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Verhoeven JE, Wolkowitz OM, Barr Satz I, Conklin Q, Lamers F, Lavebratt C, Lin J, Lindqvist D, Mayer SE, Melas PA, Milaneschi Y, Picard M, Rampersaud R, Rasgon N, Ridout K, Söderberg Veibäck G, Trumpff C, Tyrka AR, Watson K, Wu GWY, Yang R, Zannas AS, Han LKM, Månsson KNT. The researcher's guide to selecting biomarkers in mental health studies. Bioessays 2024:e2300246. [PMID: 39258367 DOI: 10.1002/bies.202300246] [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: 12/25/2023] [Revised: 07/01/2024] [Accepted: 07/03/2024] [Indexed: 09/12/2024]
Abstract
Clinical mental health researchers may understandably struggle with how to incorporate biological assessments in clinical research. The options are numerous and are described in a vast and complex body of literature. Here we provide guidelines to assist mental health researchers seeking to include biological measures in their studies. Apart from a focus on behavioral outcomes as measured via interviews or questionnaires, we advocate for a focus on biological pathways in clinical trials and epidemiological studies that may help clarify pathophysiology and mechanisms of action, delineate biological subgroups of participants, mediate treatment effects, and inform personalized treatment strategies. With this paper we aim to bridge the gap between clinical and biological mental health research by (1) discussing the clinical relevance, measurement reliability, and feasibility of relevant peripheral biomarkers; (2) addressing five types of biological tissues, namely blood, saliva, urine, stool and hair; and (3) providing information on how to control sources of measurement variability.
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Affiliation(s)
- Josine E Verhoeven
- Department of Psychiatry, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health program, Amsterdam, The Netherlands
| | - Owen M Wolkowitz
- Department of Psychiatry and Behavioral Sciences, and Weill Institute for Neurosciences, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Isaac Barr Satz
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Quinn Conklin
- Center for Mind and Brain, University of California, Davis, California, USA
- Center for Health and Community, University of California, San Francisco, California, USA
| | - Femke Lamers
- Department of Psychiatry, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health program, Amsterdam, The Netherlands
| | - Catharina Lavebratt
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, L8:00, Karolinska University Hospital, Stockholm, Sweden
| | - Jue Lin
- Department of Biochemistry and Biophysics, University of California, San Francisco, California, USA
| | - Daniel Lindqvist
- Unit for Biological and Precision Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Office for Psychiatry and Habilitation, Psychiatry Research Skåne, Region Skåne, Lund, Sweden
| | - Stefanie E Mayer
- Department of Psychiatry and Behavioral Sciences, and Weill Institute for Neurosciences, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Philippe A Melas
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health program, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Complex Trait Genetics, Amsterdam, The Netherlands
| | - Martin Picard
- Department of Psychiatry, Division of Behavioral Medicine, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, USA
- Department of Neurology, H. Houston Merritt Center, Columbia Translational Neuroscience Initiative, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, USA
- New York State Psychiatric Institute, New York, USA
- Robert N Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Ryan Rampersaud
- Department of Psychiatry and Behavioral Sciences, and Weill Institute for Neurosciences, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Natalie Rasgon
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Kathryn Ridout
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
- Department of Psychiatry, Kaiser Permanente, Santa Rosa Medical Center, Santa Rosa, California, USA
| | - Gustav Söderberg Veibäck
- Unit for Biological and Precision Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Office for Psychiatry and Habilitation, Psychiatry Research Skåne, Region Skåne, Lund, Sweden
| | - Caroline Trumpff
- Department of Psychiatry, Division of Behavioral Medicine, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, USA
| | - Audrey R Tyrka
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Kathleen Watson
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Gwyneth Winnie Y Wu
- Department of Psychiatry and Behavioral Sciences, and Weill Institute for Neurosciences, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Ruoting Yang
- Medical Readiness Systems Biology, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Anthony S Zannas
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Laura K M Han
- Department of Psychiatry, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
- Orygen, Parkville, Victoria, Australia
| | - Kristoffer N T Månsson
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Psychology and Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Romania
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Sara JDS, Lerman LO, Lerman A. What Can Biologic Aging Tell Us About the Effects of Mental Stress on Vascular Health. Hypertension 2023; 80:2515-2522. [PMID: 37814855 DOI: 10.1161/hypertensionaha.123.19418] [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] [Indexed: 10/11/2023]
Abstract
Cardiovascular disease is often a disease of aging. Considerable advances in our understanding of the biological mechanisms of aging have been made; yet, cardiovascular disease remains the leading cause of death in the United States urging a continued search for novel risk factors to target for preventing and treating disease. Mental stress (MS) is emerging as an important risk factor, and while progress has been made in understanding the link between MS and cardiovascular disease, the precise mechanisms of a putative causal relationship require greater clarification. In the current review, we (1) summarize our current understanding of the pathological effects of MS on vascular health; (2) describe important aspects of the pathobiology of vascular aging including inflammation, oxidative stress, mitochondrial dysfunction as well as novel processes such as genomic instability, epigenetic alterations, and nutrient signal pathways; (3) highlight similarities in the downstream biologic effects of aging and MS on vascular health with an emphasis on cellular and molecular processes that could be used to develop novel prognostic markers and treatment strategies for cardiovascular disease; (4) discuss lifestyle and pharmacological methods that target indicators of aging whose role could be translated into approaches managing the effects of MS; and (5) outline important future steps that should be considered in this area of research including the need for prospective clinical trials and for creating greater collaboration between preclinical aging researchers and clinical investigators managing MS.
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Affiliation(s)
| | - Lilach O Lerman
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (L.O.L.)
| | - Amir Lerman
- Department of Cardiovascular Diseases, Mayo College of Medicine, Rochester, MN (J.D.S.S., A.L.)
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Van Assche E, Hohoff C, Zang J, Knight MJ, Baune BT. Longitudinal early epigenomic signatures inform molecular paths of therapy response and remission in depressed patients. Front Mol Neurosci 2023; 16:1223216. [PMID: 37664245 PMCID: PMC10472456 DOI: 10.3389/fnmol.2023.1223216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/24/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction The etiology of major depressive disorder (MDD) involves the interaction between genes and environment, including treatment. Early molecular signatures for treatment response and remission are relevant in a context of personalized medicine and stratification and reduce the time-to-decision. Therefore, we focused the analyses on patients that responded or remitted following a cognitive intervention of 8 weeks. Methods We used data from a randomized controlled trial (RCT) with MDD patients (N = 112) receiving a cognitive intervention. At baseline and 8 weeks, blood for DNA methylation (Illumina Infinium MethylationEPIC 850k BeadChip) was collected, as well as MADRS. First, responders (N = 24; MADRS-reduction of at least 50%) were compared with non-responders (N = 60). Then, we performed longitudinal within-individual analyses, for response (N = 21) and for remission (N = 18; MADRS smaller or equal to 9 and higher than 9 at baseline), respectively, as well as patients with no change in MADRS over time. At 8 weeks the sample comprised 84 individuals; 73 patients had DNA methylation for both time-points. The RnBeads package (R) was used for data cleaning, quality control, and differential DNA-methylation (limma). The within-individual paired longitudinal analysis was performed using Welch's t-test. Subsequently gene-ontology (GO) pathway analyses were performed. Results No CpG was genome-wide significant CpG (p < 5 × 10-8). The most significant CpG in the differential methylation analysis comparing response versus non-response was in the IQSEC1 gene (cg01601845; p = 1.53 × 10-6), linked to neurotransmission. The most significant GO-terms were linked to telomeres. The longitudinal response analysis returned 67 GO pathways with a p < 0.05. Two of the three most significant pathways were linked to sodium transport. The analysis for remission returned 46 GO terms with a p-value smaller than 0.05 with pathways linked to phosphatase regulation and synaptic functioning. The analysis with stable patients returned mainly GO-terms linked to basic cellular processes. Discussion Our result suggest that DNA methylation can be suitable to capture early signs of treatment response and remission following a cognitive intervention in depression. Despite not being genome-wide significant, the CpG locations and GO-terms returned by our analysis comparing patients with and without cognitive impairment, are in line with prior knowledge on pathways and genes relevant for depression treatment and cognition. Our analysis provides new hypotheses for the understanding of how treatment for depression can act through DNA methylation and induce response and remission.
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Affiliation(s)
| | - Christa Hohoff
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Johannes Zang
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Matthew J. Knight
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Bernhard T. Baune
- Department of Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
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Rampersaud R, Wu GWY, Reus VI, Lin J, Blackburn EH, Epel ES, Hough CM, Mellon SH, Wolkowitz OM. Shorter telomere length predicts poor antidepressant response and poorer cardiometabolic indices in major depression. Sci Rep 2023; 13:10238. [PMID: 37353495 PMCID: PMC10290110 DOI: 10.1038/s41598-023-35912-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 05/25/2023] [Indexed: 06/25/2023] Open
Abstract
Telomere length (TL) is a marker of biological aging, and shorter telomeres have been associated with several medical and psychiatric disorders, including cardiometabolic dysregulation and Major Depressive Disorder (MDD). In addition, studies have shown shorter TL to be associated with poorer response to certain psychotropic medications, and our previous work suggested shorter TL and higher telomerase activity (TA) predicts poorer response to Selective Serotonin Reuptake Inhibitor (SSRI) treatment. Using a new group of unmedicated medically healthy individuals with MDD (n = 48), we sought to replicate our prior findings demonstrating that peripheral blood mononuclear cell (PBMC) TL and TA predict response to SSRI treatment and to identify associations between TL and TA with biological stress mediators and cardiometabolic risk indices. Our results demonstrate that longer pre-treatment TL was associated with better response to SSRI treatment (β = .407 p = .007). Additionally, we observed that TL had a negative relationship with allostatic load (β = - .320 p = .017) and a cardiometabolic risk score (β = - .300 p = .025). Our results suggest that PBMC TL reflects, in part, the cumulative effects of physiological stress and cardiovascular risk in MDD and may be a biomarker for predicting SSRI response.
