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Xie H, Jiang Y, Liu L, Peng H, Li J, Chen Z. Global prevalence and risk factors of depression in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis from 2000 to 2022. J Psychosom Res 2023; 175:111537. [PMID: 37907038 DOI: 10.1016/j.jpsychores.2023.111537] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 10/22/2023] [Accepted: 10/23/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVE This study aims to assess the global and regional prevalence and the potential risk factors for depression among COPD patients. METHODS Web of Science, EMBASE, PubMed, and PsycINFO databases were searched for the literature related to the prevalence and risk factors of depression in COPD. Random-effect models were performed to pool the global prevalence. Sub-group analysis and meta-regression were conducted to investigate the potential heterogeneity. Meta-analysis was performed only on the risk factors that have been reported in a minimum of three studies. RESULTS A total of 79 studies from 25 countries were included. The pooled global prevalence of variably defined depression among COPD patients was 34.5% (95% CI: 30.9-38.1). The odds of depression in COPD patients were 3.53 times higher than in non-COPD participants (95% CI: 2.35-5.29). Meta-regression results showed that region, income level, and research setting are the main sources of heterogeneity. Female sex (OR=1.92), living alone (OR=2.29), BODE index (OR=1.48), dyspnea (OR=3.02), impaired quality of life (OR=1.26), and GOLD stage III∼IV (OR=1.96) were found to be significant risk factors for depression in meta-analyses. CONCLUSIONS More than one-third of COPD patients experience depression, with marked variations in prevalence across countries and regions. This study further highlights the need for the consolidation of mental health considerations into COPD treatments. High-quality, longitudinal studies and further research are needed to gain a better understanding of risk and protective factors.
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Affiliation(s)
- Hongmei Xie
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yunlan Jiang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
| | - Lu Liu
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Hanmei Peng
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jie Li
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Zengli Chen
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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2
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Zegarra-Rodríguez CA, Plasencia-Dueñas NR, Failoc-Rojas VE. Disparities in the prevalence of screened depression at different altitudes in Peru: A retrospective analysis of the ENDES 2019. PLoS One 2022; 17:e0278947. [PMID: 36542597 PMCID: PMC9770421 DOI: 10.1371/journal.pone.0278947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 11/24/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Depression is a public health concern, nearing 1.5 million cases and accounting for 9.7% of years lost due to disability. Several factors, including altitude, contribute to its development. Altitude has become a topic for recent research, but its association with depressive symptoms has not been fully clarified. Therefore, this study aimed to determine the association between altitude and depressive symptoms in the Peruvian population. METHODS A retrospective, cross-sectional study of the 2019 Demographic and Family Health Survey (ENDES in Spanish) was conducted. The dependent variable, depressive symptoms, was measured using the Patient Health Questionnaire (PHQ-9) and the independent variable, altitude, was categorized into: <1500 meters above sea level (masl), 1500-2499 masl and ≥2500 masl. To evaluate the association between altitude and depressive symptoms, we used Poisson regression model, constructing crude and multiple models. RESULTS Of those living at 1500 to 2499 masl and ≥2500 masl, 7.23% and 7.12% had depressive symptoms, respectively. After adjusting for confounding variables, high altitude was found to be associated with depressive symptoms (prevalence ratio adjusted (aPR): 1.38, 95% confidence interval: 1.04-1.84; aPR 1.41, 95% CI: 1.20-1.66). CONCLUSIONS A statistically significant association was found between high altitude and depressive symptoms. This may be attributable to hypobaric hypoxia that occurs at high altitudes and its effects on brain function. This study's findings should be considered to identify the population at risk and expand the coverage of preventive and therapeutic measures in high-altitude areas of Peru with poor access to health services.
