Depression is one of the most commonly seen psychiatric diseases in the population in recent years. Treatment of depression is mainly carried out by psychiatric drugs. In the past few years, agomelatine which is released to the market with a trade name, Valdoxane, has been thought to have far less side effects due to its non-addictive nature, not having trouble when the drug is quitted, and also due to its property of binding only to the specific receptor that the drug interacts with. The action mechanism of agomelatine on the membrane structure has not been clarified yet, for instance, no study has been found in the literature about the interaction of agomelatin with the lipids of biological membranes. In this current study, the interaction of agomelatine with the model membranes of dipalmitoylphosphatidylcholine (DPPC), dipalmitoylphosphatidylgylcerol (DPPG) and sphingomyelin (SM) is examined by Fourier transform infrared spectroscopy (FTIR) and Differential scanning calorimetry (DSC). DSC and FTIR studies show that, agomelatine shifts the phase transition temperature of DPPC and DPPG multilamellar membrane to the lower degrees, however, it shifts the phase transition temperature of SM membrane to the higher degrees. Agomelatine addition increases the lipid order of the DPPC and SM liposome, whereas, it decreases the lipid order of DPPG liposome. Moreover this drug enhances the membrane fluidity among all types of liposome studied. The increase of v lipid order and increase of fluidity at DPPC and SM liposome indicates domain formation upon drug addition (Vest et al., 2004). This was also confirmed by DSC studies. Agomelatine enhances H bonding capacity of all types of liposomes have been studied. However it has different effects on glycerol backbones of the DPPC and DPPG liposomes. At low agomelatine concentrations the increase in the frequency values indicates a decrease in the hydrogen bonding capacity of the glycerol skeleton of DPPC. In contrast, at high concentrations of agomelatine, a decrease in the frequency values was observed as an indicator of the enhancement of the hydrogen bonding capacity. So it enhances H-bonding capacity at gel phase but lowers it at liquid chrystalline phases. A progressive decreases in Tm was observed at DPPG and DPPC liposomes where it increased the Tm at SM. The pretransition peak is abolished and the Tm peak becomes broad, indicating a larger perturbation to the membrane. These observations indicate the possible interaction of agomelatine with the head group as well. The shoulder seen at the thermograms of DPPC and DPPC liposomes at high doses may indicate the lateral phase separation in to drug-rich and drug-poor domains (D&rsquo / Souza et al., 2009). These results may indicate that agomelatine is partially buried in the hydrocarbon core of the bilayer, interacting primarily with the C2-C8 methylene region of the hydrocarbon chains. All these results highlight the fact that agomelatine interacts around the head group in such a manner that it destabilizes the membrane architecture to a large extent.

Les pathologies dépressives se caractérisent par des symptômes hétérogènes impliquant de nombreuses régions cérébrales. L’une d’entre elles, l’hippocampe, est le siège d’un processus physiologique, appelé neurogenèse, qui, chez l’adulte, serait impliqué dans l’étiologie de la dépression et la réponse au traitement antidépresseur.L’objectif de ce travail a été d’étudier le rôle des 4 étapes du processus de neurogenèse hippocampique dans l’action des antidépresseurs dans un modèle physiopathologique de la dépression, chez la Souris adulte. / Depression is characterized by heterogeneous symptoms in several brain regions. One of them, the hippocampus, is related to a phenomenon called neurogenesis, which seems to be linked to the etiology of depression and to the response of antidepressants. The main goal of this work was to study the relationships between all the 4 steps of hippocampal neurogenesis and antidepressants action in a model of depression in adult mouse.

