Venlafaxine and sertraline does not affect the expression of genes regulating stress response in female MDD patients

OBJECTIVES

The aim of this study was to analyze the expression of 3 genes involved in the regulation of HPA axis: GR, HSP90 and FKBP5, in patients with major depressive disorder (MDD) before antidepressant treatment and after 8 weeks of pharmacotherapy. Additionally, we analyzed the level of glucocorticoid receptor isoforms before and after treatment.

METHODS

The study included 30 female patients (aged 18-60 years), with major depres- sive disorder diagnosed on the basis of the Structured Clinical Interview for DSM-IV (SCID). Antidepressant treatment included use of sertraline or venlafaxine. The assessment of patients' mental state (severity of depression) was checked by the Hamilton Depression Rating Scale (HDRS). After 8 weeks of treatment, the same clinical and molecular tests were performed. All of the patients underwent dexamethasone suppression test (DST). MRNA was isolated from the peripheral blood to evaluate the expression of the studied genes using real-time PCR with TaqMan probes. The concentration of GR isoforms (α and β) in serum was also determined using ELISA. Statistical analysis was performed using Statistica v.12.0 software.

RESULTS

The abnormal cortisol level was only seen in 20% of patients. Dysregulation on HPA axis was observed in 10% of patients. We observed significant clinical improvement after 8 weeks of pharmacotherapy in all patients. Almost the whole group of patients (except one patient) showed full remission of symptoms. We observed significant moderate correlation between cortisol level after DST before treatment and after 8 weeks of pharmacotherapy (r2 = 0.44). The results showed no significant difference in the expression of 3 analyzed genes compared before and after 8 weeks of therapy. The results of ELISA showed decreased level of α isoform after pharmacotherapy, independent of drug.

CONCLUSIONS

The results showed no significant changes in the expression of genes involved in the stress axis activity during antidepressant therapy.

FKBP5 polymorphism is associated with major depression but not with bipolar disorder

BACKGROUND

Altered activity of hypothalamus-pituitary-adrenal glands (HPA) axis in response to stress underlies the pathogenesis of mood disorders such as depression and bipolar disorder. Chaperone proteins regulate sensitivity of glucocorticoid receptor (GR) to steroids. We hypothesized that genetic variants within the FKBP5 - gene encoding co-chaperone protein essential in GR signaling - may influence the susceptibility to major depressive disorder and bipolar disorder.

METHODS

In the study participated 528 bipolar patients, 218 patients with major depressive disorder and 742 subjects from control group. Genotypes for eight FKBP5 polymorphisms (rs1360780, rs755658, rs9470080, rs4713916, rs7748266, rs9296158, rs9394309, rs3800373) were established by TagMan SNP Genotyping Assays (Applied Biosystems). Linkage disequilibrium analysis for FKBP5 gene was done in Haploview. Gene-gene interactions between FKBP5 and NR3C1 polymorphisms (reported previously) were analyzed using the multidimensionality-reduction method (MDR).

RESULTS

We have observed an association between five FKBP5 polymorphisms (rs1360780, rs9470080, rs4713916, rs9296158 and rs9394309) and major depressive disorder (p=0.011; p=0.007, p=0.038; p=0.030; p=0.018, respectively), but not bipolar disorder. In linkage disequilibrium analysis we found that seven FKBP5 polymorphisms build haplotype block (rs3800373, rs755658, rs9296158, rs7748266, rs1360780, rs9394309, rs9470080, respectively). We observed that two haplotype combinations (ACATTGT and CCACTAT) were significantly more frequent in the MDD patients than in controls (p=0.014 and p=0.043). We have not observed such an association for BD patients. We have found that interaction between rs9470080 of FKBP5 and rs6198 of NR3C1 influences MDD risk.

LIMITATIONS

The main limitations of this study include low power and limited sample size of MDD patients.

CONCLUSIONS

Single markers and haplotypes of FKBP5 gene and the interaction with glucocorticoid receptor gene (NR3C1) may influence MDD predisposition.

Possible association between haplotypes of the FKBP5 gene and suicidal bipolar disorder, but not with melancholic depression and psychotic features, in the course of bipolar disorder

We aimed to analyzed the association between polymorphisms of the FKBP5 (FK506 binding protein 5) gene and subtypes of bipolar disorder. In the study, we included 195 bipolar disorder patients with psychotic features, 129 bipolar patients with melancholic depression, and 156 bipolar patients with a history of suicidal attempts. We found weak association between the haplotypes of the FKBP5 gene and bipolar patients with suicidal attempts. We did not find an association between polymorphisms of the FKBP5 gene and bipolar disorder with psychotic features, nor with bipolar disorder with melancholic depression. Limitations of our study are the absence of data about previous trauma exposure and the small sample size of patients, which of course can lead to false-positive results, so further validation and replication of the present findings are still needed.

