Neurobiology Lab, Department of Zoology, University of Allahabad, Prayagraj, 211002, UP, India.
Chemical Biology Unit, Institute of Nano Science and Technology (INST), Knowledge City, Sector-81, Mohali, 140306, Punjab, India.
Neurotox Res. 2022 Oct;40(5):1174-1190. doi: 10.1007/s12640-022-00541-3. Epub 2022 Jul 12.
Depression is a leading cause of disability which at its worst leads to suicide. Its treatment relies on psychotherapy in combination with certain antidepressants (AD) from various classes such as tricyclics, selective serotonin reuptake inhibitors, or serotonin and norepinephrine reuptake inhibitors (SNRIs). Among SNRIs, venlafaxine (VEN) is one such most commonly prescribed AD which is recently reported to be in the top 50 most prescribed drugs in the USA. Depression during pregnancy is a common condition, where prescribing an AD becomes necessary as untreated depression during pregnancy has its own complications for both mother and the child. This, probably, is why an incredible rise has been reported in prescribing ADs like VEN to pregnant women in the recent past, despite some studies, including the one from our own group, having reported the in-utero VEN-induced apoptotic neurodegeneration in the fetal neocortex and the consequent neurobehavioral anomalies in adulthood. However, there still exists a lack of insight into the effects of intrauterine exposures of VEN on other fetal brain regions like the hippocampus (HPC) and striatum (STR) and the consequent effects on their cognitive and emotional wellbeing in later life. Hence, this study has been conducted where pregnant Charles-Foster (CF) rats were oral gavaged with VEN (25, 40, and 50 mg/kg bw) from gestation day (GD) 05-19. On GD-19, half of the control and treated dams were euthanized to collect their fetuses. Fetal brains were dissected and processed for reactive oxygen species (ROS) estimation neurohistopathology and confocal microscopic studies. The remaining dams were allowed to deliver naturally, and litters were reared for up to 8 weeks then tested for their cognitive abilities by the Morris water maze test and for their emotionality by the Forced swimming test. Our results showed substantial neurocytoarchitectural deficits in both HPC and STR, along with enhanced ROS levels and apoptotic neurodegenerations. Furthermore, VEN-treated young rat offsprings displayed cognitive impairments and depressive behavior as the long-lasting impact of VEN in a dose-dependent manner. So it may be inferred that prenatal VEN-induced oxidative stress causes apoptotic neurodegeneration leading to neuronal loss in HPC and STR which consequently affects the development of the said brain areas resulting in impaired cognitive and emotional abilities of young adult offsprings. Therefore, extrapolating these findings in animal models, caution may be taken before prescribing VEN to pregnant women, especially during the sensitive phase of pregnancy.
抑郁症是导致残疾的主要原因之一,严重时会导致自杀。其治疗依赖于心理疗法与来自不同类别的特定抗抑郁药(AD)相结合,例如三环类抗抑郁药、选择性 5-羟色胺再摄取抑制剂或 5-羟色胺和去甲肾上腺素再摄取抑制剂(SNRIs)。在 SNRIs 中,文拉法辛(VEN)是一种最常用的 AD,最近据报道它是美国处方量排名前 50 的药物之一。怀孕期间的抑郁症是一种常见病症,因此需要开 AD 药物,因为怀孕期间未经治疗的抑郁症会给母亲和孩子带来自身的并发症。这可能就是为什么最近有报道称,尽管包括我们自己的研究小组在内的一些研究报告称,宫内暴露于文拉法辛会导致胎儿新皮质中的凋亡性神经退行性变,并在成年后导致神经行为异常,但在最近给孕妇开 AD 药物(如文拉法辛)的情况却令人难以置信地增加,尽管如此。然而,对于宫内暴露于文拉法辛对其他胎儿大脑区域(如海马体(HPC)和纹状体(STR))的影响以及对其日后认知和情感健康的影响,人们仍然缺乏了解。因此,进行了这项研究,给怀孕的查尔斯福斯特(CF)大鼠从妊娠第 5 天(GD)-19 天经口灌胃给予文拉法辛(25、40 和 50mg/kg bw)。在 GD-19 天,一半的对照和处理组的母鼠被安乐死以收集其胎儿。胎儿大脑被解剖并用于估计活性氧(ROS)、神经组织病理学和共聚焦显微镜研究。其余的母鼠被允许自然分娩,幼崽被饲养 8 周,然后通过 Morris 水迷宫测试评估它们的认知能力,通过强迫游泳测试评估它们的情绪。我们的结果表明,HPC 和 STR 中的神经细胞结构都有明显的缺陷,同时 ROS 水平升高和凋亡性神经退行性变。此外,VEN 治疗的幼鼠后代表现出认知障碍和抑郁行为,这是 VEN 的长期影响,呈剂量依赖性。因此,可以推断,产前文拉法辛引起的氧化应激导致 HPC 和 STR 中的凋亡性神经退行性变,导致神经元丢失,从而影响所述大脑区域的发育,导致年轻成年后代的认知和情感能力受损。因此,从动物模型推断,在给孕妇开文拉法辛之前,特别是在妊娠的敏感阶段,应谨慎行事。