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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
191

Mechanisms of specificity in neuronal activity-regulated gene transcription.

Lyons, MR, West, AE 08 1900 (has links)
The brain is a highly adaptable organ that is capable of converting sensory information into changes in neuronal function. This plasticity allows behavior to be accommodated to the environment, providing an important evolutionary advantage. Neurons convert environmental stimuli into long-lasting changes in their physiology in part through the synaptic activity-regulated transcription of new gene products. Since the neurotransmitter-dependent regulation of Fos transcription was first discovered nearly 25 years ago, a wealth of studies have enriched our understanding of the molecular pathways that mediate activity-regulated changes in gene transcription. These findings show that a broad range of signaling pathways and transcriptional regulators can be engaged by neuronal activity to sculpt complex programs of stimulus-regulated gene transcription. However, the shear scope of the transcriptional pathways engaged by neuronal activity raises the question of how specificity in the nature of the transcriptional response is achieved in order to encode physiologically relevant responses to divergent stimuli. Here we summarize the general paradigms by which neuronal activity regulates transcription while focusing on the molecular mechanisms that confer differential stimulus-, cell-type-, and developmental-specificity upon activity-regulated programs of neuronal gene transcription. In addition, we preview some of the new technologies that will advance our future understanding of the mechanisms and consequences of activity-regulated gene transcription in the brain. / Dissertation
192

BDNF/TrkB em câncer colorretal : interações funcionais com GRPR e EGFR

Farias, Caroline Brunetto de January 2012 (has links)
BDNF/TrkB são descritos em diversas neoplasias onde iniciam sinais mitogênicos, facilitam o crescimento tumoral, previnem apoptose e regulam angiogênese e metástase. Outros fatores de crescimento também são importantes para tumorigênese, como GRP/GRPR e EGF/EGFR. O objetivo geral deste trabalho foi investigar o papel de BDNF/TrkB em câncer colorretal avaliando possíveis interações com GRPR e EGFR. Verificamos que BDNF e seu receptor, TrkB, estão presentes em amostras de pacientes com câncer colorretal esporádico, e os níveis de BDNF encontram-se mais elevados no tecido neoplásico que no tecido adjacente ao tumor. O tratamento com RC- 3095, um antagonista de GRPR, na linhagem celular de câncer colorretal humana, HT-29, causa diminuição nos níveis de NGF secretados pelas células e aumento de BDNF em relação ao controle não tratado. RC-3095 inibe a proliferação e viabilidade celular das linhagens HT-29 (EGFR positiva) e SW-620 (EGFR negativa), embora apenas em HT-29 ocorra um aumento significativo na expressão de mRNA de BDNF. Por isso, um anticorpo monoclonal anti-EGFR, cetuximabe, foi combinado a RC-3095, nas células HT-29, sendo capaz de prevenir tal aumento, sugerindo que este efeito seja mediado por EGFR. Os tratamentos com um inibidor de Trks, K252a (1000 nM) ou com cetuximabe (10 nM) também inibem a proliferação celular. Entretanto, a combinação de BDNF a cetuximabe previne este efeito, enquanto que a combinação de doses não efetivas de K252a (10 nM) à cetuximabe (1 nM) inibe a proliferação celular de HT- 29. Além disso, cetuximabe também causa aumento na expressão de mRNA de TrkB e BDNF, após 600 minutos de tratamento. Nossos resultados sugerem que a inibição da proliferação celular in vitro ou do crescimento tumoral in vivo devem acontecer através do bloqueio combinado entre GRPR e TrkB em células de câncer colorretal EGFR positivas, e que BDNF também esteja envolvido em mecanismos de resistência a fármacos. Por isso, o bloqueio de BDNF / TrkB pode emergir como potencial alvo antitumoral. / BDNF / TrkB are described in various cancers where they participate in tumor growth, apoptosis, angiogenesis and metastasis. Furthermore, other growth factors are also important to tumorigenesis as GRP/GRPR and EGF/EGFR. Therefore, the aim of this study was to investigate the role of BDNF/TrkB in colorectal cancer evaluating the interactions with GRPR and EGFR. We found that BDNF and its receptor, TrkB, are present in samples from patients diagnosed with sporadic colorectal cancer, and BDNF levels were higher in tumor tissue compared to adjacent tumor tissue. Treatment with RC-3095, GRPR antagonist, in human colorectal cancer cell line, HT-29 caused a decrease in NGF levels secreted by cells, and generated increase of BDNF when compared to untreated control. RC-3095 inhibited the proliferation and cell viability in HT-29 (EGFR positive) and SW-620 (EGFR negative), but only HT-29 cells showed a significant increase in BDNF mRNA expression. Therefore, a monoclonal anti-EGFR antibody, cetuximab was combined with RC-3095 in HT-29 cells, and was able to prevent such an increase, suggesting that this effect is mediated by EGFR. The treatment with a Trk inhibitor, K252a (1000 nM) or cetuximab (10 nM), inhibited cell proliferation. However, the combination of BDNF with cetuximab prevented this effect, whereas the combination of ineffective doses of K252a (10 nM) with cetuximab (1 nM) still inhibited cell proliferation of HT-29. Furthermore, cetuximab also caused an increase in BDNF and TrkB mRNA expression, 600 minutes after treatment. In summary, our results suggest that inhibition of cell proliferation in vitro or tumor growth in vivo must occur between the combination of GRPR and TrkB in EGFR positive colorectal cancer cells, and that BDNF is also involved in drug resistance mechanisms. Therefore, blockage of BDNF / TrkB may emerge as potential antitumor target.
193

