Ketamine is a non-competitive N-methyl-D-aspartate (NMDA)-channel blocker that has recently shown promise in the treatment of major depressive disorder, distinguishing itself from classical anti-depressants through its rapid and lasting effects when given at sub-anaesthetic doses. Animal models of depression are commonly used to research individual mechanisms of action and this literature review aimed to investigate how ketamine influences BDNF-TrkB neurotransmission in the hippocampus and prefrontal cortex within animal models of depression. Reduced levels of BDNF and TrkB-transmission, as well as downstream signalling, are common in both humans experiencing depression and in rodent models of depression, and ketamine was found to counteract this reduction in the majority of studies reviewed. In the majority of studies ketamine’s anti-depressant actions were viewed to be at least partially connected to its effects on BDNF-TrkB neurotransmission. This was supported by the anti-depressant effects being readily blocked by pharmacological inhibition of TrkB. Inhibition also blocked the downstream neurobiological changes associated with ketamines anti-depressant effects. / Ketamin är en icke-kompetitiv N-methyl-D-aspartate (NMDA)-kanal antagonist som nyligen har visat lovande resultat i behandling av depression. Substansen särskiljer sig från klassiska antidepressiva läkemedel genom att dess effekt infinner sig snabbt och kvarstår under en längre period om det ges i låga doser. Djurmodeller av depression används för att undersöka individuella mekanismer relaterade till depression och denna litteraturstudie ämnade att undersöka hur ketamin påverkar BDNF-TrkB signallering inom hippocampus och prefrontala cortex i djurmodeller av depression. Minskade nivåer av BDNF och TrkB-signalering är vanligt förekommande både hos männsikor med depression och i djurmodeller av depression. I majoriteten av studierna återställde ketamin nivåerna av BDNF och TrkB-signalering till normala värden. Dess antidepressiva effekt kopplades till denna signalväg eftersom farmakologisk inhibering av TrkB i majoriteten av studierna resulterade i att den anti-depressiva effekten uteblev. Inhiberingen blockerade även nedströms neurobiologiska förändringar som anses kopplade till ketamins antidepressiva effekter.

Background: The exonic variant rs6265 in the brain-derived neurotrophic factor (BDNF) has repeatedly been linked to obesity. Objective: To discern the factors by which this effect is conveyed we aimed to investigate its correlation with obesity and metabolic parameters as well as with serum levels of BDNF and measures of energy intake in children. Secondly, we aimed to compare levels of circulating BDNF with metabolic parameters. Methods: We genotyped the variant in 2131 obese and lean children and adolescents (age 6-18 years). In 177 subjects, we determined BDNF serum levels by ELISA and assessed the association with metabolic parameters and data on eating habits from self-reported food diaries. Results: The minor Met-allele was associated with lower body weight (p=0.002). In the entire study cohort none of the investigated metabolic parameters was associated with the variant. When looking at postpubertal subjects, we observed decreased postprandial glucose levels and a decreased HbA1c in Met-allele-carriers after adjusting for BMI (p=0.046 and p=0.012, respectively). Serum BDNF did not differ between homozygous Val/Val-individuals and carriers of the Met-allele. We neither found a correlation of serum BDNF with different genotypes nor with any of the metabolic parameters. Conclusion: We confirmed the association of the minor Met-allele with decreased body weight in children and additionally observed alterations in postprandial glucose metabolism in postpubertal subjects. However, variations in serum levels of BDNF were neither related to the genotype nor to the phenotype of food intake or glucose metabolism.:Inhaltsverzeichnis 2 Abkürzungsverzeichnis 3 1 Einführung in die Thematik 4 1.1 Genetische Ursachen von Adipositas 4 1.2 Der neuronale Wachstumsfaktor BDNF 5 1.3 BDNF und Regulation von Nahrungsaufnahme und Glukosemetabolismus 6 1.4 Der exonisch gelegene Val66Met-Polymorphismus in BDNF 7 1.5 Oraler Glukosetoleranztest und HbA1c als Marker des Glukosestoffwechsels 9 1.5.1 Physiologische Grundlagen der Glukosehomöostase 9 1.5.2 OGTT und Insulinsensitivitätsindizes 10 1.5.3 HbA1c – das „Langzeitgedächtnis“ des Blutzuckerspiegels 10 1.6 Basisdiagnostik des Fettstoffwechsels 11 1.7 Einschätzung der Nährstoffaufnahme mittels Ernährungstagebuch 11 2 Überleitung zur Publikation 13 2.1 Ziel der Arbeit, Rationale und Fragestellung 13 2.2 Charakterisierung der Kohorten 14 2.3 Kurzbeschreibung der Methoden 15 2.4 Ergebnisse 15 2.5 Fazit 16 3 Originalpublikation 17 4 Zusammenfassung 30 5 Literaturverzeichnis 35 6 Anlagen 39 6.1 Erklärung über die eigenständige Abfassung der Arbeit 39 6.2 Spezifizierung des eigenen wissenschaftlichen Beitrages 40 6.3 Danksagung 41

Syfte Syftet med denna litteraturstudie var att redovisa vilken typ av träning (träningsform, intensitet, frekvens, träningspassduration och interventionsduration) som påverkar vilonivåer av BDNF hos friska vuxna. Metod För att besvara syftet gjordes en litteraturstudie. Litteratursökningar utfördes i databaserna PubMed, Web of Science och SPORTDisucs vilka gav 18 inkluderade artiklar. Träningsinterventionerna redovisades utifrån träningsform, intensitet, duration och frekvens. Resultatet redovisade de ingående gruppernas procentuella förändring gällande vilonivåer av BDNF samt tillhörande signifikansnivå. Resultat Av 18 inkluderade artiklar påvisade fem en signifikant skillnad i vilonivåer av BDNF, medan 13 artiklar inte visade någon signifikant skillnad. Slutsatser Utifrån resultatet kan inga generella slutsatser dras om träningsupplägg som påverkar vilonivåer av BDNF hos friska vuxna. Troligtvis skiljer sig den träningsinducerade responsen på vilonivåer av BDNF i olika kombinationer av träningsform, intensitet, frekvens, interventionsduration och träningspassduration. Responsen är således en komplex funktion beroende på ett flertal faktorer som såväl träningsupplägg och individuella faktorer. Regelbunden träning ger förmodligen en förändrad respons på BDNF-genuttryck, oavsett om vilonivåerna påverkas eller inte, vilket på sikt gynnar hjärnhälsan.

