Corcoran K A, Leaderbrand K, Jovasevic V, Guedea A L, Kassam F, Radulovic J
Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Transl Psychiatry. 2015 Oct 13;5(10):e657. doi: 10.1038/tp.2015.150.
In patients suffering from post-traumatic stress disorder (PTSD), fear evoked by trauma-related memories lasts long past the traumatic event and it is often complicated by general anxiety and depressed mood. This poses a treatment challenge, as drugs beneficial for some symptoms might exacerbate others. For example, in preclinical studies, antagonists of the NR2B subunit of N-methyl-d-aspartate receptors and activators of cAMP-dependent protein kinase (PKA) act as potent antidepressants and anxiolytics, but they block fear extinction. Using mice, we attempted to overcome this problem by interfering with individual NR2B and PKA signaling complexes organized by scaffolding proteins. We infused cell-permeable Tat peptides that displaced either NR2B from receptor for activated C kinase 1 (RACK1), or PKA from A-kinase anchor proteins (AKAPs) or microtubule-associated proteins (MAPs). The infusions were targeted to the retrosplenial cortex, an area involved in both fear extinction of remotely acquired memories and in mood regulation. Tat-RACK1 and Tat-AKAP enhanced fear extinction, all peptides reduced anxiety and none affected baseline depression-like behavior. However, disruption of PKA complexes distinctively interfered with the rapid antidepressant actions of the N-methyl-D-aspartate receptors antagonist MK-801 in that Tat-MAP2 blocked, whereas Tat-AKAP completely inverted the effect of MK-801 from antidepressant to depressant. These effects were unrelated to the MK-801-induced changes of brain-derived neurotrophic factor messenger RNA levels. Together, the findings suggest that NR2B-RACK1 complexes specifically contribute to fear extinction, and may provide a target for the treatment of PTSD. AKAP-PKA, on the other hand, appears to modulate fear extinction and antidepressant responses in opposite directions.
在患有创伤后应激障碍(PTSD)的患者中,与创伤相关的记忆所引发的恐惧在创伤事件过去很久之后依然持续,并且常常伴有广泛性焦虑和情绪低落。这带来了治疗上的挑战,因为对某些症状有益的药物可能会加重其他症状。例如,在临床前研究中,N-甲基-D-天冬氨酸受体NR2B亚基的拮抗剂和环磷酸腺苷依赖性蛋白激酶(PKA)的激活剂可作为有效的抗抑郁药和抗焦虑药,但它们会阻碍恐惧消退。我们利用小鼠,试图通过干扰由支架蛋白组织的单个NR2B和PKA信号复合物来克服这一问题。我们注入了可穿透细胞的Tat肽,这些肽要么将NR2B从活化C激酶1受体(RACK1)上置换下来,要么将PKA从A激酶锚定蛋白(AKAPs)或微管相关蛋白(MAPs)上置换下来。注入的部位是脾后皮质,该区域既参与远期获得记忆的恐惧消退,也参与情绪调节。Tat-RACK1和Tat-AKAP增强了恐惧消退,所有肽都减轻了焦虑,且无一影响基线抑郁样行为。然而,PKA复合物的破坏独特地干扰了N-甲基-D-天冬氨酸受体拮抗剂MK-801的快速抗抑郁作用,因为Tat-MAP2起了阻断作用,而Tat-AKAP则完全逆转了MK-801的作用,使其从抗抑郁变为促抑郁。这些效应与MK-801诱导的脑源性神经营养因子信使核糖核酸水平的变化无关。总之,这些发现表明NR2B-RACK1复合物对恐惧消退有特异性作用,可能为创伤后应激障碍的治疗提供一个靶点。另一方面,AKAP-PKA似乎在恐惧消退和抗抑郁反应中发挥相反的调节作用。