Entendendo as fronteiras e a comorbidade entre o transtorno de humor bipolar e o transtorno de déficit de atenção e hiperatividade em crianças e adolescentes

Zeni, Cristian Patrick January 2011 (has links)
Introdução: Em crianças e adolescentes, o Transtorno de Humor Bipolar (THB) é associado a danos devastadores no desenvolvimento. O Transtorno de Déficit de Atenção/Hiperatividade (TDAH), caracterizado por sintomas de desatenção, hiperatividade e impulsividade também causa prejuízo funcional significativo. O diagnóstico diferencial entre os dois transtornos é puramente clínico e, até o momento, há poucos estudos avaliando diferenças neurobiológicas. Diversas pesquisas sugerem a participação do Fator Neurotrófico Derivado do Cérebro (BDNF), cujo papel não foi elucidado em crianças e adolescentes com THB e com TDAH. Apesar das altas taxas de comorbidade entre o THB e o TDAH, de uma pior resposta ao tratamento e de um pior funcionamento psicossocial quando da comorbidade, apenas dois estudos avaliaram a resposta ao tratamento especificamente neste grupo de pacientes. Objetivos: O objetivo principal deste trabalho é avançar no entendimento do papel do BDNF na psicopatologia do THB e do TDAH, visando sua diferenciação. O tratamento da comorbidade com estimulantes tambem foi estudado. Métodos: A transmissão do alelo Val66 do BDNF foi avaliada em famílias de crianças e adolescentes com THB e TDAH, assim como o efeito do gene no nível sérico da proteína do BDNF entre os grupos. Foi realizada a comparação dos níveis séricos entre pacientes com THB em comorbidade com TDAH e TDAH isolado. Um estudo clínico cruzado com estimulantes foi realizado em crianças e adolescentes com THB e TDAH em comorbidade que tinham apresentado remissão dos sintomas de humor com o uso de aripiprazol, mas persistência dos sintomas de TDAH. Os sintomas de mania, depressão, desatenção e hiperatividade foram acompanhados ao longo de quatro semanas de tratamento, duas com placebo ou metilfenidato e duas com o tratamento inverso. Resultados: Na investigação da transmissão do gene do BDNF em crianças e adolescentes não foi detectada diferença significativa na transmissão do alelo Val66. Tampouco foi observada diferença significativa nos níveis séricos da proteína do BDNF entre os pacientes com THB em comorbidade com TDAH, quando comparados aos pacientes com TDAH e controles. No estudo cruzado com crianças e adolescentes com THB em comorbidade com TDAH, não houve diferenças entre os grupos com placebo ou estimulantes na resposta ao tratamento nos sintomas de TDAH. Os sintomas de humor mantiveram-se estáveis a despeito do uso de metilfenidato. Conclusões: Os achados quanto ao gene do BDNF não sugerem sua participação na neurobiologia do THB ou no TDAH, ou que devido à herança poligênica característica dos transtornos mentais, sua participação seja pequena. O achado de diferença significativa entre os níveis séricos do BDNF de crianças e adolescentes com THB+TDAH e TDAH indica que esse tema deve ser mais estudado, e, caso seja também encontrado de forma consistente por outros grupos, possa vir a ser utilizado como marcador biológico na diferenciação diagnóstica entre essas condições. No estudo de tratamento da comorbidade entre THB e TDAH, a ausência de resposta ao metilfenidato nos sintomas de TDAH em pacientes que apresentam a comorbidade reforça a evidência de que há pior resposta ao tratamento neste grupo, dado o elevado tamanho de efeito do metilfenidato no tratamento do TDAH em isolado O estudo de fatores biológicos para um melhor entendimento da psicopatologia e conseqüente diferenciação dos transtornos mentais tem extrema relevância porque a identificação destes fatores pode auxiliar na elaboração de tratamentos mais precisos, urgentemente necessários devido às graves conseqüências do THB e do TDAH nas vidas dos pacientes e