O câncer de mama é o tipo de câncer mais comum entre as mulheres e a sobrevivência de pacientes por ele acometidos está aumentando graças a diversas novas abordagens relacionadas ao seu diagnóstico precoce e a tratamentos mais eficientes. A enzima indoleamina- 2,3 dioxigenase (IDO) é expressa por diversas células e também por células tumorais. Esta enzima atua inibindo a proliferação de linfócitos T, comprometendo a atividade citotóxica do mesmo. O 1-metil-DL-triptofano (1MT) é um inibidor competitivo da IDO, que bloqueia seu efeito imunossupressor e poderia cooperar com a quimioterapia na regressão de tumores. Por este motivo, além de evidenciar a expressão da IDO em células tumorais mamárias em tecido e em cultivo, este trabalho também teve como objetivo verificar o efeito “in vitro” da associação do 1-metil-DL-triptofano (1MT) ao quimioterápico paclitaxel (taxol®), como método de atenuação no crescimento tumoral. Acredita-se que isto possibilitaria a restauração da capacidade de proliferação dos linfócitos T e de sua capacidade de resposta citotóxica. Os resultados demonstraram que a IDO é expressa no tecido mamário, com alta concentração no estroma tumoral. Os cultivos suplementados mostraram que as diferenças mais significativas na expressão da IDO foram observadas no grupo tratado com paclitaxel associado ao 1-metil-DL-triptofano após suplementação contínua com os fatores mencionados, onde houve redução de 12,06% para 3,56% na expressão da enzima. Dessa forma pode-se sugerir que esta associação foi mais eficaz na contenção dessa expressão o que poderia levar à uma restauração da capacidade de resposta celular dos linfócitos T contra o tumor mamário. Tal resultado poderia colaborar no desenvolvimento de uma nova estratégia terapêutica no tratamento de pessoas afetadas pelo câncer de mama / Breast cancer is the most common type of cancer among women and the survival of patients affected by it is increasing, mainly dueto several new approaches in early diagnosis and more effective treatments. The enzyme indoleamine- 2,3 - dioxygenase (IDO) is expressed on many cells and also on tumor cells. This enzyme acts by inhibiting the proliferation of T lymphocytes, thus compromising their cytotoxic activity. The 1-methyl-DL-tryptophan (1MT) is a competitive inhibitor of IDO, which blocks its immunosuppressive effect and could collaborate with chemotherapy in tumor regression. Thus, besides highlighting the expression of IDO in tumor cells in mammary tissue and culture, this study also aimed to determine the "in vitro" effect of the association of 1-methyl-DL-tryptophan (1MT) and paclitaxel (Taxol®) chemotherapy, as an attenuation approach to tumor growth. It is believed that it would allow the restoration of T-lymphocytes proliferation capability and their cytotoxic response. Results showed that IDO is expressed in breast tissue with a high concentration in the tumor stroma. The supplemented cultures showed that the most significant differences in the expression of IDO were observed in the group treated with paclitaxel associated with 1-methyl-DL-tryptophan continuous supplementation, reducing the enzyme expression from 12.06% to 3.56%. Therefore, it may be suggested that this association was more effective in reducing IDO expression and such outcome could collaborate in developing a new therapeutic strategy for breast cancer treatment

O câncer de mama é o tipo de câncer mais comum entre as mulheres e a sobrevivência de pacientes por ele acometidos está aumentando graças a diversas novas abordagens relacionadas ao seu diagnóstico precoce e a tratamentos mais eficientes. A enzima indoleamina- 2,3 dioxigenase (IDO) é expressa por diversas células e também por células tumorais. Esta enzima atua inibindo a proliferação de linfócitos T, comprometendo a atividade citotóxica do mesmo. O 1-metil-DL-triptofano (1MT) é um inibidor competitivo da IDO, que bloqueia seu efeito imunossupressor e poderia cooperar com a quimioterapia na regressão de tumores. Por este motivo, além de evidenciar a expressão da IDO em células tumorais mamárias em tecido e em cultivo, este trabalho também teve como objetivo verificar o efeito “in vitro” da associação