Synapses are the fundamental units of communication in the brain, and their proper development and function are critical for cognitive processes and behavior. While the development of glutamatergic synapses has been extensively studied, the mechanisms underlying the formation of the tripartite synapse remain poorly understood. The tripartite synapse is a specialized structure consisting of the presynaptic terminal, the postsynaptic element, and a perisynaptic astrocyte process (PAP) that ensheathes the synaptic cleft. Increasing evidence demonstrates that PAPs are critical for synapse formation, stabilization, and plasticity. However, the mechanisms that govern the formation of tripartite synapses remain to be fully elucidated. This dissertation investigates the role of the astrocyte TrkB.T1 receptor, a truncated isoform of the canonical receptor for brain derived neurotrophic factor (BDNF), in mediating behavior and excitatory synapse development. Using an astrocyte-specific conditional TrkB.T1 knockout mouse model, we demonstrate that deletion of TrkB.T1 results in hyperactive locomotion, with increased voluntary running and perseverative motor behaviors. Through a combination of molecular and cellular approaches, we demonstrate that the behavioral abnormalities that result from TrkB.T1 deletion are accompanied by developmental reductions in glutamatergic synapses and astrocyte-synapse interactions in the motor and barrel cortex. Mechanistic studies using neuron-astrocyte co-cultures also reveal that loss of TrkB.T1 in astrocytes inhibits the formation of PAPs around glutamatergic synapses. Altogether, the insights presented herein present a novel astrocyte-mediated signaling mechanism that regulates excitatory synapse formation. These insights have important implications for understanding both neurodevelopmental and neuropsychiatric disorders involving synaptic dysfunction. / Doctor of Philosophy / Synapses are the central unit of communication in the brain. These neurochemical hubs of communication are able to orchestrate systems and overall behavior. Classically, a synapse has been defined as the contact point of communication between a pre-synaptic terminal and an apposing post-synaptic element. Simply illustrated, pre-synaptic terminals release neurotransmitters that can bind to the receptors of post-synaptic elements, enabling for either excitatory or inhibitory communication. While the field of neuroscience has studied how synapses form and mature, there are still many unanswered questions about a specialized synaptic structure called the tripartite synapse. The tripartite synapse involves not just a pre- and post-synaptic element, but also a third player – a multitasking cell called the astrocyte. Astrocytes extend thousands of fine, leaflet-like processes that wrap around and support neuronal synapses. These processes, termed perisynaptic astrocyte processes (PAPs), are critical for synaptic development and function. This dissertation investigated how brain derived neurotrophic factor (BDNF) and its receptor TrkB.T1, found almost exclusively in astrocytes, control the formation of PAPs during brain development. Using a combination of advanced microscopy and cellular and molecular techniques, we demonstrate that BDNF/TrkB.T1 signaling in astrocytes acts as a critical regulator in the development of synapses and astrocyte-synapse interactions, instructing astrocytes to extend processes that can ensheath synapses as they mature. Disruption of this pathway in mice also led to hyperactive behavior, underscoring its importance for proper brain development and function. This novel astrocyte-based mechanism governing synapse maturation has important implications for understanding neurodevelopmental and neuropsychiatric disorders and could ultimately lead to novel therapeutic strategies targeting synaptic defects in these conditions.

A esquizofrenia é uma desordem altamente incapacitante que atinge cerca de 1% da população, envolvendo desequilíbrio da neurotransmissão dopaminérgica e uma hipofunção glutamatérgica. Portadores dessa doença apresentam deficiência do processamento de informações caracterizada por prejuízo no teste de inibição pré-pulso (prepulse inhibition - PPI). Essa condição pode ser reproduzida em modelos experimentais, pelo tratamento com psicoestimulantes, como a anfetamina (ANF) e atenuado/revertido pelo tratamento com antipsicóticos. O canabidiol (CBD) é o principal componente não psicotomimético da Cannabis sativa. Estudos clínicos e pré-clínicos sugerem que o CBD apresenta perfil antipsicótico, com baixa indução de efeitos adversos. Contudo, até o momento poucos estudos foram realizados com o objetivo de investigar os mecanismos farmacológicos e/ou moleculares envolvidos nesse perfil. Os prováveis mecanismos envolvidos com as propriedades antipsicóticas do CBD parecem envolver a ativação de receptores TRPV1 e o aumento da sinalização do endocanabinoide anandamida. No presente estudo, demonstramos que os receptores TRPV1 e o aumento da disponibilidade de anandamida parecem participar do perfil antipsicótico do CBD. Nessas investigações, não observamos participação dos receptores 5-HT1A. A microinjeção de CBD no córtex pré-frontal (CPF), estrutura envolvida com a fisiopatologia da esquizofrenia e um provável sítio para ação de antipsicóticos, não atenuou o prejuízo induzido por ANF no PPI. Recentemente, mecanismos epigenéticos, como a metilação do DNA, têm sido associados à fisiopatologia da esquizofrenia. Nesse sentido, avaliamos o envolvimento da metilação do DNA em estruturas envolvidas com a neurobiologia da esquizofrenia regulada por CBD, sobre as respostas comportamentais induzidas por drogas psicotomiméticas. Verificamos que a ANF causa um aumento da metilação global no estriado ventral, efeito bloqueado pelo pré-tratamento com CBD e de forma