Les pathologies dépressives se définissent par des symptômes hétérogènes qui incluent les troubles du sommeil comme facteur de comorbidité. La comorbidité des troubles du sommeil dans la dépression est habituellement marquée d’une diminution de sommeil lent, d’une augmentation de sommeil paradoxal et d’une fragmentation du sommeil, tant chez l’Homme qu’au sein des modèles animaux de la pathologie.Le premier objectif de ce travail expérimental a été de caractériser les troubles du sommeil suspectés dans un modèle animal de souris adultes rendues anxio/dépressives par l’administration chronique de corticostérone. Les résultats obtenus ont montré qu’une administration chronique de corticostérone induit une hypersomnie avec augmentation de sommeil lent, une diminution du sommeil paradoxal et une fragmentation des états de veille et de sommeil. La description du sommeil du modèle de souris CORT enrichit la classification actuelle en modélisant des troubles du sommeil atypiques présents chez près de 20% des sujets dépressifs. Le second objectif a été de corriger ces troubles du sommeil par l’administration chronique d’antidépresseurs classique (fluoxétine) et innovant (agomélatine). Si chacune des molécules antidépressives testées a révélé un effet bénéfique vis-à-vis de la somnolence des souris CORT, l’agomélatine a montré sa supériorité pour prévenir l’inhibition du sommeil paradoxal induite par la corticostérone et accentuée par la fluoxétine. / Depressive disorders are definded by heterogeneous symptoms that include sleep disorders such as comorbid condition. Comorbidity of sleep disorders in depression is usually marked by a decrease in NREM sleep, increased REM sleep and sleep fragmentation, both in humans and within animal models of the disease. The first aim of this experimental work was to characterize sleep problems suspected in an animal model of adult mice rendered anxio/depressive by chronic administration of corticosterone. The results showed that chronic administration of corticosterone induced hypersomnia with increased NREM sleep, decreased REM sleep and led to fragmented sleep/wake states. The description of the sleep cycle of the CORT mouse model of anxiety/depression enriches the current classification by modeling atypical sleep disorders present in nearly 20% of the depressed subjects. The second aim was to correct these sleep disorders by chronic administration of classical (fluoxetine) and innovative (agomelatine) antidepressants. If each antidepressant molecules tested showed a beneficial effect towards drowsiness of CORT-treated mice, agomelatine has shown its superiority to prevent the inhibition of REM sleep induced by chronic corticosterone which was enhanced by chronic fluoxetine treatment.

A doenÃa de Parkinson (DP) à uma desordem neurodegenerativa, caracterizada pela destruiÃÃo dos neurÃnios nigroestriatais dopaminÃrgicos. Hà uma busca incessante por agentes capazes de inibir a degeneraÃÃo neuronal. Muitos estudos tÃm contribuÃdo para elucidar a fisiopatologia da doenÃa de Parkinson, e essas descobertas disponibilizam uma variedade de potenciais alvos para terapia neuroprotetora. Estudos demonstraram que a agomelatina (AGO), um naftaleno anÃlogo da melatonina, possui aÃÃes neurotrÃficas, que estariam correlacionadas com possÃveis efeitos neuroprotetores demonstrados em alguns estudos com doenÃas neurodegenerativas, como a doenÃa de Alzheimer e a esclerose lateral amiotrÃfica. O presente trabalho tem como objetivo estudar os efeitos comportamentais e neuroquÃmicos da agomelatina no modelo animal da doenÃa de Parkinson induzido por 6-OHDA. Ratos Wistar machos (200-250g) foram submetidos à lesÃo intraestriatal com 6-hidroxidopamina (6-OHDA). Os animais foram divididos em 4 grupos: grupo sham, tratado com salina, grupo controle 6-OHDA e os grupos tratados com AGO (5 e 10 mg/kg). Os animais foram tratados 1 hora apÃs a lesÃo e depois diariamente por 21 dias. No 21 dia, 1 hora apÃs o Ãltimo tratamento, foi observado o comportamento rotacional induzido por apomorfina, o teste rotarod e o teste de campo aberto e no 22 dia os animais foram sacrificados e as Ãreas cerebrais retiradas (corpo estriado-NB, hipocampo-HC e cÃrtex prÃ-frontal-CPF) para a determinaÃÃo da peroxidaÃÃo lipÃdica atravÃs do mÃtodo do TBARS. A Agomelatina reduziu o nÃmero de rotaÃÃes induzida por apomorfina em torno de 20% a 42% em comparaÃÃo com o grupo controle 6-OHDA. Houve recuperaÃÃo do dÃficit motor evidenciado nos testes de rota rod e campo aberto. O tratamento com AGO reduziu o estresse oxidativo, com diminuiÃÃo dos nÃveis de nitrito em 55 % em NB na dose de 10 mg/kg em comparaÃÃo com o grupo controle 6-OHDA. O tratamento com AGO reduziu a peroxidaÃÃo lipÃdica no HC em 20 % e 39%, NB em 24 % e 54%, nas doses de 5 mg/Kg e 10 mg/Kg, respectivamente e no CPF houve reduÃÃo de 27% na dose de 10 mg/Kg, quando comparado ao grupo 6-OHDA controle. AlÃm de reduzir o estresse oxidativo e a peroxidaÃÃo lipÃdica, o tratamento com AGO recuperou os nÃveis de glutationa. A agomelatina reverteu parcialmente o dÃficit motor induzido por 6-OHDA e reduziu o estresse oxidativo, mostrando ser um possÃvel agente neuroprotetor.