Association between OPCRIT dimensions and polymorphisms of HPA axis genes in bipolar disorder

The aim of the study was to investigate the possible association between polymorphisms of HPA axis genes-CRHR1 (corticotrophin-releasing hormone receptor), NR3C1 (glucocorticoid receptor) and AVPR1B (arginine vasopressin receptor) and dimensions of bipolar disorder assessed by OPCRIT. We examined 560 patients with diagnosis of bipolar disorder (n=457) and unipolar disorder (n=103). Diagnosis was established by SCID and OPCRIT. We found association between polymorphisms of AVPR1b gene and psychotic dimension and CRHR1 polymorphisms and excitement and psychotic dimension. Our results suggest possible involvement of the AVPR1b and CRHR1 genes in the ethiology of psychotic features in the course of affective disorders, and possible involvement of CRHR1 gene in the ethiology of bipolar disorder.

Suicide attempts and clinical risk factors in patients with bipolar and unipolar affective disorders

BACKGROUND

Suicide is an important clinical problem in psychiatric patients. The highest risk of suicide attempts is noted in affective disorders.

OBJECTIVE

The aim of the study was to look for suicide risk factors among sociodemographic and clinical factors, family history and stressful life events in patients with diagnosis of unipolar and bipolar affective disorder (597 patients, 563 controls).

METHOD

In the study, the Structured Clinical Interview for DSM-IV Axis I Disorders and the Operational Criteria Diagnostic Checklist questionnaires, a questionnaire of family history, and a questionnaire of personality disorders and life events were used.

RESULTS

In the bipolar and unipolar affective disorders sample, we observed an association between suicidal attempts and the following: family history of psychiatric disorders, affective disorders and psychoactive substance abuse/dependence; inappropriate guilt in depression; chronic insomnia and early onset of unipolar disorder. The risk of suicide attempt differs in separate age brackets (it is greater in patients under 45 years old). No difference in family history of suicide and suicide attempts; marital status; offspring; living with family; psychotic symptoms and irritability; and coexistence of personality disorder, anxiety disorder or substance abuse/dependence with affective disorder was observed in the groups of patients with and without suicide attempt in lifetime history.

[No association of glucocorticoid receptor gene polymorphism (rs6190) with unipolar and bipolar disorder]

AIM

Functional polymorphism ER22/23EK glucocorticoid receptor leads to reduction of its resistance and to increase in its sensitivity to the glucocorticoid that regulate the functioning of the axis hypothalamus - pituitary - adrenal glands. Disturbances in the regulation of this axis are observed in patients with psychiatric disorders. The aim of this study was to demonstrate the association ER22/23EK polymorphism with bipolar disorder and major depressive disorders.

METHODS

In the study 144 patients with unipolar disorders and 479 patients with bipolar disorder were included. Patients were diagnosed by two psychiatrists on the basis of medical records and interview based on SCID criteria (Structured Clinical Interview for DSM Disorders). The control group comprised 595 healthy subjects. As the research material peripheral blood was used, from which DNA was obtained. Genotyping was performed using PCR - RFLP method.

RESULTS

No association of ER22/23EK polymorphism with unipolar disorder or with bipolar disorder was found. GA genotype was not observed in any of the subjects.

CONCLUSION

ER22/23EK functional polymorphism of the glucocorticoid receptor gene is not associated with unipolar and bipolar disorder.

Suicide attempts and psychological risk factors in patients with bipolar and unipolar affective disorder

Suicide is an important clinical problem in psychiatric patients. The highest risk of suicide attempts is noted in affective disorders. The aim of the study was looking for suicide risk factors among personality dimensions and value system in patients with diagnosis of unipolar and bipolar affective disorder (n=189 patients, n=101 controls). To establish the diagnosis, we used SCID (Structured clinical interview for diagnostic and statistical manual of mental disorders, fourth edition) questionnaire, TCI (Temperament and Character Inventory) questionnaire and Value Survey--to assess the personality. The main limitations of the study are number of participants, lack of data about stressful life events and treatment with lithium. Novelty seeking and harm avoidance dimensions constituted suicide attempt risk factors in the group of patients with affective disorders. Protective role of cooperativeness was discovered. Patients with and without suicide attempt in lifetime history varied in self-esteem position in Value Survey.