semelhante com o antipsicótico clozapina (CLZ). Não observamos alterações na metilação global no CPF. O tratamento com MK-801 não alterou a metilação global nas duas estruturas anteriormente citadas. Protocolo experimental semelhante foi utilizado em mais duas abordagens: (i) a expressão do fator neurotrófico do cérebro (BDNF), relacionado com a manutenção, crescimento e diferenciação dos neurônios está aumentada no hipocampo dos animais tratados com a associação CBD e ANF, padrão semelhante foi observado com a associação CLZ e ANF. (ii) a expressão de fosfo-histona acetilada, um marcador que indica alterações na cromatina, intimamente ligada com as alterações da expressão gênica está aumentada no núcleo acumbens e CPF dos animais tratados com a associação CBD e ANF. Os dados aqui apresentados sugerem que os receptores TRPV1 e o endocanabinoide anandamida parecem estar envolvidos com o perfil antipsicótico do CBD. Pela primeira vez foi demonstrado que tanto o pré-tratamento com CBD ou CLZ podem alterar o aumento da metilação global de DNA induzido por ANF. Além disso, a expressão de BDNF no hipocampo e a expressão de fosfo-histona acetilada podem ser outros mecanismos que merecem atenção em relação ao perfil antipsicótico do CBD. / Schizophrenia is a highly disabling disorder that affects about 1% of the population and involves impaired dopaminergic neurotransmission and glutamatergic hypofunction. Patients with this disorder have a deficiency in information processing characterized by disruption in the prepulse inhibition (PPI) test. This condition can be reproduced in experimental models by treatment with psychostimulants such as amphetamine and attenuated / reversed by treatment with antipsychotics. Cannabidiol (CBD) is the main non-psychotomimetic component of Cannabis sativa. Clinical and preclinical studies suggest that CBD has an antipsychotic profile, with low induction of adverse effects. However, to date, few studies have been carried out to investigate the pharmacological and / or molecular mechanisms involved in this outcome. The likely mechanisms involved with the antipsychotic properties of CBD appear to involve activation of TRPV1 receptors and increased endocannabinoid anandamide signaling. In the present study, we demonstrated that TRPV1 receptors and the increased availability of anandamide appear to participate in the CBD antipsychotic profile. In these investigations, we did not observe participation of 5-HT1A receptors. Microinjection of CBD in the prefrontal cortex, structure involved in the pathophysiology of schizophrenia and a probable site of antipsychotic action, did not attenuate the amphetamine-induced disruption in PPI. Recently, epigenetic mechanisms, such as DNA methylation, have been associated with the pathophysiology of schizophrenia. In this sense, we also evaluated the involvement of DNA methylation in structures involved with the neurobiology of CBD-regulated schizophrenia on behavioral responses induced by psychotomimetic drugs. We found that amphetamine causes increased global methylation in the ventral striatum, an effect blocked by pre-treatment with CBD and similarly with the antipsychotic clozapine. We did not observe changes in the global methylation in prefrontal cortex. Treatment with MK-801 did not alter the global methylation in the two aforementioned structures. Similar experimental protocol was used in two other approaches: (i) brain neurotrophic factor (BDNF) expression, related to the maintenance, growth and differentiation of neurons is increased in the hippocampus of animals treated with CBD and amphetamine; a similar pattern was observed with the association clozapine and amphetamine. (ii) the expression of acetylated phospho-histone, a marker indicating changes in chromatin, closely linked to changes in gene expression is increased in the nucleus acumbens and CPF in animals treated with the CBD and amphetamine combination. The data presented here suggest TRPV1 receptors and the endocannabinoid anandamide seem to be involved with the antipsychotic profile of CBD. For the first time it has been shown that both pre-treatment with CBD or clozapine may alter the increase in overall DNA methylation induced by amphetamine. In addition, the expression of BDNF in the hippocampus and the expression of acetylated phospho-histone may be different mechanisms that deserve attention in relation to the antipsychotic profile of CBD.

Introduction : Issus des données animales, les modèles neurotrophiniques du mécanisme d’action des médicaments antidépresseurs pourraient permettre d’identifier chez l’Homme des biomarqueurs prédictifs de la réponse et de la rémission sous antidépresseurs. Nous évaluons l’intérêt clinique, chez les patients souffrant de trouble dépressif caractérisé unipolaire, de 11 biomarqueurs : polymorphismes nucléotidiques simples (SNP) du Brain Derived Neurotrophic Factor (BDNF) et de son récepteur, le Récepteur Tyrosine-Kinase B (TRKB), taux plasmatiques de BDNF et volume hippocampique sur la réponse/rémission sous antidépresseurs. Méthode : Les données originales de ce travail sont issues de la cohorte METADAP. Il s’agit d’une cohorte, prospective, multicentrique incluant 624 patients présentant un épisode dépressif caractérisé dans le cadre d’un trouble dépressif caractérisé unipolaire et nécessitant l’introduction d’un traitement antidépresseur. Le traitement antidépresseur est prescrit de façon naturaliste (tous antidépresseurs commercialisés en France). Les patients sont évalués 1, 3 et 6 mois après l’introduction du traitement antidépresseur. Les biomarqueurs étudiés sont les polymorphismes Val66Met du BDNF et 8 SNP du TRKB et les dosages de BDNF plasmatiques. Une étude ancillaire est menée à partir de 63 patients ayant bénéficié d’Imagerie par Résonnance Magnétique cérébrale réalisée en pratique courante à l’inclusion de cette cohorte afin d’évaluer les volumes hippocampiques. Résultats : 1) Une revue de la littérature met en évidence une association entre la réponse aux antidépresseurs et 12 SNP du BDNF/TRKB sur 242 étudiés, ainsi qu’une association entre allèle Met du polymorphisme Val66Met du BDNF et meilleure réponse sous antidépresseurs chez les patients asiatiques. 