La mélatonine est connue pour agir directement sur l’horloge circadienne. L’agomélatine est un antidépresseur présentant des propriétés agonistes MT1/MT2 et antagonistes 5-HT2C. Tout d’abord, nous avons évalué les effets de l’agomélatine, de la mélatonine et d’un antagoniste 5-HT2C sur deux sorties de l’horloge (rythme de la mélatonine endogène et de la température corporelle). Les résultats obtenus suggèrent une action centrale de l’agomélatine et de la mélatonine, directement sur l’horloge via les récepteurs MT1/MT2, en induisant une augmentation de l’amplitude et une avance de phase du rythme de mélatonine. Pour la température corporelle, l’ensemble des drogues augmente l’amplitude du rythme, suggérant une action des propriétés agonistes MT1/MT2 et/ou antagonistes 5-HT2C de l’agomélatine. Puis, l’étude sur l’expression du gène horloge Per1, a révélé un effet supérieur de l’agomélatine par rapport à la mélatonine, mais seulement le jour du traitement. L’agomélatine pourrait agir sur la machinerie moléculaire de l’horloge, ce qui reste à exploiter davantage. Ces nouvelles données contribuent à une meilleure compréhension des mécanismes d’action de l’agomélatine. / Melatonin is known to act directly on the circadian clock. Agomelatine is an antidepressant with MT1/MT2 agonist and antagonist 5-HT2C properties. First, we evaluated the effects of agomelatine, melatonin and 5-HT2C antagonist on two clock outputs (rhythm of endogenous melatonin and body temperature). The results suggest a central action of agomelatine and melatonin, directly on the circadian clock via MT1/MT2 receptors, inducing an increase on the amplitude and a phase advance of the rhythm of melatonin. For body temperature, all drugs increased the amplitude of the rhythm, this suggest an action of MT1/MT2 agonist and antagonist 5-HT2C properties of agomelatine. Secondly, the study on the expression of clock gene Per1 revealed a greater effect of agomelatine compared to melatonin, but only on the day of treatment. Agomelatine could act on the molecular machinery of the clock, but requires further investigations. These new data allow a better understand of the mechanisms action of agomelatine.

Evidências crescentes na literatura demonstram que a fisiopatologia da ansiedade e transtornos relacionados é multifatorial, envolvendo a hiperatividade glutamatérgica, o estresse oxidativo e a neuroinflamação. Na primeira parte deste trabalho, através de uma revisão da literatura, mostramos que a N-acetilcisteína (NAC), agomelatina e os ácidos graxos ômega-3 são os principais agentes com mecanismo de ação multialvo envolvendo a modulação da hiperatividade glutamatérgica, do estresse oxidativo e da neuroinflamação que demonstram efeitos ansiolíticos tanto em estudos pré-clínicos quanto em ensaios clínicos. Os resultados dos ensaios clínicos são geralmente preliminares, mas revelam efeitos ansiolíticos promissores e um bom perfil de segurança e tolerância aos efeitos adversos desses agentes. A NAC, a agomelatina e os ácidos graxos ômega-3 mostram efeitos benéficos em condições clínicas relacionadas a ansiedade nas quais os ansiolíticos disponíveis atualmente apresentam eficácia modesta, sendo considerados candidatos promissores a ansiolíticos inovadores, efetivos e bem tolerados pelos pacientes. Mostramos também que a NAC possui efeitos ansiolíticos em camundongos nos testes de campo aberto, claro/escuro, placa-perfurada, interação social e hipertermia induzida por estresse, tanto após o tratamento agudo quanto subagudo (4 dias). Esses resultados fornecem evidências adicionais para sustentar a validade dos ensaios clínicos com NAC no contexto dos transtornos de ansiedade, destacando-se o perfil de segurança de uso da NAC em longo prazo em comparação com ansiolíticos como o diazepam. A NAC é um fármaco seguro, de baixo custo e que demonstra benefícios em outras condições psiquiátricas que frequentemente se apresentam em comorbidade com os transtornos de ansiedade. / Increasing evidence in the literature demonstrates that the pathophysiology of anxiety and related disorders is multifactorial, involving glutamatergic hyperactivity, oxidative stress, and neuroinflammation. In the first part of this work, through a review of the literature, we showed that N-acetylcysteine (NAC), agomelatine and omega-3 fatty acids are the main agents with multitarget mechanism of action involving the modulation of glutamatergic hyperactivity, oxidative stress, and