 10.9758/cpn.23.1071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/10/2023] [Indexed: 01/23/2024]
Abstract
Objective : This study aimed to identify serum biomarkers prospectively associated with remission at 12 weeks in out-patients with depressive disorders receiving stepwise psychopharmacotherapy, according to the main antidepressant used during the treatment period. Methods : This study included 1,024 depressive outpatients initially treated using antidepressant monotherapy, followed by alternating pharmacological strategies during the acute phase (3-12 weeks; 3-week interval). Fourteen serum biomarkers, sociodemographics, and clinical characteristics were evaluated at baseline. Based on the use frequency and mechanism of action, four main antidepressant types were distinguished: escitalopram, other selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), and mirtazapine. A Hamilton Depression Rating Scale score ≤ 7 was take to indicate remission. Results : Lower high-sensitivity C-reactive protein levels were correlated with remission at 12 weeks for all antidepressant types. Lower interleukin (IL)-6 levels and tumor necrosis factor-alpha levels were associated with remission using escitalopram and other SSRIs respectively. Lower IL-1β and leptin levels, predicted remission in association with SSRIs including escitalopram. For SNRIs, remission at 12 weeks was predicted by lower IL-4 and IL-10 levels. For mirtazapine, remission at 12 weeks was associated with lower leptin levels, and higher serotonin and folate levels. Conclusion : Baseline serum status, as estimated by nine serum markers, may help clinicians determine the most appropriate antidepressant to achieve remission in the acute phase of depression.
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Affiliation(s)
- Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Ju-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Wonsuk Choi
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
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Hamada F, Hori H, Iida H, Yokoyama H, Sugawara H, Hatanaka A, Gotoh L, Ogata M, Kumagai H, Yano R, Tomiyama Y, Yoshida T, Yamaguchi Y, Asada R, Masuda M, Okamoto Y, Kawasaki H. Effects of Exercise on Functional Recovery in Patients with Bipolar Depression: A Study Protocol for a Randomized Controlled Trial. Metabolites 2023; 13:981. [PMID: 37755261 PMCID: PMC10536584 DOI: 10.3390/metabo13090981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/24/2023] [Accepted: 08/28/2023] [Indexed: 09/28/2023] Open
Abstract
Treatment of bipolar disorder is prone to prolongation despite various treatments, including medication. The efficacy of exercise treatment (i.e., interventions involving physical exercise and sports intervention) for major depressive disorders has been reported for depressive symptoms, cognitive function, and sleep disturbances. However, its efficacy for bipolar disorder has yet to be established. We designed a randomized, controlled, double-blind clinical trial that includes 100 patients with bipolar disorder aged 20-65 years. This will be a cluster-randomized, two-group trial that will be conducted in ten psychiatric hospitals. The hospitals will be randomly assigned to an exercise intervention + treatment as usual (exercise) group or a placebo exercise intervention (stretching) + treatment as usual (control) group. Patients will be assessed using an extensive battery of clinical tests, physical parameters, sleep status, biological parameters (cytokines, neurotrophic factors), and genetic parameters (DNA and RNA) at baseline after a 6-week intervention period, at 10-week follow-up, and at 6-month follow-up. This innovative study may provide important evidence for the effectiveness of exercise in the treatment of bipolar depression based on clinical, biological, genetic, and physiological markers.
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Affiliation(s)
- Fumito Hamada
- Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka 8140180, Japan; (F.H.); (H.I.); (H.S.); (L.G.); (R.A.)
| | - Hikaru Hori
- Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka 8140180, Japan; (F.H.); (H.I.); (H.S.); (L.G.); (R.A.)
| | - Hitoshi Iida
- Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka 8140180, Japan; (F.H.); (H.I.); (H.S.); (L.G.); (R.A.)
| | - Hiroyuki Yokoyama
- Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka 8140180, Japan; (F.H.); (H.I.); (H.S.); (L.G.); (R.A.)
| | - Hiroko Sugawara
- Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka 8140180, Japan; (F.H.); (H.I.); (H.S.); (L.G.); (R.A.)
| | - Akito Hatanaka
- Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka 8140180, Japan; (F.H.); (H.I.); (H.S.); (L.G.); (R.A.)
| | - Leo Gotoh
- Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka 8140180, Japan; (F.H.); (H.I.); (H.S.); (L.G.); (R.A.)
