Major depressive illness is alleviated by chronic, but not acute,
administration of antidepressant drugs and electroconvulsive seizures
(ECS). While the mechanism of action of these widely used treatments is
not clearly understood, the delay in therapeutic efficacy has led to the
hypothesis that some adaptive alteration in neuronal function must occur
over the course of treatment. Preclinical and clinical studies support
the hypothesis that the norepinephrine (NE) and serotonin (5-HT)
neurotransmitter systems are involved in the therapeutic action of
antidepressant treatments, but regulation of neurotransmitter levels
and/or receptors cannot fully account for such actions. This is not
surprising, since different types of antidepressants exert different
effects on NE and 5-HT neurotransmitter systems. An updated hypothesis
is that the actions of antidepressant treatments are mediated by
adaptations of postreceptor, intracellular sites and regulation of gene
expression. Our preliminary studies demonstrate that chronic, but not
acute, administration of antidepressants increases levels of cAMP-
dependent protein kinase (PKA) enzyme activity in particulate fractions,
and levels of cAMP response element binding protein (CREB)
immunoreactivity in rat frontal cortex. We have also found that
antidepressant treatments increase levels of brain derived neurotrophic
factor (BDNF) mRNA and its receptor, trkB, in frontal cortex and
hippocampus, and that induction of BDNF is blocked by local infusion of
CREB antisense, but not sense, oligonucleotides, providing a functional
link between the PKA-CREB cascade and expression of BDNF. Based on these
results, we hypothesize that antidepressant treatments activate the PKA-
CREB cascade and increase expression of BDNF. To test this hypothesis,
we will determine the influence of different types of antidepressant
treatments, including electroconvulsive seizure, monoamine oxidase
inhibitors, selective NE and 5-HT re-uptake inhibitors, and several
atypical antidepressants on levels of PKA and CREB and expression of BDNF
and trkB mRNA in rat limbic brain regions. The relevance and significance
of these postreceptor adaptations will be verified by several criteria,
including analysis of pharmacological specificity, determined by
examination of nonantidepressant psychotropic drug treatments
(haloperidol, cocaine, diazepam, and morphine), selective dose responses,
time course, and regional specificity. PKA will be analyzed by standard
enzyme assays and Western blot analysis, CREB immunoreactivity, both
phosphorylated and dephosphorylated forms, will be determined by Western
blot, CREB function will be determined by CRE gel shift analysis, and
BDNF and trkB mRNA will be determined by RNase protection, northern blot,
and in situ hybridization. Activation of the PKA-CREB cascade and
induction of BDNF could mediate long-term adaptations of neuronal
function in response to antidepressant treatments.
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