de suas famílias. A criação de um programa específico para Crianças e Adolescentes com Transtorno Bipolar (ProCAB) e de uma linha de pesquisa com foco na etiologia e tratamento possibilitam uma constante geração de conhecimento nesta área, onde poucos estudos estão disponíveis. / Introduction: Bipolar Disorder (BD) in children and adolescents is associated to devastating developmental deficits. Attention-Deficit/Hyperactivity Disorder (ADHD), characterized by inattention, hyperactivity, and impulsivity, also promotes significant impairment. Differential diagnosis between both conditions is purely clinical – currently, there are scarce investigations on neurobiological differences. Several studies suggest the participation of the Brain-Derived Neurotrophic Factor (BDNF) in these disorders, whose role has not been elucidated in BD and ADHD in children and adolescents. Despite high comorbidity rates between BD and ADHD, worse psychosocial functioning, and worse response to treatment, only two studies addressed treatment response specifically in this group of patients. Objectives: promote advances in understanding the role of BDNF in the psychopathology of BD and ADHD. The treatment of the comorbidity was also studied. Methods: Transmission of the Val66 allele at the BDNF was assessed in children and adolescents with BD and ADHD, as well as the effect of the gene on the serum levels of BDNF protein in both conditions. BDNF serum levels were compared between patients with BD comorbid with ADHD, and ADHD. A crossover clinical trial with stimulants and placebo was performed with children and adolescents preseting BD and comorbid ADHD. Manic, depressive, inatention and hyperactivity symptoms were assessed along a 4-week treatment, 2 weeks in each treatment arm (placebo or stimulants). Results: There was no significant transmission of the Val66 allele at the BDNF gene in children and adolescents with BD or ADHD. A significant difference in BDNF protein serum levels between BD+ADHD when compared to ADHD alone and controls. In the crossover trial with children and adolescents with BD and comorbid ADHD, we did not observe differences between the placebo and stimulant treatment groups in the response of ADHD symptoms. Mood symptoms remained stable despite the use of methylphenidate. Conclusions: our results regarding the BDNF gene do not suggest its participation in the neurobiology of BD or ADHD, or that due to the polygenic characteristic of mental disorders, that this gene confers a only a small risk, undetectable in our sample. The finding of a significant difference in BDNF serum levels between BD comorbid with ADHD, and ADHD alone warrants further investigation, and in case replication studies with larger samples from other groups are positive, BDNF serum levels might be used as a biological marker in the diagnostic difference between these conditions. In the investigation of the treatment of the comorbidity between BD and ADHD, the absence of different responses between placebo and methylphenidate in ADHD symptoms strengthens the evidence that there is a worse response to treatment in this group, given the large effect size of methylphenidate response in the treatment of ADHD alone. The quest for biological markers for a better understanding of the psychopathology and subsequent differentiation of mental disorders is extremely relevant. The identification of these factors may facilitate the creation of more accurate treatment regimens, urgently needed due to the severe developmental consequences of BD and ADHD in the patients’ and families’ lives. In this sense, the creation of a specific outpatient program for children and adolescent BD (ProCAB), a research line with focus on risk factors and treatment, will enable a Constant generation of knowledge in this área, where scarce data is available.
194

