Heydendael Willem, Jacobson Lauren
Center for Neuropharmacology and Neuroscience, Albany Medical College, Mail Code 136, Albany, NY 12208, USA.
Brain Res. 2008 Oct 31;1238:93-107. doi: 10.1016/j.brainres.2008.08.018. Epub 2008 Aug 16.
Although glucocorticoid feedback sensitivity of the hypothalamic-pituitary-adrenal (HPA) axis is frequently impaired in depression, atypical depression may exhibit increased feedback sensitivity. Because monoamine oxidase inhibitors (MAOI) are often more effective than tricyclic antidepressants (TCA) for atypical depression, we hypothesized that to normalize HPA function in atypical depression, MAOI would differ from TCA in decreasing rather than increasing feedback sensitivity. Consistent with this hypothesis and prior evidence for opposing effects on HPA feedback in mice, we report contrasting effects of chronic MAOI (phenelzine) and TCA (imipramine) treatment on neural corticosteroid receptor gene expression in adrenalectomized male C57BL/6 mice with fixed glucocorticoid levels. Our findings corroborate prior reports of antidepressant-induced increases in hippocampal mineralocorticoid (MR) and glucocorticoid receptor (GR) expression. However, hippocampal effects were neither sustained nor representative of effects in other brain regions. Imipramine typically increased and phenelzine decreased GR expression in other feedback-related brain regions such as the paraventricular hypothalamus and prefrontal cortex. Imipramine effects were limited to feedback-related regions, whereas phenelzine had additional effects to decrease accumbens GR and central amygdala MR expression. Our results suggest an expansion of the corticosteroid receptor hypothesis of depression to include drug- and brain region-specific actions of antidepressants to decrease as well as increase corticosteroid receptor expression and feedback sensitivity. Our findings further suggest how antidepressants could improve glucocorticoid regulation of HPA activity without also facilitating the adverse effects of glucocorticoids on mood.
虽然下丘脑-垂体-肾上腺(HPA)轴的糖皮质激素反馈敏感性在抑郁症中常常受损,但非典型抑郁症可能表现出反馈敏感性增加。由于单胺氧化酶抑制剂(MAOI)对非典型抑郁症通常比对三环类抗抑郁药(TCA)更有效,我们推测,为使非典型抑郁症中的HPA功能正常化,MAOI与TCA的不同之处在于会降低而非增加反馈敏感性。与这一假设以及之前关于对小鼠HPA反馈有相反作用的证据一致,我们报告了慢性MAOI(苯乙肼)和TCA(丙咪嗪)治疗对肾上腺切除的、糖皮质激素水平固定的雄性C57BL/6小鼠神经皮质类固醇受体基因表达的对比作用。我们的研究结果证实了之前关于抗抑郁药诱导海马盐皮质激素(MR)和糖皮质激素受体(GR)表达增加的报道。然而,海马效应既未持续,也不能代表其他脑区的效应。丙咪嗪通常会增加,而苯乙肼会降低其他与反馈相关的脑区(如下丘脑室旁核和前额叶皮质)中的GR表达。丙咪嗪的作用仅限于与反馈相关的区域,而苯乙肼还有额外作用,可降低伏隔核GR和中央杏仁核MR的表达。我们的结果表明抑郁症的皮质类固醇受体假说是可以扩展的,以纳入抗抑郁药在降低以及增加皮质类固醇受体表达和反馈敏感性方面的药物和脑区特异性作用。我们的研究结果还进一步表明了抗抑郁药如何能够改善HPA活性的糖皮质激素调节,而又不会促进糖皮质激素对情绪的不良影响。