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Affiliation(s)
- Ryan Rampersaud
- Weill Institute for Neurosciences and Department of Psychiatry and Behavioral Sciences, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA.
| | - Gwyneth W Y Wu
- Weill Institute for Neurosciences and Department of Psychiatry and Behavioral Sciences, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Victor I Reus
- Weill Institute for Neurosciences and Department of Psychiatry and Behavioral Sciences, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Jue Lin
- Department of Biochemistry and Biophysics, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Elizabeth H Blackburn
- Department of Biochemistry and Biophysics, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Elissa S Epel
- Weill Institute for Neurosciences and Department of Psychiatry and Behavioral Sciences, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Christina M Hough
- Weill Institute for Neurosciences and Department of Psychiatry and Behavioral Sciences, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
- Department of Psychology, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Synthia H Mellon
- Department of OB-GYN and Reproductive Sciences, UCSF School of Medicine, San Francisco, CA, USA
| | - Owen M Wolkowitz
- Weill Institute for Neurosciences and Department of Psychiatry and Behavioral Sciences, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
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Ho NC, Dunlop K. Establishing the Clinical Potential of Brain Aging in Depression: Implications for Suicidality and Antidepressant Response. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:347-348. [PMID: 37028903 DOI: 10.1016/j.bpsc.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 04/08/2023]
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Ahmed R, Ryan C, Christman S, Elson D, Bermudez C, Landman BA, Szymkowicz SM, Boyd BD, Kang H, Taylor WD. Structural MRI-Based Measures of Accelerated Brain Aging do not Moderate the Acute Antidepressant Response in Late-Life Depression. Am J Geriatr Psychiatry 2022; 30:1015-1025. [PMID: 34949526 PMCID: PMC9142760 DOI: 10.1016/j.jagp.2021.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/14/2021] [Accepted: 11/21/2021] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Late-life depression (LLD) is characterized by accelerated biological aging. Accelerated brain aging, estimated from structural magnetic resonance imaging (sMRI) data by a machine learning algorithm, is associated with LLD diagnosis, poorer cognitive performance, and disability. We hypothesized that accelerated brain aging moderates the antidepressant response. DESIGN AND INTERVENTIONS Following MRI, participants entered an 8-week randomized, controlled trial of escitalopram. Nonremitting participants then entered an open-label 8-week trial of bupropion. PARTICIPANTS Ninety-five individuals with LLD. MEASUREMENTS A machine learning algorithm estimated each participant's brain age from sMRI data. This was used to calculate the brain-age gap (BAG), or how estimated age differed from chronological age. Secondary sMRI measures of aging pathology included white matter hyperintensity (WMH) volumes and hippocampal volumes. Mixed models examined the relationship between sMRI measures and change in depression severity. Initial analyses tested for a moderating effect of MRI measures on change in depression severity with escitalopram. Subsequent analyses tested for the effect of MRI measures on change in depression severity over time across trials. RESULTS In the blinded initial phase, BAG was not significantly associated with a differential response to escitalopram over time. BAG was also not associated with a change in depression severity over time across both arms in the blinded phase or in the subsequent open-label bupropion phase. We similarly did not observe effects of WMH volume or hippocampal volume on change in depression severity over time. CONCLUSION sMRI markers of accelerated brain aging were not associated with treatment response in this sequential antidepressant trial.
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Affiliation(s)
- Ryan Ahmed
- School of Medicine (RA), Vanderbilt University, Nashville, TN; Department of Psychiatry and Behavioral Sciences (SC, DE, BAL, SMS, BDB, WDT), Vanderbilt University Medical Center, Nashville, TN; Department of Biomedical Engineering (CB, BAL), Vanderbilt University, Nashville TN; Department of Electrical Engineering and Computer Science (BAL), Vanderbilt University, Nashville, TN; Department of Biostatistics (HK), Vanderbilt University Medical Center, Nashville, TN; Geriatric Research, Education, and Clinical Center (WDT), Veterans Affairs Tennessee Valley Health System, Nashville, TN
| | - Claire Ryan
- School of Medicine (RA), Vanderbilt University, Nashville, TN; Department of Psychiatry and Behavioral Sciences (SC, DE, BAL, SMS, BDB, WDT), Vanderbilt University Medical Center, Nashville, TN; Department of Biomedical Engineering (CB, BAL), Vanderbilt University, Nashville TN; Department of Electrical Engineering and Computer Science (BAL), Vanderbilt University, Nashville, TN; Department of Biostatistics (HK), Vanderbilt University Medical Center, Nashville, TN; Geriatric Research, Education, and Clinical Center (WDT), Veterans Affairs Tennessee Valley Health System, Nashville, TN
| | - Seth Christman
- School of Medicine (RA), Vanderbilt University, Nashville, TN; Department of Psychiatry and Behavioral Sciences (SC, DE, BAL, SMS, BDB, WDT), Vanderbilt University Medical Center, Nashville, TN; Department of Biomedical Engineering (CB, BAL), Vanderbilt University, Nashville TN; Department of Electrical Engineering and Computer Science (BAL), Vanderbilt University, Nashville, TN; Department of Biostatistics (HK), Vanderbilt University Medical Center, Nashville, TN; Geriatric Research, Education, and Clinical Center (WDT), Veterans Affairs Tennessee Valley Health System, Nashville, TN
| | - Damian Elson
- School of Medicine (RA), Vanderbilt University, Nashville, TN; Department of Psychiatry and Behavioral Sciences (SC, DE, BAL, SMS, BDB, WDT), Vanderbilt University Medical Center, Nashville, TN; Department of Biomedical Engineering (CB, BAL), Vanderbilt University, Nashville TN; Department of Electrical Engineering and Computer Science (BAL), Vanderbilt University, Nashville, TN; Department of Biostatistics (HK), Vanderbilt University Medical Center, Nashville, TN; Geriatric Research, Education, and Clinical Center (WDT), Veterans Affairs Tennessee Valley Health System, Nashville, TN
| | - Camilo Bermudez
- School of Medicine (RA), Vanderbilt University, Nashville, TN; Department of Psychiatry and Behavioral Sciences (SC, DE, BAL, SMS, BDB, WDT), Vanderbilt University Medical Center, Nashville, TN; Department of Biomedical Engineering (CB, BAL), Vanderbilt University, Nashville TN; Department of Electrical Engineering and Computer Science (BAL), Vanderbilt University, Nashville, TN; Department of Biostatistics (HK), Vanderbilt University Medical Center, Nashville, TN; Geriatric Research, Education, and Clinical Center (WDT), Veterans Affairs Tennessee Valley Health System, Nashville, TN
| | - Bennett A Landman
- School of Medicine (RA), Vanderbilt University, Nashville, TN; Department of Psychiatry and Behavioral Sciences (SC, DE, BAL, SMS, BDB, WDT), Vanderbilt University Medical Center, Nashville, TN; Department of Biomedical Engineering (CB, BAL), Vanderbilt University, Nashville TN; Department of Electrical Engineering and Computer Science (BAL), Vanderbilt University, Nashville, TN; Department of Biostatistics (HK), Vanderbilt University Medical Center, Nashville, TN; Geriatric Research, Education, and Clinical Center (WDT), Veterans Affairs Tennessee Valley Health System, Nashville, TN
| | - Sarah M Szymkowicz
- School of Medicine (RA), Vanderbilt University, Nashville, TN; Department of Psychiatry and Behavioral Sciences (SC, DE, BAL, SMS, BDB, WDT), Vanderbilt University Medical Center, Nashville, TN; Department of Biomedical Engineering (CB, BAL), Vanderbilt University, Nashville TN; Department of Electrical Engineering and Computer Science (BAL), Vanderbilt University, Nashville, TN; Department of Biostatistics (HK), Vanderbilt University Medical Center, Nashville, TN; Geriatric Research, Education, and Clinical Center (WDT), Veterans Affairs Tennessee Valley Health System, Nashville, TN
| | - Brian D Boyd
- School of Medicine (RA), Vanderbilt University, Nashville, TN; Department of Psychiatry and Behavioral Sciences (SC, DE, BAL, SMS, BDB, WDT), Vanderbilt University Medical Center, Nashville, TN; Department of Biomedical Engineering (CB, BAL), Vanderbilt University, Nashville TN; Department of Electrical Engineering and Computer Science (BAL), Vanderbilt University, Nashville, TN; Department of Biostatistics (HK), Vanderbilt University Medical Center, Nashville, TN; Geriatric Research, Education, and Clinical Center (WDT), Veterans Affairs Tennessee Valley Health System, Nashville, TN
| | - Hakmook Kang
- School of Medicine (RA), Vanderbilt University, Nashville, TN; Department of Psychiatry and Behavioral Sciences (SC, DE, BAL, SMS, BDB, WDT), Vanderbilt University Medical Center, Nashville, TN; Department of Biomedical Engineering (CB, BAL), Vanderbilt University, Nashville TN; Department of Electrical Engineering and Computer Science (BAL), Vanderbilt University, Nashville, TN; Department of Biostatistics (HK), Vanderbilt University Medical Center, Nashville, TN; Geriatric Research, Education, and Clinical Center (WDT), Veterans Affairs Tennessee Valley Health System, Nashville, TN
| | - Warren D Taylor
- School of Medicine (RA), Vanderbilt University, Nashville, TN; Department of Psychiatry and Behavioral Sciences (SC, DE, BAL, SMS, BDB, WDT), Vanderbilt University Medical Center, Nashville, TN; Department of Biomedical Engineering (CB, BAL), Vanderbilt University, Nashville TN; Department of Electrical Engineering and Computer Science (BAL), Vanderbilt University, Nashville, TN; Department of Biostatistics (HK), Vanderbilt University Medical Center, Nashville, TN; Geriatric Research, Education, and Clinical Center (WDT), Veterans Affairs Tennessee Valley Health System, Nashville, TN.
