Disorders of Endogenous and Exogenous Antioxidants in Neurological Diseases

In diseases of the central nervous system, such as Alzheimer's disease (AD), Parkinson's disease (PD), stroke, amyotrophic lateral sclerosis (ALS), Huntington's disease (HD), and even epilepsy and migraine, oxidative stress load commonly surpasses endogenous antioxidative capacity. While oxidative processes have been robustly implicated in the pathogenesis of these diseases, the significance of particular antioxidants, both endogenous and especially exogenous, in maintaining redox homeostasis requires further research. Among endogenous antioxidants, enzymes such as catalase, superoxide dismutase, and glutathione peroxidase are central to disabling free radicals, thereby preventing oxidative damage to cellular lipids, proteins, and nucleic acids. Whether supplementation with endogenously occurring antioxidant compounds such as melatonin and glutathione carries any benefit, however, remains equivocal. Similarly, while the health benefits of certain exogenous antioxidants, including ascorbic acid (vitamin C), carotenoids, polyphenols, sulforaphanes, and anthocyanins are commonly touted, their clinical efficacy and effectiveness in particular neurological disease contexts need to be more robustly defined. Here, we review the current literature on the cellular mechanisms mitigating oxidative stress and comment on the possible benefit of the most common exogenous antioxidants in diseases such as AD, PD, ALS, HD, stroke, epilepsy, and migraine. We selected common neurological diseases of a basically neurodegenerative nature.

Changes in Adipokine, Resitin, and BDNF Concentrations in Treatment-Resistant Depression after Electroconvulsive Therapy

OBJECTIVES

One of the current challenges in psychiatry is the search for answers on how to effectively manage drug-resistant depression. The occurrence of drug resistance in patients is an indication for the use of electroconvulsive therapy (ECT). This method is highly effective and usually results in relatively quick health improvement. Despite the knowledge of how ECT works, not all of the biological pathways activated during its use have been identified. Hence, based on the neuroinflammatory hypothesis of depression, we investigated the concentration of two opposite-acting adipokines (anti-inflammatory adiponectin and proinflammatory resistin) and BDNF in antidepressant-resistant patients undergoing ECT.

METHODS

The study group comprised 52 patients hospitalized due to episodes of depression in the course of unipolar and bipolar affective disorder. The serum concentration of adipokines and BDNF was determined before and after the therapeutic intervention using an ELISA method. In the analyses, we also included comparisons considering the type of depression, sex, and achieving remission.

RESULTS

Adiponectin, resistin, and BDNF concentrations change after ECT treatment. These changes are correlated with an improvement in the severity of depressive symptoms and are more or less pronounced depending on the type of depression.

CONCLUSIONS

Although not all observed changes reach statistical significance, adipokines in particular remain exciting candidates for biomarkers in assessing the course of the disease and response to ECT treatment.

Investigation of serum BDNF levels in alcohol withdrawal syndrome with and without other medical co-morbidities

INTRODUCTION

Consequences of alcohol use disorder (AUD) are associated with mental and somatic burdens that result in alcohol withdrawal syndrome (AWS), with 30% of AWS cases leading to life-threatening delirium tremens (DTs). So far, biomarkers for tracking abstinence syndrome that are useful in clinical practice have yet to be detected. Current research focuses on brain-derived neurotrophic factor (BDNF) effects on neurogenesis, modulation of plasticity, and its role in the pathogenesis of AWS and DTs.

AIMS

The present study aimed to assess pro-BDNF and BDNF concentrations in a group of patients with AWS. Changes in BDNF and prof-BDNF were also evaluated with attention to subgroups of patients with coexisting mental and somatic disorders, with a particular emphasis on the presence or absence of DTs.

RESULTS

The AWS group had a higher concentration of BDNF and a lower concentration of pro-BDNF compared to the control group, and BDNF increased during 7 days of hospitalisation. Patients with comorbid psychiatric disorders had higher levels of pro-BDNF than those without disease and also had higher levels of BDNF at the end of the study than at the beginning. On the other hand, patients with coexisting somatic diseases had higher levels of pro-BDNF at the beginning than at the end of the study, while patients with delirium had higher BDNF levels at the end of the study than at the beginning.