neuroinflammation that demonstrate anxiolytic effects in both preclinical studies and clinical trials. Clinical trials data are generally preliminary but show promising anxiolytic effects and an adequate safety profile and tolerance to adverse effects. NAC, agomelatine and omega-3 fatty acids show beneficial effects under clinical conditions related to anxiety in which available anxiolytics show moderate efficacy, and are considered promising candidates for innovative, effective and well tolerated anxiolytic agents by patients. We also showed that NAC has anxiolytic effects in mice in the open field, light/dark, hole-board, social interaction and stress-induced hyperthermia tests, either after acute or subacute treatment (4 days). These results provide additional evidence to support the validity of NAC clinical trials in the context of anxiety disorders, highlighting the long-term safety profile of NAC use compared to anxiolytics as diazepam. NAC is a safe, low-cost agent that demonstrates benefits in other psychiatric conditions that often present in comorbidity with anxiety disorders.

Evidências crescentes na literatura demonstram que a fisiopatologia da ansiedade e transtornos relacionados é multifatorial, envolvendo a hiperatividade glutamatérgica, o estresse oxidativo e a neuroinflamação. Na primeira parte deste trabalho, através de uma revisão da literatura, mostramos que a N-acetilcisteína (NAC), agomelatina e os ácidos graxos ômega-3 são os principais agentes com mecanismo de ação multialvo envolvendo a modulação da hiperatividade glutamatérgica, do estresse oxidativo e da neuroinflamação que demonstram efeitos ansiolíticos tanto em estudos pré-clínicos quanto em ensaios clínicos. Os resultados dos ensaios clínicos são geralmente preliminares, mas revelam efeitos ansiolíticos promissores e um bom perfil de segurança e tolerância aos efeitos adversos desses agentes. A NAC, a agomelatina e os ácidos graxos ômega-3 mostram efeitos benéficos em condições clínicas relacionadas a ansiedade nas quais os ansiolíticos disponíveis atualmente apresentam eficácia modesta, sendo considerados candidatos promissores a ansiolíticos inovadores, efetivos e bem tolerados pelos pacientes. Mostramos também que a NAC possui efeitos ansiolíticos em camundongos nos testes de campo aberto, claro/escuro, placa-perfurada, interação social e hipertermia induzida por estresse, tanto após o tratamento agudo quanto subagudo (4 dias). Esses resultados fornecem evidências adicionais para sustentar a validade dos ensaios clínicos com NAC no contexto dos transtornos de ansiedade, destacando-se o perfil de segurança de uso da NAC em longo prazo em comparação com ansiolíticos como o diazepam. A NAC é um fármaco seguro, de baixo custo e que demonstra benefícios em outras condições psiquiátricas que frequentemente se apresentam em comorbidade com os transtornos de ansiedade. / Increasing evidence in the literature demonstrates that the pathophysiology of anxiety and related disorders is multifactorial, involving glutamatergic hyperactivity, oxidative stress, and neuroinflammation. In the first part of this work, through a review of the literature, we showed that N-acetylcysteine (NAC), agomelatine and omega-3 fatty acids are the main agents with multitarget mechanism of action involving the modulation of glutamatergic hyperactivity, oxidative stress, and neuroinflammation that demonstrate anxiolytic effects in both preclinical studies and clinical trials. Clinical trials data are generally preliminary but show promising anxiolytic effects and an adequate safety profile and tolerance to adverse effects. NAC, agomelatine and omega-3 fatty acids show beneficial effects under clinical conditions related to anxiety in which available anxiolytics show moderate efficacy, and are considered promising candidates for innovative, effective and well tolerated anxiolytic agents by patients. We also showed that NAC has anxiolytic effects in mice in the open field, light/dark, hole-board, social interaction and stress-induced hyperthermia tests, either after acute or subacute treatment (4 days). These results provide additional evidence to support the validity of NAC clinical trials in the context of anxiety disorders, highlighting the long-term safety profile of NAC use compared to anxiolytics as diazepam. NAC is a safe, low-cost agent that demonstrates benefits in other psychiatric conditions that often present in comorbidity with anxiety disorders.