AAV-vector mediated gene delivery for Huntington's Disease: an investigative therapeutic study

Kells, Adrian P January 2007 (has links)
Progressive degeneration in the central nervous system (CNS) of Huntington’s disease (HD) patients is a relentless debilitating process, resulting from the inheritance of a single gene mutation. With limited knowledge of the underlying pathological molecular mechanisms, pharmaceutical intervention has to-date not provided any effective clinical treatment strategies to attenuate or compensate the neuronal cell death. Attention has therefore turned to biotherapeutic molecules and novel treatment approaches to promote restoration and protection of selectively vulnerable populations of neurons in the HD brain. Rapid advances in vectorology and gene-based medicine over the past decade have opened the way for safe and efficient delivery of biotherapeutics to the CNS. With numerous factors known to regulate the development, plasticity and maintenance of the mammalian nervous system many proteins have emerged as potential therapeutic agents to alleviate HD progression. This investigative study utilised gene delivery vectors derived from the non-pathogenic adeno-associated virus (AAV) to direct high-level expression of brain-derived neurotrophic factor (BDNF), glial cell-line derived neurotrophic factor (GDNF), Bcl-xL or X-linked inhibitor of apoptosis protein (XIAP) within the rodent striatum. Maintenance of the basal ganglia and functional behaviour deficits were assessed following excitotoxic insult of the striatum by quinolinic acid (QA), a neurotoxic model of HD pathology. Enhanced striatal expression of BDNF prior to QA-induced lesioning provided maintenance of the striosome-matrix organisation of the striatum, attenuating impairments of sensorimotor behaviour with a 36-38% increase in the maintenance of DARPP-32 / krox-24 expressing striatal neurons, reduced striatal atrophy and increased maintenance of striatonigral projections. Higher levels of BDNF however induced seizures and weight-loss highlighting the need to provide regulatable control over biotherapeutic protein expression. Continuous high-expression of BDNF or GDNF resulted in a downregulation of intracellular signal mediating proteins including DARPP-32, with AAV-GDNF not found to enhance the overall maintenance of striatal neurons. Neither of the anti-apoptotic factors provided significant protection of transduced striatal neurons but tended towards ameliorating QA-induced behavioural deficits, displaying behaviour – pathology correlations with the survival of parvalbumin-expressing neurons in the globus pallidus. The results of this thesis suggest BDNF as a promising putative biotherapeutic for HD, but emphasises the requirement to control expression following gene delivery, and for further elucidation of the physiological impact that enhanced expression of endogenous factors has on the host cells. Additionally the maintenance of neural networks beyond the caudate-putamen will be vital to ensuring efficient clinical outcomes for HD. / Auckland Medical Research Foundation. Foundation for Research, Science and Technology. The University of Auckland.
195