2) Nos données ne mettent pas en évidence d’impact de 8 SNP du TRKB sur la réponse/rémission après traitement antidépresseur, mais un effet différentiel du Val66Met du BDNF selon la classe de traitement antidépresseur. 3) L’étude des dosages de BDNF plasmatiques n’est pas concluante. 4) Concernant les volumes hippocampiques, notre méta-analyse montre que des volumes hippocampiques moindres prédisent une moindre réponse/rémission après traitement antidépresseur. 5) Concernant les liens entre les biomarqueurs étudiés, nous ne mettons pas en évidence d’association. Conclusion : Sur les 11 biomarqueurs étudiés, seuls 2 pourraient présenter une utilité en pratique clinique. Si nos travaux étaient répliqués, le polymorphisme Val66Met du BDNF et le volume hippocampique pourraient conduire à orienter le choix des antidépresseurs dans le traitement des épisodes dépressifs caractérisés. Malgré une littérature cohérente chez l’Animal, nous n’avons pas mis en évidence, dans l’échantillon étudié, de lien entre les biomarqueurs génétiques étudiés et les volumes hippocampiques. Nous poursuivons ce travail d’évaluation des biomarqueurs neurotrophiniques et neurogéniques avec des méthodes d’évaluations nouvelles : séquençage nouvelle génération pour la génétique et imagerie multimodale (acquisition répétée d’IRM structurelle, fonctionnelle et de diffusion) de l’hippocampe. Nous évaluerons également de nouveaux biomarqueurs. / Introduction: developed with Animal preclinical approachs, neurtrophinic and neurogenic models of antidepressant mechanism of action lead to identify biomarkers in Human which could be predict antidepressant response and remission in depressed patients. We assess the clinical benefit of 11 biomarkers in depressed patients: Brain Derived Neurotrophic Factor (BDNF) and its receptor Tyrosine Receptor -Kinase B (TRKB), Plasma BDNF and Hippocampal volumes to predict antidepressant response/remission. Methods: The original research data of this work are from METADAP cohort. It is a prospective, multicentric cohort including 624 patients with a diagnosis of major depressive disorder and a current major depressive episode at the start of the index antidepressant treatment. Antidepressant treatment is prescribed in naturalistic conditions (all commercialized antidepressant in France). Patient are assessed 1, 3 and 6 months after the start of antidepressant treatment. Studied biomarkers are BDNF Val66Met polymorphism, 8 TRKB SNP and plasma BDNF. Ancillary study are done with 63 patients which benefit in clinical practice of Magnetic Resonnance (MRI) at the inclusion of the cohort. Results: 1) A review of literature reports associations between antidepressant efficacy and 12 BDNF/TRKB SNP on 242 studied SNP and an association with Met allele of Val66Met BDNF polymorphism and a best antidepressant efficacy in Asian patients. 2) Our original data show no impact of 8 TRKB SNP on antidepressant response remission but a differential effect of Val66Met BDNF polymorphism depending on antidepressant treatment class. 3) Plasma BDNF study is not conclusive. 4) Concerning hippocampal volumes, our meta-analysis show that smaller hippocampal volumes predict lower response/remission rate after antidepressant treatment. 5) No association is found between studied biomarkers. Conclusion: 2 of the 11 studied biomarkers could be useful in clinical practice. After replication of our results, Val66Met polymorphism could lead to personalized antidepressant prescription in major depressive disorder. Although the animal prelinical littérature appar strong, we dont report association between genetic biomarker and hippocampal volume in ours ample. We will assess neurotrophinic and neurogenic biomarkers with new methods: next generation sequencing for genetic, multimodal imaging (repeated structural, functional and diffusion MRI) of hippocampus. We also will assess new biomarkers.

PEREIRA, V.S. Participação da via NMDA-NO do córtex pré-frontal medial ventral na modulação das consequências comportamentais do estresse de nado forçado: mecanismos intracelulares. 2015. 191p. Tese (Doutorado) Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, 2014. A ativação dos receptores glutamatérgicos do tipo NMDA é capaz de desencadear a síntese de óxido nítrico (NO) no SNC. A administração de antagonistas NMDA (p.ex., ketamina) ou de inibidores da síntese de NO (p.ex., 7-NI) produz efeitos do tipo antidepressivo em animais e reforça o potencial dos sistemas glutamatérgico e nitrérgico como alvos terapêuticos para o tratamento da depressão. Trabalhos recentes sugerem o envolvimento de vias intracelulares no controle de mecanismos de plasticidade neural, como a via BDNF-TrkBmTOR, nos efeitos antidepressivos produzidos por antagonistas NMDA. Foi demonstrado, por exemplo, que os efeitos antidepressivos da ketamina dependem da síntese de BDNF e da ativação da mTOR no córtex pré-frontal medial (CPFMv) de ratos. O bloqueio farmacológico do CPFMv ou a administração de antagonista NMDA (LY235959) nessa estrutura também produz efeitos do tipo antidepressivo em animais. Porém, não se sabe se esses efeitos envolvem a via NMDA-NO do CPFMv, assim como não se sabe se o efeito antidepressivo induzido por inibidores da síntese de NO dependeria da via BDNF-TrkB-mTOR do CPFMv. Dessa forma, avaliamos a participação da neurotransmissão glutamatérgica e nitrérgica, bem como a participação da via BDNF-TrkB-mTOR, no CPFMv-pré límbico (PL), na modulação de respostas comportamentais de animais