Evidências crescentes na literatura demonstram que a fisiopatologia da ansiedade e transtornos relacionados é multifatorial, envolvendo a hiperatividade glutamatérgica, o estresse oxidativo e a neuroinflamação. Na primeira parte deste trabalho, através de uma revisão da literatura, mostramos que a N-acetilcisteína (NAC), agomelatina e os ácidos graxos ômega-3 são os principais agentes com mecanismo de ação multialvo envolvendo a modulação da hiperatividade glutamatérgica, do estresse oxidativo e da neuroinflamação que demonstram efeitos ansiolíticos tanto em estudos pré-clínicos quanto em ensaios clínicos. Os resultados dos ensaios clínicos são geralmente preliminares, mas revelam efeitos ansiolíticos promissores e um bom perfil de segurança e tolerância aos efeitos adversos desses agentes. A NAC, a agomelatina e os ácidos graxos ômega-3 mostram efeitos benéficos em condições clínicas relacionadas a ansiedade nas quais os ansiolíticos disponíveis atualmente apresentam eficácia modesta, sendo considerados candidatos promissores a ansiolíticos inovadores, efetivos e bem tolerados pelos pacientes. Mostramos também que a NAC possui efeitos ansiolíticos em camundongos nos testes de campo aberto, claro/escuro, placa-perfurada, interação social e hipertermia induzida por estresse, tanto após o tratamento agudo quanto subagudo (4 dias). Esses resultados fornecem evidências adicionais para sustentar a validade dos ensaios clínicos com NAC no contexto dos transtornos de ansiedade, destacando-se o perfil de segurança de uso da NAC em longo prazo em comparação com ansiolíticos como o diazepam. A NAC é um fármaco seguro, de baixo custo e que demonstra benefícios em outras condições psiquiátricas que frequentemente se apresentam em comorbidade com os transtornos de ansiedade. / Increasing evidence in the literature demonstrates that the pathophysiology of anxiety and related disorders is multifactorial, involving glutamatergic hyperactivity, oxidative stress, and neuroinflammation. In the first part of this work, through a review of the literature, we showed that N-acetylcysteine (NAC), agomelatine and omega-3 fatty acids are the main agents with multitarget mechanism of action involving the modulation of glutamatergic hyperactivity, oxidative stress, and neuroinflammation that demonstrate anxiolytic effects in both preclinical studies and clinical trials. Clinical trials data are generally preliminary but show promising anxiolytic effects and an adequate safety profile and tolerance to adverse effects. NAC, agomelatine and omega-3 fatty acids show beneficial effects under clinical conditions related to anxiety in which available anxiolytics show moderate efficacy, and are considered promising candidates for innovative, effective and well tolerated anxiolytic agents by patients. We also showed that NAC has anxiolytic effects in mice in the open field, light/dark, hole-board, social interaction and stress-induced hyperthermia tests, either after acute or subacute treatment (4 days). These results provide additional evidence to support the validity of NAC clinical trials in the context of anxiety disorders, highlighting the long-term safety profile of NAC use compared to anxiolytics as diazepam. NAC is a safe, low-cost agent that demonstrates benefits in other psychiatric conditions that often present in comorbidity with anxiety disorders.

