O crescente interesse na avaliação da estereosseletividade na farmacocinética e farmacodinâmica de fármacos quirais, visando estabelecer as vantagens na produção de fármacos estereoquimicamente puros, tem levado ao desenvolvimento de métodos de análises com baixos limites de quantificação, seletividade e reprodutibilidade compatíveis com sua utilização em estudos de disposição cinética. Nesse contexto, um método empregando a cromatografia líquida de alta eficiência (HPLC) foi desenvolvido para a análise enantiosseletiva da mirtazapina em plasma humano. A mirtazapina foi selecionada para esse estudo por ser um novo antidepressivo, com propriedades farmacocinéticas e farmacodinâmicas estereosseletivas e em razão da carência de metodologia adequada para a quantificação individual dos seus enantiômeros. O procedimento de preparação das amostras envolveu tanto a extração líquido-líquido (LLE) quanto uma nova técnica de microextração em fase líquida empregando fibra cilíndrica microporosa de polipropileno (LPME), ambas usando tolueno como solvente de extração, seguido de análise cromatográfica, com detecção por absorção no UV, em 292 nm. A separação cromatográfica das formas (+)-(S)- e (-)-(R)- mirtazapina foi obtida em uma coluna Chiralpak AD protegida por coluna de guarda CN, usando hexano:etanol (98:2, v/v) + 0,1% de dietilamina como fase móvel. A recuperação média dos enantiômeros da mirtazapina empregando a LLE (96%) foi superior à obtida com a LPME (29%); apesar disso, os limites de quantificação foram muito próximos, isto é, 5,0 ng mL-1 para a LLE e 6,25 ng mL-1 para a LPME. Nos estudos de precisão e exatidão, os coeficientes de variação e erros relativos foram inferiores a 15% para todas as amostras avaliadas, empregando ambas as técnicas. O método de microextração baseado na LPME provou ser mais econômico e menos poluente e tão rápido, sensível e reprodutível quanto a LLE. As duas técnicas de preparação de amostras provaram ser adequadas e compatíveis para sua aplicações em estudos de disposição cinética. / The increased interest in enantioselective pharmacokinetic and pharmacodynamic properties of chiral drugs, aiming to establish the advantages in the production of estereochemically pure drugs, has led to the development of methods of analysis with low limits of quantification, selectivity and reproducibility, which are suitable to be used in kinetic disposition studies. On this basis, mirtazapine, a new antidepressant with estereoselective pharmacokinetic and pharmacodynamic properties but with few suitable methodologies for the separation and quantification of its enantiomers, was selected to evaluate two techniques of sample preparation. The procedure involved a classic liquid-liquid extraction and a new technique of liquid-phase microextraction using microporous polypropylene hollow fiber, both using toluene as extraction solvent. The analyses were carried out by high-performance liquid chromatography using chiral stationary phase and UV detection, at 292 nm. The chromatographic separation of (+)-(S)- e (-)-(R)- mirtazapine was performed on a Chiralpak AD column protected by a CN guard column, using hexane:ethanol (98:2, v/v) + 0.1% diethylamine as mobile phase. The mean recovery of mirtazapine enantiomers using LLE (96%) was higher than LPME (29%); in spite of this, the quantification limits have been very close, i.e, 5.0 ng mL-1 for LLE and 6.25 ng mL-1 for LPME. In precision and accuracy studies, coefficients of variation and relative errors were below 15% for all the evaluated samples in both LLE and LPME techniques. The microextraction method based on LPME proved to be more economic and less pollutant than LLE and as fast, sensible and reproducible as LLE. The two techniques of sample preparation have proved to be suitable for their application in kinetic disposition studies.

