ABSTRACT
Abstract: Platelets llave serotonin (5-HT) uptake and storage mechanisms similar to those from neurons. In addition, they represent nearly 99% of blood 5-HT concentration. For these characteristics, platelets are considered useful biomarkers of the serotonergic synaptic neurotransmission, particularly in psychiatric disturbances such as depression. However, most studies which have evaluated platelet 5-HT concentrations in depression have not shown similar findings. It has been suggested that changes in plasma tryptophan (TRP) concentrations might modify 5-HT concentration in the brain, as well as in platelets. Likewise, decreased plasma concentrations of TRP have been found in depressed patients, and the selective 5-HT reuptake inhibitors (SSRIs) induce changes in platelet 5-HT concentration. Considering the controversy surrounding platelet 5-HT concentrations in depressed patients, and the fact that blood 5-HT and TRP have not been studied in the Mexican population, we decided to study 5-HT and tryptophan concentrations in blood and platelets from depressed and control Mexican subjects to evaluate a possible correlation with the severity of depression. The effect of fluoxetine and citalopram treatment on blood and platelet 5-HT and TRP concentrations in depressed patients was also studied. Material and methods Depressed patients The patients of this study were carefully selected and evaluated. Scales based on semi-structured interviews were applied (MINI and SCID-II) by clinical investigators to reduce any possible bias in patient selection. The influence of the seasonal variability on the 5-HT or TRP blood concentrations was controlled by pairing depressed patients and healthy subjects according to age, gender and, in the case of women, menstrual cycle phase. Patients with a complete remission of depression symptoms (defined as a score not higher than 5 points in the Hamilton's scale, and lower than 7 points in Beck's scale) were asked for a blood sample to measure platelet and blood concentrations of 5-HT and TRP. The patients were weighted before the treatment and after their improvement. Control subjects The control group was integrated by 30 healthy subjects, 24 women and 6 men, with an average age of 32.3 ± 10.8 years. Participants were recruited from the overall Mexican population, interviewed by a psychiatrist, and evaluated with the structured interview MINI and the SCID-II, all these to discard any psychiatric diagnose. None of them had received any pharmacological treatment during the three weeks prior to the study. Control and depressed women were paired according to their menstrual cycle phase. All participants received a detailed explanation of the study, and those who voluntarily accepted the stipulations signed an informed consent document. Control and patient subjects were clinically examined and studied with routine laboratory tests (blood count, blood chemistry, urinalysis, and thyroid function test). Blood sample procedures 5-HT and TRP measurements in total blood preparation were carried out according to the method described by Anderson, and were quantified by high performance liquid chromatography (HPLC). Statistical analysis The differences were statistically determined through an analysis of variance (ANOVA), with the assistance of the SPSS 12.00 (Statistical Software by SPPS Inc.). Results Results from laboratory tests, such as blood count, blood chemistry, thyroid function (T3, T4 and TSH) and urinalysis were normal in depressed subjects, as well as in healthy volunteers. Platelet number, blood 5-HT concentration, platelet content of 5-HT, and blood tryptophan concentration showed no significant differences in depressed patients in comparison to control subjects. 5-HT values in blood and platelet were significantly lower than the initial concentrations in patients after antidepressant treatment. Discussion and conclusions Discrepancies between our study and those found in the literature can be explained with three different approaches: ethnical, physiological, and methodological, as is further discussed. The significant decrease produced by the antidepressant treatment in blood and platelet serotonin concentration may be a consequence of the action of SSRIs, due to a 5-HT diminished uptake by the platelet. Considering our results, we conclude that: Blood and platelet 5-HT concentrations were not different between depressed patients and healthy volunteers. Blood TRP concentrations were not different between depressed patients and healthy volunteers. SSRIs (fluoxetine or citalopram) used in the treatment of depressed patients induced a significant decrease in blood and platelet content of 5-HT, and had no effect in TRP concentrations. Based on these results, neither blood/platelet 5-HT nor blood tryptophan concentrations seem to be good biological markers of depressive patients status. However, 5-HT, but not tryp-tophan, might be a reference point for pharmacological treatment effect.