Association between functional polymorphism of the AVPR1b gene and polymorphism rs1293651 of the CRHR1 gene and bipolar disorder with psychotic features

BACKGROUND

An association between HPA-axis disturbances and susceptibility towards depression with psychotic features has been reported. NR3C1, CRHR1 and AVPR1b are the key components of this system. We investigated the possible involvement of the polymorphisms of those genes with the susceptibility to psychotic features in the course of BP I disorder.

METHODS

The study was conducted on 194 patients with psychotic features in the course of BPI. Control group consisted of 732 healthy subjects. Genotyping for NR3C1, AVPR1b and CRHR1 polymorphisms was done with use of TagMan SNP Genotyping Assays.

RESULTS

The association of polymorphisms rs28536160 genotype TT of the AVPR1b gene and polymorphisms rs1293651 of CRHR1 gene with psychotic features in the course of BPI.

LIMITATIONS

The main limitation of our study is the small sample size of the group of patients with psychotic features.

CONCLUSIONS

The results of our study suggest that the studied polymorphisms may increase susceptibility for obtaining psychotic features in the course of BP I.

Glucocorticoid receptor polymorphism is associated with major depression and predominance of depression in the course of bipolar disorder

BACKGROUND

A strong association has been found between dysregulation of hypothalamic-pituitary-adrenal (HPA) axis and depression and bipolar disorder. Glucocorticoid receptor is one of the involved receptors and its gene has been recognized as a candidate gene for major depressive disorder and bipolar disorder. Therefore, we investigated if polymorphism of the glucocorticoid receptor gene (NR3C1), involved in the regulation of HPA axis, may alter susceptibility as well as the course of major depressive disorder and bipolar disorder.

METHODS

In the study we included 514 patients with bipolar disorder and 193 patients with major depressive disorder. Consensus diagnosis by at least two psychiatrists was made, according to DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) criteria, using SCID (Structured Clinical Interview for DSM Disorders). Control group consisted of 732 healthy subjects. Genotyping for eight NR3C1 polymorphisms was done with use of TaqMan SNP (single nucleotide polymorphism) Genotyping Assays. Linkage disequilibrium analysis was done in Haploview.

RESULTS

We have found three polymorphisms (rs6198, rs6191 and rs33388) to be associated with major depressive disorder (MDD) and the same polymorphisms were associated with the predominance of depressive symptoms in the course of bipolar disorder. In linkage disequilibrium analysis we observed two haplotype blocks, however, none of those shows involvement in susceptibility to MDD or bipolar disorder.

LIMITATIONS

The main limitation of this study is relatively small sample size of MDD patients group.

CONCLUSIONS

Polymorphisms of NR3C1 gene analyzed in this study may modify susceptibility to major depressive disorder and seem to influence the course of bipolar disorder.

No Association Between Catecholamine-O-Methyltransferase Gene Polymorphism and Bipolar Disorder and it Subtypes

Aims:

The catecholamine hypothesis of affective disorders suggests that depression is associated with a functional decrease of catecholamines. There is consistent evidence that COMT gene would be a candidate gene for studies of bipolar disorder.

Methods:

The study was performed on patients with bipolar disorder n=298 (male n=126, female n=172). Control subjects were blood donors n=336 (male n=130, female n=206), who were not psychiatrically assessed. The subgroup of patients with psychotic features not congruent with mood contained n=88 patients, males n=41, females n=47. The subgroup of patients with psychotic features congruent with mood contained n=89 patients, males n=47, females n=42. The subgroup of patients with melancholic depression contained n=197 patients, males n=76, females n= 121. A polymorphism was analysed by PCR-RFLP method.

Results:

There were no differences in the frequency of genotypes, alleles between patients and controls in the whole group (p=0,286 for genotypes, p= 0,652 for alleles). Dividing the patients according to the gender, no differences in the frequency of either genotypes or alleles were found (p=0,298 for genotype males, p=0,456 for genotypes females). We did not find the association in the subgroup of patients with psychotic features congruent (p=0,828 for genotypes, p= 0,866 for alleles), or not congruent with mood (p=0,116 for genotypes, p= 0,673 for alleles) and with the subgroup of patients with depression with melancholic features (p= 0,758 for genotypes, p= 0,849 for alleles).