A necessidade de metodologias adequadas para análise de fármacos e seus metabólitos em matrizes biológicas complexas levaram a um crescente interesse no desenvolvimento de novas técnicas de preparação de amostras, particularmente as técnicas de microextração, por serem altamente seletivas e requererem o consumo mínimo de solventes orgânicos. Aliado a esses avanços, o emprego de modernas e eficientes tecnologias analíticas, como a eletroforese capilar (CE) e a cromatografia líquida de alta eficiência acoplada à espectrometria de massas (LC-MS-MS), tem resultado em um considerável avanço em qualidade nas metodologias analíticas disponíveis para bioanálises. Dentro desse cenário, destaca-se a utilização dessas técnicas para o desenvolvimento de metodologias enantiosseletivas, permitindo quantificar os enantiômeros de fármacos administrados como racematos. Sendo assim, propusemos o desenvolvimento e a validação de metodologias enantiosseletivas para a análise dos enantiômeros da mirtazapina (MRT) e de seus principais metabólitos em plasma e urina, utilizando a CE e a LC-MS-MS. Para a preparação das amostras foram empregadas a microextração em fase sólida (SPME) e a microextração em fase líquida (LPME). No primeiro método desenvolvido, a LPME foi utilizada para extrair os analitos das amostras de plasma (1 mL), previamente diluídas, alcalinizadas com 3,0 mL de uma solução tampão fosfato 0,5 mol L-1 (pH 8) e adicionadas de 15% (m/v) de cloreto de sódio. Éter n-hexílico e uma solução de ácido acético 0,01 moL L-1 foram utilizados como solvente extrator e fase aceptora, respectivamente. As análises cromatográficas foram feitas em uma coluna Chiralpak AD-RH, empregando acetonitrila:metanol:etanol (98:1:1, v/v/v) mais 0,2% de dietilamina como fase móvel, na vazão de 1 mL min-1. A detecção dos analitos foi conduzida por LC-MS-MS usando um analisador triplo-quadrupolo e ionização por eletrospray positivo. Nessas condições, foram obtidas recuperações de 18,3 a 45,5%, resposta linear na faixa de concentração de 1,25-125 ng mL-1 e limite de quantificação (LQ) de 1,25 ng mL-1 para todos os enantiômeros avaliados. Posteriormente, a CE e a LPME foram utilizadas para a análise da MRT e seus principais metabólitos em urina. Antes da extração, amostras de urina (1 mL) foram submetidas a hidrólise enzimática a 37 ºC por 16 horas. Então, a enzima foi precipitada com ácido tricloroacético, o pH foi ajustado para 8 com uma solução tampão fosfato 0,5 mol L-1 (pH 11) e 10% de NaCl também foi adicionado. Em seguida as amostras foram submetidas a extração de forma similar aquela realizada para as amostras de plasma. As análises eletroforéticas foram obtidas em uma solução tampão fosfato 50 mmol L-1 (pH 2,5) contendo 0,55% (m/v) de carboximetil-b-ciclodextrina (CM-b-CD). O método foi linear na faixa de concentração de 62,5-2500 ng mL-1 para cada enantiômero da MRT e 8-hidroximirtazapina (8-OHM) e 62,5-1250 ng mL-1 para cada enantiômero da desmetilmirtazapina (DMR). O LQ foi 62,5 ng mL-1 para todos os enantiômeros. A SPME também foi utilizada no desenvolvimento de um método para a determinação simultânea do fármaco e seus metabólitos em urina usando CE e LC-MS-MS. Os analitos de interesse foram transferidos da solução aquosa hidrolisada para uma fibra de polidimetilsiloxano-divinilbenzeno (PMDS-DVB) e então foram desorvidos em metanol. As recuperações médias foram de 12 % para os enantiômeros da MRT, 3,8 % para a DMR e 0,72 % para a 8-OHM. O método foi linear na faixa de concentração de 62,5-2500 ng mL-1 com adequado LQ (62,5 ng mL-1) para todos os enantiômeros. A precisão e exatidão foram menores que 15% para todos os métodos desenvolvidos. Além disso, os métodos foram adequadamente aplicados em estudos preliminares de determinação dos enantiômeros da MRT, 8-OHM e DMR em amostras de plasma