Atualmente, a quantidade de pacientes que são diagnosticados com alguma forma de depressão, entre elas, o transtorno depressivo maior, aumenta consideravelmente, quer seja em razão de diagnósticos mais precisos ou pela própria epidemiologia da doença. Acresça-se o fato de que muitos pacientes, apesar da quantidade de tipos de antidepressivos atualmente disponíveis para a terapêutica, são refratários ao tratamento prescrito, em razão dos efeitos adversos apresentados ou ainda em razão de simplesmente não se observar melhora com a prescrição. Em razão disso, novos tratamentos farmacológicos são disponibilizados. Para auxiliar na máxima eficácia em sua utilização, esse trabalho propôs o desenvolvimento de metodologia analítica para a determinação simultânea de antidepressivos tricíclicos e não tricíclicos, a saber: moclobemida, venlafaxina, citalopram, agomelatina, duloxetina, amitriptilina e sertralina em plasma humano por cromatografia líquida de alta eficiência (HPLC), para posteriormente ser aplicada na monitorização de pacientes depressivos. O método consistiu na extração líquido-líquido com recuperação entre 73% a 86%, exceto para a moclobemida (55%). A separação foi obtida usando uma coluna em fase reversa LiChrospher® 60 RP-select B em LichroCART 250mm x 4mm, 5 ?m de diâmetro interno, Merck sob condições isocráticas com detecção em UV em 230 nm, com fase móvel composta por 35% de uma mistura de acetonitrila/metanol 55/5 v/v e 65% de tampão acetato 0,25M pH 4,4. As curvas padrão foram lineares em uma faixa de trabalho de 2,5-1000 ng/mL para moclobemida, 5-2000 ng/mL para venlafaxina, citalopram, agomelatina, duloxetina e amitriptilina, 10-2000 ng/mL para sertralina. A precisão intra e interensaios foi efetuada em 3 concentrações (50, 200 e 500 ng/mL). Os coeficientes de variação para a precisão intraensaio foram menores que 8,8% para todos os compostos e os coeficientes de variação para a precisão interensaios foram menores que 8,6%. Os limites de quantificação foram de 2,5 ng/mL para a moclobemida, 5 ng/mL para venlafaxina, citalopram, duloxetina, agomelatina, amitriptilina e 10 ng/mL para sertralina com a etidocaína como padrão interno. Não se observou qualquer interferência das drogas normalmente associadas com antidepressivos. O método desenvolvido foi aplicado na monitorização de 79 pacientes em tratamento prolongado com amitriptilina, sertralina e venlafaxina. Paralelamente, foram avaliadas as concentrações plasmáticas de pacientes voluntários sadios submetidos a tratamento em dose única com agomelatina. A monitorização terapêutica se faz necessária para monitorar adesão ao tratamento já que a depressão está entre as principais causas mundiais de morbidade por incapacitação social e estimativa de prevalência crescente até 2030; caracterizando-se como um dos maiores e mais onerosos problemas de saúde pública. / Currently, the number of patients who are diagnosed with some form of depression, among them, major depressive disorder, increases considerably, either because of more accurate diagnosis or by the epidemiology of the disease. One should add the fact that many patients, despite the amount of types of antidepressants currently available for therapy are refractory to the treatment prescribed, because of the adverse effects appear, or their toxic effects, or by simply not observed improvement then the prescription. Therefore, new pharmacological treatments are available. To assist in maximum effectiveness in its use, this paper presents a methodology on HPLC for simultaneous determination of seven antidepressants, tricyclic and non-tricyclic, moclobemide, venlafaxine, citalopram, agomelatine, duloxetine, amitriptyline and sertraline in human plasma, later to be applied in monitoring depressed patients. The simple and accurate method of sample preparation consists of the liquid-liquid extraction with recovery between 73% to 86% (except for moclobemide, 55%). Separation was achieved using a reverse phase column Lichrospher® 60 RP-select B LiChroCART 4mm x 250mm, 5?m internal diameter, Merck, under isocratic conditions, with UV detection at 230nm, with a mobile phase consisting of a mixture of 35% acetonitrile:methanol 55/5 (v/v) and 65% 0.25M acetate buffer, pH 4.4. The standard curves were linear in the working range of 2,5-1000 ng/mL for moclobemide, 5-2000 ng/mL to venlafaxine, citalopram, agomelatine, duloxetine and amitriptyline and 10-2000ng/mL to