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De Giorgi R, Rizzo Pesci N, Rosso G, Maina G, Cowen PJ, Harmer CJ. The pharmacological bases for repurposing statins in depression: a review of mechanistic studies. Transl Psychiatry 2023; 13:253. [PMID: 37438361 PMCID: PMC10338465 DOI: 10.1038/s41398-023-02533-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 06/13/2023] [Accepted: 06/20/2023] [Indexed: 07/14/2023] Open
Abstract
Statins are commonly prescribed medications widely investigated for their potential actions on the brain and mental health. Pre-clinical and clinical evidence suggests that statins may play a role in the treatment of depressive disorders, but only the latter has been systematically assessed. Thus, the physiopathological mechanisms underlying statins' putative antidepressant or depressogenic effects have not been established. This review aims to gather available evidence from mechanistic studies to strengthen the pharmacological basis for repurposing statins in depression. We used a broad, well-validated search strategy over three major databases (Pubmed/MEDLINE, Embase, PsychINFO) to retrieve any mechanistic study investigating statins' effects on depression. The systematic search yielded 8068 records, which were narrowed down to 77 relevant papers. The selected studies (some dealing with more than one bodily system) described several neuropsychopharmacological (44 studies), endocrine-metabolic (17 studies), cardiovascular (6 studies) and immunological (15 studies) mechanisms potentially contributing to the effects of statins on mood. Numerous articles highlighted the beneficial effect of statins on depression, particularly through positive actions on serotonergic neurotransmission, neurogenesis and neuroplasticity, hypothalamic-pituitary axis regulation and modulation of inflammation. The role of other mechanisms, especially the association between statins, lipid metabolism and worsening of depressive symptoms, appears more controversial. Overall, most mechanistic evidence supports an antidepressant activity for statins, likely mediated by a variety of intertwined processes involving several bodily systems. Further research in this area can benefit from measuring relevant biomarkers to inform the selection of patients most likely to respond to statins' antidepressant effects while also improving our understanding of the physiopathological basis of depression.
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Affiliation(s)
- Riccardo De Giorgi
- University of Oxford, Department of Psychiatry, Warneford Hospital, Warneford Lane, Oxfordshire, Oxford, OX3 7JX, United Kingdom.
- Oxford Health NHS Foundation Trust, Warneford Hospital, Warneford Lane, Oxfordshire, Oxford, OX3 7JX, United Kingdom.
| | - Nicola Rizzo Pesci
- University of Turin, Department of Neurosciences "Rita Levi Montalcini", Via Cherasco 15, Turin, 10126, Italy
| | - Gianluca Rosso
- University of Turin, Department of Neurosciences "Rita Levi Montalcini", Via Cherasco 15, Turin, 10126, Italy
| | - Giuseppe Maina
- University of Turin, Department of Neurosciences "Rita Levi Montalcini", Via Cherasco 15, Turin, 10126, Italy
| | - Philip J Cowen
- University of Oxford, Department of Psychiatry, Warneford Hospital, Warneford Lane, Oxfordshire, Oxford, OX3 7JX, United Kingdom
- Oxford Health NHS Foundation Trust, Warneford Hospital, Warneford Lane, Oxfordshire, Oxford, OX3 7JX, United Kingdom
| | - Catherine J Harmer
- University of Oxford, Department of Psychiatry, Warneford Hospital, Warneford Lane, Oxfordshire, Oxford, OX3 7JX, United Kingdom
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Carroll CB, Wyse RKH. Simvastatin as a Potential Disease-Modifying Therapy for Patients with Parkinson's Disease: Rationale for Clinical Trial, and Current Progress. JOURNAL OF PARKINSONS DISEASE 2018; 7:545-568. [PMID: 29036837 PMCID: PMC5676977 DOI: 10.3233/jpd-171203] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Many now believe the holy grail for the next stage of therapeutic advance surrounds the development of disease-modifying approaches aimed at intercepting the year-on-year neurodegenerative decline experienced by most patients with Parkinson’s disease (PD). Based on recommendations of an international committee of experts who are currently bringing multiple, potentially disease-modifying, PD therapeutics into long-term neuroprotective PD trials, a clinical trial involving 