e urina obtidos após a administração oral de uma dose única de rac-MRT a voluntários sadios. / The need for appropriate methodology for the analysis of drugs and their metabolites in complex biological matrices led to a growing interest in developing new techniques for sample preparation, particularly microextraction techniques because they are highly selective and require a minimum consumption of organic solvents. Allied to these developments, the employment of modern and efficient analytical technologies, such as capillary electrophoresis (CE) and high-performance liquid chromatography coupled to mass spectrometry (LC-MS-MS), has resulted in a considerable improvement in quality in the analytical methodologies available for bioanalysis. In this context, it is worth to mention the use of such techniques to develop enantioselective methodologies, allowing the quantification of the enantiomers of drugs administered as racemates. Therefore, we proposed the development and validation of enantioselective methodologies for the analysis of the enantiomers of mirtazapine (MRT) and of its main metabolites in plasma and urine, using the CE and LC-MS-MS. Solid phase microextraction (SPME) and liquid phase microextraction (LPME) were used for sample preparation. In the first method, LPME was used to extract the analytes from plasma samples (1 ml), previously diluted, alkalinized with 3.0 mL 0.5 mol L-1 pH 8 phosphate buffer solution and supplemented with 15% (w/v) sodium chloride. N-hexyl ether and 0.01 mol L-1 acetic acid solution were used as solvent extractor and acceptor phase, respectively. The analyses were carried out on a CHIRALPAK AD-RH column and acetonitrile: methanol: ethanol (98:1:1, v / v / v) plus 0.2% of diethylamine was used as mobile phase, at a flow rate of 1 mL min-1. The detection was performed by LC-MS-MS equipped with a triple-quadrupole analyzer and ionization by eletrospray positive. Under these conditions, recoveries were from 18.3 to 45.5%; linear response over the 1,25-125 ng ml-1 concentration range and limit of quantification (LOQ) of 1.25 ng ml-1 for all enantiomers evaluated were obtained. CE and LPME were also used for the analysis of MRT and its main metabolites in urine. Before the extraction, urine samples (1 mL) were submitted to enzymatic hydrolysis at 37 ºC for 16 hours, the enzyme was precipitated with trichloroacetic acid, the pH was adjusted to 8 with 0.5 mol L-1 phosphate buffer solution (pH 11) and 10% (w/v) sodium chloride was further added. Then, the LPME extraction was performed according to the procedure previously developed. The electrophoretic analyses were carried out in 50 mmol L-1 phosphate buffer solution (pH 2.5) containing 0.55% (w/v) carboxymethyl-b-cyclodextrin (CM-b-CD). The method was linear over the concentration range of 62.5-2500 ng mL-1 for each MRT and 8-OHM enantiomer and 62.5-1250 ng mL-1 for each DMR enantiomer. The quantification limit (LOQ) was 62.5 ng mL-1 for all the enantiomers. A SPME method was also developed for the simultaneous enantioselective determination of MRT and its metabolites in urine using CE and LC-MS-MS. The target analytes were transferred from the hydrolyzed aqueous solution to the polydimetylsiloxane-divinylbenzene (PMDS-DVB) fiber coating and then desorbed in methanol. The means recoveries were 12 % for the enantiomers of MRT, 3.8 % for DMR and 0.72 % for 8-OHM. The method was linear over the concentration range of 62.5-2500 ng mL-1 with suitable LOQ (62.5 ng mL-1) for all the enantiomers. The precision and accuracy were lower than 15% for all developed methods. Moreover, the methods were successfully employed for the determination of MRT, 8-OHM and DMR enantiomers in plasma and urine samples obtained after oral administration of a single dose of rac-MRT to healthy volunteers.