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Telomere length and telomerase activity of leukocytes as biomarkers of selective serotonin reuptake inhibitor responses in patients with major depressive disorder. Psychiatr Genet 2022; 32:34-36. [PMID: 34873130 DOI: 10.1097/ypg.0000000000000305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
We analyze the leukocyte telomere length (LTL) and telomerase activity in patients with major depressive disorder (MDD) before and after treatment with selective serotonin reuptake inhibitors (SSRIs). Before treatment, there was a reduction in the LTLs and expression levels of the human telomerase reverse transcriptase (hTERT) in the patients with MDD compared with controls. However, after 24 weeks of treatment with SSRIs, there was a significant increase in the LTLs and the expression levels of hTERT, with values approaching those observed in the controls. We conclude that SSRI antidepressant therapy can directly influence the increased expression levels of hTERT in patients.
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Pisanu C, Vitali E, Meloni A, Congiu D, Severino G, Ardau R, Chillotti C, Trabucchi L, Bortolomasi M, Gennarelli M, Minelli A, Squassina A. Investigating the Role of Leukocyte Telomere Length in Treatment-Resistant Depression and in Response to Electroconvulsive Therapy. J Pers Med 2021; 11:jpm11111100. [PMID: 34834452 PMCID: PMC8622097 DOI: 10.3390/jpm11111100] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/19/2021] [Accepted: 10/25/2021] [Indexed: 12/15/2022] Open
Abstract
Psychiatric disorders seem to be characterized by premature cell senescence. However, controversial results have also been reported. In addition, the relationship between accelerated aging and treatment-resistance has scarcely been investigated. In the current study, we measured leukocyte telomere length (LTL) in 148 patients with treatment-resistant depression (TRD, 125 with major depressive disorder, MDD, and 23 with bipolar disorder, BD) treated with electroconvulsive therapy (ECT) and analyzed whether LTL was associated with different response profiles. We also compared LTL between patients with TRD and 335 non-psychiatric controls. For 107 patients for which genome-wide association data were available, we evaluated whether a significant overlap among genetic variants or genes associated with LTL and with response to ECT could be observed. LTL was negatively correlated with age (Spearman’s correlation coefficient = −0.25, p < 0.0001) and significantly shorter in patients with treatment-resistant MDD (Quade’s F = 35.18, p < 0.0001) or BD (Quade’s F = 20.84, p < 0.0001) compared to controls. Conversely, baseline LTL was not associated with response to ECT or remission. We did not detect any significant overlap between genetic variants or genes associated with LTL and response to ECT. Our results support previous findings suggesting premature cell senescence in patients with severe psychiatric disorders and suggest that LTL could not be a predictive biomarker of response to ECT.
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Affiliation(s)
- Claudia Pisanu
- Department of Biomedical Science, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Cagliari, Italy; (C.P.); (A.M.); (D.C.); (G.S.)
| | - Erika Vitali
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy; (E.V.); (M.G.); (A.M.)
- Genetics Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | - Anna Meloni
- Department of Biomedical Science, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Cagliari, Italy; (C.P.); (A.M.); (D.C.); (G.S.)
| | - Donatella Congiu
- Department of Biomedical Science, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Cagliari, Italy; (C.P.); (A.M.); (D.C.); (G.S.)
| | - Giovanni Severino
- Department of Biomedical Science, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Cagliari, Italy; (C.P.); (A.M.); (D.C.); (G.S.)
| | - Raffaella Ardau
- Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, 09123 Cagliari, Italy; (R.A.); (C.C.)
| | - Caterina Chillotti
- Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, 09123 Cagliari, Italy; (R.A.); (C.C.)
| | - Luigi Trabucchi
- Psychiatric Hospital “Villa Santa Chiara”, 37142 Verona, Italy; (L.T.); (M.B.)
| | - Marco Bortolomasi
- Psychiatric Hospital “Villa Santa Chiara”, 37142 Verona, Italy; (L.T.); (M.B.)
| | - Massimo Gennarelli
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy; (E.V.); (M.G.); (A.M.)
- Genetics Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | - Alessandra Minelli
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy; (E.V.); (M.G.); (A.M.)
- Genetics Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | - Alessio Squassina
- Department of Biomedical Science, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Cagliari, Italy; (C.P.); (A.M.); (D.C.); (G.S.)
- Correspondence: ; Tel.: +39-070-675-4323
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Bazaz MR, Balasubramanian R, Monroy-Jaramillo N, Dandekar MP. Linking the Triad of Telomere Length, Inflammation, and Gut Dysbiosis in the Manifestation of Depression. ACS Chem Neurosci 2021; 12:3516-3526. [PMID: 34547897 DOI: 10.1021/acschemneuro.1c00457] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Telomere length is an indispensable marker for cellular and biological aging, and it also represents an individual's physical and mental health status. Telomere shortening has been observed in chronic inflammatory conditions, which in turn accelerates aging and risk for psychiatric disorders, including depression. Considering the influence of inflammation and telomere shortening on the gut-brain axis, herein we describe a plausible interplay between telomere attrition, inflammation, and gut dysbiosis in the neurobiology of depression. Telomere shortening and hyperinflammation are well reported in depression. A negative impact of augmented inflammation has been noted on the intestinal permeability and microbial consortia and their byproducts in depressive patients. Moreover, gut dysbiosis provokes host-immune responses. As the gut microbiome is gaining importance in the manifestation and management of depression, herein we discuss whether telomere attrition is connected with the perturbation of commensal microflora. We also describe a pathological connection of cortisol with hyperinflammation, telomere shortening, and gut dysbiosis occurring in depression. This review summarizes how the triad of telomere attrition, inflammation, and gut dysbiosis is interconnected and modulates the risk for depression by regulating the systemic cortisol levels.
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Affiliation(s)
- Mohd Rabi Bazaz
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Telangana, India, 500037
| | - Ramya Balasubramanian
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Telangana, India, 500037
| | - Nancy Monroy-Jaramillo
- Department of Genetics, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez (NINN), Mexico City, Mexico, 14269
| | - Manoj P. Dandekar
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Telangana, India, 500037
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10
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Navarro-Mateu F, Husky M, Cayuela-Fuentes P, Álvarez FJ, Roca-Vega A, Rubio-Aparicio M, Chirlaque MD, Cayuela ML, Martínez S, Sánchez-Meca J. The association of telomere length with substance use disorders: a systematic review and meta-analysis of observational studies. Addiction 2021; 116:1954-1972. [PMID: 33140537 DOI: 10.1111/add.15312] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 07/09/2020] [Accepted: 10/28/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIMS Several recent studies have investigated the relationship between telomere length and substance use disorders with inconsistent results. We aimed to assess this association and to identify moderators of the relationship. METHODS Systematic review and meta-analysis. Selection criteria were observational studies reporting telomere length in people with a substance use disorder compared with a control group. Studies focused solely on nicotine addiction, employing other study designs, and non-human studies were excluded. Study selection and data extraction were independently conducted by two researchers following a standardized protocol and included studies until December 2019. Standardized mean differences were used as the effect size index [d; 95% confidence interval (CI)] and random-effects models were used for the meta-analysis. Cochran's Q-statistic, I2 index, visual inspection of the forest plot and a 95% prediction interval were applied to verify study heterogeneity. Subgroup analyses and meta-regressions were conducted to explore heterogeneity. Small study effects were examined using the 'funnel plot', the Egger test, Duval & Tweedie's trim-and-fill method and the precision-effect test-precision-effect estimate with standard error (PET-PEESE) method. The risk of bias and the quality of evidence were assessed. RESULTS Ten studies (12 analysis units with 2671 cases and 4532 controls) met the selection criteria. An overall effect size of moderate magnitude was found (d+ = -0.63; 95% CI = -1.00 and -0.26; P = 0.0008). A potential small study effect was detected, as well as large heterogeneity between studies (Q-statistic P < 0.001, I2 = 97.3%). Selection of controls, reporting laboratory quality control procedures and total sample size significantly affected the effect size. The quality of the evidence was very low, based on risk of bias analysis and the grading of recommendations assessment, development and evaluation (GRADE) system. CONCLUSIONS People with substance use disorders appear to have shorter telomere length than controls; however, this finding should be interpreted with caution due to the poor quality of the evidence.