- Laboratory of Neuroscience, Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka 8140180, Japan
| | - Muneaki Ogata
- Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka 8140180, Japan; (F.H.); (H.I.); (H.S.); (L.G.); (R.A.)
| | - Hiroki Kumagai
- Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka 8140180, Japan; (F.H.); (H.I.); (H.S.); (L.G.); (R.A.)
| | - Rika Yano
- Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka 8140180, Japan; (F.H.); (H.I.); (H.S.); (L.G.); (R.A.)
| | - Yuko Tomiyama
- Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka 8140180, Japan; (F.H.); (H.I.); (H.S.); (L.G.); (R.A.)
| | - Tetsuya Yoshida
- Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka 8140180, Japan; (F.H.); (H.I.); (H.S.); (L.G.); (R.A.)
| | - Yoshimi Yamaguchi
- Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka 8140180, Japan; (F.H.); (H.I.); (H.S.); (L.G.); (R.A.)
| | - Ryo Asada
- Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka 8140180, Japan; (F.H.); (H.I.); (H.S.); (L.G.); (R.A.)
| | - Masato Masuda
- Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka 8140180, Japan; (F.H.); (H.I.); (H.S.); (L.G.); (R.A.)
| | - Yuta Okamoto
- Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka 8140180, Japan; (F.H.); (H.I.); (H.S.); (L.G.); (R.A.)
| | - Hiroaki Kawasaki
- Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka 8140180, Japan; (F.H.); (H.I.); (H.S.); (L.G.); (R.A.)
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Tsai SJ, Kao CF, Su TP, Li CT, Lin WC, Hong CJ, Bai YM, Tu PC, Chen MH. Cytokine- and Vascular Endothelial Growth Factor-Related Gene-Based Genome-Wide Association Study of Low-Dose Ketamine Infusion in Patients with Treatment-Resistant Depression. CNS Drugs 2023; 37:243-253. [PMID: 36763263 DOI: 10.1007/s40263-023-00989-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/15/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND AND OBJECTIVE Ketamine may work as an anti-inflammatory agent, and it increases the levels of vascular endothelial growth factor (VEGF) in patients with treatment-resistant depression. However, whether genes related to pro-inflammatory and anti-inflammatory cytokines and VEGF may predict the treatment response to ketamine remains unknown.Therefore the aim of this study was to analyze whether specific genes related to inflammatory processes and VEGF were associated with treatment response to low-dose ketamine in patients with treatment-resistant depression. METHODS Based on the genome data from our clinical trial, this study was a secondary analysis of candidate genes correlated with different timepoints of depressive symptoms. In total, 65 patients with treatment-resistant depression (n = 21 for ketamine 0.5 mg/kg, 20 for ketamine 0.2 mg/kg, and 24 for normal saline) were genotyped for 684,616 single nucleotide polymorphisms. Genes associated with 80 cytokines (i.e., interleukin [IL]-1, IL-6, tumor necrosis factor-α, and adiponectin) and VEGF (i.e., VEGF and VEGF receptors) were selected for the gene-based genome-wide association study on the antidepressant effect of a ketamine infusion. RESULTS Specific single nucleotide polymorphisms, including rs2540315 and rs75746675 in IL1R1 and rs79568085 in VEGFC, were related to the rapid (within 240 min) antidepressant effect of a ketamine infusion; specific single nucleotide polymorphisms, such as Affx-20131665 in PIGF and rs8179353, rs8179353, and rs8179353 in TNFRSF8, were associated with the sustained (up to 2 weeks) antidepressant effect of low-dose (combined 0.5 mg/kg and 0.2 mg/kg) ketamine. CONCLUSIONS Our findings further revealed that genes related to both anti-inflammatory and pro-inflammatory cytokines (i.e., IL-1, IL-2, IL-6, tumor necrosis factor-α, C-reactive protein, and adiponectin) and VEGF-FLK signaling predicted the treatment response to a ketamine infusion in patients with treatment-resistant depression. The synergic modulation of inflammatory and VEGF systems may contribute to the antidepressant effect of ketamine. CLINICAL TRIAL REGISTRATION University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) number: UMIN000016985.