submetidos ao teste do nado forçado (TNF), um teste preditivo de efeito antidepressivo. Em um primeiro grupo de experimentos observou-se que a administração de inibidor da nNOS (NPA), da sGC (ODQ) ou de sequestrador de NO (c-PTIO) no PL de animais submetidos ao TNF promoveu efeito do tipo-antidepressivo, de forma similar ao que foi previamente descrito com a injeção local de LY235959. Posteriormente, os efeitos do LY235959, mas não os do NPA, foram bloqueados pelo tratamento prévio com antagonista dos receptores glutamatérgicos do tipo AMPA (NBQX), sugerindo que as vias NMDA e NO do PL estejam dissociadas na modulação das alterações comportamentais promovidas pelo TNF. A administração de BDNF no PL promoveu efeito tipoantidepressivo, o qual foi bloqueado pelo pré-tratamento com antagonista dos receptores TrkB (K252a) ou com inibidor da mTOR (rapamicina). Os efeitos tipo antidepressivo da administração de LY235959 ou NPA, no PL, não foram alterados na presença de K252a. No entanto, a administração prévia de rapamicina foi capaz de bloquear os efeitos do LY235959, mas não os do NPA, novamente sugerindo mecanismos distintos desencadeados por NMDA e NO no PL. Nossos dados indicam uma interação maior dos efeitos dos antagonistas NMDA com a via BDNF-TrkB-mTOR, enquanto os efeitos dos inibidores da via do NO parecem não modular essa via no PL. O tratamento sistêmico com ketamina (antagonista NMDA) ou 7-NI (inibidor preferencial da nNOS) foi capaz de produzir efeitos do tipo antidepressivo, sendo que esses tratamentos não alteraram a ativação ou expressão dos receptores TrkB e da mTOR, no CPFm de animais estressados ou não estressados. Assim, mais estudos são necessários para esclarecer a interação das neurotransmissões glutamatérgica e nitrérgica com a via BDNFTrkB-mTOR, no CPFMv-PL, no que diz respeito ao efeito antidepressivo em animais estressados, após administração sistêmica. Em conjunto, os dados do presente trabalho suportam o envolvimento da neurotransmissao glutamatérgica e nitrérgica do PL na neurobiologia das respostas comportamentais associadas a neurobiologia da depressão. Porém, a interação entre esses sistemas no PL e os mecanismos envolvidos se mostram consideravelmente complexos. / PEREIRA, V.S. Participation of NMDA-NO pathway from the medial préfrontal córtex on the behavioural consequences of forced swim stress: molecular mechanisms. 2015. 191p. Thesis (Doctoral) School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, 2014. The activation of NMDA receptors is capable of increasing nitric oxide (NO) synthesis in the brain. The administration of NMDA antagonists (e.g., ketamine) or nitric oxide synthesis inhibitors (e.g., 7-NI) produce antidepressant-like effects in animals and highlights the potential of glutamatergic and nitrergic systems as therapeutic targets for the treatment of major depression. The involvement of intracellular mechanisms associated to neural plasticity, such as BDNF-TrkBmTOR pathway, has been implicated in the antidepressant-like effects induced by systemic administration of NMDA antagonists. For instance, the antidepressant effects of ketamine are associated with increased BDNF synthesis and mTOR in the medial prefrontal cortex (vMPFC). In addition, injection of an NMDA antagonist (LY235959) into the vMPFC-PL produces antidepressant-like effect in animals. However, it is not yet known if the aforementioned antidepressant-like effects involve the modulation of NO synthesis or the activation of the BDNF-TrkB-mTOR pathway in the vMPFC. Therefore, this work investigated the involvement of glutamatergic and nitrergic neurotransmission of the vMPFC, as well as the participation of local BDNF-TrkBmTOR pathway, in the modulation of behavioral responses of animals submitted to forced swimming test, an animal model predictive of antidepressant effects. The administration of nNOS inhibitor (NPA), sGC inhibitor (ODQ) or NO scavenger (c-PTIO) into the vMPFC-PL produced antidepressant-like effects, similarly to what has been previously described with the local injection of LY235959. The effects of LY235959 were blocked by pretreatment with an antagonist of AMPA receptors (NBQX), but not the NPA effects. Thus suggesting a possible dissociation between NMDA- and NO-induced mechanism in the PL. BDNF administration in the PL induced antidepressant-like effect, which was blocked by prior administration of the TrkB receptor antagonist (K252a) or the mTOR inhibitor (rapamycin). The antidepressant-like effects induced by intra-PL administration of LY235959 and NPA, into vMPFC-PL were not altered in the presence of K252a. However, the prior administration of rapamycin was able to block the effects of LY235959, but not NPA-induced effect. This result further supports the dissociation of the NMDA-NO system in the PL in the modulation of immobility in the FST. Systemic treatment with ketamine (NMDA antagonist) or 7-NI (nNOS inhibitor) produced antidepressant-like effects in the FST, although these treatments did not affect the activation or the expression of TrkB receptors or mTOR in the MPFC of stressed animals. These results further corroborate the involvement of the glutamatergic and nitrergic neurotransmission in the modulation of behavioral consequences of the forced swim stress and highlight that the interaction of these systems with mTOR and trkB in the PL is considerably complex. Altogether, our data supports the possible modulation of BDNF-TrkBmTOR pathway of the PL in the effects induced by NMDA antagonist injection.. However, the effects induced by inhibitors of the NO pathway semms dissociated from an interaction with the aforementioned pathway. Thus, further studies are necessary to clarify the interaction of glutamatergic and nitrergic neurotransmission with BDNF-TrkB-mTOR pathway into vMPFC-PL regarding the neurobiology of stress and depression.