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Affiliation(s)
- Cynthia Alejandra Zegarra-Rodríguez
- School of Medicine, Universidad Nacional Pedro Ruiz Gallo, Lambayeque, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional Pedro Ruiz Gallo (SOCIEM-UNPRG), Lambayeque, Peru
| | - Nahún Raphael Plasencia-Dueñas
- School of Medicine, Universidad Nacional Pedro Ruiz Gallo, Lambayeque, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional Pedro Ruiz Gallo (SOCIEM-UNPRG), Lambayeque, Peru
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Burtscher J, Niedermeier M, Hüfner K, van den Burg E, Kopp M, Stoop R, Burtscher M, Gatterer H, Millet GP. The interplay of hypoxic and mental stress: Implications for anxiety and depressive disorders. Neurosci Biobehav Rev 2022; 138:104718. [PMID: 35661753 DOI: 10.1016/j.neubiorev.2022.104718] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 12/14/2022]
Abstract
Adequate oxygen supply is essential for the human brain to meet its high energy demands. Therefore, elaborate molecular and systemic mechanism are in place to enable adaptation to low oxygen availability. Anxiety and depressive disorders are characterized by alterations in brain oxygen metabolism and of its components, such as mitochondria or hypoxia inducible factor (HIF)-pathways. Conversely, sensitivity and tolerance to hypoxia may depend on parameters of mental stress and the severity of anxiety and depressive disorders. Here we discuss relevant mechanisms of adaptations to hypoxia, as well as their involvement in mental stress and the etiopathogenesis of anxiety and depressive disorders. We suggest that mechanisms of adaptations to hypoxia (including metabolic responses, inflammation, and the activation of chemosensitive brain regions) modulate and are modulated by stress-related pathways and associated psychiatric diseases. While severe chronic hypoxia or dysfunctional hypoxia adaptations can contribute to the pathogenesis of anxiety and depressive disorders, harnessing controlled responses to hypoxia to increase cellular and psychological resilience emerges as a novel treatment strategy for these diseases.
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Affiliation(s)
- Johannes Burtscher
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland; Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland.
| | - Martin Niedermeier
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Katharina Hüfner
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Clinic for Psychiatry II, Innsbruck Medical University, Innsbruck, Austria
| | - Erwin van den Burg
- Department of Psychiatry, Center of Psychiatric Neuroscience (CNP), University Hospital of Lausanne (CHUV), Prilly, Lausanne, Switzerland
| | - Martin Kopp
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Ron Stoop
- Department of Psychiatry, Center of Psychiatric Neuroscience (CNP), University Hospital of Lausanne (CHUV), Prilly, Lausanne, Switzerland
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Hannes Gatterer
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland; Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
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Sex-based changes in rat brain serotonin and behavior in a model of altitude-related vulnerability to treatment-resistant depression. Psychopharmacology (Berl) 2021; 238:2867-2881. [PMID: 34159421 DOI: 10.1007/s00213-021-05902-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 06/08/2021] [Indexed: 01/03/2023]
Abstract
RATIONALE Rates of depression and suicide increase with altitude. In our animal model, rats housed at moderate altitude vs. at sea level exhibit increased depressive symptoms in the forced swim test (FST) and lack of response to selective serotonin reuptake inhibitors (SSRIs). Depression and SSRI resistance are linked to disrupted serotonergic function, and hypobaric hypoxia may reduce the oxygen-dependent synthesis of serotonin. We therefore tested brain serotonin in rats housed at altitude. METHODS Sprague-Dawley rats were housed at altitude (4,500 ft, 10,000 ft) vs. sea level for 7-36 days. Brain serotonin was measured by ELISA, or behavior evaluated in the FST, sucrose preference (SPT), or open-field tests (OFT). RESULTS After 2 weeks at 4,500 ft or 10,000ft vs. sea level, serotonin levels decreased significantly at altitude in the female prefrontal cortex, striatum, hippocampus, and brainstem, but increased with altitude in the male hippocampus and brainstem. Female brain serotonin decreased from 7 to 36 days at 4,500 ft, but males did not vary. At 2 weeks and 24 days, females at altitude exhibit lower brain serotonin and increased depressive symptoms in the FST and SPT, with motor behavior unaltered. In males, serotonin, passive coping in the FST and OFT immobility increased with altitude at 2 weeks, but not at 24 days. Male SPT behavior did not change with altitude. CONCLUSIONS Females may be more vulnerable to depressive symptoms at altitude, while males may be resilient. Chronic hypoxic stress at altitudes as low as 4,500 ft may cause a brain serotonin imbalance to worsen vulnerability to depression and SSRI resistance, and potentially worsen suicide risk.