do 1-metil-DL-triptofano (1MT) ao quimioterápico paclitaxel (taxol®), como método de atenuação no crescimento tumoral. Acredita-se que isto possibilitaria a restauração da capacidade de proliferação dos linfócitos T e de sua capacidade de resposta citotóxica. Os resultados demonstraram que a IDO é expressa no tecido mamário, com alta concentração no estroma tumoral. Os cultivos suplementados mostraram que as diferenças mais significativas na expressão da IDO foram observadas no grupo tratado com paclitaxel associado ao 1-metil-DL-triptofano após suplementação contínua com os fatores mencionados, onde houve redução de 12,06% para 3,56% na expressão da enzima. Dessa forma pode-se sugerir que esta associação foi mais eficaz na contenção dessa expressão o que poderia levar à uma restauração da capacidade de resposta celular dos linfócitos T contra o tumor mamário. Tal resultado poderia colaborar no desenvolvimento de uma nova estratégia terapêutica no tratamento de pessoas afetadas pelo câncer de mama / Breast cancer is the most common type of cancer among women and the survival of patients affected by it is increasing, mainly dueto several new approaches in early diagnosis and more effective treatments. The enzyme indoleamine- 2,3 - dioxygenase (IDO) is expressed on many cells and also on tumor cells. This enzyme acts by inhibiting the proliferation of T lymphocytes, thus compromising their cytotoxic activity. The 1-methyl-DL-tryptophan (1MT) is a competitive inhibitor of IDO, which blocks its immunosuppressive effect and could collaborate with chemotherapy in tumor regression. Thus, besides highlighting the expression of IDO in tumor cells in mammary tissue and culture, this study also aimed to determine the "in vitro" effect of the association of 1-methyl-DL-tryptophan (1MT) and paclitaxel (Taxol®) chemotherapy, as an attenuation approach to tumor growth. It is believed that it would allow the restoration of T-lymphocytes proliferation capability and their cytotoxic response. Results showed that IDO is expressed in breast tissue with a high concentration in the tumor stroma. The supplemented cultures showed that the most significant differences in the expression of IDO were observed in the group treated with paclitaxel associated with 1-methyl-DL-tryptophan continuous supplementation, reducing the enzyme expression from 12.06% to 3.56%. Therefore, it may be suggested that this association was more effective in reducing IDO expression and such outcome could collaborate in developing a new therapeutic strategy for breast cancer treatment

This doctoral thesis investigated the role of the neuromodulator serotonin on four different value-based decision making tasks, using an acute tryptopahin intervention and an associative genetic approach - a naturally occuring variation in the promoter region of the serotonin transporter gene (5-HTTLPR). Additionally, structural (DTI) and functional aspects (BOLD-fMRI) of the brain were assessed using magnetic resonance imaging in relation to decision-making. Overall, we only found limited evidence for a serotonergic effect on decision-making that was restricted to a genetic association with risk-seeking for losses behaviour that could no be corroborated by differences in tonic serotonin levels or white matter microstructure. / In der vorliegenden Doktorarbeit wurde die Rolle des Neuromodulators Serotonin hinsichtlich vier verschiedener wertbasierter Entscheidungsfindungsaufgaben untersucht, wobei eine akute Tryptophanintervention und ein assoziativer genetischer Ansatz, eine natürlich vorkommende Variation in der Promoterregion des Serotonintransportergens (5-HTTLPR), zur Anwendung gekommen sind. Zusätzlich wurden strukturelle (DTI) und funktionelle Aspekte (BOLD-fMRI) des Gehirns mittels Magnetresonanztomographie in Bezug auf die Entscheidungsfindung erhoben. Insgesamt fanden wir nur eine begrenzte Evidenz eines serotonergen Effekts auf Entscheidungsverhalten, die sich auf eine genetische Assoziation mit risikofreudigem Verhalten bei Verlusten beschränkte. Diese Assoziation ließ sich nicht durch Unterschiede im tonischen Serotoninspiegel oder der Mikrostruktur der weißen Substanz erhärten.

