Pharmacological evaluation of a novel corticotropin-releasing factor 1 receptor antagonist T-3047928 in stress-induced animal models in a comparison with alosetron

Causal relationship between major depressive disorder, anxiety disorder and constipation: a two-sample Mendelian randomization study

BACKGROUND

Epidemiological and other studies have shown correlations among major depressive disorder (MDD), anxiety disorder (AXD) and constipation. However, no consensus has been reached regarding their interdependence and pathogenesis. Herein, we sought to further explore the causal associations between them.

METHODS

Bidirectional two-sample Mendelian randomization (MR) analysis was performed to confirm the causal link between MDD, AXD and constipation. Genetic instrumental variables for MDD, AXD, and constipation were obtained from publicly available genome-wide association studies (GWASs). In this MR analysis, inverse variance weighting (IVW) was used as the primary analysis method to evaluate the causal effect. Additionally, we employed Cochran's Q test, MR‒Egger intercept and MR-PRESSO analysis to examine heterogeneity and pleiotropy. Moreover, leave-one-out analysis was employed to investigate the stability of the associations. Finally, a reverse analysis of Mendelian randomization was conducted.

RESULTS

The results revealed a causal relationship between MDD and an increased risk of constipation (p = 0.0001), whereas AXD (p = 8.52 × 10-1) did not increase the risk of constipation. In the inverse MR analysis, no causal associations were found (constipation to MDD: p = 9.37 × 10-1; constipation to AXD: p = 8.51 × 10-1).

CONCLUSION

This MR study revealed genetic evidence supporting a causal relationship between MDD and constipation.

Beyond depression and anxiety; a systematic review about the role of corticotropin-releasing hormone antagonists in diseases of the pelvic and abdominal organs

Evidence for beneficial effects of corticotropin releasing hormone (CRH) antagonists in abdominal and pelvic organs is emerging in preclinical studies. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement a compilation of preclinical studies using CRH receptor antagonists as a treatment for abdominal and pelvic disease was carried out. The Animal Research: Reporting of In Vivo Experiments (ARRIVE) essential 10 guidelines were used to determine quality of the included studies. A total of 40 studies from the last 15 years studying irritable bowel syndrome, inflammatory bowel disease, endometriosis, enteritis, stress impact on gastrointestinal processes and exogenous CRH administration effects were included. Blockage of the CRH receptor 1 was mainly associated with beneficial effects while that of CRH receptor 2 worsened studied effects. However, time of administration, route of administration and the animal model used, all had an impact on the beneficial outcomes. Frequency of drugs administered indicated that astressin-2B, astressin and antalarmin were among the most utilized antagonists. Of concern, studies included were predominantly carried out in male models only, representing a gender discrepancy in preclinical studies compared to the clinical scenario. The ARRIVE score average was 13 with ~60% of the studies failing to randomize or blind the experimental units. Despite the failure to date of the CRH antagonists in moving across the clinical trials pipeline, there is evidence for their beneficial effects beyond mood disorders. Future pre-clinical studies should be tailored towards effectively predicting the clinical scenario, including reduction of bias and randomization.