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Kanekar S, Ettaro R, Hoffman MD, Ombach HJ, Brown J, Lynch C, Sheth CS, Renshaw PF. Sex-Based Impact of Creatine Supplementation on Depressive Symptoms, Brain Serotonin and SSRI Efficacy in an Animal Model of Treatment-Resistant Depression. Int J Mol Sci 2021; 22:ijms22158195. [PMID: 34360959 PMCID: PMC8348220 DOI: 10.3390/ijms22158195] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 07/25/2021] [Accepted: 07/27/2021] [Indexed: 02/05/2023] Open
Abstract
Background: Rates of major depressive disorder (MDD) increase with living at altitude. In our model, rats housed at moderate altitude (in hypobaric hypoxia) exhibit increased depression-like behavior, altered brain serotonin and a lack of antidepressant response to most selective serotonin reuptake inhibitors (SSRIs). A forebrain deficit in the bioenergetic marker creatine is noted in people living at altitude or with MDD. Methods: Rats housed at 4500 ft were given dietary creatine monohydrate (CRMH, 4% w/w, 5 weeks) vs. un-supplemented diet, and impact on depression-like behavior, brain bioenergetics, serotonin and SSRI efficacy assessed. Results: CRMH significantly improved brain creatine in a sex-based manner. At altitude, CRMH increased serotonin levels in the female prefrontal cortex and striatum but reduced male striatal and hippocampal serotonin. Dietary CRMH was antidepressant in the forced swim test and anti-anhedonic in the sucrose preference test in only females at altitude, with motor behavior unchanged. CRMH improved fluoxetine efficacy (20 mg/kg) in only males at altitude: CRMH + SSRI significantly improved male striatal creatine and serotonin vs. CRMH alone. Conclusions: Dietary CRMH exhibits sex-based efficacy in resolving altitude-related deficits in brain biomarkers, depression-like behavior and SSRI efficacy, and may be effective clinically for SSRI-resistant depression at altitude. This is the first study to link CRMH treatment to improving brain serotonin.
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Affiliation(s)
- Shami Kanekar
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA; (R.E.); (M.D.H.); (H.J.O.); (J.B.); (C.L.); (C.S.S.); (P.F.R.)
- VISN19 MIRECC, 500 Foothill Drive, Salt Lake City, UT 84148, USA
- Veterans Affairs Salt Lake City Health Care System, 500 Foothill Drive, Salt Lake City, UT 84148, USA
- Correspondence: ; Tel.: +1-801-587-1477 or +1-801-585-5375
| | - Robert Ettaro
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA; (R.E.); (M.D.H.); (H.J.O.); (J.B.); (C.L.); (C.S.S.); (P.F.R.)
| | - Michael D. Hoffman
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA; (R.E.); (M.D.H.); (H.J.O.); (J.B.); (C.L.); (C.S.S.); (P.F.R.)
| | - Hendrik J. Ombach
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA; (R.E.); (M.D.H.); (H.J.O.); (J.B.); (C.L.); (C.S.S.); (P.F.R.)
| | - Jadeda Brown
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA; (R.E.); (M.D.H.); (H.J.O.); (J.B.); (C.L.); (C.S.S.); (P.F.R.)
| | - Cayla Lynch
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA; (R.E.); (M.D.H.); (H.J.O.); (J.B.); (C.L.); (C.S.S.); (P.F.R.)
| | - Chandni S. Sheth
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA; (R.E.); (M.D.H.); (H.J.O.); (J.B.); (C.L.); (C.S.S.); (P.F.R.)
| | - Perry F. Renshaw
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA; (R.E.); (M.D.H.); (H.J.O.); (J.B.); (C.L.); (C.S.S.); (P.F.R.)
