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Schwerthöffer D, Förstl H. [Insomniac symptoms and suicidality-link and management]. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2024; 38:53-61. [PMID: 37171521 PMCID: PMC11143018 DOI: 10.1007/s40211-023-00466-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/01/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND A link between insomniac symptoms and suicidality has long been suspected and deserves specific attention. OBJECTIVE We examine the current evidence for this relationship from epidemiology and neurobiology in order to propose a targeted management. MATERIAL AND METHOD Clinical example and selective Medline-literature research for insomnia symptoms and suicidality. RESULTS Epidemiological data and statistical analysis show that symptoms of insomnia are independent risk factors for suicidality. Neurobiological factors associated with combined insomnia symptoms and suicidality are: serotonergic dysfunction and circadian rhythm disorder leading to hypofrontality with reduced problem solving capacity and impaired emotional and impulse-control. Social isolation, recurrent rumination, comorbid psychiatric disorders, access to potentially lethal drugs or weapons need urgent evaluation in patients with a combination of suicidality and symptoms of insomnia. CONCLUSION patients with insomnia and further risk factors for suicide need to be treated resolutely and at an early stage. Modern sleep-promoting antidepressants with low toxicity and antipsychotics must be preferred in the treatment of patients with insomniac sleep disorders and suicidality. Multimodal anti-insomnia and anti-depressive therapy adapted to the circadian rhythm can exert a favorable influence both on depressive-suicidal and insomnia symptoms and their inherent risks.
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Affiliation(s)
- Dirk Schwerthöffer
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, TU-München, Ismaningerstraße 22, 81675, München, Deutschland.
| | - Hans Förstl
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, TU-München, Ismaningerstraße 22, 81675, München, Deutschland
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Wu Y, Lu Y, Kong L, Xie Y, Liu W, Yang A, Xin K, Yan X, Wu L, Liu Y, Zhu Q, Cao Y, Zhou Y, Jiang X, Tang Y, Wu F. Gender differences in plasma S100B levels of patients with major depressive disorder. BMC Psychiatry 2024; 24:387. [PMID: 38783266 PMCID: PMC11112965 DOI: 10.1186/s12888-024-05852-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Low concentrations of S100B have neurotrophic effects and can promote nerve growth and repair, which plays an essential role in the pathophysiological and histopathological alterations of major depressive disorder (MDD) during disease development. Studies have shown that plasma S100B levels are altered in patients with MDD. In this study, we investigated whether the plasma S100B levels in MDD differ between genders. METHODS We studied 235 healthy controls (HCs) (90 males and 145 females) and 185 MDD patients (65 males and 120 females). Plasma S100B levels were detected via multifactor assay. The Mahalanobis distance method was used to detect the outliers of plasma S100B levels in the HC and MDD groups. The Kolmogorov-Smirnov test was used to test the normality of six groups of S100B samples. The Mann-Whitney test and Scheirer-Ray-Hare test were used for the comparison of S100B between diagnoses and genders, and the presence of a relationship between plasma S100B levels and demographic details or clinical traits was assessed using Spearman correlation analysis. RESULTS All individuals in the HC group had plasma S100B levels that were significantly greater than those in the MDD group. In the MDD group, males presented significantly higher plasma S100B levels than females. In the male group, the plasma S100B levels in the HC group were significantly higher than those in the MDD group, while in the female group, no significant difference was found between the HC and MDD groups. In the male MDD subgroup, there was a positive correlation between plasma S100B levels and years of education. In the female MDD subgroup, there were negative correlations between plasma S100B levels and age and suicidal ideation. CONCLUSIONS In summary, plasma S100B levels vary with gender and are decreased in MDD patients, which may be related to pathological alterations in glial cells.
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Affiliation(s)
- Yifan Wu
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China
| | - Yihui Lu
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China
| | - Lingtao Kong
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China
| | - Yu Xie
- Faculty of Public Health, China Medical University, 110001, Liaoning, P.R. China
| | - Wen Liu
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China
| | - Anqi Yang
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China
| | - Kaiqi Xin
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China
| | - Xintong Yan
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China
| | - Longhai Wu
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China
| | - Yilin Liu
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China
| | - Qianying Zhu
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China
| | - Yang Cao
- Shenyang Mental Health Center, 110001, Liaoning, P.R. China
| | - Yifang Zhou
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China
| | - Xiaowei Jiang
- Brain Function Research Section, Department of Radiology, The First Hospital of China Medical University, 110001, Liaoning, P.R. China
| | - Yanqing Tang
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China
- Department of Geriatric Medicine, The First Hospital of China Medical University, 110001, Liaoning, P.R. China
| | - Feng Wu
- Department of Psychiatry, The First Hospital of China Medical University, 155 Nanjing North Street, 110001, Liaoning, P.R. China.