resumen está disponible en el texto completo
ABSTRACT
Abstract: The attributes that characterize a molecule as neurotransmitter at CNS are: i . neuronal synthesis, ii . being present at presynapsis, iii. Ca2+-dependent release, iv. postsynaptic actions mediated by receptors, v. an elimination mechanism at synapse. Since 1964, 5-hydroxytryptamine (5-HT) was included as a neurotransmitter and is part of a set of neurotransmitters named biogenic amines. In rodents, the 5-hydroxytryptaminergic system is constituted by nine nuclei at brainstem, and divided in two groups, rostral and caudal by ther localization. The rostral group projects mainly to the telencephalon and diencephalon, while the caudal group does it to the spinal cord. 5-HT innervation to brainstem and cerebellar nuclei have been also described. The most well-known function of 5-hydroxytryptamine (5-HT) in the CNS is neuromodulation, in processes such as memory, learning, mood, sleep-wake cycle; all of these are regulated by this biogenic amine through a wide family of receptors. All the receptors are metabotropic with the sole exception of 5-HT1, which is an ionotropic receptor. The 5-HT system differentiates early in ontogenesis; 5-HT immunoreactive neurons are evident in rat fetuses at embryonic day 12 (E12), when almost any other neuronal lineage possesses a cellular commitment. This fact highlights the importance 5-HT has at neurodevelopment. Scientific works are focused in the 5-HT auto-regulatory signalling for neuropil outgrowth at ontogeny, another remarkable trait of the 5-HT system. In addition, 5-HT releases astrocyte neurotrophic factor S-100 beta, necessary for dendritic maintenance. The 5-HT set point at different stages during ontogeny remains unknown. Several target structures of the 5-HT system are dependent on the level of 5-HT activity in newborn rodents; e.g. the somatosensory cortex where proper barrel field arrangement requires an active 5-HT innervation. Moreover, besides the 5-HT level, other factors, such as the level of reelin, are determinant for the proper cytoarchitectonic organization of the neocortex. The use of 5-methoxytryptamine, an unespecific 5-HT agonist, in the prenatal period, which negatively affects the reelin level, leads to cytoarchitectonic derangement, as it has been described to occur in the presubicular cortex. 5-HT and plasticity are also related to neurogenesis in adulthood. Neurogenesis in adulthood is influenced by several factors. Some of them, such as exercise and an enriched environment, increase the rate of newly born neurons in the dentate gyrus and olfactory bulb; while others, such as mood depression (in humans), low 5-HT levels, 5-HT1A receptor blockade by antagonists, or down-regulation, account for a poor neurogenesis rate. Chronic administration of 5-HT reuptake inhibitors, such as fluoxetine, increases the number of bromodeoxiuridine- labelled (BrdU) granule cells at the dentate gyrus and hilus versus control rats. This means that fluoxetine increases the neurogenesis rate. Newly born granule cells at dentate gyrus are more likely to survive, thus contributing to maintaining the hippocampal volume unchanged. On the contrary, following chronic 5-HT antagonist administration, specifically 5-HT1A receptor blockade BrdU-labelled granule cells in dentate gyrus are 30% reduced. Reduced hippocampal volume develops in humans affected by major depression, concomitant in some cases with a decrease in 5-HT neurotransmiter level. Recent studies linking 5-HT neurogenesis stimulation in dentate gyrus explain why plastic phenomena associated to pathology could be reversed by 5-HT reuptake inhibitors like fluoxetine. These works contribute to a better understanding of both depression etiology and clinical approach.
Resumen: Se considera que la 5-hidroxitriptamina (5-HT) como un neurotransmisor en el SNC si cubre los siguientes criterios: i. síntesis y vesiculación al interior de la neurona, ii. presencia de la molécula en la presinapsis, iii . liberación en un mecanismo dependiente de Ca+2, iv. acción postsináptica mediada por receptores para la molécula y v. presencia de mecanismos de recaptura y degradación. Los cuerpos celulares de las neuronas que sintetizan 5-HT se agrupan en nueve núcleos distribuidos en el tallo cerebral. A su vez, estos núcleos se dividen en dos grandes grupos, rostral y caudal, de acuerdo con su localización. El grupo rostral inerva principalmente el telencéfalo y el diencéfalo, mientras que el grupo caudal hace lo propio con la médula espinal. La actividad del sistema 5-HT es neuromoduladora, esto es, interviene en la regulación de la actividad neuronal por medio de receptores, todos ellos metabotrópicos, con excepción del receptor 5-HT 3, que es ionotrópico. Los procesos relacionados con el sistema 5-HT comprenden la regulación del talante emocional, el aprendizaje, la memoria, la regulación del tono muscular, la ingesta de alimentos, la conducta sexual y la regulación del ciclo sueño-vigilia en humanos. Durante el desarrollo, las primeras neuronas inmunorreactivas a 5-HT se observan en el día 12 de la gestación de ratas a lo largo del borde entre el metencéfalo y el mielencéfalo rostral, en la región externa de la zona ventricular. El pico de proliferación celular para este fenotipo ocurre en E15 y, pese a que la inervación completa del SNC concluye en la