O crescente interesse na avaliação da estereosseletividade na farmacocinética e farmacodinâmica de fármacos quirais, visando estabelecer as vantagens na produção de fármacos estereoquimicamente puros, tem levado ao desenvolvimento de métodos de análises com baixos limites de quantificação, seletividade e reprodutibilidade compatíveis com sua utilização em estudos de disposição cinética. Nesse contexto, um método empregando a cromatografia líquida de alta eficiência (HPLC) foi desenvolvido para a análise enantiosseletiva da mirtazapina em plasma humano. A mirtazapina foi selecionada para esse estudo por ser um novo antidepressivo, com propriedades farmacocinéticas e farmacodinâmicas estereosseletivas e em razão da carência de metodologia adequada para a quantificação individual dos seus enantiômeros. O procedimento de preparação das amostras envolveu tanto a extração líquido-líquido (LLE) quanto uma nova técnica de microextração em fase líquida empregando fibra cilíndrica microporosa de polipropileno (LPME), ambas usando tolueno como solvente de extração, seguido de análise cromatográfica, com detecção por absorção no UV, em 292 nm. A separação cromatográfica das formas (+)-(S)- e (-)-(R)- mirtazapina foi obtida em uma coluna Chiralpak AD protegida por coluna de guarda CN, usando hexano:etanol (98:2, v/v) + 0,1% de dietilamina como fase móvel. A recuperação média dos enantiômeros da mirtazapina empregando a LLE (96%) foi superior à obtida com a LPME (29%); apesar disso, os limites de quantificação foram muito próximos, isto é, 5,0 ng mL-1 para a LLE e 6,25 ng mL-1 para a LPME. Nos estudos de precisão e exatidão, os coeficientes de variação e erros relativos foram inferiores a 15% para todas as amostras avaliadas, empregando ambas as técnicas. O método de microextração baseado na LPME provou ser mais econômico e menos poluente e tão rápido, sensível e reprodutível quanto a LLE. As duas técnicas de preparação de amostras provaram ser adequadas e compatíveis para sua aplicações em estudos de disposição cinética. / The increased interest in enantioselective pharmacokinetic and pharmacodynamic properties of chiral drugs, aiming to establish the advantages in the production of estereochemically pure drugs, has led to the development of methods of analysis with low limits of quantification, selectivity and reproducibility, which are suitable to be used in kinetic disposition studies. On this basis, mirtazapine, a new antidepressant with estereoselective pharmacokinetic and pharmacodynamic properties but with few suitable methodologies for the separation and quantification of its enantiomers, was selected to evaluate two techniques of sample preparation. The procedure involved a classic liquid-liquid extraction and a new technique of liquid-phase microextraction using microporous polypropylene hollow fiber, both using toluene as extraction solvent. The analyses were carried out by high-performance liquid chromatography using chiral stationary phase and UV detection, at 292 nm. The chromatographic separation of (+)-(S)- e (-)-(R)- mirtazapine was performed on a Chiralpak AD column protected by a CN guard column, using hexane:ethanol (98:2, v/v) + 0.1% diethylamine as mobile phase. The mean recovery of mirtazapine enantiomers using LLE (96%) was higher than LPME (29%); in spite of this, the quantification limits have been very close, i.e, 5.0 ng mL-1 for LLE and 6.25 ng mL-1 for LPME. In precision and accuracy studies, coefficients of variation and relative errors were below 15% for all the evaluated samples in both LLE and LPME techniques. The microextraction method based on LPME proved to be more economic and less pollutant than LLE and as fast, sensible and reproducible as LLE. The two techniques of sample preparation have proved to be suitable for their application in kinetic disposition studies.

A necessidade de metodologias adequadas para análise de fármacos e seus metabólitos em matrizes biológicas complexas levaram a um crescente interesse no desenvolvimento de novas técnicas de preparação de amostras, particularmente as técnicas de microextração, por serem altamente seletivas e requererem o consumo mínimo de solventes orgânicos. Aliado a esses avanços, o emprego de modernas e eficientes tecnologias analíticas, como a eletroforese capilar (CE) e a cromatografia líquida de alta eficiência acoplada à espectrometria de massas (LC-MS-MS), tem resultado em um considerável avanço em qualidade nas metodologias analíticas disponíveis para bioanálises. Dentro desse cenário, destaca-se a utilização dessas técnicas para o desenvolvimento de metodologias enantiosseletivas, permitindo quantificar os enantiômeros de fármacos administrados como racematos. Sendo assim, propusemos o desenvolvimento e a validação de metodologias enantiosseletivas para a análise dos enantiômeros da mirtazapina (MRT) e de seus principais metabólitos em plasma e urina, utilizando a CE e a LC-MS-MS. Para a preparação das amostras foram empregadas a microextração