Suicidal behavior has to be considered as a multifactorial phenomenon, which can be analyzed in a classifying-phenomenological manner. We have examined the relation of parasuicide typology to whole blood concentrations of serotonin, HVA, and tryptophan in 58 patients classified into 4 groups of parasuicide typology compared to 22 nonsuicidal depressed patients and 20 healthy subjects. Suicidal patients classified as impetuous, desperate and ambivalent types had significantly reduced whole blood 5-HT levels in comparison with the appealing type as well as nonsuicidal subjects. No differences were detected in the HVA content, but whole blood tryptophan concentrations were significantly reduced in impetuous suicidal patients and depressed patients compared to healthy subjects. This study provides evidence for reduced whole blood serotonin content based on different types of parasuicide. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Background: Serotonin has been implicated in impulsive behaviours such as temporal discounting. While animal studies and theoretical approaches suggest that reduced tonic serotonin levels increase temporal discounting rates and vice versa, evidence from human studies is scarce and inconclusive. Furthermore, an important modulator of serotonin signalling, a genetic variation in the promoter region of the serotonin transporter gene (5-HTTLPR), has not been investigated for temporal discounting so far. Objective: First, the purpose of this study was to test for a significant association between 5-HTTLPR and temporal discounting. Second, we wished to investigate the effect of high/low tonic serotonin levels on intertemporal choice and blood oxygen-level-dependent response, controlling for 5-HTTLPR. Methods: We tested the association of 5-HTTLPR with temporal discounting rates using an intertemporal choice task in 611 individuals. We then manipulated tonic serotonin levels with acute tryptophan interventions (depletion, loading, balanced) in a subsample of 45 short (S)-allele and 45 long (L)/L-allele carriers in a randomised double-blind crossover design using functional magnetic resonance imaging and an intertemporal choice task. Results: Overall, we did not find any effect of serotonin and 5-HTTLPR on temporal discounting rates or the brain networks associated with valuation and cognitive control. Conclusion: Our findings indicate that serotonin may not be directly involved in choices including delays on longer timescales such as days, weeks or months. We speculate that serotonin plays a stronger role in dynamic intertemporal choice tasks where the delays are on a timescale of seconds and hence are therefore directly experienced during the experiment.

Herz-Kreislauf-Erkrankungen sind nach wie vor die häufigste Todesursache. Vor allem Bluthochdruck ist in diesem Zusammenhang ein wichtiger Risikofaktor für die Entstehung von koronaren Herzerkrankungen, Myokardinfarkten, Herzinsuffizienz und Schlaganfall. Zur Behandlung der Hypertonie werden unterschiedliche Pharmaka eingesetzt, hauptsächlich Substanzen, die das Renin-Angiotensin-Aldosteron-System (RAAS) hemmen. Dazu gehören synthetische Inhibitoren des angiotensin-converting enzyme (ACE). Für präventive Zwecke können diese ACE-Inhibitoren auf Grund mehrerer Nebenwirkungen nicht eingesetzt werden. Interessant für eine präventive Anwendung sind natürliche ACE-hemmende Peptide, welche in der Sequenz unterschiedlicher Lebensmittelproteine vorliegen und durch enzymatische Hydrolyse freigesetzt werden. Ein besonders potenter ACE-Hemmer ist das Dipeptid Isoleucin-Tryptophan (IW) und damit ein interessanter Kandidat für den Einsatz in einem funktionellen Lebensmittel. Um dies jedoch realisieren zu können, muss IW in einer ausreichenden Menge produziert werden. Durch die enzymatische Hydrolyse ist dies aktuell nicht möglich, da die Peptidsequenz IW sehr selten in Proteinen vorhanden ist. Aus diesem Grund war es Ziel der vorliegenden Arbeit eine innovative biotechnologische Methode zu etablieren, um das ACE-hemmende Dipeptid IW in höheren Mengen und vor allem lebensmittelkonform zu produzieren. Die Produktion des ACE-hemmenden Peptids wurde biotechnologisch mittels rekombinanter DNA-Technologie realisiert. Hierfür wurde eine repetitive IW-Sequenz entworfen (264 bp), welche für ein 10 kDa großes Protein codierte. Dieses IW-Konstrukt enthielt in der Sequenz 16-mal IW. Mit Hilfe von Escherichia coli (E. coli) wurde ein 52 kDa großes Fusionsprotein überexprimiert. Als Fusionstag diente das Maltose Binding Protein (MBP). Dieses rekombinante Fusionsprotein (MBP-IW) lag nach einer Kombination von zwei verschiedenen chromatographischen Verfahren gereinigt vor. Mit dieser Methode war es möglich, 0,52 mg lösliches MBP-IW pro 