tercera semana de vida post natal, al nacimiento están presentes la totalidad de las neuronas 5-HT, así como las principales proyecciones de este sistema. La relevancia de la 5-HT es notoria al observarse los procesos con que se relaciona durante el desarrollo. Uno de ellos es la elongación axónica en función de un gradiente de concentración. Al momento en que los neuroblastos intervienen en el nivel celular y se diferencian en neuronas 5-HT, sintetizan y secretan el neurotransmisor. De esta forma, el milieu posee un gradiente 5-HT que influye en la elongación axónica por medio de un asa de retroalimentación negativa. Otra forma en que la 5-HT incide en el neurodesarrollo es al promover la secreción del factor neurotrófico derivado de astrositos: S-100p. Esta proteína estimula el crecimiento neurítico en las neuronas 5-HT y contribuye a mantener la inervación 5-HT a las estructuras blanco. La administración prenatal de 5-metoxitriptamina, agonista específico 5-HT, provocó alteraciones citoarquitectónicas en la corteza presubicular de las crías evaluadas en P7. Con lo anterior se sugiere, por último, que la 5-HT influye en el desarrollo de sus estructuras blanco. El vínculo entre 5-HT y plasticidad continúa en la vida adulta, cuando la 5-HT sostiene una estrecha relación con la neurogénesis en el giro dentado. Trastornos y procesos como el estrés crónico, la depresión (en humanos) y la disminución en el nivel de 5-HT, así como la administración de antagonistas del receptor 5-HT1A, disminuyen la tasa de proliferación neuronal, evaluada mediante el marcaje de células recién generadas con bromodeoxiuridina. Esto lo efectúan en una magnitud similar a la que se observa tras la administración de un inhibidor de la síntesis de 5-HT. Por otra parte, la administración crónica de inhibidores de la recaptura de 5-HT, como la fluoxetina, incrementa la tasa de neurogénesis en ratas adultas. Estos trabajos resaltan la importancia del sistema 5-HT a lo largo de toda la vida del individuo en los fenómenos de plasticidad.
ABSTRACT
Resumen Los neurotransmisores de la amígdala en el sistema límbico comprenden, entre otros, al ácido γ-aminobutírico (GABAA,B,G), el ácido glutámico (GLU) y el N-metil-D-aspartato (NMDA), así como a las monoaminas [dopamina (DA) e hidroxitriptamina (5-HT)]. El GABA es el principal neurotransmisor inhibidor. Su actividad inhibidora se bloquea, por ejemplo, por los efectos ansiolíticos de las benzodiacepinas, tanto en la amígdala como en otros centros del sistema límbico (tálamo, corteza prefrontal, hipocampo, etc.) conectados con esta estructura. Igualmente, la corteza prefrontal cerebral regula los procesos de memoria en los que esté involucrado un componente afectivo a través de conexiones inhibidoras GABAérgicas sobre el núcleo lateral (LA) de la amígdala. Al estimularse las vías córtico-amigdalinas y tálamo-amigdalinas, se produce una excitación seguida de una inhibición mediadas por receptores del GABA en el LA. Una reducción de la inhibición puede obtenerse ya sea al estimular conjuntamente ambas vías, o al estimular primero una y luego la otra vía. Ambos tipos de depresión se regulan por inhibidores presinápticos del GABAB en interneuronas del LA que conectan con el núcleo central (CE) de la amígdala, y que aparentemente llegan por una u otra vía. Este dato apoya la existencia de un ingreso monosináptico convergente de información al LA, ingreso que interviene en la respuesta a diferentes condiciones estresantes y que limita una actividad neuronal excesiva. El GLU es el principal neurotransmisor excitador. Al estimularse la amígdala durante la aversión condicionada contra ciertos sabores por este neurotransmisor, se produce una inhibición de la actividad hipotalámica procedente de vías GABAérgicas amigdalinas que van al hipotálamo. El LA es parte del circuito neural que subyace al condicionamiento pavloviano al miedo. En este circuito, el bloqueo de los receptores de NMDA glutámicos en el LA antes del entrenamiento altera el aprendizaje del condicionamiento al miedo, pero el bloqueo previo a la prueba también altera dicha expresión. Se ha visto que un bloqueo específico causa una disrupción del circuito que interviene en el aprendizaje de este condicionamiento, mas no de la consolidación en la memoria del proceso en un momento posterior al aprendizaje. La estimulación de los colículos inferiores (CI) causa un aumento significativo de los niveles de DA en la corteza prefrontal (PFC). Asimismo, el complejo basolateral de la amígdala (BLA) sirve como filtro de la información con carga negativa que promueve el escape y que asciende a estructuras más elevadas del tallo cerebral. Se ha observado que la desactivación del BLA interfiere con la activación de los egresos dopaminérgicos corticales producidos por una estimulación con carga negativa de los CI. Se ha podido demostrar que la información con carga negativa que asciende desde los CI cursa con una modulación opuesta dada por mecanismos de DA/5-HT que descienden desde la PFC. Estos procesos parecen regularse por filtros localizados en el BLA. Existe la posibilidad de que la DA proveniente del BLA module las respuestas de la DA del nucleus accumbens durante el estrés indirectamente por medio de conexiones de la primera con la corteza prefrontal medial, la cual inhibirá, por medio de la DA, la transmisión dopaminérgica de este núcleo.