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Affiliation(s)
- Fernando Navarro-Mateu
- Servicio Murciano de Salud, Unidad de Docencia, Investigación y Formación en Salud Mental (UDIF-SM), Murcia, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,IMIB-Arrixaca, Murcia, Spain.,Departamento de Psicología Básica y Metodología, University of Murcia, Murcia, Spain
| | - Mathilde Husky
- Université de Bordeaux, Laboratoire de Psychologie EA4139, Bordeaux, France
| | - Pedro Cayuela-Fuentes
- Escuela Universitaria de Enfermería de Cartagena, University of Murcia, Murcia, Spain
| | - Francisco-Javier Álvarez
- Servicio Murciano de Salud, Unidad de Docencia, Investigación y Formación en Salud Mental (UDIF-SM), Murcia, Spain
| | - Agustín Roca-Vega
- Biblioteca Virtual MurciaSalud, Centro Tecnológico de Información y Documentación Sanitaria, Servicio Murciano de Salud, Murcia, Spain
| | | | - María Dolores Chirlaque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,IMIB-Arrixaca, Murcia, Spain.,Servicio de Epidemiología, Consejería de Salud, Murcia, Spain.,Departamento de Ciencias Sociosanitarias, University of Murcia, Murcia, Spain
| | - María Luisa Cayuela
- Grupo Telomerasa, Cáncer y Envejecimiento, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain.,CIBER de Enfermedades Raras (CIBERER), Madrid, Spain
| | - Salvador Martínez
- Instituto de Neurociencias, UMH-CSIC, Alicante, Spain.,and CIBER de Salud Mental (CIBERSAM), Madrid, Spain
| | - Julio Sánchez-Meca
- Departamento de Psicología Básica y Metodología, University of Murcia, Murcia, Spain
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11
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Wojcicki JM, Lustig RH, Jacobs LM, Mason AE, Hartman A, Leung C, Stanhope K, Lin J, Schmidt LA, Epel ES. Longer Leukocyte Telomere Length Predicts Stronger Response to a Workplace Sugar-Sweetened Beverage Sales Ban: An Exploratory Study. Curr Dev Nutr 2021; 5:nzab084. [PMID: 34235373 PMCID: PMC8257411 DOI: 10.1093/cdn/nzab084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/17/2021] [Accepted: 05/19/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Shorter leukocyte telomere length (LTL) is associated with increased risk of a number of metabolic diseases including insulin resistance and the development of type 2 diabetes mellitus. Shorter LTL is also associated with stress reactivity suggestive of a possible role for LTL to predict response to behavioral interventions. However, few studies have evaluated how interventions, such as weight loss or dietary changes, are associated with LTL changes or whether LTL can predict behavioral responses to interventions. OBJECTIVES We evaluated metabolic changes in relation to LTL changes and LTL at baseline in a cohort of at-risk adults in response to a 10-mo workplace-based sugar-sweetened beverage (SSB) intervention. METHODS At baseline, metabolic health and LTL measurements were assessed through standard blood draws on 212 participants. Multivariable linear regression models were used to assess changes in anthropometrics, SSB consumption, and 13 blood-based metabolic risk factors, in relation to LTL at baseline and changes in LTL. RESULTS Longer LTL at baseline was associated with decreases in SSB consumption over the 6-mo follow-up period (B = -29.67; P = 0.04). Slower LTL attrition rates were associated with decreases in waist circumference (B = -0.27; P = 0.03), HDL cholesterol (B = -0.20; P = 0.05), and apoA1 (B = -0.09; P = 0.01). CONCLUSIONS Longer LTL at baseline predicted a favorable overall response to a behavioral intervention: decreases in SSB consumption. Abdominal adiposity losses paralleled slower declines in LTL suggestive of overall health benefits, but we found differences in the relations between metabolic changes and LTL at baseline compared with LTL attrition rates. Longer LTL may be a proxy marker of a positive behavioral response.This trial was registered at clinicaltrials.gov as NCT02585336.
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Affiliation(s)
- Janet M Wojcicki
- Department of Pediatrics, University of California, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Robert H Lustig
- Department of Pediatrics, University of California, San Francisco, CA, USA
- Philip R Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA
| | - Laurie M Jacobs
- Philip R Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA
| | - Ashley E Mason
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
- Osher Center for Integrative Medicine, University of California, San Francisco, CA, USA
| | - Alison Hartman
- Center for Health and Community, University of California, San Francisco, CA, USA
| | - Cindy Leung
- Department of Nutritional Science, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Kimber Stanhope
- Department of Molecular Biosciences, University of California, Davis, CA, USA
| | - Jue Lin
- Department of Biophysics and Biochemistry, University of California, San Francisco, CA, USA
| | - Laura A Schmidt
- Philip R Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA
- Department of Anthropology, History and Social Medicine, University of California, San Francisco, CA, USA
| | - Elissa S Epel
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
- Center for Health and Community, University of California, San Francisco, CA, USA
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12
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Accelerated brain aging predicts impulsivity and symptom severity in depression. Neuropsychopharmacology 2021; 46:911-919. [PMID: 33495545 PMCID: PMC8115107 DOI: 10.1038/s41386-021-00967-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 01/08/2021] [Indexed: 01/30/2023]
Abstract
Multiple structural and functional neuroimaging measures vary over the course of the lifespan and can be used to predict chronological age. Accelerated brain aging, as quantified by deviations in the MRI-based predicted age with respect to chronological age, is associated with risk for neurodegenerative conditions, bipolar disorder, and mortality. Whether age-related changes in resting-state functional connectivity are accelerated in major depressive disorder (MDD) is unknown, and, if so, it is unclear if these changes contribute to specific cognitive weaknesses that often occur in MDD. Here, we delineated age-related functional connectivity changes in a large sample of normal control subjects and tested whether brain aging is accelerated in MDD. Furthermore, we tested whether accelerated brain aging predicts individual differences in cognitive function. We trained a support vector regression model predicting age using resting-state functional connectivity in 710 healthy adults aged 18-89. We applied this model trained on normal aging subjects to a sample of actively depressed MDD participants (n = 109). The difference between predicted brain age and chronological age was 2.11 years greater (p = 0.015) in MDD patients compared to control participants. An older MDD brain age was significantly associated with increased impulsivity and, in males, increased depressive severity. Unexpectedly, accelerated brain aging was also associated with increased placebo response in a sham-controlled trial of high-frequency repetitive transcranial magnetic stimulation targeting the dorsomedial prefrontal cortex. Our results indicate that MDD is associated with accelerated brain aging, and that accelerated aging is selectively associated with greater impulsivity and depression severity.
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13
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Squassina A, Manchia M, Pisanu C, Ardau R, Arzedi C, Bocchetta A, Caria P, Cocco C, Congiu D, Cossu E, Dettori T, Frau DV, Garzilli M, Manca E, Meloni A, Montis MA, Mura A, Nieddu M, Noli B, Paribello P, Pinna F, Robledo R, Severino G, Sogos V, Del Zompo M, Ferri GL, Chillotti C, Vanni R, Carpiniello B. Telomere attrition and inflammatory load in severe psychiatric disorders and in response to psychotropic medications. Neuropsychopharmacology 2020; 45:2229-2238. [PMID: 32919410 PMCID: PMC7784910 DOI: 10.1038/s41386-020-00844-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/14/2020] [Accepted: 08/26/2020] [Indexed: 12/15/2022]
Abstract
Individuals with severe psychiatric disorders have a reduced life expectancy compared to the general population. At the biological level, patients with these disorders present features that suggest the involvement of accelerated aging, such as increased circulating inflammatory markers and shorter telomere length (TL). To date, the role of the interplay between inflammation and telomere dynamics in the pathophysiology of severe psychiatric disorders has been scarcely investigated. In this study we measured T-lymphocytes TL with quantitative fluorescent in situ hybridization (Q-FISH) and plasma levels of inflammatory markers in a cohort comprised of 40 patients with bipolar disorder (BD), 41 with schizophrenia (SZ), 37 with major depressive disorder (MDD), and 36 non-psychiatric controls (NPC). TL was shorter in SZ and in MDD compared to NPC, while it was longer in BD (model F6, 137 = 20.128, p = 8.73 × 10-17, effect of diagnosis, F3 = 31.870; p = 1.08 × 10-15). There was no effect of the different classes of psychotropic medications, while duration of treatment with mood stabilizers was associated with longer TL (Partial correlation controlled for age and BMI: correlation coefficient = 0.451; p = 0.001). Levels of high-sensitivity C-Reactive Protein (hsCRP) were higher in SZ compared to NPC (adjusted p = 0.027), and inversely correlated with TL in the whole sample (r = -0.180; p = 0.042). Compared to NPC, patients with treatment resistant (TR) SZ had shorter TL (p = 0.001), while patients with TR MDD had higher levels of tumor necrosis factor-α (TNFα) compared to NPC (p = 0.028) and to non-TR (p = 0.039). Comorbidity with cardio-metabolic disorders did not influence the observed differences in TL, hsCRP, and TNFα among the diagnostic groups. Our study suggests that patients with severe psychiatric disorders present reduced TL and increased inflammation.
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Affiliation(s)
- Alessio Squassina
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042, Monserrato, Cagliari, Italy.