1 g E. coli Feuchtmasse zu produzieren. MBP-IW wurde enzymatisch mit dem Enzym α-Chymotrypsin hydrolisiert und das Dipeptid IW anschließend chromatographisch isoliert. Nach der Hydrolyse und Isolation lag die Ausbeute des rekombinant produzierten IW (rIW) mit einer Reinheit von ≥ 96 % bei 14 µg. Somit konnten 28 % des möglichen Anteils an rIW vom sauberen MBP-IW gewonnen werden. Die Identifikation von IW erfolgte mit drei unterschiedlichen Methoden, der reversed phase-high performance liquid chromatography-UV-Detektion, der liquid chromatography-electrospray ionisation-tandem mass spectrometry und durch eine N-terminale Derivatisierung des Peptids. Mit diesen Methoden wurde bestätigt, dass es sich bei dem produzierten Peptid um IW handelte. Das rIW wurde im Vergleich zum chemisch produzierten kommerziell erwerblichen L-IW (cIW) und chemisch produzierten kommerziell erwerblichen D-IW (cDIW) auf sein ACE-hemmendes Potential getestet. Um der komplexen und heterogenen Verteilung der ACE-Aktivität im menschlichen Organismus gerecht zu werden, wurde das ACE-hemmende Potential der Dipeptide an verschiedenen ACE-Quellen untersucht. Neben dem nicht-humanen ACE-System (ACE aus der Kaninchenlunge) wurde auch humanes lösliches ACE (aus humanem Plasma) sowie humanes membrangebundenes ACE (aus Human umbilical vein endothelial cells, HUVECs) verwendet. Bei allen getesteten ACE-Systemen zeigte sich kein ACE-hemmendes Potential durch cDIW. Beim Vergleich von rIW mit cIW in Bezug auf deren ACE-hemmendes Potential wurden IC50-Werte von 1,72 ± 0,12 bis 23,30 ± 3,68 µM, abhängig vom getesteten ACE-System, bestimmt. Für alle verwendeten ACE-Quellen konnte gezeigt werden, dass beide unterschiedlich produzierten Dipeptide gleich effektiv waren. Ein weiteres Ziel der Arbeit bestand darin neben einem Peptidmix aus Molkenprotein mit hohem Anteil an IW, noch zwei weitere Peptidmixe pflanzlichen Proteinursprungs hinsichtlich des ACE-hemmenden Potentials zu untersuchen. Auf Grundlage der identifizierten tryptophan- und tyrosinhaltigen Dipeptide in den Hydrolysaten des Molken-, Soja- und Reisproteins wurden drei Peptidmixe hergestellt. Auch hier wurde wieder die Wirkung auf mehrere ACE-Quellen ermittelt. Neben den oben genannten, wurde hier zusätzlich der Einfluss auf membrangebundenes ACE der Rattenaorta untersucht. In allen getesteten ACE-Systemen zeigte der Peptidmix Molke ein signifikant höheres ACE-hemmendes Potential als die Peptidmixe von Soja und Reis. Der Peptidmix Soja war von den getesteten hydrolisierten Pflanzenproteinen der potenteste ACE-Inhibitor. Die IC50-Werte der Peptidmixe lagen, je nach getestetem ACE-System, zwischen 16,60 ± 2,59 und 282,04 ± 18,51 mg/l. Der starke ACE-hemmende Effekt vom Peptidmix Molke wurde mit der hohen Konzentration an IW assoziiert (bis zu 10-fach höher verglichen mit den anderen beiden Peptidmixen). Dies legt nahe, dass das Dipeptid IW hauptverantwortlich für das ACE-hemmende Potential in den getesteten Peptidmixen ist, was nochmals das große Potential des Dipeptids verdeutlicht. Im Rahmen dieser Arbeit konnte gezeigt werden, dass IW aus Molkenprotein im Vergleich mit den bioaktiven Peptidquellen der Proteine aus Soja und Reis, die stärkste ACE-Hemmung aufweist. Des Weiteren ist es erstmals gelungen, das ACE-hemmende Dipeptid IW in hoher Reinheit biotechnologisch mit Hilfe von rekombinanten Proteinen herzustellen. Um den Einsatz als funktionelles Lebensmittel realisieren zu können, müsste im Weiteren die biotechnologische Herstellung von IW optimiert werden, um eine höhere Ausbeute zu generieren. Nach dieser Optimierung könnte in einem Scale-up Verfahren so viel an IW gewonnen werden, dass es industriell einsetzbar wäre. Die ACE-hemmende Wirkung des biotechnologisch hergestellten IWs wurde in dieser Arbeit bestätigt, sodass es in einem innovativen funktionellen Lebensmittel für die tägliche Ernährung eingesetzt werden könnte. Perspektivisch eröffnet sich damit die Möglichkeit IW präventiv zu nutzen, um die Entwicklung von Bluthochdruck und deren Folgeschädigungen zu verzögern oder zu minimieren. / Cardiovascular diseases are still the leading cause of death. Especially hypertension is an important risk factor for the development of coronary heart disease, myocardial infarction, heart failure and stroke. To treat hypertension different drugs are clinically used. This are mainly substances, which inhibit the renin-angiotensin-aldosterone-system (RAAS), such as synthetic inhibitors of angiotensin-converting enzyme (ACE). However these ACE-inhibitors cannot be used for preventive purposes because of several side effects. Therefore natural ACE-inhibitory peptides, which are mostly encrypted in food proteins and released by enzymatic hydrolysis, are of main interest for