- VISN19 MIRECC, 500 Foothill Drive, Salt Lake City, UT 84148, USA
- Veterans Affairs Salt Lake City Health Care System, 500 Foothill Drive, Salt Lake City, UT 84148, USA
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Xiong H, Huang Q, He C, Shuai T, Yan P, Zhu L, Yang K, Liu J. Prevalence of chronic obstructive pulmonary disease at high altitude: a systematic review and meta-analysis. PeerJ 2020; 8:e8586. [PMID: 32280564 PMCID: PMC7134014 DOI: 10.7717/peerj.8586] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 01/17/2020] [Indexed: 12/13/2022] Open
Abstract
Background and objective Recently, several studies have investigated the prevalence of chronic obstructive pulmonary disease (COPD) at high altitude (>1,500 m). However, much remains to be understood about the correlation between altitude and COPD. We aimed to summarize the prevalence of COPD at high-altitudes and find out if altitude could be a risk factor for COPD. Methods We searched PubMed/Medline, Cochrane Library, Web of Science, SCOPUS, OVID, Chinese Biomedical Literature Database (CBM) and Embase databases from inception to April 30th, 2019, with no language restriction. We used STATA 14.0 to analyze the extracted data. A random-effect model was used to calculate the combined OR and 95% CI. Heterogeneity was assessed by the I2 statistic versus P-value. We performed a subgroup analysis to analyze possible sources of heterogeneity. The Egger’s test and the Begg’s test were used to assess any publication bias. Results We retrieved 4,574 studies from seven databases and finally included 10 studies (54,578 participants). Males ranged from 18.8% to 49.3% and the population who smoked ranged from 3.3% to 53.3%. The overall prevalence of COPD at high-altitude was 10.0% (95% CI [0.08–0.12], P < 0.001). In a subgroup analysis, based on different regions, the results showed that the prevalence in Asia was higher than that in Europe and America. Seven studies compared the relationship between the prevalence of COPD at high-altitudes and the lowlands. The results showed that altitude was not an independent risk factor for the prevalence of COPD (ORadj = 1.18, 95% CI [0.85–1.62], P = 0.321). There was no publication bias among the studies. Conclusions Our study found a higher prevalence of COPD at high-altitudes than those from average data. However, altitude was not found to be an independent risk factor for developing COPD (PROSPERO Identifier: CRD42019135012).
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Affiliation(s)
- Huaiyu Xiong
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou, China.,Department of Intensive Care Unit, The First Hospital of Lanzhou University, Lanzhou, China.,Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Qiangru Huang
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou, China.,Department of Intensive Care Unit, The First Hospital of Lanzhou University, Lanzhou, China.,Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Chengying He
- Department of Intensive Care Unit, The First Hospital of Lanzhou University, Lanzhou, China
| | - Tiankui Shuai
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou, China.,Department of Intensive Care Unit, The First Hospital of Lanzhou University, Lanzhou, China.,Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Peijing Yan
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.,Institute of Clinical Research and Evidence Based Medicine, The Gansu Provincial Hospital, Lanzhou, China
| | - Lei Zhu
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou, China.,Department of Intensive Care Unit, The First Hospital of Lanzhou University, Lanzhou, China
| | - Kehu Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.,Institute of Clinical Research and Evidence Based Medicine, The Gansu Provincial Hospital, Lanzhou, China.,Evidence Based Social Science Research Center, Lanzhou University, Lanzhou, China.,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Jian Liu
- The First Clinical Medical College of the First Hospital of Lanzhou University, Lanzhou, China.,Department of Intensive Care Unit, The First Hospital of Lanzhou University, Lanzhou, China
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Ombach HJ, Scholl LS, Bakian AV, Renshaw KT, Sung YH, Renshaw PF, Kanekar S. Association between altitude, prescription opioid misuse, and fatal overdoses. Addict Behav Rep 2019; 9:100167. [PMID: 31193784 PMCID: PMC6542744 DOI: 10.1016/j.abrep.2019.100167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 01/10/2019] [Accepted: 02/01/2019] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Prescription opioid misuse and fatal overdoses have increased significantly over the last two decades. Living at altitude has been linked to greater reward benefits of other drugs of abuse, and living at altitude may also exacerbate the respiratory depression linked to opioid use. Therefore, we examined the relationships between living at altitude, and prescription opioid misuse and fatal overdoses. METHOD State-level past