| | - Mirko Manchia
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
- Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Claudia Pisanu
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042, Monserrato, Cagliari, Italy
| | - Raffaella Ardau
- Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Carlo Arzedi
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Alberto Bocchetta
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042, Monserrato, Cagliari, Italy
- Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Paola Caria
- Department of Biomedical Sciences, Unit of Biology and Genetics, University of Cagliari, Monserrato, Cagliari, Italy
| | - Cristina Cocco
- Department of Biomedical Sciences, NEF Laboratory, University of Cagliari, Monserrato, Cagliari, Italy
| | - Donatella Congiu
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042, Monserrato, Cagliari, Italy
| | - Eleonora Cossu
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Tinuccia Dettori
- Department of Biomedical Sciences, Unit of Biology and Genetics, University of Cagliari, Monserrato, Cagliari, Italy
| | - Daniela Virginia Frau
- Department of Biomedical Sciences, Unit of Biology and Genetics, University of Cagliari, Monserrato, Cagliari, Italy
| | - Mario Garzilli
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Elias Manca
- Department of Biomedical Sciences, NEF Laboratory, University of Cagliari, Monserrato, Cagliari, Italy
| | - Anna Meloni
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042, Monserrato, Cagliari, Italy
| | - Maria Antonietta Montis
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Andrea Mura
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Mariella Nieddu
- Department of Biomedical Sciences, Unit of Biology and Genetics, University of Cagliari, Monserrato, Cagliari, Italy
| | - Barbara Noli
- Department of Biomedical Sciences, NEF Laboratory, University of Cagliari, Monserrato, Cagliari, Italy
| | - Pasquale Paribello
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Federica Pinna
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Renato Robledo
- Department of Biomedical Sciences, Unit of Biology and Genetics, University of Cagliari, Monserrato, Cagliari, Italy
| | - Giovanni Severino
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042, Monserrato, Cagliari, Italy
| | - Valeria Sogos
- Department of Biomedical Sciences, Section of Cytomorphology, University of Cagliari, Monserrato, Cagliari, Italy
| | - Maria Del Zompo
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042, Monserrato, Cagliari, Italy
- Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Gian Luca Ferri
- Department of Biomedical Sciences, NEF Laboratory, University of Cagliari, Monserrato, Cagliari, Italy
| | - Caterina Chillotti
- Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Roberta Vanni
- Department of Biomedical Sciences, Unit of Biology and Genetics, University of Cagliari, Monserrato, Cagliari, Italy
| | - Bernardo Carpiniello
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
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14
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Ryan KM, McLoughlin DM. Telomere length in depression and association with therapeutic response to electroconvulsive therapy and cognitive side-effects. Psychol Med 2020; 50:2096-2106. [PMID: 31477194 DOI: 10.1017/s0033291719002228] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Electroconvulsive therapy (ECT) is the most acutely effective treatment for severe treatment-resistant depression. However, there are concerns about its cognitive side-effects and we cannot yet confidently predict who will experience these. Telomeres are DNA-protein complexes that maintain genomic integrity. In somatic cells, telomeres shorten with each cell division. Telomere length (TL) can thus provide a measure of 'biological' aging. TL appears to be reduced in depression, though results are mixed. We sought to test the following hypotheses: (1) that TL would be shorter in patients with depression compared to controls; (2) that TL would be a predictor of response to ECT; and (3) that shorter TL would predict cognitive side-effects following ECT. METHOD We assessed TL in whole blood DNA collected from severely depressed patients (n = 100) recruited as part of the EFFECT-Dep Trial and healthy controls (n = 80) using quantitative real-time polymerase chain reaction. Mood and selected cognitive measures, including global cognition, re-orientation time, and autobiographical memory, were obtained pre-/post-ECT and from controls. RESULTS Our results indicate that TL does not differ between patients with depression compared to controls. TL itself was not associated with mood ratings and did not predict the therapeutic response to ECT. Furthermore, shorter baseline TL is not a predictor of cognitive side-effects post-ECT. CONCLUSIONS Overall, TL assessed by PCR does not represent a useful biomarker for predicting the therapeutic outcomes or risk for selected cognitive deficits following ECT.
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Affiliation(s)
- Karen M Ryan
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland
- Department of Psychiatry, St. Patrick's University Hospital, Trinity College Dublin, James Street, Dublin 8, Ireland
| | - Declan M McLoughlin
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland
- Department of Psychiatry, St. Patrick's University Hospital, Trinity College Dublin, James Street, Dublin 8, Ireland
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15
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Prabu P, Poongothai S, Shanthirani CS, Anjana RM, Mohan V, Balasubramanyam M. Altered circulatory levels of miR-128, BDNF, cortisol and shortened telomeres in patients with type 2 diabetes and depression. Acta Diabetol 2020; 57:799-807. [PMID: 32025863 DOI: 10.1007/s00592-020-01486-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 01/20/2020] [Indexed: 12/11/2022]
Abstract
AIMS Several studies have reported the role of biomarkers either in diabetes or depression. The present study is aimed at profiling the circulating levels of miR-128, brain-derived neurotrophic factor (BDNF), cortisol and telomere length in patients with type 2 diabetes with and without depression compared to individuals with normal glucose tolerance. METHODS Study subjects (n = 160) were recruited from an ongoing epidemiological study in southern India. Non-diabetic and diabetic individuals were diagnosed as per the World Health Organization criteria. Depression score was derived using PHQ-12 questionnaire. Real-time quantitative PCR and ELISA methodologies were used to quantify the biomarkers. RESULTS Circulatory levels of miR-128 and cortisol were significantly (p < 0.05) increased with decreased BDNF levels and shortened telomeres in T2DM patients with or without depression compared to NGT individuals. T2DM patients with depression had the highest levels of miR-128 and cortisol and lowest levels of BDNF and telomere length compared to other groups. Pearson correlation analysis showed miR-128 levels were negatively associated with BDNF, telomere length and HDL cholesterol and positively correlated with cortisol, depression score, poor glycemic control and insulin resistance. Regression analysis confirmed that miR-128 was significantly associated with depression score even after adjusted for several confounding factors. However, this association was lost when adjusted for cortisol or telomere length. CONCLUSIONS Patients with type 2 diabetes and depression exhibited increased circulatory levels of miR-128 and serum cortisol and decreased levels of BDNF and shortened telomeres. These neuroendocrine signatures were more markedly altered in those with combined diabetes and depression.
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Affiliation(s)
- Paramasivam Prabu
- Department of Cell and Molecular Biology, Madras Diabetes Research Foundation (MDRF) and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases Prevention and Control & ICMR Centre for Advanced Research on Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, 600086, India
| | - Subramani Poongothai
- Department of Cell and Molecular Biology, Madras Diabetes Research Foundation (MDRF) and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases Prevention and Control & ICMR Centre for Advanced Research on Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, 600086, India
| | - Coimbatore Subramanian Shanthirani
- Department of Cell and Molecular Biology, Madras Diabetes Research Foundation (MDRF) and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases Prevention and Control & ICMR Centre for Advanced Research on Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, 600086, India
| | - Ranjit Mohan Anjana
- Department of Cell and Molecular Biology, Madras Diabetes Research Foundation (MDRF) and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases Prevention and Control & ICMR Centre for Advanced Research on Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, 600086, India
| | - Viswanathan Mohan
- Department of Cell and Molecular Biology, Madras Diabetes Research Foundation (MDRF) and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases Prevention and Control & ICMR Centre for Advanced Research on Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, 600086, India
| | - Muthuswamy Balasubramanyam
- Department of Cell and Molecular Biology, Madras Diabetes Research Foundation (MDRF) and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases Prevention and Control & ICMR Centre for Advanced Research on Diabetes, No 4, Conran Smith Road, Gopalapuram, Chennai, 600086, India.
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16
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Lever-van Milligen BA, Verhoeven JE, Schmaal L, van Velzen LS, Révész D, Black CN, Han LKM, Horsfall M, Batelaan NM, van Balkom AJLM, van Schaik DJF, van Oppen P, Penninx BWJH. The impact of depression and anxiety treatment on biological aging and metabolic stress: study protocol of the MOod treatment with antidepressants or running (MOTAR) study. BMC Psychiatry 2019; 19:425. [PMID: 31888565 PMCID: PMC6937704 DOI: 10.1186/s12888-019-2404-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 12/11/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Depressive and anxiety disorders have shown to be associated to premature or advanced biological aging and consequently to adversely impact somatic health. Treatments with antidepressant medication or running therapy are both found to be effective for many but not all patients with mood and anxiety disorders. These interventions may, however, work through different pathophysiological mechanisms and could differ in their impact on biological aging and somatic health. This study protocol describes the design of an unique intervention study that examines whether both treatments are similarly effective in reducing or reversing biological aging (primary outcome), psychiatric status, metabolic stress and neurobiological indicators (secondary outcomes). METHODS The MOod Treatment with Antidepressants or Running (MOTAR) study will recruit a total of 160 patients with a current major depressive and/or anxiety disorder in a mental health care setting. Patients will receive a 16-week treatment with either antidepressant medication or running therapy (3 times/week). Patients will undergo the treatment of their preference and a subsample will be randomized (1:1) to overcome preference bias. An additional no-disease-no-treatment group of 60 healthy controls without lifetime psychopathology, will be included as comparison group for primary and secondary outcomes at baseline. Assessments are done at week 0 for patients and controls, and at week 16 and week 52 for patients only, including written questionnaires, a psychiatric and medical examination, blood, urine and saliva collection and a cycle ergometer test, to gather information about biological aging (telomere length and telomerase activity), mental health (depression and anxiety disorder characteristics), general fitness, metabolic stress-related biomarkers (inflammation, metabolic syndrome, cortisol) and genetic determinants. In addition, neurobiological alterations in brain processes will be assessed using structural and functional Magnetic Resonance Imaging (MRI) in a subsample of at least 25 patients per treatment arm and in all controls. DISCUSSION This intervention study aims to provide a better understanding of the impact of antidepressant medication and running therapy on biological aging, metabolic stress and neurobiological indicators in patients with depressive and anxiety disorders in order to guide a more personalized medicine treatment. TRIAL REGISTRATION Trialregister.nl Number of identification: NTR3460, May 2012.