em fase sólida (SPME) e a microextração em fase líquida (LPME). No primeiro método desenvolvido, a LPME foi utilizada para extrair os analitos das amostras de plasma (1 mL), previamente diluídas, alcalinizadas com 3,0 mL de uma solução tampão fosfato 0,5 mol L-1 (pH 8) e adicionadas de 15% (m/v) de cloreto de sódio. Éter n-hexílico e uma solução de ácido acético 0,01 moL L-1 foram utilizados como solvente extrator e fase aceptora, respectivamente. As análises cromatográficas foram feitas em uma coluna Chiralpak AD-RH, empregando acetonitrila:metanol:etanol (98:1:1, v/v/v) mais 0,2% de dietilamina como fase móvel, na vazão de 1 mL min-1. A detecção dos analitos foi conduzida por LC-MS-MS usando um analisador triplo-quadrupolo e ionização por eletrospray positivo. Nessas condições, foram obtidas recuperações de 18,3 a 45,5%, resposta linear na faixa de concentração de 1,25-125 ng mL-1 e limite de quantificação (LQ) de 1,25 ng mL-1 para todos os enantiômeros avaliados. Posteriormente, a CE e a LPME foram utilizadas para a análise da MRT e seus principais metabólitos em urina. Antes da extração, amostras de urina (1 mL) foram submetidas a hidrólise enzimática a 37 ºC por 16 horas. Então, a enzima foi precipitada com ácido tricloroacético, o pH foi ajustado para 8 com uma solução tampão fosfato 0,5 mol L-1 (pH 11) e 10% de NaCl também foi adicionado. Em seguida as amostras foram submetidas a extração de forma similar aquela realizada para as amostras de plasma. As análises eletroforéticas foram obtidas em uma solução tampão fosfato 50 mmol L-1 (pH 2,5) contendo 0,55% (m/v) de carboximetil-b-ciclodextrina (CM-b-CD). O método foi linear na faixa de concentração de 62,5-2500 ng mL-1 para cada enantiômero da MRT e 8-hidroximirtazapina (8-OHM) e 62,5-1250 ng mL-1 para cada enantiômero da desmetilmirtazapina (DMR). O LQ foi 62,5 ng mL-1 para todos os enantiômeros. A SPME também foi utilizada no desenvolvimento de um método para a determinação simultânea do fármaco e seus metabólitos em urina usando CE e LC-MS-MS. Os analitos de interesse foram transferidos da solução aquosa hidrolisada para uma fibra de polidimetilsiloxano-divinilbenzeno (PMDS-DVB) e então foram desorvidos em metanol. As recuperações médias foram de 12 % para os enantiômeros da MRT, 3,8 % para a DMR e 0,72 % para a 8-OHM. O método foi linear na faixa de concentração de 62,5-2500 ng mL-1 com adequado LQ (62,5 ng mL-1) para todos os enantiômeros. A precisão e exatidão foram menores que 15% para todos os métodos desenvolvidos. Além disso, os métodos foram adequadamente aplicados em estudos preliminares de determinação dos enantiômeros da MRT, 8-OHM e DMR em amostras de plasma e urina obtidos após a administração oral de uma dose única de rac-MRT a voluntários sadios. / The need for appropriate methodology for the analysis of drugs and their metabolites in complex biological matrices led to a growing interest in developing new techniques for sample preparation, particularly microextraction techniques because they are highly selective and require a minimum consumption of organic solvents. Allied to these developments, the employment of modern and efficient analytical technologies, such as capillary electrophoresis (CE) and high-performance liquid chromatography coupled to mass spectrometry (LC-MS-MS), has resulted in a considerable improvement in quality in the analytical methodologies available for bioanalysis. In this context, it is worth to mention the use of such techniques to develop enantioselective methodologies, allowing the quantification of the enantiomers of drugs administered as racemates. Therefore, we proposed the development and validation of enantioselective methodologies for the analysis of the enantiomers of mirtazapine (MRT) and of its main metabolites in plasma and urine, using the CE and LC-MS-MS. Solid phase microextraction (SPME) and liquid phase microextraction (LPME) were used for sample preparation. In the first method, LPME was used to extract the analytes from plasma samples (1 ml), previously diluted, alkalinized with 3.0 mL 0.5 mol L-1 pH 8 phosphate buffer solution and supplemented with 15% (w/v) sodium chloride. N-hexyl ether and 0.01 mol L-1 acetic acid solution were used as solvent extractor and acceptor phase, respectively. The analyses were carried out on a CHIRALPAK AD-RH column and acetonitrile: methanol: ethanol (98:1:1, v / v / v) plus 0.2% of diethylamine was used as mobile phase, at a flow rate of 1 mL min-1. The detection was performed by LC-MS-MS equipped with a triple-quadrupole analyzer and ionization by eletrospray positive. Under these conditions, recoveries were from 18.3 to 45.5%; linear response over the 1,25-125 ng ml-1 concentration range and limit of quantification (LOQ) of 1.25 ng ml-1 for all enantiomers evaluated were obtained. CE and LPME were also used for the analysis of MRT and its main metabolites in urine. Before the extraction, urine samples (1 mL) were submitted to enzymatic hydrolysis at 37 ºC for 16 hours, the