year rates of prescription opioid misuse were retrieved from the Substance Abuse and Mental Health Services Administration. County-level overdose data were extracted from the Centers for Disease Control and Prevention. Multiple linear regression models were fit to determine the relationship between average state elevation and state rates of opioid misuse. Logistic regression models were fit to determine the relationship between county elevation and county-level fatal opioid overdose prevalence. RESULTS After controlling for state opioid prescribing rates and other confounders, we identified a significant positive association between mean state altitude and state-level opioid misuse rates for women, but not men. We also found a significant positive association between county-level altitude and prevalence of fatal opioid overdose. CONCLUSIONS Living at altitude is thus demographically associated with increasing rates of misuse of prescription opioids, as well as of cocaine and methamphetamine. Animal studies suggest that the hypobaric hypoxia exposure involved with living at altitude may disrupt brain neurochemistry, to increase reward benefits of drugs of abuse. This increased misuse of both stimulants and opioids may increase likelihood of overdose at altitude, with overdoses by opioid use also potentially facilitated by altitude-related hypoxia.
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Affiliation(s)
- Hendrik J. Ombach
- Department of Psychiatry, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT, 84108, United States
| | - Lindsay S. Scholl
- Department of Psychiatry, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT, 84108, United States
| | - Amanda V. Bakian
- Department of Psychiatry, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT, 84108, United States
| | - Kai T. Renshaw
- Department of Psychiatry, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT, 84108, United States
| | - Young-Hoon Sung
- Department of Psychiatry, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT, 84108, United States
| | - Perry F. Renshaw
- Department of Psychiatry, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT, 84108, United States
- Utah Science Technology and Research (USTAR) Initiative, Salt Lake City, UT, 84108, United States
- Rocky Mountain VISN19 Mental Illness Research, Education, and Clinical Centers (MIRECC), 500 Foothill Drive, Salt Lake City, UT, 84148, United States
- Salt Lake City Veterans Affairs Health Care System, 500 Foothill Drive, Salt Lake City, UT, 84148, United States
| | - Shami Kanekar
- Department of Psychiatry, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT, 84108, United States
- Rocky Mountain VISN19 Mental Illness Research, Education, and Clinical Centers (MIRECC), 500 Foothill Drive, Salt Lake City, UT, 84148, United States
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8
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Reno E, Brown TL, Betz ME, Allen MH, Hoffecker L, Reitinger J, Roach R, Honigman B. Suicide and High Altitude: An Integrative Review. High Alt Med Biol 2018; 19:99-108. [DOI: 10.1089/ham.2016.0131] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Elaine Reno
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Talia L. Brown
- Boulder County Public Health, Colorado School of Public Health, Aurora, Colorado
| | - Marian E. Betz
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Michael H. Allen
- Johnson Depression Center, Department of Psychiatry and Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Lilian Hoffecker
- Health Sciences Library, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Jeremy Reitinger
- Altitude Research Center, Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Robert Roach
- Altitude Research Center, Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Benjamin Honigman
- Altitude Research Center, Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado
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Kanekar S, Sheth CS, Ombach HJ, Olson PR, Bogdanova OV, Petersen M, Renshaw CE, Sung YH, D'Anci KE, Renshaw PF. Hypobaric hypoxia exposure in rats differentially alters antidepressant efficacy of the selective serotonin reuptake inhibitors fluoxetine, paroxetine, escitalopram and sertraline. Pharmacol Biochem Behav 2018; 170:25-35. [PMID: 29738811 DOI: 10.1016/j.pbb.2018.05.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 05/01/2018] [Accepted: 05/03/2018] [Indexed: 01/19/2023]
Abstract