sertraline. The intra and interassay precisions were performed at three concentrations (50, 200 and 500 ng/mL). The coefficients of variation for intra-assay precision were less than 8.6% for all compounds and the coefficients of variation for interassay precision were lower than 8.5%. The limits of quantification were 2.5 ng/mL for moclobemide, 5 ng/mL for venlafaxine, citalopram, duloxetine, agomelatine, amitriptyline and 10 ng/mL for sertraline. No interference of drugs normally associated with antidepressants was observed. The developed method was applied to the monitoring of 79 patients receiving prolonged treatment with amitriptyline, sertraline and venlafaxine. And, the plasma concentrations of healthy volunteer patients undergoing single dose agomelatine were evaluated. Therapeutic drug monitoring, is to ensure maximum clinical efficacy coupled with minimal adverse effects in patients undergoing long-term therapy is needed and to monitor adherence to treatment since depression is among the major causes of morbidity and social disability increasing prevalence estimate of 2030; characterized as one of the largest and most costly public health problems

Les antidépresseurs ISRS (inhibiteurs sélectifs de la recapture de sérotonine) sont parmi les plus prescrits pour traiter les épisodes dépressifs majeurs. Cependant, leur efficacité n’est pas optimale. En effet, ils montrent un long délai d’action, de nombreux effets indésirables et sont inefficaces pour une proportion non négligeable de patients. La dépression étant actuellement un enjeu de santé publique majeur, il est donc nécessaire de développer de nouvelles molécules possédant un meilleur profil thérapeutique. Récemment, un intérêt croissant a été porté sur le récepteur 5-HT3, notamment depuis le développement de la vortioxétine, ISRS de nouvelle génération ayant des propriétés antagonistes pour ce récepteur localisé dans les zones cérébrales contrôlant l’humeur. Le but de ce travail de thèse a été d’étudier le rôle du récepteur 5-HT3 dans la réponse aux antidépresseurs, ainsi que dans la physiopathologie de la dépression. Dans ce cadre, nous avons utilisé une approche génétique, en caractérisant un modèle de souris knockout (KO) dont le gène de la sous-unité 3A du récepteur 5-HT3 a été invalidé. Le phénotype de ces animaux et leurs contrôles de type sauvage (Wild-Type, WT) a tout d’abord été évalué dans des tests comportementaux de screening de molécules anxiolytiques et antidépressives, puis leur réponse à des traitements aigus d’ISRS a été mesurée par ces mêmes approches. L’effet de traitements antidépresseurs chroniques a quant à lui été évalué par une technique d’électrophysiologie in vitro. Enfin, les souris ont été soumises au modèle du stress de défaite sociale chronique (CSDS), afin de déterminer le rôle du récepteur 5-HT3 dans la réponse au stress. En conditions basales, le turn-over de la sérotonine est diminué chez les souris 5-HT3 KO par rapport aux souris WT. Cet effet est accompagné par une augmentation de l’expression génique des récepteurs 5-HT1A et de leur couplage aux protéines G au niveau du noyau raphé dorsal (NRD) des souris KO par rapport aux WT. Au niveau comportemental, les souris KO 5-HT3 montrent un phénotype apparenté à celui induit par un anxiolytique et par un antidépresseur. Lorsqu’elles reçoivent une injection de citalopram, un ISRS sélectif, les souris 5-HT3 KO ne se comportent pas différemment de leurs contrôles WT dans les tests de screening des antidépresseurs. Cependant, dans ces mêmes tests, l’effet de la fluoxétine, ISRS possédant des propriétés antagonistes pour le récepteur 5-HT3, est perdu chez les souris 5-HT3 KO. Le traitement chronique par le citalopram (20 mg/kg/j) induit une désensibilisation similaire des autorécepteurs 5-HT1A localisés sur les neurones sérotoninergiques du NRD chez les animaux WT et KO. Dans les mêmes conditions, mais en utilisant une dose de citalopram plus faible (5 mg/kg/j), la désensibilisation des autorécepteurs 5-HT1A est plus forte chez les animaux KO que chez les WT, confortant ainsi l’effet potentialisateur de l’invalidation des récepteurs 5-HT3 dans l’efficacité thérapeutique des ISRS. Afin de disséquer le rôle des récepteurs 5-HT3 dans la réponse au stress chronique, le CSDS a fait l’objet d’une validation avec l’agomélatine, antidépresseur de nouvelle génération. Ce stress a engendré des altérations de la mémoire à long terme, en lien avec