preventive applications. The dipeptide isoleucine-tryptophan (IW) is a potent ACE-inhibitor and thus an interesting ingredient in functional foods. However, to realize this, IW must be produced in sufficient amounts. This is not possible with the current enzymatic hydrolysis, because the peptide sequence of IW is very rarely present in proteins. For that reason, the aim of the present thesis was to establish an innovative biotechnological method to produce the ACE-inhibitory dipeptide IW in an enlarged amount and especially considering the food-safety. The production of the ACE-inhibitory peptide was realized biotechnologically via recombinant DNA technology. For this, a repetitive IW-sequence (264 bp) was designed, which encoded a 10 kDa protein. In this IW-construct IW was sequenced 16 times. Using Escherichia coli (E. coli) a fusion protein with a size of 52 kDa was overexpressed. The maltose binding protein (MBP) served as fusion tag. This recombinant fusion protein (MBP-IW) was purified by a combination of two different chromatographic methods. It has become possible to produce 0.52 mg of soluble MBP-IW per 1 g wet weight of E. coli. MBP-IW was enzymatically hydrolysed with the enzyme α-chymotrypsin and the dipeptide IW was subsequently isolated by chromatography. After hydrolysis and isolation, the yield of the recombinant produced IW (rIW) with a purity of ≥ 96 % was 14 μg. Thus, 28 % from the possible content of rIW was obtained from the clean MBP-IW. IW was identified by three different methods: reversed phase-high performance liquid chromatography with UV-detection, liquid chromatography-electrospray ionisation-tandem mass spectrometry and N-terminal derivatization of the peptide. These methods confirmed the produced peptide as IW. The ACE-inhibitory potential of rIW was analysed and compared to that of the chemically produced commercially available L-IW (cIW) and of the chemically produced commercially available D-IW (cDIW). To address the complex and heterogeneous distribution of ACE-activity in the human organism, the ACE-inhibitory potential of the dipeptides was investigated in different ACE-sources. Additionally to non-human ACE (from rabbit lung) also human soluble ACE (from human plasma) and human membrane-bound ACE (from human umbilical vein endothelial cells, HUVECs) were used. In all tested ACE-systems cDIW did not show any ACE-inhibitory effect. IC50 values of rIW and cIW ranged from 1.72 ± 0.12 to 23.30 ± 3.68 μM, depending on the investigated ACE-system. In all sources of ACE an equal inhibitory potency of both differently produced dipeptides were determined. The second aim of the thesis was to investigate the ACE-inhibitory effect of two peptide mixes of plant proteins beside the peptide mix of whey protein, containing a high concentration of IW. Based on the identified tryptophan- and tyrosine-containing dipeptides in the hydrolysates of the whey-, soy- and rice-protein, three peptide mixes were prepared. Also here the effect on different ACE-sources was determined. Additionally to the named above, membrane-bound ACE from rat aorta was investigated. In all analysed ACE-systems, the peptide mix of whey showed a significantly higher ACE-inhibitory potential than the peptide mixes of soy and rice. The peptide mix soy was the most potent ACE-inhibitor tested among the hydrolysed plant proteins. The IC50-values of the peptide mixes were between 16.60 ± 2.59 and 282.04 ± 18.51 mg/l, depending on the used ACE-system. The strong ACE-inhibitory effect of the whey peptide mix was associated with the high concentration of IW (10 times higher compared to the other peptide mixes). This indicates that the dipeptide IW is mainly responsible for the ACE-inhibitory potential in the investigated peptide mixes, which demonstrate again the great potential of this dipeptide. It was shown in the present study that IW from whey protein had the strongest ACE-inhibition compared to the bioactive peptides of proteins from soy and rice. Furthermore, for the first time it was possible to produce the ACE-inhibitory dipeptide IW in high purity biotechnologically using recombinant proteins. To use IW as an ingredient in functional foods, the biotechnological production of IW needs to be optimized to receive higher yields. After this optimization, it would be conceivable to increase the production of IW in a scale-up process for industrial application. The ACE-inhibitory effect of the biotechnologically produced IW was confirmed in the present study, thus it could be used in an innovative functional food for daily nutrition. Prospectively, this increases the possibility of using IW preventively in order to delay or minimize the development of hypertension and the consequentially diseases.