Conclusion:

Results of our study suggest that the polymorphism of COMT gene is not associated with the susceptibility to bipolar disorder.

[Association between polymorphisms of Val66Met in the BDNF gene and the response to escitalopram and nortriptyline treatment in the light of the neurodevelopmental hypothesis of depression]

AIM

Results from pharmacogenetic studies show importance of the relationship between response to treatment with antidepressants and polymorphisms within the genes involved in the neurotransmission and signal transduction. Changes in BDNF levels were reported in response to antidepressant treatment. The aim of study was to investigate a possible association of Val66Met polymorphism in the BDNF gene with response to antidepressants in patients with depression.

METHOD

In the study, 90 patients (21 male and 69 females) were included, in the age range 19-68 years and suffering from a depressive disorder of at least moderate severity and meeting the research criteria of ICD-10 and DSM-IV for major depression. All patients were given the written consent for the study. The project was accepted by the local ethics committee. Patients were randomized into two groups: one was treated with the serotonergic drug - escitalopram (n=51) with therapeutic doses between 10-20 mg/day. The second group was treated with the noradrenergic drug--nortriptyline (n=39) with a dose range of 75-150 mg/day. The DNA was extracted from blood cells by the salting out method. The genotype for polymorphism of the Val66Met BDNF gene was established by the PCR-RFLP method in the Laboratory of Psychiatric Genetics of the Psychiatric Clinic. Statistical analysis was performed with the Statistica version 7.1 Results. We have not found any association between the Val66Met polymorphism of the BDNF gene with treatment response neither to escitalopram (p = 0.751 for genotypes, p = 0.798 for alleles) nor for nortryptyline (p = 0.607 for genotypes, p = 0.607 for alleles)

CONCLUSIONS

The polymorphism of the BDNF gene is not likely to be associated with treatment response to escitalopram and nortriptyline in our group of patients with depression.

Association of tumor necrosis factor -308G/A promoter polymorphism with schizophrenia and bipolar affective disorder in a Polish population

BACKGROUND/AIMS

Schizophrenia (SCH) and bipolar affective disorder (BPAD) are complex disorders with significant participation of genetic risk factors. Several lines of evidence point to the role of shared neurobiological mechanisms and common genetic background in SCH and BPAD. Immune disturbances have been suggested as contributing factor in the pathogenesis of both SCH and BPAD. The gene coding cytokine tumor necrosis factor (TNF) has been the object of a number of association studies in SCH, with ambiguous results. Only 3 such studies were performed in BPAD. The aim of our study was to perform a case-control association analysis of the TNF -308G/A polymorphism in a Polish sample of patients with SCH, BPAD and healthy controls.

METHODS

We genotyped the TNF -308G/A polymorphism (rs1800629) by PCR-RFLP in 348 patients with SCH, 361 patients with BPAD and in 351 controls.

RESULTS

We observed an association of the -308G allele with both SCH (p = 0.008) and BPAD (p = 0.039), and also with a positive family history in patients with SCH (p = 0.048) and BPAD (p = 0.027). For TNF genotypes, the association was only seen in SCH (p = 0.018).

CONCLUSIONS

Our results may point to an association of the TNF -308G allele and -308G/G genotype with both SCH and BPAD, and to a relationship of the -308G allele with the risk of SCH and BPAD in patients with a positive family history. TNF could be potentially a susceptibility gene, shared between SCH and BPAD. Complex TNF gene studies--based on multiple single-nucleotide polymorphisms and involving haplotype analysis--are necessary for the clarification of currently contradictory findings.

Study of dopamine receptors genes polymorphisms in bipolar patients with comorbid alcohol abuse

Alcoholism is present in approximately 40-60% of bipolar patients. This comorbidity between bipolar disorder and alcoholism is high and may result from existence of common genetic factors for the two disorders. In both disorders, dysregulation of the dopaminergic neurotransmission had been implicated. Association analyses revealed several candidate genes acting in the dopaminergic pathway and polymorphisms in those genes that might be associated with both disorders.

AIM

The aim of this study was to analyse possible relationship between polymorphisms in the dopaminergic pathway genes (one SNP for each dopamine receptor gene 1-4) and alcohol abuse comorbidity in bipolar patients.

METHODS

We analysed 317 patients with bipolar disorder. In this group, 42 patients were diagnosed with alcohol abuse. The diagnosis was made for each patient by at least two psychiatrists, using structured clinical interviews for DSM-IV Axis I disorders (SCID). The control group consisted of 350 subjects. We performed RFLP analysis of polymorphisms in four genes: DRD1, DRD2, DRD3, and DRD4.