Treatment-resistant depression, a chronic condition that affects 30% of depressed patients on antidepressants, is highly linked to suicidal behavior. Chronic hypoxia exposure via living at altitude (hypobaric hypoxia) or with chronic hypoxic diseases is demographically linked to increased risk for depression and suicide. We previously demonstrated that housing rats at altitude for a week incrementally increases depression-like behavior in the forced swim test (FST) in females, but not males. In animal models, high altitude exposure reduces brain serotonin, and selective serotonin reuptake inhibitors (SSRIs) can lose efficacy when brain serotonin levels are low. To address whether residence at moderate altitude is detrimental to SSRI function, we examined SSRI efficacy in the FST after a week of housing rats at altitudes of 4500 ft. or 10,000 ft. as compared to at sea level. In females, the tricyclic antidepressant desipramine (positive control) functioned well in all groups, increasing latency to immobility and decreasing immobility, by increasing climbing. However, the SSRIs fluoxetine, paroxetine and escitalopram were ineffective in females in all groups: only paroxetine improved swimming in the FST as expected of a SSRI, while all three unexpectedly reduced climbing. Fluoxetine was also ineffective in male rats. Sertraline was the only SSRI with antidepressant efficacy at altitude in both females and males, increasing swimming, climbing and latency to immobility, and reducing immobility. Hypobaric hypoxia thus appears to be detrimental to efficacy of the SSRIs fluoxetine, paroxetine and escitalopram, but not of sertraline. Unlike the other SSRIs, sertraline can improve both serotonergic and dopaminergic transmission, and may be less impacted by a hypoxia-induced serotonin deficit. A targeted approach may thus be necessary for successful antidepressant treatment in patients with depression who live at altitude or with chronic hypoxic diseases, and that sertraline may be the SSRI of choice for prescription for this population.
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Affiliation(s)
- Shami Kanekar
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT, United States; VISN19 MIRECC, 500 Foothill Drive, Salt Lake City, UT 84148, United States; The Brain Institute, University of Utah, 383 Colorow Drive, Salt Lake City, UT 84108, United States.
| | - Chandni S Sheth
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT, United States
| | - Hendrik J Ombach
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT, United States
| | - Paul R Olson
- The Brain Institute, University of Utah, 383 Colorow Drive, Salt Lake City, UT 84108, United States
| | - Olena V Bogdanova
- The Brain Institute, University of Utah, 383 Colorow Drive, Salt Lake City, UT 84108, United States
| | - Matthew Petersen
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT, United States
| | - Chloe E Renshaw
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT, United States
| | - Young-Hoon Sung
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT, United States
| | | | - Perry F Renshaw
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, Salt Lake City, UT, United States; VISN19 MIRECC, 500 Foothill Drive, Salt Lake City, UT 84148, United States; The Brain Institute, University of Utah, 383 Colorow Drive, Salt Lake City, UT 84108, United States; Veterans Affairs Salt Lake City Health Care System, 500 Foothill Drive, Salt Lake City, UT 84148, United States
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Ma S, Wang C, Zhao B, Ren X, Tian S, Wang J, Zhang C, Shao Y, Qiu M, Wang X. Tandem mass tags labeled quantitative proteomics to study the effect of tobacco smoke exposure on the rat lung. BIOCHIMICA ET BIOPHYSICA ACTA. PROTEINS AND PROTEOMICS 2018; 1866:496-506. [PMID: 29307719 DOI: 10.1016/j.bbapap.2018.01.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 12/24/2017] [Accepted: 01/03/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND The causal link between tobacco smoke exposure (TSE) and numerous severe respiratory system diseases (RSD), including chronic bronchitis, chronic obstructive pulmonary disease, and lung cancer, is well established. However, the pathogenesis of TSE-induced RSD remains incompletely understood. This research aims to detect the pathogenetic mechanisms and potential therapeutic targets of TSE-induced RSD. METHODS This study employed TSE model which rats were exposed to a concentration of 60% tobacco smoke in a toxicant exposure system for four weeks. Tandem mass tags (TMT) labeled quantitative proteomics combined with off-line high pH reversed-phase fractionation, and nano-liquid chromatography-mass spectrometry method (off-line high pH RPF-nano-LC-MS/MS) were adopted to detect differentially expressed proteins (DEPs) in the lung tissues of the TSE model rats and to compare them with those in control. The accuracy of the results was verified by western blot. RESULTS Compared with the control group, 33 proteins in the TSE model group's lung tissues showed significant differential expression. Analysis based on the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways indicated that, several biological pathways, such as the steroid biosynthesis pathway, were involved and played significant roles in the pathogenesis of the experimental group's TSE. CONCLUSIONS These findings make a crucial contribution to the search for a comprehensive understanding of TSE-induced RSD's pathogenesis, and furthermore provide guidance for the diagnosis and treatment of TSE-induced RSD.