CONCLUSIONS

The obtained results indicate that pro-BDNF and BDNF may be useful markers for the course of withdrawal syndrome. In particular, BDNF showed an association with the development of delirium complications. The authors are aware of several limitations of the work only men in the SG, different age between SG and CG.

Changes in adipokine concentrations in antidepressant-resistant bipolar depression after ketamine infusion and electroconvulsive therapy

OBJECTIVES

This study attempts to assess the concentration of two opposite-acting adipokines (anti-inflammatory adiponectin and pro-inflammatory resistin) in antidepressant-resistant patients undergoing ketamine infusion (KI) and electroconvulsive therapy (ECT).

METHODS

The study group comprised 52 patients hospitalised due to episodes of depression in the course of bipolar disorders. The Hamilton depression scale was used to assess the intensity of the depression symptoms before starting therapy and one day after its completion. The serum concentration of adipokines was determined before and after the therapeutic intervention using an ELISA method.

RESULTS

Baseline adipokine levels differed between patients receiving KI and ECT therapy. Regardless of the procedure used, these levels changed after treatment, with the nature of these changes being different. In the case of KI, the adiponectin levels increased, and resistin levels decreased. In contrast, after ECT, the concentrations of both adipokines decreased. Changes in adipokine concentrations correlated with improvement in mental status, as assessed by the Hamilton Rating Scale, type of bipolar disorder, and gender.

CONCLUSIONS

Adipokines remain interesting candidate biomarkers in assessing the state and course of the disease depending on the therapeutic procedure applied. However, the relatively small study group and limited original research available for discussion justify further investigation.

Metabolic Syndrome and Adipokines Profile in Bipolar Depression

Metabolic syndrome (MS) is a growing social, economic, and health problem. MS coexists with nearly half of all patients with affective disorders. This study aimed to evaluate the neurobiological parameters (clinical, anthropometric, biochemical, adipokines levels, and ultrasound of carotid arteries) and their relationship with the development of MS in patients with bipolar disorder. The study group consisted of 70 patients (50 women and 20 men) hospitalized due to episodes of depression in the course of bipolar disorders. The Hamilton Depression Rating Scale was used to assess the severity of the depression symptoms in an acute state of illness and after six weeks of treatment. The serum concentration of adipokines was determined using an ELISA method. The main finding of this study is that the following adipokines correlated with MS in the bipolar depression women group: visfatin, S100B, and leptin had a positive correlation, whereas adiponectin, leptin-receptor, and adiponectin/leptin ratio showed a negative correlation. Moreover, the adiponectin/leptin ratio showed moderate to strong negative correlation with insulin level, BMI, waist circumference, triglyceride level, treatment with metformin, and a positive moderate correlation with HDL. The adiponectin/leptin ratio may be an effective tool to assess MS in depressed female bipolar patients.

Studies on candidate genes for lithium prophylaxis performed at the Poznan University of Medical Sciences

Lit jest lekiem normotymicznym, stosowanym z wyboru w leczeniu profilaktycznym choroby afektywnej dwubiegunowej (ChAD). Skuteczność profilaktyczna litu może być uwarukowana czynnikami genetycznymi, związanymi częściowo z predyspozycją do choroby afektywnej dwubiegunowej. W dziedzinie genetyki w psychiatrii pierwsza dekada XXI wieku została zdominowana przez badania „genów kandydujących”. W niniejszym artykule przedstawiono badania genów kandydujących związanych z profilaktyką litem, prowadzone na Uniwersytecie Medycznym w Poznaniu w latach 2005-2018. W tym czasie badane były polimorfizmy wielu genów, z których część jest również związana z predyspozycją do choroby afektywnej dwubiegunowej. Związek ze skutecznością profilaktyczną litu stwierdzono w przypadku polimorfizmów genów 5HTT, ACP1, ARNTL, BDNF, COMT, DRD1, FKBP5, FYN, GLCC, NR3C1 i TIM. Nie stwierdzono takiego związku w odniesieniu do genów 5HT2A, 5HT2C, DRD2, DRD3, DRD3, GRIN2B, GSK-3β, MMP-9 i NTRK2. Wykazano natomiast asocjację polimorfizmu genu GSK-3β z nerkowymi działaniami niepożądanymi w przebiegu stosowania litem. Omówiona została możliwa rola tych genów zarówno w mechanizmie profilaktycznej skuteczności litu, jak i w patogenezie choroby afektywnej dwubiegunowej.