Experimental Studies of BMP Signalling in Neuronal Cells

Althini, Susanna January 2003 (has links)
<p>The developing nervous system depends largely on extracellular cues to shape its complex network of neurons. Classically, neurotrophins are known to be important mediators in this process. More recently, Bone Morphogenetic Proteins (BMPs), belonging to the Transforming Growth Factor beta (TGFβ) superfamily of secreted cytokines, have been shown to exert a wide range of effects, such as cellular growth, differentiation, survival and apoptosis, both in the developing and adult nervous system. They signal via serine/threonine kinase receptor essentially to the Smad pathway, which carries the signal to the nucleus where the transcription of target genes is regulated.</p><p>This thesis investigates the functions of BMPs in the nervous system, using a set of different models. Firstly, a targeted deletion of GDF10 (BMP3b) in the mouse was established to evaluate the role of this growth/differentiation factor in the hippocampal formation, a brain area known to be involved in memory processing. Other members of the TGFβ superfamily likely compensate for the lack of GDF10, since no detectable alterations in hippocampal function or gene transcription profile have been found. Secondly, a mouse model was set up, with the aim to study impaired BMP-signalling in dopaminergic neurons. The tyrosine hydroxylase (TH) locus was used to drive the expression of dominant negative BMP receptors by means of bicistronic mRNAs. TH is the rate-limiting enzyme in the biosynthesis of catecholamine and the mice described, show a graded decrease of TH-activity resulting in severe to mild dopamine deficiency. The contribution of the dominant negative BMP receptors to the phenotype is however secondary to the apparent TH hypomorphism. The final theme of this thesis is the potentiating effects of BMPs on neurotrophin-induced neurite outgrowth as studied in explanted ganglia from chick embryos and in the rat phaeochromocytoma cell line PC12. A number of pharmacological inhibitors of intracellular signalling kinases were applied to the cultures in order to reveal the contribution of different pathways to the enhanced neurite outgrowth. We made the unexpected finding that inhibition of MEK signalling mimicked the potentiating effects of BMP stimulation in the chick system. The underlying mechanisms for the synergistic effects, however, are still an enigma.</p>
196

Experimental Studies of BMP Signalling in Neuronal Cells

Althini, Susanna January 2003 (has links)
The developing nervous system depends largely on extracellular cues to shape its complex network of neurons. Classically, neurotrophins are known to be important mediators in this process. More recently, Bone Morphogenetic Proteins (BMPs), belonging to the Transforming Growth Factor beta (TGFβ) superfamily of secreted cytokines, have been shown to exert a wide range of effects, such as cellular growth, differentiation, survival and apoptosis, both in the developing and adult nervous system. They signal via serine/threonine kinase receptor essentially to the Smad pathway, which carries the signal to the nucleus where the transcription of target genes is regulated. This thesis investigates the functions of BMPs in the nervous system, using a set of different models. Firstly, a targeted deletion of GDF10 (BMP3b) in the mouse was established to evaluate the role of this growth/differentiation factor in the hippocampal formation, a brain area known to be involved in memory processing. Other members of the TGFβ superfamily likely compensate for the lack of GDF10, since no detectable alterations in hippocampal function or gene transcription profile have been found. Secondly, a mouse model was set up, with the aim to study impaired BMP-signalling in dopaminergic neurons. The tyrosine hydroxylase (TH) locus was used to drive the expression of dominant negative BMP receptors by means of bicistronic mRNAs. TH is the rate-limiting enzyme in the biosynthesis of catecholamine and the mice described, show a graded decrease of TH-activity resulting in severe to mild dopamine deficiency. The contribution of the dominant negative BMP receptors to the phenotype is however secondary to the apparent TH hypomorphism. The final theme of this thesis is the potentiating effects of BMPs on neurotrophin-induced neurite outgrowth as studied in explanted ganglia from chick embryos and in the rat phaeochromocytoma cell line PC12. A number of pharmacological inhibitors of intracellular signalling kinases were applied to the cultures in order to reveal the contribution of different pathways to the enhanced neurite outgrowth. We made the unexpected finding that inhibition of MEK signalling mimicked the potentiating effects of BMP stimulation in the chick system. The underlying mechanisms for the synergistic effects, however, are still an enigma.
197