des modifications de l’expression génique de l’exon IV du BDNF et d’enzymes de régulation épigénétique. Ces effets délétères du stress ont été traités efficacement par l’agomélatine (50 mg/kg/j) en injection chronique, mais cette molécule n’a cependant pas modifié les effets du CSDS sur les phénotypes de type anxieux et dépressifs observés après le stress. Nous avons montré que le CSDS augmentait l’expression génique de la sous-unité 3A du récepteur 5-HT3 dans différentes structures cérébrales des souris WT. De plus, les altérations de l’expression génique de CamkIIa et SOD1 induites par le stress dans le cortex préfrontal des souris WT n’ont pas été retrouvées chez les souris 5-HT3 KO (...) / SSRI (selective serotonin reuptake inhibitor) antidepressants are among the most prescribed drugs to treat major depression. However, their efficacy is not optimal yet. Indeed, they possess a long delay of action, various side effects and show not efficacy in some patients. As depression is currently a global burden, there is a great need for new molecules with a better therapeutic efficacy. Recently, an increased attention has been taking to 5-HT3 receptors, notably since the development of vortioxetine, a new generation SSRI that antagonizes this receptor. The aim of the study was to assess the role of 5-HT3 receptor in the antidepressant response and the physiopathology of depression. In this context, we used a genetic approach, by characterizing a knockout (KO) mice model lacking the 3A subunit of the 5-HT3 receptor. Their phenotype and the one of wild-type (WT) control mice was first evaluated in behavioral tests widely used for antidepressant and anxiolytic drugs screening, then following acute SSRI treatments. Effect of chronic SSRI administration was assessed by in vitro electrophysiology. Finally, mice were submitted to the chronic social defeat stress (CSDS) model, to determine the role of 5-HT3 receptor in stress response. In basal conditions, 5-HT turnover was decreased in 5-HT3 KO mice compared with WT mice. This effect was accompanied by an increase in the 5-HT1A receptor gene expression and their coupling to G proteins at the dorsal raphe nucleus (DRN) level. 5-HT3 KO mice displayed anxiolytic-like and antidepressive-like phenotype. When injected with citalopram, a very selective SSRI, 5-HT3 KO mice behaved similarly as WT mice in antidepressant screening tests. However, in the same tests, the effect of fluoxetine, a SSRI that possesses 5-HT3 receptor antagonist properties, was blunted in 5-HT3 KO mice. Chronic treatment with citalopram (20 mg/kg/d) induced in WT and KO mice a similar desensitization of 5-HT1A autoreceptors located on DRN 5-HT neurons. In the same conditions, but using a lower citalopram dose (5 mg/kg/d), 5-HT1A autoreceptor desensitization was higher in 5-HT3 KO mice than in WT mice, thus reinforcing the potentiating effect of the 5-HT3 receptor in the SSRI efficacy. In order to assess the role of 5-HT3 receptor in chronic stress response, CSDS paradigm was validated using agomelatine, a new generation antidepressant drug. This stress model provoked long term memory alterations, linked with modifications in hippocampal mRNA levels of BDNF exon IV and epigenetic modifying enzymes. These deleterious stress effects were prevented by chronic agomelatine treatment (50 mg/kg/d), but this molecule did not modify the stress-induced anxious- and depressive-like phenotypes. We showed that subunit 3A gene expression was increased in various WT mice brain structures subjected to CSDS. Moreover, stress-induced modifications of CamkIIa and SOD1 gene expression in the prefrontal cortex of WT mice were not present in KO mice. Genetic invalidation of 5-HT3 receptor blocked the effects of social stress in some behavioral tests (splash test, saccharine preference test) and on body weight gain. Taken altogether, these data show that 5-HT3 receptor plays an important role in anxiety- and depression-related behaviors. Moreover, invalidation of this receptor increased the effect of a low dose chronic SSRI treatment, and blunted the effect of a SSRI targeting 5-HT3 receptor. These results highlight the interest of this receptor in the development of innovating therapies to treat anxio-depressive disorders. Finally, the reduced sensitivity of 5-HT3 KO mice to chronic stress suggests an involvement of this receptor in stress-related behaviors and depression physiopathology.