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Affiliation(s)
- Shuangshuang Ma
- School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing 100102, China; Shandong Analysis and Test Center, Shandong Academy of Sciences, Jinan 250014, China
| | - Chunguo Wang
- Beijing Academy of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Baosheng Zhao
- Beijing Academy of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Xiaolei Ren
- School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing 100102, China
| | - Simin Tian
- School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing 100102, China
| | - Juan Wang
- School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing 100102, China
| | - Chi Zhang
- School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing 100102, China
| | - Yuanyang Shao
- School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing 100102, China
| | - Minyi Qiu
- School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing 100102, China
| | - Xueyong Wang
- School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing 100102, China.
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Sheth C, Ombach H, Olson P, Renshaw PF, Kanekar S. Increased Anxiety and Anhedonia in Female Rats Following Exposure to Altitude. High Alt Med Biol 2018; 19:81-90. [PMID: 29431475 DOI: 10.1089/ham.2017.0125] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Sheth, Chandni, Hendrik Ombach, Paul Olson, Perry F. Renshaw, and Shami Kanekar. Increased anxiety and anhedonia in female rats following exposure to altitude. High Alt Med Biol. 19:81-90, 2018.-Anxiety disorders are chronic, highly prevalent conditions, often comorbid with depression. Both anxiety and depression form major risk factors for suicide. Living at altitude is associated with higher rates of depression and suicide, leading us to address whether anxiety disorders may also be amplified at altitude. Using a novel translational animal model, we previously showed that depression-like behavior increases with altitude of housing in female, but not male rats. We now use this model to examine the effects of altitude on both anxiety-like behavior and anhedonia, a core symptom of depression. After housing for a week at sea level, 4500 or 10,000 ft, rats were evaluated for anxiety in the open-field test or the elevated plus maze, and anhedonia in the sucrose preference test. Another group was tested at baseline. Anxiety-like behavior increased in females housed at altitude. In females, lower sucrose preference was seen in those housed at 10,000 ft versus those at sea level. Males showed no change in anxiety or anhedonia across groups. These data suggest that living at moderate-high altitude may pose a risk factor for those vulnerable to anxiety disorders, with the potential to be particularly detrimental to females at altitude.