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Affiliation(s)
- Bianca A. Lever-van Milligen
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Josine E. Verhoeven
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Lianne Schmaal
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Laura S. van Velzen
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Dóra Révész
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Catherine N. Black
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Laura K. M. Han
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Melany Horsfall
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Neeltje M. Batelaan
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Anton J. L. M. van Balkom
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Digna J. F. van Schaik
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Patricia van Oppen
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Brenda W. J. H. Penninx
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
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Navarro-Mateu F, Rubio-Aparicio M, Cayuela P, Álvarez FJ, Roca-Vega A, Chirlaque MD, Cayuela ML, Husky M, Martínez S, Sánchez-Meca J. The association of telomere length with substance use disorders: systematic review and meta-analysis protocol. Syst Rev 2019; 8:298. [PMID: 31787100 PMCID: PMC6886210 DOI: 10.1186/s13643-019-1199-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 10/15/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The present protocol was designed for a systematic review and meta-analysis aimed at determining the association of telomere length with substance use disorders with the exclusion of nicotine addiction, and to identify potential moderators of the effect of telomere length. Such methodological information may provide guidance to improve the quality of future research on this important topic. METHODS Potential studies will be identified through electronic databases (PubMed/MEDLINE, EMBASE, PsycINFO, and Web of Science) up from inception onwards. The inclusion criteria will include published or unpublished observational studies (cohort, case-control, and cross-sectional studies) reporting telomere length in adult patients with substance use disorder compared with a control group. Non-human studies or other study designs such as reviews, case-only, family-based, and/or population studies with only healthy participants will be excluded, as well as those focused solely on nicotine addiction. The main outcome will be telomere length in adults with substance use disorder (primary) and, specifically, in those with alcohol use disorder (secondary). Two investigators will independently evaluate the preselected studies for possible inclusion and will extract data following a standardized protocol. Disagreements will be resolved by consensus. The risk of bias of all included studies will be assessed using the Newcastle-Ottawa Quality Assessment Scale for non-randomized studies. Data will be converted into standardized mean differences as effect size index, and random-effects models will be used for the meta-analysis. Cochran's Q statistic, I2 index, and visual inspection of the forest plot will be used to verify study heterogeneity. Subgroup analyses and meta-regressions will be conducted to ascertain heterogeneity. Several sensitivity analyses will be conducted to address the influence of potential confounding factors. Publication bias will be examined using the "funnel plot" method with Duval and Tweedie's trim-and-fill method and Egger test. DISCUSSION This systematic review will assess the association of telomere length with substance use disorders aside from nicotine addiction. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42019119785.
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Affiliation(s)
- Fernando Navarro-Mateu
- Unidad de Docencia, Investigación y Formación en Salud Mental (UDIF-SM), Servicio Murciano de Salud, c/ Lorca, n° 58, 30120, Murcia, Spain. .,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. .,IMIB-Arrixaca, Murcia, Spain. .,Departamento de Psicología Básica y Metodología, University of Murcia, Murcia, Spain.
| | | | - Pedro Cayuela
- Escuela Universitaria de Enfermería de Cartagena, University of Murcia, Murcia, Spain
| | - Francisco-Javier Álvarez
- Unidad de Docencia, Investigación y Formación en Salud Mental (UDIF-SM), Servicio Murciano de Salud, c/ Lorca, n° 58, 30120, Murcia, Spain
| | - Agustín Roca-Vega
- Biblioteca Virtual MurciaSalud, Centro Tecnológico de Información y Documentación Sanitaria, Servicio Murciano de Salud, Murcia, Spain
| | - María Dolores Chirlaque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,IMIB-Arrixaca, Murcia, Spain.,Servicio de Epidemiología, Consejería de Salud, Murcia, Spain.,Departamento de Ciencias Sociosanitarias, University of Murcia, Murcia, Spain
| | - María Luisa Cayuela
- IMIB-Arrixaca, Murcia, Spain.,Grupo Telomerasa, Cáncer y Envejecimiento, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Mathilde Husky
- Laboratoire de Psychologie EA4139, Université de Bordeaux, Bordeaux, France
| | | | - Julio Sánchez-Meca
- Departamento de Psicología Básica y Metodología, University of Murcia, Murcia, Spain
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18
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Pisanu C, Tsermpini EE, Skokou M, Kordou Z, Gourzis P, Assimakopoulos K, Congiu D, Meloni A, Balasopoulos D, Patrinos GP, Squassina A. Leukocyte telomere length is reduced in patients with major depressive disorder. Drug Dev Res 2019; 81:268-273. [DOI: 10.1002/ddr.21612] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 09/30/2019] [Accepted: 10/01/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Claudia Pisanu
- Department of Biomedical Sciences, Section of Neuroscience and Clinical PharmacologyUniversity of Cagliari Cagliari Italy
| | | | - Maria Skokou
- Psychiatric Clinic, Patras General Hospital Patras Greece
| | - Zoe Kordou
- Department of PharmacyUniversity of Patras School of Health Sciences Patras Greece
| | - Philippos Gourzis
- Department of MedicineUniversity of Patras School of Health Sciences Patras Greece
| | | | - Donatella Congiu
- Department of Biomedical Sciences, Section of Neuroscience and Clinical PharmacologyUniversity of Cagliari Cagliari Italy
| | - Anna Meloni
- Department of Biomedical Sciences, Section of Neuroscience and Clinical PharmacologyUniversity of Cagliari Cagliari Italy
| | | | - George P. Patrinos
- Department of PharmacyUniversity of Patras School of Health Sciences Patras Greece
- Department of PathologyUnited Arab Emirates University, College of Medicine and Health Sciences Al‐Ain UAE
- Zayed Center of Health SciencesUnited Arab Emirates University Al‐Ain UAE
| | - Alessio Squassina
- Department of Biomedical Sciences, Section of Neuroscience and Clinical PharmacologyUniversity of Cagliari Cagliari Italy
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19
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Valiati FE, Hizo GH, Pinto JV, Kauer-Sant`Anna M. The Possible Role of Telomere Length and Chemokines in the Aging Process: A Transdiagnostic Review in Psychiatry. CURRENT PSYCHIATRY RESEARCH AND REVIEWS 2019. [DOI: 10.2174/1573400515666190719155906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:Psychiatric disorders are common, reaching a worldwide prevalence of 29.2%. They are associated with a high risk of premature death and with accelerated aging in clinical, molecular and neuroimaging studies. Recently, there is strong evidence suggesting a possible role of telomere length and chemokines in aging processes in psychiatric disorders.Objective:We aimed to review the literature on telomere length and chemokines and its association with early aging in mental illnesses on a transdiagnostic approach.Results:The review highlights the association between psychiatric disorders and early aging. Several independent studies have reported shorter telomere length and dysregulations on levels of circulating chemokines in schizophrenia, bipolar disorder, major depressive disorder, and anxiety disorders, suggesting a complex interaction between these markers in a transdiagnostic level. However, studies have investigated the inflammatory markers and telomere shortening separately and associated with a particular diagnosis, rather than as a transdiagnostic biological feature.Conclusion:There is consistent evidence supporting the relationship between accelerated aging, telomere length, and chemokines in mental disorders, but they have been studied individually. Thus, more research is needed to improve the knowledge of accelerated senescence and its biomarkers in psychiatry, not only individually in each diagnosis, but also based on a transdiagnostic perspective. Moreover, further research should try to elucidate how the intricate association between the chemokines and telomeres together may contribute to the aging process in psychiatric disorders.
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Affiliation(s)
- Fernanda Endler Valiati
- Laboratory of Molecular Psychiatry, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Gabriel Henrique Hizo
- Laboratory of Molecular Psychiatry, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Jairo Vinícius Pinto
- Laboratory of Molecular Psychiatry, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Márcia Kauer-Sant`Anna
- Laboratory of Molecular Psychiatry, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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20
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Han LKM, Verhoeven JE, Tyrka AR, Penninx BWJH, Wolkowitz OM, Månsson KNT, Lindqvist D, Boks MP, Révész D, Mellon SH, Picard M. Accelerating research on biological aging and mental health: Current challenges and future directions. Psychoneuroendocrinology 2019; 106:293-311. [PMID: 31154264 PMCID: PMC6589133 DOI: 10.1016/j.psyneuen.2019.04.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 01/22/2019] [Accepted: 04/02/2019] [Indexed: 12/13/2022]
Abstract
Aging is associated with complex biological changes that can be accelerated, slowed, or even temporarily reversed by biological and non-biological factors. This article focuses on the link between biological aging, psychological stressors, and mental illness. Rather than comprehensively reviewing this rapidly expanding field, we highlight challenges in this area of research and propose potential strategies to accelerate progress in this field. This effort requires the interaction of scientists across disciplines - including biology, psychiatry, psychology, and epidemiology; and across levels of analysis that emphasize different outcome measures - functional capacity, physiological, cellular, and molecular. Dialogues across disciplines and levels of analysis naturally lead to new opportunities for discovery but also to stimulating challenges. Some important challenges consist of 1) establishing the best objective and predictive biological age indicators or combinations of indicators, 2) identifying the basis for inter-individual differences in the rate of biological aging, and 3) examining to what extent interventions can delay, halt or temporarily reverse aging trajectories. Discovering how psychological states influence biological aging, and vice versa, has the potential to create novel and exciting opportunities for healthcare and possibly yield insights into the fundamental mechanisms that drive human aging.
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Affiliation(s)
- Laura K M Han
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute, Oldenaller 1, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Josine E Verhoeven
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute, Oldenaller 1, the Netherlands
| | - Audrey R Tyrka
- Butler Hospital and the Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Brenda W J H Penninx
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute, Oldenaller 1, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Owen M Wolkowitz
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, School of Medicine, San Francisco, CA, USA
| | - Kristoffer N T Månsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Psychology, Stockholm University, Stockholm, Sweden; Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Daniel Lindqvist
- Faculty of Medicine, Department of Clinical Sciences, Psychiatry, Lund University, Lund, Sweden; Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA; Psychiatric Clinic, Lund, Division of Psychiatry, Lund, Sweden
| | - Marco P Boks
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, the Netherlands
| | - Dóra Révész
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Synthia H Mellon
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, School of Medicine, San Francisco, CA, USA
| | - Martin Picard
- Department of Psychiatry, Division of Behavioral Medicine, Columbia University Medical Center, New York, NY, USA; Department of Neurology, H. Houston Merritt Center, Columbia Translational Neuroscience Initiative, Columbia University Medical Center, New York, NY, USA; Columbia Aging Center, Columbia University, New York, NY, USA.