PEREIRA, V.S. Participação da via NMDA-NO do córtex pré-frontal medial ventral na modulação das consequências comportamentais do estresse de nado forçado: mecanismos intracelulares. 2015. 191p. Tese (Doutorado) Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, 2014. A ativação dos receptores glutamatérgicos do tipo NMDA é capaz de desencadear a síntese de óxido nítrico (NO) no SNC. A administração de antagonistas NMDA (p.ex., ketamina) ou de inibidores da síntese de NO (p.ex., 7-NI) produz efeitos do tipo antidepressivo em animais e reforça o potencial dos sistemas glutamatérgico e nitrérgico como alvos terapêuticos para o tratamento da depressão. Trabalhos recentes sugerem o envolvimento de vias intracelulares no controle de mecanismos de plasticidade neural, como a via BDNF-TrkBmTOR, nos efeitos antidepressivos produzidos por antagonistas NMDA. Foi demonstrado, por exemplo, que os efeitos antidepressivos da ketamina dependem da síntese de BDNF e da ativação da mTOR no córtex pré-frontal medial (CPFMv) de ratos. O bloqueio farmacológico do CPFMv ou a administração de antagonista NMDA (LY235959) nessa estrutura também produz efeitos do tipo antidepressivo em animais. Porém, não se sabe se esses efeitos envolvem a via NMDA-NO do CPFMv, assim como não se sabe se o efeito antidepressivo induzido por inibidores da síntese de NO dependeria da via BDNF-TrkB-mTOR do CPFMv. Dessa forma, avaliamos a participação da neurotransmissão glutamatérgica e nitrérgica, bem como a participação da via BDNF-TrkB-mTOR, no CPFMv-pré límbico (PL), na modulação de respostas comportamentais de animais submetidos ao teste do nado forçado (TNF), um teste preditivo de efeito antidepressivo. Em um primeiro grupo de experimentos observou-se que a administração de inibidor da nNOS (NPA), da sGC (ODQ) ou de sequestrador de NO (c-PTIO) no PL de animais submetidos ao TNF promoveu efeito do tipo-antidepressivo, de forma similar ao que foi previamente descrito com a injeção local de LY235959. Posteriormente, os efeitos do LY235959, mas não os do NPA, foram bloqueados pelo tratamento prévio com antagonista dos receptores glutamatérgicos do tipo AMPA (NBQX), sugerindo que as vias NMDA e NO do PL estejam dissociadas na modulação das alterações comportamentais promovidas pelo TNF. A administração de BDNF no PL promoveu efeito tipoantidepressivo, o qual foi bloqueado pelo pré-tratamento com antagonista dos receptores TrkB (K252a) ou com inibidor da mTOR (rapamicina). Os efeitos tipo antidepressivo da administração de LY235959 ou NPA, no PL, não foram alterados na presença de K252a. No entanto, a administração prévia de rapamicina foi capaz de bloquear os efeitos do LY235959, mas não os do NPA, novamente sugerindo mecanismos distintos desencadeados por NMDA e NO no PL. Nossos dados indicam uma interação maior dos efeitos dos antagonistas NMDA com a via BDNF-TrkB-mTOR, enquanto os efeitos dos inibidores da via do NO parecem não modular essa via no PL. O tratamento sistêmico com ketamina (antagonista NMDA) ou 7-NI (inibidor preferencial da nNOS) foi capaz de produzir efeitos do tipo antidepressivo, sendo que esses tratamentos não alteraram a ativação ou expressão dos receptores TrkB e da mTOR, no CPFm de animais estressados ou não estressados. Assim, mais estudos são necessários para esclarecer a interação das neurotransmissões glutamatérgica e nitrérgica com a via BDNFTrkB-mTOR, no CPFMv-PL, no que diz respeito ao efeito antidepressivo em animais estressados, após administração sistêmica. Em conjunto, os dados do presente trabalho suportam o envolvimento da neurotransmissao glutamatérgica e nitrérgica do PL na neurobiologia das respostas comportamentais associadas a neurobiologia da depressão. Porém, a interação entre esses sistemas no PL e os mecanismos envolvidos se mostram consideravelmente complexos. / PEREIRA, V.S. Participation of NMDA-NO pathway from the medial préfrontal córtex on the behavioural consequences of forced swim stress: molecular mechanisms. 2015. 191p. Thesis (Doctoral) School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, 2014. The activation of NMDA receptors is capable of increasing nitric oxide (NO) synthesis in the brain. The administration of NMDA antagonists (e.g., ketamine) or nitric oxide synthesis inhibitors (e.g., 7-NI) produce antidepressant-like effects in animals and highlights the potential of glutamatergic and nitrergic systems as therapeutic targets for the treatment of major depression. The involvement of intracellular mechanisms associated to neural plasticity, such as BDNF-TrkBmTOR pathway, has been implicated in the antidepressant-like effects induced by systemic administration of NMDA antagonists. For instance, the antidepressant effects of ketamine are associated with increased BDNF synthesis and mTOR in the medial prefrontal cortex (vMPFC). In addition, injection of an NMDA antagonist (LY235959) into the vMPFC-PL produces antidepressant-like effect in animals. However, it is not yet known if the aforementioned antidepressant-like effects involve the modulation of NO synthesis or the activation of the BDNF-TrkB-mTOR pathway in the vMPFC. Therefore, this work investigated the involvement of glutamatergic and nitrergic neurotransmission of the vMPFC, as well as the participation of local BDNF-TrkBmTOR pathway, in the modulation of behavioral responses of animals submitted to forced swimming test, an animal model predictive of antidepressant effects. The administration of nNOS inhibitor (NPA), sGC inhibitor (ODQ) or NO scavenger (c-PTIO) into the vMPFC-PL produced antidepressant-like effects, similarly to what has been previously described with the local injection of LY235959. The effects of LY235959 were blocked by pretreatment with an antagonist of AMPA receptors (NBQX), but not the NPA effects. Thus suggesting a possible dissociation between NMDA- and NO-induced mechanism in the PL. BDNF administration in the PL induced antidepressant-like effect, which was blocked by prior administration of the TrkB receptor antagonist (K252a) or the mTOR inhibitor (rapamycin). The antidepressant-like effects induced by intra-PL administration of LY235959 and NPA, into vMPFC-PL were not altered in the presence of K252a. However, the prior administration of rapamycin was able to block the effects of LY235959, but not NPA-induced effect. This result further supports the dissociation of the NMDA-NO system in the PL in the modulation of immobility in the FST. Systemic treatment with ketamine (NMDA antagonist) or 7-NI (nNOS inhibitor) produced antidepressant-like effects in the FST, although these treatments did not affect the activation or the expression of TrkB receptors or mTOR in the MPFC of stressed animals. These results further corroborate the involvement of the glutamatergic and nitrergic neurotransmission in the modulation of behavioral consequences of the forced swim stress and highlight that the interaction of these systems with mTOR and trkB in the PL is considerably complex. Altogether, our data supports the possible modulation of BDNF-TrkBmTOR pathway of the PL in the effects induced by NMDA antagonist injection.. However, the effects induced by inhibitors of the NO pathway semms dissociated from an interaction with the aforementioned pathway. Thus, further studies are necessary to clarify the interaction of glutamatergic and nitrergic neurotransmission with BDNF-TrkB-mTOR pathway into vMPFC-PL regarding the neurobiology of stress and depression.