Disc1 Mutant Mice Subjected to Chronic Social Defeat Stress as a Model of Gene-Environment Interaction in Schizophrenia and Depression

Haque, F. Nipa 25 January 2010 (has links)
Human genetic data suggests DISC1 (Disrupted-in-schizophrenia 1) is a susceptibility gene for schizophrenia and depression. Disc1 Q31L-/- mutants show depression-like behaviour and Disc1 L100P-/- mutants schizophrenia-like behaviour. Heterozygous mutants show an intermediate phenotype. In a gene-environment interaction study, we exposed heterozygotes to chronic social defeat (CSD) stress and phenotyped behaviour. Disc1, Bdnf(III) and Pde4b mRNA levels were also measured. Moreover, as epigenetic mechanisms may mediate some effects of CSD, we also exposed wildtype mice to CSD concurrently with the histone deacetylase inhibitor valproate. We found that CSD increased anxiety in L100P-/+ mutants, and that levels of Disc1, Bdnf(III) and Pde4b mRNA were higher in this mutant. Valproate treatment did not correct CSD-induced behavioural changes. In conclusion, we have demonstrated an interaction between a strong susceptibility gene for psychiatric disease and an environmental manipulation similar to stressors known to affect mental illness.
198

Disc1 Mutant Mice Subjected to Chronic Social Defeat Stress as a Model of Gene-Environment Interaction in Schizophrenia and Depression

Haque, F. Nipa 25 January 2010 (has links)
Human genetic data suggests DISC1 (Disrupted-in-schizophrenia 1) is a susceptibility gene for schizophrenia and depression. Disc1 Q31L-/- mutants show depression-like behaviour and Disc1 L100P-/- mutants schizophrenia-like behaviour. Heterozygous mutants show an intermediate phenotype. In a gene-environment interaction study, we exposed heterozygotes to chronic social defeat (CSD) stress and phenotyped behaviour. Disc1, Bdnf(III) and Pde4b mRNA levels were also measured. Moreover, as epigenetic mechanisms may mediate some effects of CSD, we also exposed wildtype mice to CSD concurrently with the histone deacetylase inhibitor valproate. We found that CSD increased anxiety in L100P-/+ mutants, and that levels of Disc1, Bdnf(III) and Pde4b mRNA were higher in this mutant. Valproate treatment did not correct CSD-induced behavioural changes. In conclusion, we have demonstrated an interaction between a strong susceptibility gene for psychiatric disease and an environmental manipulation similar to stressors known to affect mental illness.
199

Cardiopulmonary Fitness, Depressive Symptoms and Cognitive Performance in Patients with Coronary Artery Disease: Phenomenology and Biomarkers