198 patients is underway to determine whether Simvastatin provides protection against chronic neurodegeneration. Statins are widely used to reduce cardiovascular risk, and act as competitive inhibitors of HMG-CoA reductase. It is also known that statins serve as ligands for PPARα, a known arbiter for mitochondrial size and number. Statins possess multiple cholesterol-independent biochemical mechanisms of action, many of which offer neuroprotective potential (suppression of proinflammatory molecules & microglial activation, stimulation of endothelial nitric oxide synthase, inhibition of oxidative stress, attenuation of α-synuclein aggregation, modulation of adaptive immunity, and increased expression of neurotrophic factors). We describe the biochemical, physiological and pharmaceutical credentials that continue to underpin the rationale for taking Simvastatin into a disease-modifying trial in PD patients. While unrelated to the Simvastatin trial (because this conducted in patients who already have PD), we discuss conflicting epidemiological studies which variously suggest that statin use for cardiovascular prophylaxis may increase or decrease risk of developing PD. Finally, since so few disease-modifying PD trials have ever been launched (compared to those of symptomatic therapies), we discuss the rationale of the trial structure we have adopted, decisions made, and lessons learnt so far.
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Affiliation(s)
- Camille B Carroll
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
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Patel TK, Patel VB, Rana DG. Possible anti-depressant effect of efavirenz and pro-depressive-like effect of voriconazole in specified doses in various experimental models of depression in mice. Pharmacol Rep 2017; 69:1082-1087. [DOI: 10.1016/j.pharep.2017.04.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 03/28/2017] [Accepted: 04/26/2017] [Indexed: 01/20/2023]
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Shojaei S, Ghavami S, Panjehshahin MR, Owji AA. Effects of Ethanol on the Expression Level of Various BDNF mRNA Isoforms and Their Encoded Protein in the Hippocampus of Adult and Embryonic Rats. Int J Mol Sci 2015; 16:30422-37. [PMID: 26703578 PMCID: PMC4691182 DOI: 10.3390/ijms161226242] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 11/29/2015] [Accepted: 12/14/2015] [Indexed: 01/19/2023] Open
Abstract
We aimed to compare the effects of oral ethanol (Eth) alone or combined with the phytoestrogen resveratrol (Rsv) on the expression of various brain-derived neurotrophic factor (BDNF) transcripts and the encoded protein pro-BDNF in the hippocampus of pregnant and embryonic rats. A low (0.25 g/kg body weight (BW)/day) dose of Eth produced an increase in the expression of BDNF exons I, III and IV and a decrease in that of the exon IX in embryos, but failed to affect BDNF transcript and pro-BDNF protein expression in adults. However, co-administration of Eth 0.25 g/kg·BW/day and Rsv led to increased expression of BDNF exons I, III and IV and to a small but significant increase in the level of pro-BDNF protein in maternal rats. A high (2.5 g/kg·BW/day) dose of Eth increased the expression of BDNF exons III and IV in embryos, but it decreased the expression of exon IX containing BDNF mRNAs in the maternal rats. While the high dose of Eth alone reduced the level of pro-BDNF in adults, it failed to change the levels of pro-BDNF in embryos. Eth differentially affects the expression pattern of BDNF transcripts and levels of pro-BDNF in the hippocampus of both adult and embryonic rats.
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Affiliation(s)
- Shahla Shojaei
- Department of Biochemistry and Recombinant Protein Laboratory, School of Medicine, Shiraz University of Medical Sciences, Shiraz 713484579, Iran.
| | - Saeid Ghavami
- Department of Human Anatomy and Cell Science, Faculty of Health Sciences College of Medicine, University of Manitoba, Winnipeg, MB R3E 0J9, Canada.
- Health Research Policy Centre, Shiraz University of Medical Sciences, Shiraz 713484579, Iran.
| | - Mohammad Reza Panjehshahin
- Department of Pharmacology, School of Medicine, Shiraz University of Medical Sciences, Shiraz 713484579, Iran.
| | - Ali Akbar Owji
- Research Center for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz 713484579, Iran.
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