Un traumatisme de la moelle épinière (TME) est une condition dévastatrice entraînant la perte permanente de fonctions neuronales. L’objectif de cette thèse est de formuler de microsupports pharmacologiquement actif (MPAs) avec une surface de fibronectine (FN), libérant le« brain-derived neurotrophic factor » (BDNF) de façon controlée. Nous voulons combiner ce système avec des cellules souches mésenchymateuses (CSMs) pour la réparation de TME. Le BDNF nanoprécipité a été encapsulé dans les FN-MPAs et le profil de libération in vitro a été évaluée. Elle a montré une libération biphasique et prolongée de BDNF bioactifs. Nous avons combinés des cellules souches humaines mésenchymateuse issues de la moelle osseuse adulte (cellules MIAMI) et FN-MPAs avec un hydrogel non-toxique silanisés-hydroxypropylméthylcellulose (Si-HPMC). Nous avons démontré que les FN-MPAs et le Si-HPMC augmentait l'expression de marqueurs neuraux/neuronaux de cellules MIAMI après 1 semaine. En outre, l'environnement 3D (hydrogel ou FN-MPAs) a augmenté le sécrétome thérapeutique de cellules MIAMI. Pour avoir un système facile à appliquer en clinique, nous avons choisi d’utiliser les cellules souches de la papille apicale (SCAP) et FN-MPAs libérant ou non du BDNF pour la thérapie du TME. Plus de 90 % du SCAP complexée avec FN-MPAs (libérant ou pas BDNF) demeurent viables pendant 7 jours et il y a augmentation de l'expression des gènes neuronaux/oligodendrogliaux in vitro. La récupération de la fonction locomotrice a été significativement améliorée après la transplantation du SCAP complexée avec FN-MPAs-BDNF avec une coordination cohérente du membre postérieur après 28 jours de traitement. / Traumatic spinal cord injury (SCI) is a devastating condition resulting in permanent loss of neural functions. The objective of this thesis is to develop pharmacologically active microcarriers (PAMs) with a fibronectin (FN) surface that deliver biologically active brain derived neurotrophic factor (BDNF) in a controlled manner. We want to combine this system with adult mesenchymal stem cells (MSCs) for SCI repair. The nanoprecipitated BDNF was encapsulated in FN-PAMs and the in vitro release profile was evaluated. It showed a prolonged, bi-phasic, release of bioactive BDNF, without burst effect. We combined human marrow-isolated adult multilineage-inducible (MIAMI) stem cells and FN-PAMs with an injectable non-toxic silanized-hydroxypropylmethylcellulose (Si-HPMC) hydrogel. We demonstrated that FN-PAMs and the Si-HPMC hydrogel increased the expression of neural/neuronal differentiation markers of MIAMI cells after 1 week. Moreover, the 3D environment (FN-PAMs or hydrogel) enhanced the therapeutic MIAMI cell secretome. To have a clinically translatable system, we chose to use stem cells of the apical papilla (SCAP) and FNPAMs releasing or not BDNF for SCI therapy. More than 90% of SCAP complexed with FN-PAMs (releasing or not BDNF) remained viable for 7 days and an increased neuronal-oligodendroglial gene expression in vitro. The recovery of locomotor function was significantly improved after transplantation of SCAP complexed with FN-PAMs-BDNF with frequent to consistent forelimb-hindlimb coordination after 28 days of treatment.

Made available in DSpace on 2014-12-17T15:37:21Z (GMT). No. of bitstreams: 1 IsabellaMOP_DISSERT.pdf: 1986488 bytes, checksum: 1f1b995fa77d662628cf94f2e167faf0 (MD5) Previous issue date: 2014-05-09 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / Lithium (Li) is the first choice to treat bipolar disorder, a psychiatric illness characterized by mood oscillations between mania and depression. However, studies have demonstrated that this drug might influence mnemonic process due to its neuroprotector, antiapoptotic and neurogenic effects. The use of Li in the treatment of cognitive deficits caused by brain injury or neurodegenerative disorders have been widely studied, and this drug shows to be effective in preventing or even alleviating the memory impairment. The effects of Li on anxiety and depression are controversial and the relationship of the effects of lithium on memory, anxiety and depression remain unknown. In this context, this study aims to: evaluate the effects of acute and chronic administration of lithium carbonate in aversive memory and anxiety, simultaneously, using the plus maze discriminative avoidance task (PMDAT); test the antidepressant effect of the drug through the forced swimming test (FS) and analyze brainderived neurotrophic factor (BDNF) expression in structures related to memory and emotion. To evaluation of the acute effects, male Wistar rats were submitted to i.p. administration of lithium carbonate (50, 100 or 200 mg/kg) one hour before the training session (PMDAT) or lithium carbonate (50 or 100 mg/kg) one hour before the test session (FS). To evaluation of the chronic effects, the doses administered were 50 or 100 mg/kg or vehicle once a day for 21 days before the beginning of behavioral tasks (PMDAT and FS). Afterwards, the animals were euthanized and their brains removed and submitted to immunohistochemistry procedure to quantify BDNF. The animals that received acute treatment with 100 and 200 mg/kg of Li did not discriminated between the enclosed arms (aversive and non-aversive) in the training session of PMDAT, showing that these animal did not learned the task. This lack of discrimination was also observed in the test session, showing that the animals did not recall the aversive task. We also observed an increased exploration of the open arms of these same groups, indicating an