Summary Neurotransmitters of the amygdala in the limbic system include, among others, γ-aminobutyric acid (GABAA,B.G), glutamic acid (GLU) and N-methyl-D-aspartate (NMDA), as well as the monoamines [dopamine (DA) and 5-hydroxytriptamine (5-HT)]. GABA is the main inhibitory neurotransmitter. Its inhibitory activity will be blocked, for example, by the anxiolytic effects of benzodiazepines both in the amygdala and in other nuclei of the limbic system (thalamus, prefrontal cortex, hippocampus, etc.) connected to this structure. Similarly, the cerebral prefrontal cortex will regulate memory and learning processes in which an affective component may be involved through GABAergic inhibitory connections reaching the lateral nucleus (LA) of the amygdala. On stimulating cortico- and thalamo-amygdalar pathways, an excitation will be produced followed by an inhibition, both of which are mediated by GABA receptors in LA. A reduction of the second inhibition may be obtained either by joint stimulation of both pathways or by stimulation of the first and then the other pathway. Both types of depression can be regulated by presynaptic inhibitors of GABAB in LA interneurons connecting with the central nucleus of the amygdala, and which apparently arrive via either the cortical or the thalamic pathway. These data support the existence of a convergent monosynaptic information input which will be active in response to different stressful conditions, and which will limit excessive neuronal activity. GLU is the main excitatory neurotransmitter. When the amygdala is excited in the course of aversive conditioning against certain flavors by this neurotransmitter, a further inhibition of hypothalamic activity will be produced arriving via GABAergic amygdalar pathways to the hypothalamus. LA is part of the neural circuit underlying pavlovian fear conditioning. In this circuit, blocking glutamate NMDA receptors in LA before training will alter acquisition of fear conditioning, but blocking this nucleus before testing will also alter such expression. Recent research has shown that blocking will cause specific disruption of the circuits participating in fear learning, and not of memory consolidation of this process some time after learning. Stimulation of the inferior colliculi (IC) will cause a significant increment of DA levels in prefrontal cortex (PFC). Likewise, the basolateral complex (BLA) of the amygdala will serve as a filter of aversive information ascending to upper structures of the brainstem. In this regard, it has been observed that deactivation of BLA will interfere with activation of cortical dopaminergic outputs produced by aversive stimulation arriving from the IC. Aversive information ascending from the IC has been shown to be modulated by DA/5-HT mechanisms descending from PFC. These processes appear to be regulated by filters located in BLA. In the same fashion, there is the possibility that DA from the basolateral amygdala may modulate responses of DA from the nucleus accumbens during stress indirectly via connections of the amygdala with the PFC, which will inhibit, again, via DA, dopaminergic transmission of the nucleus accumbens.
ABSTRACT
PURPOSE--To evaluate the cardiogenic depressor Bezold-Jarisch reflex in rats with chronic myocardial infarction. METHODS--Adult Wistar rats were submitted to ligation of the anterior descending coronary artery of the left ventricle (group INF, n = 15) and compared with rats submitted to sham-operation (group Sham, n = 15). Thirty days after the surgery, without influence of anesthetics, the basal mean arterial pressure (MAP) and heart rate (HR) were measured. Immediately after, the Bezold-Jarisch reflex was evaluated measuring the falls in diastolic arterial pressure (DAP) and the simultaneous bradycardia induced by injections of 5-hydroxytryptamine (5-HT, 4 to 32 micrograms/kg, i.v.). RESULTS--The INF group showed significantly lower basal MAP and HR values (103 +/- 3 mmHg and 328 +/- 6 bpm) when compared to the Sham group (110 +/- 2 mmHg and 348 +/- 7 bpm). The Bezold-Jarisch reflex was significantly attenuated in the INF group (falls of DAP from 2 +/- 2 to 31 +/- 3 mmHg and HR from 8 +/- 5 to 204 +/- 15 bpm), when compared to the Sham group (falls of DAP from 10 +/- 3 to 41 +/- 3 mmHg and HR from 58 +/- 12 to 276 +/- 16 bpm). The morphological analysis showed a myocardial infarction mainly located at the anterolateral portion of the left ventricle with a maximal extension of 35 of the left ventricle circumference. The INF group showed right ventricular and left atrial hypertrophy when compared to the Sham group. CONCLUSION--The experimental chronic myocardial infarction in rats is followed by significant attenuation of the Bezold-Jarisch reflex, probably as result of a heart failure and, consequently, of functional alterations in the chemosensitive receptors of cardiac unmyelinated vagal afferents.