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Zakowicz P, Skibińska M, Waśniewski F, Skulimowski B, Pawlak J. Plasma biomarkers in adolescents with schizophrenia-spectrum disorder. Early Interv Psychiatry 2023; 17:1154-1161. [PMID: 37041682 DOI: 10.1111/eip.13414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 03/03/2023] [Accepted: 03/28/2023] [Indexed: 04/13/2023]
Abstract
AIM Schizophrenia onset in the developmental age has a strong neurodevelopmental burden and is associated with a poorer prognosis. The approach to diagnosis is still based on symptomatic description without objective validation. In this study, we aimed to compare the peripheral blood levels of hypothesized biomarker proteins: brain-derived neurotrophic factor (BDNF), proBDNF, p75 neurotrophin receptor (p75NTR ) and S100B between early-onset schizophrenia-spectrum adolescents (n = 45) and healthy controls (n = 34). METHODS Clinical assessment of the participants encompassed symptomatic description with the use of structured interviews and executive function objective measurement. Plasma levels of BDNF protein were significantly lower in schizophrenia patients than in controls both at admission (p = .003) and 6-8 weeks follow-up (p = .007). RESULTS We observed significant correlations between BDNF, proBDNF and p75NTR levels and positive and negative symptoms scale (PANSS) scores, p75NTR and S100B levels and suicidal parameters, as well as a correlation of BDNF plasma level with the risky decision-making style in Iowa Gambling Task (IGT). CONCLUSIONS The results indicate a potential value of studied proteins as a biomarker in the diagnosis and monitoring of the disease's course.
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Affiliation(s)
- Przemysław Zakowicz
- Department of Genetics in Psychiatry, Poznań University of Medical Sciences, Poznań, Poland
- Children and Adolescent Treatment Centre in Zabór, University of Zielona Góra, Zielona Góra, Poland
| | - Maria Skibińska
- Department of Genetics in Psychiatry, Poznań University of Medical Sciences, Poznań, Poland
| | - Filip Waśniewski
- Department of Genetics in Psychiatry, Poznań University of Medical Sciences, Poznań, Poland
| | - Bartosz Skulimowski
- Department of Genetics in Psychiatry, Poznań University of Medical Sciences, Poznań, Poland
| | - Joanna Pawlak
- Department of Genetics in Psychiatry, Poznań University of Medical Sciences, Poznań, Poland
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Hassamal S. Chronic stress, neuroinflammation, and depression: an overview of pathophysiological mechanisms and emerging anti-inflammatories. Front Psychiatry 2023; 14:1130989. [PMID: 37252156 PMCID: PMC10213648 DOI: 10.3389/fpsyt.2023.1130989] [Citation(s) in RCA: 45] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 04/21/2023] [Indexed: 05/31/2023] Open
Abstract
In a subset of patients, chronic exposure to stress is an etiological risk factor for neuroinflammation and depression. Neuroinflammation affects up to 27% of patients with MDD and is associated with a more severe, chronic, and treatment-resistant trajectory. Inflammation is not unique to depression and has transdiagnostic effects suggesting a shared etiological risk factor underlying psychopathologies and metabolic disorders. Research supports an association but not necessarily a causation with depression. Putative mechanisms link chronic stress to dysregulation of the HPA axis and immune cell glucocorticoid resistance resulting in hyperactivation of the peripheral immune system. The chronic extracellular release of DAMPs and immune cell DAMP-PRR signaling creates a feed forward loop that accelerates peripheral and central inflammation. Higher plasma levels of inflammatory cytokines, most consistently interleukin IL-1β, IL-6, and TNF-α, are correlated with greater depressive symptomatology. Cytokines sensitize the HPA axis, disrupt the negative feedback loop, and further propagate inflammatory reactions. Peripheral inflammation exacerbates central inflammation (neuroinflammation) through several mechanisms including disruption of the blood-brain barrier, immune cellular trafficking, and activation of glial cells. Activated glial cells release cytokines, chemokines, and reactive oxygen and nitrogen species into the extra-synaptic space dysregulating neurotransmitter systems, imbalancing the excitatory to inhibitory ratio, and disrupting neural circuitry plasticity and adaptation. In particular, microglial activation and toxicity plays a central role in the pathophysiology of neuroinflammation. Magnetic resonance imaging (MRI) studies most consistently show reduced hippocampal volumes. Neural circuitry dysfunction such as hypoactivation between the ventral striatum and the ventromedial prefrontal cortex underlies the melancholic phenotype of depression. Chronic administration of monoamine-based antidepressants counters the inflammatory response, but with a delayed therapeutic onset. Therapeutics targeting cell mediated immunity, generalized and specific inflammatory signaling pathways, and nitro-oxidative stress have enormous potential to advance the treatment landscape. Future clinical trials will need to include immune system perturbations as biomarker outcome measures to facilitate novel antidepressant development. In this overview, we explore the inflammatory correlates of depression and elucidate pathomechanisms to facilitate the development of novel biomarkers and therapeutics.