Determination of the three-dimensional structure of enzymes at atomic resolution is a key prerequisite for elucidation of molecular mechanisms of catalysis and catalysis mechanism prediction. X-ray protein crystallography is the most widely used method today for determining protein structures. In this thesis we describe the expression, purification, crystallization and structure solution of two new enzymes: PyrH and PrnB. PyrH is a member of the new emerging family of FADH dependent tryptophan halogenases. It catalyzes the regioselective halogenation of tryptophan at the C-5 position of the indole ring. Elucidation of its structure (Chapter 2) and comparison with PrnA, aregioselective 7th tryptophan halogenase whose structure has already been solved confirmed the proposed mechanism of action for this class of enzymes. PrnB is the only enzyme known to perform exquisite and peculiar ring rearrangement chemistry: it converts 7-Cl-tryptophan and tryptophan into respectively monodechloroaminopyrrolnitrin and aminophenylpyrrole. We developed a method for expression and purification of milligrams of pure and homogeneous recombinant PrnB (Chapter 3). We identified suitable crystallization conditions and determined PrnB structure (Chapter 4). Analysis of the PrnB structure helped us to propose a reaction mechanism for this unique enzyme.

This cross-sectional study examined neurobiologic correlates of depression in ischemic stroke patients. Depression severity was measured with a standardized scale (Center for Epidemiologic Studies Depression Scale; CES-D). Eighty-two patients (53.1% male, mean (± SD) age 71.9 ± 14.2 years, mean (± SD) National Institutes of Health Stroke Scale (NIHSS) score 4.6±4.7, mean (± SD) CES-D score 12.6 ± 10.8) were recruited. A linear regression controlling for age and stroke severity (NIHSS) determined that the kynurenine to tryptophan ratio (β= -0.105, p=0.369) was not significantly associated with CES-D (primary hypothesis) (overall model R2=0.069, F3,73=1.805, p=0.154). Secondary analyses suggested one instance of cytokines favouring inflammatory states in mild depressive symptomatology; IFN-Ɣ/IL-10 (OR, 2.17; 95% CI, 1.02-4.64, p=0.045). For the most part however, inclusion of cytokines and neuroimaging correlates such as atrophy, lesion location and white matter changes were non-significant. Longitudinal studies are necessary to identify the possible neurobiologic correlates of depressive symptoms post-stroke.

This cross-sectional study examined neurobiologic correlates of depression in ischemic stroke patients. Depression severity was measured with a standardized scale (Center for Epidemiologic Studies Depression Scale; CES-D). Eighty-two patients (53.1% male, mean (± SD) age 71.9 ± 14.2 years, mean (± SD) National Institutes of Health Stroke Scale (NIHSS) score 4.6±4.7, mean (± SD) CES-D score 12.6 ± 10.8) were recruited. A linear regression controlling for age and stroke severity (NIHSS) determined that the kynurenine to tryptophan ratio (β= -0.105, p=0.369) was not significantly associated with CES-D (primary hypothesis) (overall model R2=0.069, F3,73=1.805, p=0.154). Secondary analyses suggested one instance of cytokines favouring inflammatory states in mild depressive symptomatology; IFN-Ɣ/IL-10 (OR, 2.17; 95% CI, 1.02-4.64, p=0.045). For the most part however, inclusion of cytokines and neuroimaging correlates such as atrophy, lesion location and white matter changes were non-significant. Longitudinal studies are necessary to identify the possible neurobiologic correlates of depressive symptoms post-stroke.

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.