Shi Hanrui, Fang Jianqun, Wang Yanrong, Chen Yundong, Wang Yuan, Dai Deshang
School of First Clinical, Ningxia Medical University, Yinchuan, Ningxia, China.
Mental Health Center, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China.
Synapse. 2025 Sep;79(5):e70029. doi: 10.1002/syn.70029.
Obsessive-compulsive disorder (OCD) is a chronic and debilitating psychiatric condition characterized by persistent, intrusive thoughts (obsessions) and repetitive ritualistic behaviors (compulsions). Accumulating evidence suggests that individuals with OCD demonstrate marked cognitive impairments, especially in executive function domains, including cognitive flexibility and working memory. Although existing therapeutic approaches (e.g., serotonin reuptake inhibitors and cognitive-behavioral therapy) can partially mitigate behavioral symptoms, their effectiveness in improving cognitive impairments remains limited. Although dopaminergic dysregulation has been implicated in OCD, the involvement of dopamine transporter (DAT) polymorphisms in cognitive flexibility and working memory impairments remains unclear, limiting the development of targeted therapeutic interventions. Although current investigations predominantly focus on dopamine (DA) D1/D2 receptors and serotonin transporters, the contribution of the DAT to OCD pathophysiology remains insufficiently explored. In the present study, we utilized Sapap3 knockout (KO) mice as a preclinical OCD model to examine dopaminergic dysregulation. Using ELISA, we conducted systematic comparisons of both dopaminergic levels and DAT expression between Sapap3 KO and wild-type (WT) mice. Additionally, we implemented targeted epigenetic modulation via histone acetylation in the nucleus accumbens (NAc) of Sapap3 KO mice. Our data demonstrated a significant decrease in DAT expression in the NAc of Sapap3 KO mice compared to WT (p = 0.0019). Strikingly, the administration of the histone deacetylase inhibitor 4-phenylbutyric acid (PBA) normalized DAT expression in KO mice to levels statistically equivalent to WT mice (p = 0.1107), achieving complete functional recovery of DAT deficiency. This restoration of DAT expression (p = 0.1107 PBA vs. WT) was accompanied by a significant reduction in the abnormally elevated baseline DA levels in Sapap3 KO mice (pretreatment: 192.46 ± 6.69 pg/mg; posttreatment: 173.67 ± 4.10 pg/mg, p < 0.01), which consequently improved executive function impairments. Our findings demonstrate that DAT polymorphisms represent a previously unrecognized pathogenic factor in cognitive impairment associated with OCD. Investigations of histone acetylation regulatory mechanisms revealed that changes in histone acetylation levels directly regulate DAT expression. We provide mechanistic evidence showing that epigenetic regulation of DAT expression can effectively reverse these neurological deficits, particularly through modulation of histone acetylation status to significantly improve DAT functional abnormalities, thereby identifying a novel and promising therapeutic target for OCD treatment.
强迫症(OCD)是一种慢性且使人衰弱的精神疾病,其特征为持续存在的、侵入性的想法(强迫观念)和重复性的仪式化行为(强迫行为)。越来越多的证据表明,患有强迫症的个体表现出明显的认知障碍,尤其是在执行功能领域,包括认知灵活性和工作记忆。尽管现有的治疗方法(如5-羟色胺再摄取抑制剂和认知行为疗法)可以部分缓解行为症状,但它们在改善认知障碍方面的效果仍然有限。尽管多巴胺能调节异常与强迫症有关,但多巴胺转运体(DAT)基因多态性在认知灵活性和工作记忆损伤中的作用仍不清楚,这限制了针对性治疗干预措施的开发。尽管目前的研究主要集中在多巴胺(DA)D1/D2受体和5-羟色胺转运体上,但DAT在强迫症病理生理学中的作用仍未得到充分探索。在本研究中,我们利用Sapap3基因敲除(KO)小鼠作为临床前强迫症模型来研究多巴胺能调节异常。我们使用酶联免疫吸附测定(ELISA)系统比较了Sapap3基因敲除小鼠和野生型(WT)小鼠的多巴胺能水平和DAT表达。此外,我们通过组蛋白乙酰化对Sapap3基因敲除小鼠伏隔核(NAc)进行靶向表观遗传调控。我们的数据表明,与野生型小鼠相比,Sapap3基因敲除小鼠伏隔核中的DAT表达显著降低(p = 0.0019)。令人惊讶的是,给予组蛋白去乙酰化酶抑制剂4-苯基丁酸(PBA)可使基因敲除小鼠的DAT表达恢复正常,达到与野生型小鼠统计学上相当的水平(p = 0.1107),实现了DAT缺陷的完全功能恢复。DAT表达的这种恢复(PBA与野生型相比,p = 0.1107)伴随着Sapap3基因敲除小鼠异常升高的基线多巴胺水平的显著降低(预处理:192.46±6.69 pg/mg;后处理:173.67±4.10 pg/mg,p < 0.01),从而改善了执行功能障碍。我们的研究结果表明,DAT基因多态性是与强迫症相关的认知障碍中一个先前未被认识到的致病因素。对组蛋白乙酰化调控机制的研究表明,组蛋白乙酰化水平的变化直接调节DAT表达。我们提供了机制证据表明,DAT表达的表观遗传调控可以有效逆转这些神经功能缺陷,特别是通过调节组蛋白乙酰化状态来显著改善DAT功能异常,从而确定了一个用于强迫症治疗的新的、有前景的治疗靶点。