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21
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Kim Y, Vadodaria KC, Lenkei Z, Kato T, Gage FH, Marchetto MC, Santos R. Mitochondria, Metabolism, and Redox Mechanisms in Psychiatric Disorders. Antioxid Redox Signal 2019; 31:275-317. [PMID: 30585734 PMCID: PMC6602118 DOI: 10.1089/ars.2018.7606] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 12/21/2018] [Accepted: 12/23/2018] [Indexed: 12/17/2022]
Abstract
Significance: Our current knowledge of the pathophysiology and molecular mechanisms causing psychiatric disorders is modest, but genetic susceptibility and environmental factors are central to the etiology of these conditions. Autism, schizophrenia, bipolar disorder and major depressive disorder show genetic gene risk overlap and share symptoms and metabolic comorbidities. The identification of such common features may provide insights into the development of these disorders. Recent Advances: Multiple pieces of evidence suggest that brain energy metabolism, mitochondrial functions and redox balance are impaired to various degrees in psychiatric disorders. Since mitochondrial metabolism and redox signaling can integrate genetic and environmental environmental factors affecting the brain, it is possible that they are implicated in the etiology and progression of psychiatric disorders. Critical Issue: Evidence for direct links between cellular mitochondrial dysfunction and disease features are missing. Future Directions: A better understanding of the mitochondrial biology and its intracellular connections to the nuclear genome, the endoplasmic reticulum and signaling pathways, as well as its role in intercellular communication in the organism, is still needed. This review focuses on the findings that implicate mitochondrial dysfunction, the resultant metabolic changes and oxidative stress as important etiological factors in the context of psychiatric disorders. We also propose a model where specific pathophysiologies of psychiatric disorders depend on circuit-specific impairments of mitochondrial dysfunction and redox signaling at specific developmental stages.
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Affiliation(s)
- Yeni Kim
- Department of Child and Adolescent Psychiatry, National Center for Mental Health, Seoul, South Korea
- Laboratory of Genetics, The Salk Institute for Biological Studies, La Jolla, California
| | - Krishna C. Vadodaria
- Laboratory of Genetics, The Salk Institute for Biological Studies, La Jolla, California
| | - Zsolt Lenkei
- Laboratory of Dynamic of Neuronal Structure in Health and Disease, Institute of Psychiatry and Neuroscience of Paris (UMR_S1266 INSERM, University Paris Descartes), Paris, France
| | - Tadafumi Kato
- Laboratory for Molecular Dynamics of Mental Disorders, RIKEN Center for Brain Science, Wako, Japan
| | - Fred H. Gage
- Laboratory of Genetics, The Salk Institute for Biological Studies, La Jolla, California
| | - Maria C. Marchetto
- Laboratory of Genetics, The Salk Institute for Biological Studies, La Jolla, California
| | - Renata Santos
- Laboratory of Genetics, The Salk Institute for Biological Studies, La Jolla, California
- Laboratory of Dynamic of Neuronal Structure in Health and Disease, Institute of Psychiatry and Neuroscience of Paris (UMR_S1266 INSERM, University Paris Descartes), Paris, France
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22
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Monroy-Jaramillo N, Dyukova E, Walss-Bass C. Telomere length in psychiatric disorders: Is it more than an ageing marker? World J Biol Psychiatry 2019; 19:S2-S20. [PMID: 28000540 DOI: 10.1080/15622975.2016.1273550] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Psychiatric and substance-use disorders have been associated with premature biological ageing. Telomere length (TL), considered an ageing marker, has been analysed in psychiatric disorders, and to a lesser extent in substance-use disorders, with recent findings suggesting TL may be related to disease pathology. METHODS We conducted a critical and non-systematic literature search of TL studies published up to June 2016 in psychiatric and substance-use disorders, focussing on studies describing mechanisms, including studies linking telomere biology with genetic factors, stress and mitochondrial alterations (104 studies selected). RESULTS Patients with major depressive disorder and anxiety appear to have shorter leukocyte telomeres compared to controls. Inconclusive results are found for other psychiatric disorders and for substance-use disorders. This may be due in part to differences in medication treatment and response, as studies suggest that some psychotropic medications may modulate TL. Importantly, some studies establish a relationship between telomere machinery, stress and mitochondria function in psychiatric and substance-use disorders. CONCLUSIONS While further longitudinal studies considering telomere genetics are needed to clarify the cause-effect link between telomeres and mitochondria function in psychiatric and substance-use disorders, the recent findings linking these biological processes suggest that telomeres may be more than ageing markers.
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Affiliation(s)
- Nancy Monroy-Jaramillo
- a Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences , McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth) , Houston , TX , USA.,b Department of Genetics , National Institute of Neurology and Neurosurgery, Manuel Velasco Suarez , Mexico City , Mexico
| | - Elena Dyukova
- a Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences , McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth) , Houston , TX , USA
| | - Consuelo Walss-Bass
- a Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences , McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth) , Houston , TX , USA
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23
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Gillis JC, Chang SC, Wang W, Simon NM, Normand SL, Rosner BA, Blacker D, DeVivo I, Okereke OI. The relation of telomere length at midlife to subsequent 20-year depression trajectories among women. Depress Anxiety 2019; 36:565-575. [PMID: 30958913 PMCID: PMC6548605 DOI: 10.1002/da.22892] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 02/18/2019] [Accepted: 03/13/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Telomeres cap and protect DNA but shorten with each somatic cell division. Aging and environmental and lifestyle factors contribute to the speed of telomere attrition. Current evidence suggests a link between relative telomere length (RTL) and depression but the directionality of the relationship remains unclear. We prospectively examined associations between RTL and subsequent depressive symptom trajectories. METHODS Among 8,801 women of the Nurses' Health Study, depressive symptoms were measured every 4 years from 1992 to 2012; group-based trajectories of symptoms were identified using latent class growth-curve analysis. Multinomial logistic models were used to relate midlife RTLs to the probabilities of assignment to subsequent depressive symptom trajectory groups. RESULTS We identified four depressive symptom trajectory groups: minimal depressive symptoms (62%), worsening depressive symptoms (14%), improving depressive symptoms (19%), and persistent-severe depressive symptoms (5%). Longer midlife RTLs were related to significantly lower odds of being in the worsening symptoms trajectory versus minimal trajectory but not to other trajectories. In comparison with being in the minimal symptoms group, the multivariable-adjusted odds ratio of being in the worsening depressive symptoms group was 0.78 (95% confidence interval, 0.62-0.97; p = 0.02), for every standard deviation increase in baseline RTL. CONCLUSIONS In this large prospective study of generally healthy women, longer telomeres at midlife were associated with significantly lower risk of a subsequent trajectory of worsening mood symptoms over 20 years. The results raise the possibility of telomere shortening as a novel contributing factor to late-life depression.
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Affiliation(s)
- J. Cai Gillis
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA,,Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Shun-Chiao Chang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Wei Wang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Naomi M. Simon
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA,Department of Psychiatry, NYU School of Medicine, One Park Avenue, New York NY 10016
| | - Sharon-Lise Normand
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA,,Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115, USA
| | - Bernard A. Rosner
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA,,Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Deborah Blacker
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA
| | - Immaculata DeVivo
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA
| | - Olivia I. Okereke
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA,,Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA,,Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
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24
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Squassina A, Pisanu C, Vanni R. Mood Disorders, Accelerated Aging, and Inflammation: Is the Link Hidden in Telomeres? Cells 2019; 8:cells8010052. [PMID: 30650526 PMCID: PMC6356466 DOI: 10.3390/cells8010052] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 01/10/2019] [Accepted: 01/12/2019] [Indexed: 12/26/2022] Open
Abstract
Mood disorders are associated with an increased risk of aging-related diseases, which greatly contribute to the excess morbidity and mortality observed in affected individuals. Clinical and molecular findings also suggest that mood disorders might be characterized by a permanent state of low-grade inflammation. At the cellular level, aging translates into telomeres shortening. Intriguingly, inflammation and telomere shortening show a bidirectional association: a pro-inflammatory state seems to contribute to aging and telomere dysfunction, and telomere attrition is able to induce low-grade inflammation. Several independent studies have reported shorter telomere length and increased levels of circulating inflammatory cytokines in mood disorders, suggesting a complex interplay between altered inflammatory–immune responses and telomere dynamics in the etiopathogenesis of these disorders. In this review, we critically discuss studies investigating the role of telomere attrition and inflammation in the pathogenesis and course of mood disorders, and in pharmacological treatments with psychotropic medications.
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Affiliation(s)
- Alessio Squassina
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Monserrato Cagliari, Italy.
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 2E2, Canada.
| | - Claudia Pisanu
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Monserrato Cagliari, Italy.
- Department of Neuroscience, Unit of Functional Pharmacology, Uppsala University, 752 39 Uppsala, Sweden.
| | - Roberta Vanni
- Department of Biomedical Sciences, Unit of Biology and Genetics, University of Cagliari, 09042 Monserrato Cagliari, Italy.
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25
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Solana C, Pereira D, Tarazona R. Early Senescence and Leukocyte Telomere Shortening in SCHIZOPHRENIA: A Role for Cytomegalovirus Infection? Brain Sci 2018; 8:brainsci8100188. [PMID: 30340343 PMCID: PMC6210638 DOI: 10.3390/brainsci8100188] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 10/09/2018] [Accepted: 10/16/2018] [Indexed: 12/17/2022] Open
Abstract
Schizophrenia is a severe, chronic mental disorder characterized by delusions and hallucinations. Several evidences support the link of schizophrenia with accelerated telomeres shortening and accelerated aging. Thus, schizophrenia patients show higher mortality compared to age-matched healthy donors. The etiology of schizophrenia is multifactorial, involving genetic and environmental factors. Telomere erosion has been shown to be accelerated by different factors including environmental factors such as cigarette smoking and chronic alcohol consumption or by psychosocial stress such as childhood maltreatment. In humans, telomere studies have mainly relied on measurements of leukocyte telomere length and it is generally accepted that individuals with short leukocyte telomere length are considered biologically older than those with longer ones. A dysregulation of both innate and adaptive immune systems has been described in schizophrenia patients and other mental diseases supporting the contribution of the immune system to disease symptoms. Thus, it has been suggested that abnormal immune activation with high pro-inflammatory cytokine production in response to still undefined environmental agents such as herpesviruses infections can be involved in the pathogenesis and pathophysiology of schizophrenia. It has been proposed that chronic inflammation and oxidative stress are involved in the course of schizophrenia illness, early onset of cardiovascular disease, accelerated aging, and premature mortality in schizophrenia. Prenatal or neonatal exposures to neurotropic pathogens such as Cytomegalovirus or Toxoplasma gondii have been proposed as environmental risk factors for schizophrenia in individuals with a risk genetic background. Thus, pro-inflammatory cytokines and microglia activation, together with genetic vulnerability, are considered etiological factors for schizophrenia, and support that inflammation status is involved in the course of illness in schizophrenia.