Swardfager, Walter 26 March 2012 (has links)
Introduction: Coronary artery disease (CAD) has been associated with depressive symptoms and deficits in cognitive performance, both of which have been associated with poorer medical prognoses and poorer psychosocial outcomes. Physical activity can improve cognitive and depressive symptoms, and, for those with CAD, improve medical prognoses. It was hypothesized that depressive symptoms and poorer cognitive performance would be associated with poorer cardiopulmonary fitness in patients with CAD, and that these sequelae would be associated prospectively with noncompletion of cardiac rehabilitation (CR). The benefits of physical activity are thought to result, in part, from decreased inflammatory activity and increased adaptive neural plasticity, to which the ratio of kynurenine to tryptophan (K/T) and brain derived neurotrophic factor (BDNF), respectively, in peripheral blood may pertain. Methods and Results: In a cohort study of patients entering CR, depressive symptoms (Center for Epidemiological Studies Depression scale; CES-D scores) were associated with cardiopulmonary fitness (peak volume of oxygen uptake; VO2Peak) during an exercise stress test (B=-.404, p=.001, n=366). The VO2Peak was also associated with performance across multiple cognitive domains, but most strongly with performance on tests involving executive function, attention and psychomotor processing speed (β=.322, p=.002 for composite score, n=81) in a cohort of patients entering CR. In prospective cohort studies, Major Depressive Disorder (adjusted hazard ratio [HR] 2.5, 95% confidence interval [CI] 1.3–4.7, n=195) and poorer performance on a verbal memory test (HR 0.86, 95% CI 0.77-0.96, p=.009, n=131) predicted non-completion of CR. In patients undertaking CR, higher serum K/T ratios were associated with CES-D scores (β=.322, p=.002, n=95) and with VO2Peak (β=-.391, p<.001, n=95), and in a cohort of patients entering CR (n=88), serum concentrations of BDNF were associated with psychomotor processing speed (F1,87=9.620, p=.003), overall cognitive status (Mini Mental Status Exam) scores (F1,87=15.406, p<.0005) and VO2Peak (β=.305, p=.013). Conclusions: Depressive symptoms and poorer cognitive performance are clinically important in patients with CAD entering CR and they are both associated with poorer cardiopulmonary fitness. Poorer cardiopulmonary fitness was also associated with higher K/T ratios and with lower BDNF concentrations in serum, which predicted depressive symptoms and poorer cognitive performance, respectively.
200

Cardiopulmonary Fitness, Depressive Symptoms and Cognitive Performance in Patients with Coronary Artery Disease: Phenomenology and Biomarkers

Swardfager, Walter 26 March 2012 (has links)
Introduction: Coronary artery disease (CAD) has been associated with depressive symptoms and deficits in cognitive performance, both of which have been associated with poorer medical prognoses and poorer psychosocial outcomes. Physical activity can improve cognitive and depressive symptoms, and, for those with CAD, improve medical prognoses. It was hypothesized that depressive symptoms and poorer cognitive performance would be associated with poorer cardiopulmonary fitness in patients with CAD, and that these sequelae would be associated prospectively with noncompletion of cardiac rehabilitation (CR). The benefits of physical activity are thought to result, in part, from decreased inflammatory activity and increased adaptive neural plasticity, to which the ratio of kynurenine to tryptophan (K/T) and brain derived neurotrophic factor (BDNF), respectively, in peripheral blood may pertain. Methods and Results: In a cohort study of patients entering CR, depressive symptoms (Center for Epidemiological Studies Depression scale; CES-D scores) were associated with cardiopulmonary fitness (peak volume of oxygen uptake; VO2Peak) during an exercise stress test (B=-.404, p=.001, n=366). The VO2Peak was also associated with performance across multiple cognitive domains, but most strongly with performance on tests involving executive function, attention and psychomotor processing speed (β=.322, p=.002 for composite score, n=81) in a cohort of patients entering CR. In prospective cohort studies, Major Depressive Disorder (adjusted hazard ratio [HR] 2.5, 95% confidence interval [CI] 1.3–4.7, n=195) and poorer performance on a verbal memory test (HR 0.86, 95% CI 0.77-0.96, p=.009, n=131) predicted non-completion of CR. In patients undertaking CR, higher serum K/T ratios were associated with CES-D scores (β=.322, p=.002, n=95) and with VO2Peak (β=-.391, p<.001, n=95), and in a cohort of patients entering CR (n=88), serum concentrations of BDNF were associated with psychomotor processing speed (F1,87=9.620, p=.003), overall cognitive status (Mini Mental Status Exam) scores (F1,87=15.406, p<.0005) and VO2Peak (β=.305, p=.013). Conclusions: Depressive symptoms and poorer cognitive performance are clinically important in patients with CAD entering CR and they are both associated with poorer cardiopulmonary fitness. Poorer cardiopulmonary fitness was also associated with higher K/T ratios and with lower BDNF concentrations in serum, which predicted depressive symptoms and poorer cognitive performance, respectively.

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