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Affiliation(s)
- Chandni Sheth
- 1 Diagnostic Neuroimaging, Department of Psychiatry, University of Utah School of Medicine , Salt Lake City, Utah
| | - Hendrik Ombach
- 1 Diagnostic Neuroimaging, Department of Psychiatry, University of Utah School of Medicine , Salt Lake City, Utah
| | - Paul Olson
- 1 Diagnostic Neuroimaging, Department of Psychiatry, University of Utah School of Medicine , Salt Lake City, Utah
| | - Perry F Renshaw
- 1 Diagnostic Neuroimaging, Department of Psychiatry, University of Utah School of Medicine , Salt Lake City, Utah.,2 VISN 19 Mental Illness Research, Education and Clinical Center (MIRREC) , Salt Lake City Veterans Health Administration, Salt Lake City, Utah
| | - Shami Kanekar
- 1 Diagnostic Neuroimaging, Department of Psychiatry, University of Utah School of Medicine , Salt Lake City, Utah.,2 VISN 19 Mental Illness Research, Education and Clinical Center (MIRREC) , Salt Lake City Veterans Health Administration, Salt Lake City, Utah
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12
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Strewe C, Zeller R, Feuerecker M, Hoerl M, Kumprej I, Crispin A, Johannes B, Debevec T, Mekjavic I, Schelling G, Choukèr A. PlanHab study: assessment of psycho-neuroendocrine function in male subjects during 21 d of normobaric hypoxia and bed rest. Stress 2017; 20:131-139. [PMID: 28166699 DOI: 10.1080/10253890.2017.1292246] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Immobilization and hypoxemia are conditions often seen in patients suffering from severe heart insufficiency or primary pulmonary diseases (e.g. fibrosis, emphysema). In future planned long-duration and exploration class space missions (including habitats on the moon and Mars), healthy individuals will encounter such a combination of reduced physical activity and oxygen tension by way of technical reasons and the reduced gravitational forces. These overall unconventional extraterrestrial conditions can result in yet unknown consequences for the regulation of stress-permissive, psycho-neuroendocrine responses, which warrant appropriate measures in order to mitigate foreseeable risks. The Planetary Habitat Simulation Study (PlanHab) investigated these two space-related conditions: bed rest as model of reduced gravity and normobaric hypoxia, with the aim of examining their influence on psycho-neuroendocrine responses. We hypothesized that both conditions independently increase measures of psychological stress and enhance neuroendocrine markers of stress, and that these effects would be exacerbated by combined treatment. The cross-over study composed of three interventions (NBR, normobaric normoxic horizontal bed rest; HBR, normobaric hypoxic horizontal bed rest; HAMB, normobaric hypoxic ambulatory confinement) with 14 male subjects during three sequential campaigns separated by 4 months. The psychological state was determined through three questionnaires and principal neuroendocrine responses were evaluated by measuring cortisol in saliva, catecholamine in urine, and endocannabinoids in blood. The results revealed no effects after 3 weeks of normobaric hypoxia on psycho-neuroendocrine responses. Conversely, bed rest induced neuroendocrine alterations that were not influenced by hypoxia.
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Affiliation(s)
- C Strewe
- a Department of Anaesthesiology , Klinikum Großhadern, University of Munich, Stress and Immunology Lab , Munich , Germany
| | - R Zeller
- a Department of Anaesthesiology , Klinikum Großhadern, University of Munich, Stress and Immunology Lab , Munich , Germany
| | - M Feuerecker
- a Department of Anaesthesiology , Klinikum Großhadern, University of Munich, Stress and Immunology Lab , Munich , Germany
| | - M Hoerl
- a Department of Anaesthesiology , Klinikum Großhadern, University of Munich, Stress and Immunology Lab , Munich , Germany
| | - I Kumprej
- a Department of Anaesthesiology , Klinikum Großhadern, University of Munich, Stress and Immunology Lab , Munich , Germany
- b Department of Automation, Biocybernetics and Robotics , Jozef Stefan Institute , Ljubljana , Slovenia
| | - A Crispin
- c Department of Biometry and Epidemiology, Klinikum Großhadern , University of Munich , Munich , Germany
| | - B Johannes
- d Department of Space Physiology , Institute of Aerospace Medicine, German Aerospace Center (DLR) , Cologne , Germany
| | - T Debevec
- b Department of Automation, Biocybernetics and Robotics , Jozef Stefan Institute , Ljubljana , Slovenia
| | - I Mekjavic
- b Department of Automation, Biocybernetics and Robotics , Jozef Stefan Institute , Ljubljana , Slovenia
| | - G Schelling
- a Department of Anaesthesiology , Klinikum Großhadern, University of Munich, Stress and Immunology Lab , Munich , Germany
| | - A Choukèr
- a Department of Anaesthesiology , Klinikum Großhadern, University of Munich, Stress and Immunology Lab , Munich , Germany
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