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Affiliation(s)
- Corona Solana
- Centro Hospitalar Psiquiatrico de Lisboa, 1700-063 Lisboa, Portugal.
| | - Diana Pereira
- Centro Hospitalar Psiquiatrico de Lisboa, 1700-063 Lisboa, Portugal.
| | - Raquel Tarazona
- Immunology Unit, University of Extremadura, 10003 Caceres, Spain.
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Epel ES, Prather AA. Stress, Telomeres, and Psychopathology: Toward a Deeper Understanding of a Triad of Early Aging. Annu Rev Clin Psychol 2018; 14:371-397. [PMID: 29494257 DOI: 10.1146/annurev-clinpsy-032816-045054] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Telomeres play an important part in aging and show relationships to lifetime adversity, particularly childhood adversity. Meta-analyses demonstrate reliable associations between psychopathology (primarily depression) and shorter telomere length, but the nature of this relationship has not been fully understood. Here, we review and evaluate the evidence for impaired telomere biology as a consequence of psychopathology or as a contributing factor, and the important mediating roles of chronic psychological stress and impaired allostasis. There is evidence for a triadic relationship among stress, telomere shortening, and psychiatric disorders that is positively reinforcing and unfolds across the life course and, possibly, across generations. We review the role of genetics and biobehavioral responses that may contribute to shorter telomere length, as well as the neurobiological impact of impaired levels of telomerase. These complex interrelationships are important to elucidate because they have implications for mental and physical comorbidity and, potentially, for the prevention and treatment of depression.
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Affiliation(s)
| | - Aric A Prather
- Department of Psychiatry; Center for Health and Community; Aging, Metabolism, and Emotions Center; University of California, San Francisco, California 94118, USA; ,
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Gałecki P, Mossakowska-Wójcik J, Talarowska M. The anti-inflammatory mechanism of antidepressants - SSRIs, SNRIs. Prog Neuropsychopharmacol Biol Psychiatry 2018; 80:291-294. [PMID: 28342944 DOI: 10.1016/j.pnpbp.2017.03.016] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 03/15/2017] [Accepted: 03/20/2017] [Indexed: 12/12/2022]
Abstract
The cytokine theory of depression no longer brings about any doubts. Experiments and research studies conducted in the last ten years have confirmed that both physical and psychological (emotional) stress increases the likelihood of occurrence of mental disorders (including depressive disorders) owing to the action of a series of hormonal and biochemical mechanisms. Selective serotonin reuptake inhibitors (SSRI) as well as serotonin and norepinephrine reuptake inhibitors (SNRIs) are some of the most commonly applied drugs in the world during pharmacotherapy of recurrent depressive disorder. The underestimated anti-inflammatory and anti-oxidative effect may be one of the potential mechanisms of action of the preparations mentioned above. The detailed specificity of action of this mechanism still remains unknown. The aim of our work will be to perform a review of contemporary literature in order to present the latest scientific reports regarding the anti-inflammatory effects of SSRIs and SNRIs. The mechanism of anti-inflammatory action may serve as a possible explanation for the efficacy of antidepressants from the groups of SSRIs and SNRIs.
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Affiliation(s)
- Piotr Gałecki
- Department of Adult Psychiatry, Medical University of Lodz, Lodz, Poland
| | | | - Monika Talarowska
- Department of Adult Psychiatry, Medical University of Lodz, Lodz, Poland.
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Anderson G. Linking the biological underpinnings of depression: Role of mitochondria interactions with melatonin, inflammation, sirtuins, tryptophan catabolites, DNA repair and oxidative and nitrosative stress, with consequences for classification and cognition. Prog Neuropsychopharmacol Biol Psychiatry 2018; 80:255-266. [PMID: 28433458 DOI: 10.1016/j.pnpbp.2017.04.022] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 04/01/2017] [Indexed: 01/08/2023]
Abstract
The pathophysiological underpinnings of neuroprogressive processes in recurrent major depressive disorder (rMDD) are reviewed. A wide array of biochemical processes underlie MDD presentations and their shift to a recurrent, neuroprogressive course, including: increased immune-inflammation, tryptophan catabolites (TRYCATs), mitochondrial dysfunction, aryl hydrocarbonn receptor activation, and oxidative and nitrosative stress (O&NS), as well as decreased sirtuins and melatonergic pathway activity. These biochemical changes may have their roots in central, systemic and/or peripheral sites, including in the gut, as well as in developmental processes, such as prenatal stressors and breastfeeding consequences. Consequently, conceptualizations of MDD have dramatically moved from simple psychological and central biochemical models, such as lowered brain serotonin, to a conceptualization that incorporates whole body processes over a lifespan developmental timescale. However, important hubs are proposed, including the gut-brain axis, and mitochondrial functioning, which may provide achievable common treatment targets despite considerable inter-individual variability in biochemical changes. This provides a more realistic model of the complexity of MDD and the pathophysiological processes that underpin the shift to rMDD and consequent cognitive deficits. Such accumulating data on the pathophysiological processes underpinning MDD highlights the need in psychiatry to shift to a classification system that is based on biochemical processes, rather than subjective phenomenology.
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Manoliu A, Bosch OG, Brakowski J, Brühl AB, Seifritz E. The potential impact of biochemical mediators on telomere attrition in major depressive disorder and implications for future study designs: A narrative review. J Affect Disord 2018; 225:630-646. [PMID: 28889049 DOI: 10.1016/j.jad.2017.08.022] [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: 02/27/2017] [Revised: 05/30/2017] [Accepted: 08/10/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) has been proposed to represent a "disease of premature aging", which is associated with certain biomarkers of cellular ageing and numerous other age-related diseases. Over the last decade, telomere length (TL) arose as a surrogate for cellular aging. Recent data suggests that TL might be reduced in patients with MDD, however, results are still inconclusive. This might be explained by the lack of assessment of potential biochemical mediators that are directly associated with telomere shortening and frequently observed in patients with MDD. METHODS A narrative review was performed. The PubMed database was searched for relevant studies. RESULTS We identified four major mediators, which are recurrently reported in patients with MDD and are associated with reduced TL: inflammation/oxidative stress, dysregulation of the hypothalamic-pituitary-adrenal axis, metabolic dysbalance including insulin resistance, and decreased brain-derived neurotrophic factor. These mediators are also mutually associated and were not systematically assessed in current studies investigating TL and MDD, which might explain inconclusive findings across current literature. Finally, we discuss possible ways to assess those mediators and potential implications of such approaches for future research. LIMITATIONS The majority of identified studies had cross-sectional designs and used heterogeneous methods to assess TL and associated relevant biochemical mediators. CONCLUSIONS A better understanding of the complex interactions between biochemical mediators, somatic comorbidities and shortened telomeres in patients with MDD might further specify the pathophysiology-based conceptualization and, based on that, personalized treatment of MDD.
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Affiliation(s)
- Andrei Manoliu
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Lenggstrasse 31, CH-8032 Zurich, Switzerland.
| | - Oliver G Bosch
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Lenggstrasse 31, CH-8032 Zurich, Switzerland
| | - Janis Brakowski
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Lenggstrasse 31, CH-8032 Zurich, Switzerland
| | - Annette B Brühl
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Lenggstrasse 31, CH-8032 Zurich, Switzerland; Department of Psychiatry and Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Lenggstrasse 31, CH-8032 Zurich, Switzerland
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The effect of trauma and PTSD on telomere length: An exploratory study in people exposed to combat trauma. Sci Rep 2017; 7:4375. [PMID: 28663541 PMCID: PMC5491524 DOI: 10.1038/s41598-017-04682-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 05/18/2017] [Indexed: 01/30/2023] Open
Abstract
Telomere length has been suggested to be a cellular marker for age-related diseases as well as psychosocial stress. The present study investigated whether telomere length is associated with post-traumatic stress disorder (PTSD) among veterans exposed to combat trauma in the Vietnam War. The potentially associated factors on cellular aging were considered. Korean male veterans with (n = 122) and without (n = 120) PTSD were included and leukocyte telomere length was measured with a quantitative PCR-based technique. As a whole, no significant difference in telomere length was found between PTSD and non-PTSD groups. In linear regression analysis stratified by trauma levels, among veterans exposed to severe combat (n = 45), PTSD status (B = -1.176, t = -2.259, p = 0.029), antidepressant use (B = 0.168, t = 2.528, p = 0.015), and education level (B = 0.019, t = 2.369, p = 0.023) affected telomere length. However, among veterans with light-to-moderate combat exposure (n = 197), only age (B = -0.007, t = -2.434, p = 0.016) and education level (B = 0.010, t = 2.295, p = 0.023) were associated with telomere length. In the Post-hoc analysis, antidepressant use was associated with longer telomere length in subjects exposed to severe combat. Our exploratory results suggest that PTSD status in combination with severe trauma may be associated with accelerated telomere shortening, and that antidepressant use may have a protective effect on telomere dynamics.
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