enzyme was precipitated with trichloroacetic acid, the pH was adjusted to 8 with 0.5 mol L-1 phosphate buffer solution (pH 11) and 10% (w/v) sodium chloride was further added. Then, the LPME extraction was performed according to the procedure previously developed. The electrophoretic analyses were carried out in 50 mmol L-1 phosphate buffer solution (pH 2.5) containing 0.55% (w/v) carboxymethyl-b-cyclodextrin (CM-b-CD). The method was linear over the concentration range of 62.5-2500 ng mL-1 for each MRT and 8-OHM enantiomer and 62.5-1250 ng mL-1 for each DMR enantiomer. The quantification limit (LOQ) was 62.5 ng mL-1 for all the enantiomers. A SPME method was also developed for the simultaneous enantioselective determination of MRT and its metabolites in urine using CE and LC-MS-MS. The target analytes were transferred from the hydrolyzed aqueous solution to the polydimetylsiloxane-divinylbenzene (PMDS-DVB) fiber coating and then desorbed in methanol. The means recoveries were 12 % for the enantiomers of MRT, 3.8 % for DMR and 0.72 % for 8-OHM. The method was linear over the concentration range of 62.5-2500 ng mL-1 with suitable LOQ (62.5 ng mL-1) for all the enantiomers. The precision and accuracy were lower than 15% for all developed methods. Moreover, the methods were successfully employed for the determination of MRT, 8-OHM and DMR enantiomers in plasma and urine samples obtained after oral administration of a single dose of rac-MRT to healthy volunteers.

Research in the field of molecular neuroscience contributes a better perception of the events that trigger neurodegeneration. At the forefront of this work is the study of intracellular calcium as a consequence of mitochondrial dumping and NMDA receptor activation by glutamate. Increased intracellular calcium presages excitotoxicity with ultimate apoptosis of the cell. Among the many disorders involving this sequence is depression, a disorder that in and of itself is a risk factor for neurodegenerative disorders such as Alzheimer disease. The successful use of anti-depressants to alleviate the depressive state leads to the question about whether these pharmacological agents, as part of their effect to ameliorate depression, might have an effect on intracellular calcium. Until now, this has not been explored directly but such exploration was initiated with this thesis. As a model for astrocytes and neurons, two cell lines, C6 and SH-SY5Y were used. These were differentiated with all-trans retinoic acid into astrocyte-like and neuron-like cells. Graphic imaging of intracellular calcium by ratiometrics is not new, but what is new is using this technique to evaluate the effect of the antidepressants mirtazapine and citalopram on intracellular calcium fluxes induced by glutamate. Furthermore, comparing the ratiometric intracellular calcium flux in the presence of mirtazapine and citalopram to that of known NMDA blockers was also done for the first time. Also studied were the acute and chronic effects of mirtazapine and citalopram on cell viability. The antidepressant agents, mirtazapine and citalopram, were chosen for this study. Mirtazapine blocks the adrenergic and serotonergic inhibitory autoreceptors which results in the increased release of these neurotransmitters and increases their concentration in the synapse. And it also has been shown to have an anti-oxidant and a calcium modulatory effect. Citalopram has the highest degree of serotonin reuptake selectivity of all the selective serotonin reuptake inhibitors. The ratiometric studies found that mirtazapine and citalopram reduce the effect of glutamate-induced increase in relative [Ca2+]i by either a direct or indirect action on NMDA receptors. This effect is not similar to the NMDA blockers memantine and AP5. The supporting evidence is that CCCP, which normally releases calcium from mitochondria, has no effect in cells treated with acute mirtazapine or citalopram. This indicates that no calcium entered the cell – and subsequently none was taken up by mitochondria – in response to glutamate. However, these observations were with a limited number of cells and, therefore, these results will have to be verified by different techniques by different laboratories. In microplate studies, all drugs studied reduced cell viability but the mechanism behind this reduced viability remains to be determined. This may be due to mutations in enzymatic expression, uptake of drug through the cell membrane, or other perturbations. The reduction in cell viability induced by acute glutamate was attenuated by pretreatment with mirtazapine or citalopram. Moreover, chronic treatment of the cells with mirtazapine or citalopram for 10 weeks before acute treatment with glutamate either attenuated the effect on viability or reversed it. Based on this present study, mirtazapine and citalopram may be useful as neuroprotective agents to alleviate not only depression but also to reduce cell death in neurodegenerative diseases, trauma and stroke.