anxiolytic effect. The same groups showed a reduction of locomotor activity, however, this effect does not seem to be related with the anxiolytic effect of the drug. Chronic treatment with Li did not promote alterations on learning or memory processes. Nevertheless, we observed a reduction of open arms exploration by animals treated with 50 mg/kg when compared to the other groups, showing an anxiogenic effect caused by this dose. This effect it is not related to locomotor alterations since there were no alterations in these parameters. Both acute and chronic treatment were ineffective in the FS. Chronic treatment with lithium was not able to modify BDNF expression in hippocampus, amygdala and pre-frontal cortex. These results suggest that acute administration of lithium promote impairments on learning in an aversive task, blocking the occurrence of memory consolidation and retrieval. The reduction of anxiety following acute treatment may have prevented the learning of the aversive task, as it has been found that optimum levels of anxiety are necessary for the occurrence of learning with emotional context. With continued, treatment the animals recover the ability to learn and recall the task. Indeed, they do not show differences in relation to control group, and the lack of alterations on BDNF expression corroborates this result. Possibly, the regimen of treatment used was not able to promote cognitive improvement. Li showed acute anxiolytic effect, however chronic administration 4 promoted the opposite effect. More studies are necessary to clarify the potential beneficial effect of Li on aversive memory / L?tio (Li) ? o f?rmaco de escolha para o tratamento do transtorno bipolar, doen?a psiqui?trica caracterizada por oscila??es de humor entre mania e depress?o. Entretanto, estudos mostram que essa droga pode ter influ?ncia sobre os processos mnem?nicos devido a seu car?ter neuroprotetor, antiapopt?tico e neurog?nico. O emprego no l?tio para o tratamento de d?ficits cognitivos provocados por les?es cerebrais ou doen?as neurodegenerativas vem sendo amplamente estudado, visto que esse f?rmaco mostra-se capaz de prevenir ou at? mesmo aliviar preju?zos na mem?ria. Os efeitos do Li na ansiedade e depress?o s?o controversos e a rela??o entre os efeitos do Li na mem?ria, ansiedade e depress?o s?o ainda desconhecidos. Neste contexto, os objetivos deste estudo foram: avaliar os efeitos da administra??o aguda e cr?nica de carbonato de l?tio na mem?ria aversiva e ansiedade, simultaneamente, utilizando a esquiva discriminativa no labirinto em cruz elevado (ED); testar o efeito antidepressivo do f?rmaco atrav?s do teste do nado for?ado (NF); avaliar a express?o de fator neurotr?fico derivado do enc?falo (BDNF) em estruturas relacionadas com mem?ria e emo??o. Para a avalia??o do efeito agudo, ratos Wistar machos foram submetidos ? administra??o intraperitoneal de carbonato de l?tio 50, 100 ou 200 mg/kg uma hora antes do treino (ED) ou carbonato de l?tio 50 ou 100 mg/kg uma hora antes do teste (NF). Para a avalia??o cr?nica, foram administradas as doses de 50 ou 100 mg/kg ou ve?culo por 21 dias antes do in?cio das tarefas comportamentais (ED e NF). Ap?s o t?rmino dessas tarefas, os animais foram eutanasiados e seus enc?falos removidos para realiza??o de imunohistoqu?mica para quantificar BDNF. Os animais que receberam tratamento agudo com Li nas doses de 100 e 200 mg/kg n?o demonstraram discrimina??o entre os bra?os fechados (aversivo e n?o-aversivo) na sess?o treino da ED, mostrando que esses animais n?o aprenderam a tarefa. Essa aus?ncia na discrimina??o foi observada tamb?m na sess?o teste, mostrando que n?o houve evoca??o da mem?ria aversiva. Foi ainda observado um aumento da explora??o dos bra?os abertos para essas mesmas doses, apontando um efeito ansiol?tico do f?rmaco. Os mesmos grupos apresentaram ainda uma redu??o na atividade locomotora, no entanto, esse efeito parece n?o estar relacionado com o efeito ansiol?tico do f?rmaco. O tratamento cr?nico com l?tio n?o promoveu altera??es nos processos de aprendizado e mem?ria. No entanto, foi observado uma redu??o da explora??o dos bra?os abertos pelos animais tratados com a dose de 50 mg/kg em rela??o aos outros grupos, mostrando um efeito ansiog?nico causado pelo tratamento cr?nico. Esse efeito n?o est? relacionado a altera??es locomotoras, visto que n?o foi detectado altera??es nesses par?metros. Ambos os tratamentos (agudo e cr?nico) foram ineficazes em demonstrar o efeito antidepressivo do l?tio na tarefa do NF. O tratamento cr?nico com l?tio tamb?m n?o foi capaz de alterar a express?o de BDNF no hipocampo, am?gdala e c?rtex pr?-frontal. Esses resultados sugerem que a administra??o aguda de l?tio promove preju?zos no aprendizado em uma tarefa aversiva, impedindo a ocorr?ncia de consolida??o e evoca??o da mem?ria. A redu??o da ansiedade no tratamento agudo pode ter impedido o aprendizado da tarefa aversiva, visto que j? foi verificado que n?veis adequados de ansiedade s?o necess?rios para que ocorra aprendizado com contexto 2 emocional. Com a continuidade do tratamento os animais recuperam a capacidade de aprender e evocar a tarefa, mas n?o apresentam altera??es em rela??o ao grupo controle e a aus?ncia de altera??o na express?o de BDNF corrobora esse resultado. Possivelmente, o regime de tratamento utilizado n?o foi capaz de promover melhora cognitiva nos animais. O l?tio demonstrou efeito ansiol?tico agudo, todavia a administra??o cr?nica promoveu efeito oposto. Mais estudos s?o necess?rios para esclarecer o potencial efeito ben?fico do l?tio sobre a mem?ria