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Affiliation(s)
- Sameer Hassamal
- California University of Sciences and Medicine, Colton, CA, United States
- Clinicaltriallink, Los Angeles, CA, United States
- California Neuropsychiatric Institute, Ontario, CA, United States
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Schiweck C, Aichholzer M, Reif A, Edwin Thanarajah S. Targeting IL-17A signaling in suicidality, promise or the long arm of coincidence? Evidence in psychiatric populations revisited. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023. [DOI: 10.1016/j.jadr.2022.100454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Systematic Review on Post-Mortem Protein Alterations: Analysis of Experimental Models and Evaluation of Potential Biomarkers of Time of Death. Diagnostics (Basel) 2022; 12:diagnostics12061490. [PMID: 35741301 PMCID: PMC9222196 DOI: 10.3390/diagnostics12061490] [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: 05/13/2022] [Revised: 06/06/2022] [Accepted: 06/13/2022] [Indexed: 11/16/2022] Open
Abstract
Estimating the post-mortem interval (PMI) is a very complex issue due to numerous variables that may affect the calculation. Several authors have investigated the quantitative and qualitative variations of protein expression on post-mortem biological samples in certain time intervals, both in animals and in humans. However, the literature data are very numerous and often inhomogeneous, with different models, tissues and proteins evaluated, such that the practical application of these methods is limited to date. The aim of this paper was to offer an organic view of the state of the art about post-mortem protein alterations for the calculation of PMI through the analysis of the various experimental models proposed. The purpose was to investigate the validity of some proteins as “molecular clocks” candidates, focusing on the evidence obtained in the early, intermediate and late post-mortem interval. This study demonstrates how the study of post-mortem protein alterations may be useful for estimating the PMI, although there are still technical limits, especially in the experimental models performed on humans. We suggest a protocol to homogenize the study of future experimental models, with a view to the next concrete application of these methods also at the crime scene.
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Peyron PA, Lehmann S, Delaby C, Baccino E, Hirtz C. Biochemical markers of time since death in cerebrospinal fluid: A first step towards "Forensomics". Crit Rev Clin Lab Sci 2019; 56:274-286. [PMID: 31088325 DOI: 10.1080/10408363.2019.1619158] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The accurate estimation of the time of death is a challenge in forensic medicine, as the methods routinely used to assess the postmortem interval (PMI) are far from being precise. Over the past decades, biochemical methods have been implemented on postmortem samples to improve the precision of PMI estimation. Studies have focussed on the biochemical profiles of closed compartment body fluids, as they are preserved longer than blood after death and are thus subject to confined postmortem chemical changes. Cerebrospinal fluid (CSF) has been considered a suitable fluid to investigate these changes, as it is found in large amounts and is easy to sample. Moreover, the main molecules found in CSF have known reference values in living subjects, unlike most other body fluids. In this literature review, we focus on the panel of biomarkers that have been studied in CSF based on their potential of offering information on the time of death. The interest in these biomarkers for casework and the research perspectives in this field are discussed. Integrating data from different methods, including biochemistry, for better estimation of the time of death would represent a step forward in the forensic field, paving the way for an innovative approach that we suggest to call "Forensomics."