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Affiliation(s)
- Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan
- Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chung-Feng Kao
- Department of Agronomy, College of Agriculture and Natural Resources, National Chung Hsing University, Taichung, Taiwan
- Advanced Plant Biotechnology Center, National Chung Hsing University, Taichung, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan
- Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan
- Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan
- Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chen-Jee Hong
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan
- Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan
- Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Pei-Chi Tu
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan
- Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.
- Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Kato M, Ogata H, Tahara H, Shimamoto A, Takekita Y, Koshikawa Y, Nishida K, Nonen S, Higasa K, Kinoshita T. Multiple Pre-Treatment miRNAs Levels in Untreated Major Depressive Disorder Patients Predict Early Response to Antidepressants and Interact with Key Pathways. Int J Mol Sci 2022; 23:ijms23073873. [PMID: 35409234 PMCID: PMC8999364 DOI: 10.3390/ijms23073873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/29/2022] [Accepted: 03/29/2022] [Indexed: 12/16/2022] Open
Abstract
Major depressive disorder (MDD) is a life-impairing disorder, and early successful treatment is important for a favorable prognosis. However, early response to antidepressants differs widely among individuals, and is difficult to predict pre-treatment. As miRNAs have been reported to play important roles in depression, identification of miRNAs associated with antidepressant treatment responses and their interacting genes and pathways will be beneficial in understanding the predictors and molecular mechanisms of depression treatment. This randomized control trial examined miRNAs correlated with the early therapeutic effect of selective serotonin reuptake inhibitors (SSRIs; paroxetine or sertraline) and mirtazapine monotherapy. Before medication, we comprehensively analyzed the miRNA expression of 92 depressed participants and identified genes and pathways interacting with miRNAs. A total of 228 miRNAs were significantly correlated with depressive symptoms improvements after 2 weeks of SSRIs treatment, with miR-483.5p showing the most robust correlation. These miRNAs are involved in 21 pathways, including TGF-β, glutamatergic synapse, long-term depression, and the mitogen-activated protein kinase (MAPK) signaling pathways. Using these miRNAs enabled us to predict SSRI response at week 2 with a 57% difference. This study shows that pre-treatment levels of miRNAs could be used to predict early responses to antidepressant administration, a knowledge of genes, and an identification of genes and pathways associated with the antidepressant response.
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Affiliation(s)
- Masaki Kato
- Department of Neuropsychiatry, Kansai Medical University, Osaka 573-1191, Japan; (H.O.); (Y.T.); (Y.K.); (K.N.); (T.K.)
- Correspondence:
| | - Haruhiko Ogata
- Department of Neuropsychiatry, Kansai Medical University, Osaka 573-1191, Japan; (H.O.); (Y.T.); (Y.K.); (K.N.); (T.K.)
| | - Hidetoshi Tahara
- Department of Cellular and Molecular Biology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima 734-8533, Japan;
| | - Akira Shimamoto
- Faculty of Pharmaceutical Sciences, Sanyo-Onoda City University, Sanyo Onoda 756-0084, Japan;
| | - Yoshiteru Takekita
- Department of Neuropsychiatry, Kansai Medical University, Osaka 573-1191, Japan; (H.O.); (Y.T.); (Y.K.); (K.N.); (T.K.)
| | - Yosuke Koshikawa
- Department of Neuropsychiatry, Kansai Medical University, Osaka 573-1191, Japan; (H.O.); (Y.T.); (Y.K.); (K.N.); (T.K.)
| | - Keiichiro Nishida
- Department of Neuropsychiatry, Kansai Medical University, Osaka 573-1191, Japan; (H.O.); (Y.T.); (Y.K.); (K.N.); (T.K.)
| | - Shinpei Nonen
- Department of Pharmacy, Hyogo University of Health Sciences, Kobe 650-8530, Japan;
| | - Koichiro Higasa
- Department of Genome Analysis, Institute of Biomedical Science, Kansai Medical University, Osaka 573-1191, Japan;
| | - Toshihiko Kinoshita
- Department of Neuropsychiatry, Kansai Medical University, Osaka 573-1191, Japan; (H.O.); (Y.T.); (Y.K.); (K.N.); (T.K.)
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