RESULTS

We have not found association of any of the analysed polymorphisms in the dopamine genes in the group of bipolar patients with comorbid alcohol abuse as compared to the control group. In the male group of bipolar patients with comorbid alcohol abuse, we also have not observed any significant differences between the patients and the control subjects.

CONCLUSION

Our findings suggest that the analysed polymorphisms of the dopamine genes polymorphisms may not be involved in the shared genetic vulnerability to both, bipolar disorder, and alcohol abuse.

Association studies of 5-HT2A and 5-HT2C serotonin receptor gene polymorphisms with prophylactic lithium response in bipolar patients

Lithium is one of the most commonly used drugs in the prophylaxis and treatment of bipolar disorder. The mechanisms of mood stabilization by lithium incorporate its effect on serotonergic neurotransmission. This paper investigates a relationship between response to lithium prophylaxis and polymorphisms in two genes: T102C of 5-HT2A receptor and G68C (Cys23Ser) of 5-HT2C serotonin receptor gene. Genotypes were estimated in 92 bipolar patients (39 males and 53 females) who have been taking lithium for at least 5 years. The patients were classified as excellent responders, partial responders and non-responders to lithium. The obtained results suggest that these polymorphisms may not be related to the degree of prophylactic lithium response.

Lack of association between polymorphisms of dopamine receptors, type D2, and bipolar affective illness in a Polish population

BACKGROUND

Biochemical abnormalities are thought to be important factors causing bipolar disorder. Several lines of evidence suggest dopamine may play a role in its etiology, e.g. depressive syndrome is frequently encountered in subjects affected by Parkinson's disease, where dopamine depletion is observed. Thus the genes of the dopaminergic system are good candidates for studies on bipolar disorder. In the present study, we investigated polymorphisms of dopamine receptors, type D2, including the dopamine receptors D2, D3 and D4.

MATERIAL/METHODS

Polish bipolar patients (n=339) and control subjects (n=366) were analyzed for three dopamine receptor gene polymorphisms: dopamine receptor D2 (DRD2) 141 ins/del, dopamine receptor D3 (DRD3) Ser9Gly, and dopamine receptor D4 (DRD4) 521 C/T.

RESULTS

Allele and genotype frequencies did not differ significantly among patients and controls. We did not obtain any significant association between the studied polymorphisms and bipolar disorder.

CONCLUSIONS

The results suggests that the studied gene variants of type D2 dopamine receptors are not promising candidate genes for bipolar affective illness. We did not consider the family history of the examined subjects, and also the control group was not psychiatrically screened, which may contribute to the lack of significant results.

[Eye movement disturbances and working memory deficit in bipolar affective disorder]

THE AIM AND METHODS: The aim of this study was to assess the intensity and frequency of eye movement abnormalities measured with infrared reflectometry, and working memory disturbances assessed with the Wisconsin Card Sorting Test (WCST). The study was performed in 87 patients with bipolar affective illness, in 119 patients with schizophrenia and in 90 healthy persons. In patients, the assessment was done during a mild symptomatic period or in remission.

RESULTS

In patients with bipolar affective illness significant disturbances of eye movement and working memory compared with healthy subjects were found. Frequency and intensity of fixation abnormalities was less intense compared to schizophrenic patients, while smooth pursuit abnormalities had a similar degree. Working memory disturbances in bipolar patients were, as to the ability of formulation of logical conception, of similar degree as in schizophrenia. On the other hand, as to the effectiveness of thinking, no difference compared with healthy controls was found.

CONCLUSIONS

The results obtained suggest that eye movement and working memory disturbances may constitute neurophysiological and neuropsychological endophenotypic markers of bipolar affective illness what makes possible using them in molecular genetic studies of this illness.

A polymorphism of the norepinephrine transporter gene in bipolar disorder and schizophrenia: lack of association

Norepinephrine is one of the neurotransmitters which has been implicated in the pathogenesis of mood disorders and schizophrenia. The norepinephrine transporter (NET) gene may be a candidate gene for the study of the genetics of these disorders. In this study, 198 patients with schizophrenia and 100 patients with bipolar disorder were analysed for a silent mutation 1287 A/G, located in the coding region (exon 9) of the NET gene, to determine the association between this polymorphism of the NET gene and bipolar disorder or schizophrenia. No association was found between the studied polymorphism of the NET gene and either bipolar disorder or schizophrenia.