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Affiliation(s)
- Pierre-Antoine Peyron
- a Department of Forensic Medicine , Montpellier University Hospital , Montpellier , France.,b Laboratory of Biochemistry and Clinical Proteomics, Montpellier University Hospital, Institute for Regenerative Medicine and Biotherapy , Montpellier , France
| | - Sylvain Lehmann
- b Laboratory of Biochemistry and Clinical Proteomics, Montpellier University Hospital, Institute for Regenerative Medicine and Biotherapy , Montpellier , France
| | - Constance Delaby
- b Laboratory of Biochemistry and Clinical Proteomics, Montpellier University Hospital, Institute for Regenerative Medicine and Biotherapy , Montpellier , France
| | - Eric Baccino
- a Department of Forensic Medicine , Montpellier University Hospital , Montpellier , France
| | - Christophe Hirtz
- b Laboratory of Biochemistry and Clinical Proteomics, Montpellier University Hospital, Institute for Regenerative Medicine and Biotherapy , Montpellier , France
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Franklin TC, Xu C, Duman RS. Depression and sterile inflammation: Essential role of danger associated molecular patterns. Brain Behav Immun 2018; 72:2-13. [PMID: 29102801 DOI: 10.1016/j.bbi.2017.10.025] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 10/14/2017] [Accepted: 10/31/2017] [Indexed: 12/12/2022] Open
Abstract
Stress is a major risk factor for psychiatric disorder including major depressive disorder (MDD) and can induce inflammation, which is known to be dysregulated in depression. Several clinical and pre-clinical studies have demonstrated a strong association between depressive symptoms and the expression of factors that increase inflammation. Conversely, administration of anti-inflammatory agents has been shown to ameliorate depressive symptoms, demonstrating the importance of inflammation as a mediator of depression. Although it is clear that inflammation plays a role in the pathophysiology of depression, the mechanism by which inflammation is activated in mood disorders remains unclear. To address this issue, studies have investigated the role of pattern recognition receptor (PRR) activation in stress-induced inflammation and mood disorders. However, the identification of the endogenous factors, referred to as danger-associated molecular patterns (DAMP) that activate these receptors remains understudied. Here we review the role of DAMPs in depression and highlight the clinical evidence for elevation of DAMP signaling in MDD patients and in pre-clinical animal stress models of depression.
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Affiliation(s)
- Tina C Franklin
- Laboratory of Molecular Psychiatry, Center for Genes and Behavior, Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06508, USA
| | - Chelsea Xu
- Laboratory of Molecular Psychiatry, Center for Genes and Behavior, Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06508, USA
| | - Ronald S Duman
- Laboratory of Molecular Psychiatry, Center for Genes and Behavior, Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06508, USA.
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El-Kashef N, Gomes I, Mercer-Chalmers-Bender K, Schneider PM, Rothschild MA, Juebner M. Comparative proteome analysis for identification of differentially abundant proteins in SIDS. Int J Legal Med 2017; 131:1597-1613. [DOI: 10.1007/s00414-017-1632-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 07/04/2017] [Indexed: 12/01/2022]
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Wu X, Yao J, Ding M, Shi ZS, Xu FL, Zhang JJ, Wang BJ. 5-HT1A receptor (HTR1A) 5' region haplotypes significantly affect protein expression in vitro. Neurosci Lett 2016; 638:51-54. [PMID: 27939355 DOI: 10.1016/j.neulet.2016.12.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 12/02/2016] [Accepted: 12/06/2016] [Indexed: 01/13/2023]
Abstract
The aim of this study was to explore the role of two SNPs (rs6295 & rs113195492) in the HTR1A gene promoter region that regulates the expression of the 5-HT1A receptor. A fragment spanning from -551 to +672 of HTR1A (Transcription start site +1) was cloned into the pGL-3 Basic Vector and three haplotype plasmids composed of two SNPs were constructed. HEK-293 cells and the SK-N-SH cells were transfected with the three plasmids, and the relative fluorescence intensity was measured. In HEK-293 cells, there was a significant difference when the relative fluorescence intensity of plasmid 1-1 was compared to that of plasmid 2-1. However, no significant difference was observed when the luciferase expression of plasmid 2-1 and plasmid 3-1 was analyzed. We also found that the expression trend of the SK-N-SH cells was similar to the HEK-293 cells, but the overall relative fluorescence intensity of the SK-N-SH cells was lower than that of the HEK-293 cells. Our finding showed that the rs6295 SNP, as a suspected variant that indicates susceptibility to schizophrenia, exhibited a higher transcriptional activity. The influence of the rs113195492 locus on schizophrenia needs to be explored further.
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Affiliation(s)
- Xue Wu
- School of Forensic Medicine, China Medical University, Shenyang, 110122, China
| | - Jun Yao
- School of Forensic Medicine, China Medical University, Shenyang, 110122, China
| | - Mei Ding
- School of Forensic Medicine, China Medical University, Shenyang, 110122, China
| | - Zhang-Sen Shi
- School of Forensic Medicine, China Medical University, Shenyang, 110122, China
| | - Feng-Ling Xu
- School of Forensic Medicine, China Medical University, Shenyang, 110122, China
| | - Jing-Jing Zhang
- School of Forensic Medicine, China Medical University, Shenyang, 110122, China
| | - Bao-Jie Wang
- School of Forensic Medicine, China Medical University, Shenyang, 110122, China.
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