The effects of the antidepressant mirtazapine on cytosolic Ca2+ concentrations ([Ca2+]i) in human prostate cancer PC3 cells and human osteosarcoma MG63 cells were measured by Ca2+-sensitive fluorescent probe fura-2. In Ca2+-containing medium, mirtazapine induced [Ca2+]i rises in a concentration-dependent manner in both PC3 and MG63 cells. Removal of extracellular Ca2+ inhibited the mirtazapine-induced Ca2+ signal. In Ca2+-free medium, thapsigargin (an inhibitor of the endoplasmic reticulum Ca2+-ATPase pump) induced [Ca2+]i rises by passively depleting the endoplasmic reticulum Ca2+ store, after which the increasing effect of mirtazapine (1.5 mM) on [Ca2+]i was reduced. Conversely, pretreatment with mirtazapine decreased thapsigargin-induced [Ca2+]i rises in PC3 and MG63 cells. When PC3 cells were pretreated with U73122, a phospholipase C inhibitor, mirtazapine-induced [Ca2+]i rises were inhibited by 47%. But in MG63 cells, 2 mM U73122 did not change mirtazapine-induced [Ca2+]i rises. These finding suggest that mirtazapine-induced [Ca2+]i rises were caused both by extracellular Ca2+ influx and intracellular depletion of the endoplasmic reticulum Ca2+ stores. Furthermore, the mechanism of mirtazapine-induced Ca2+ release may be different between PC3 and MG63 cells. Additionally, cell proliferation assays suggest that overnight incubation with higher concentrations of mirtazapine decreased cell viability in a concentration-dependent manner.

Depression is commonly associated with abnormal sleep architecture. This thesis undertook to assess sleep architecture as a biological correlate of self and observer-rated depressive state, and consists of three studies. The first used a categorical approach to examine the association of sleep architecture with subjective mood in a community sample of 74 preoperative patients, and found no association between high depression scores and hypothesized sleep markers. The second followed 16 patients with Major Depression who were treated with the antidepressant mirtazapine in an 8 week longitudinal study during which they underwent polysomnography on 6 occasions. It was found that classes of sleep markers (REM latency or REM, arousal index, and slow wave sleep) tend to predict response when analyzed concurrently. The third study was methodological in nature, and found that commercially available software for automating eye movement counts did not show strong correspondence with visually scored polysomnographic data.

Depression is commonly associated with abnormal sleep architecture. This thesis undertook to assess sleep architecture as a biological correlate of self and observer-rated depressive state, and consists of three studies. The first used a categorical approach to examine the association of sleep architecture with subjective mood in a community sample of 74 preoperative patients, and found no association between high depression scores and hypothesized sleep markers. The second followed 16 patients with Major Depression who were treated with the antidepressant mirtazapine in an 8 week longitudinal study during which they underwent polysomnography on 6 occasions. It was found that classes of sleep markers (REM latency or REM, arousal index, and slow wave sleep) tend to predict response when analyzed concurrently. The third study was methodological in nature, and found that commercially available software for automating eye movement counts did not show strong correspondence with visually scored polysomnographic data.

In der Pathophysiologie der Depression könnte das Zusammenspiel von Immun- und Nervensystem eine zentrale Rolle spielen. In den Krankheitsepisoden zeigen depressive Patienten eine gesteigerte Produktion pro-inflammatorischer Zytokine wie z. B. Interleukin (IL)-1β und dem Tumornekrosefaktor (TNF)-α. Es gibt nur begrenzte Informationen bezüglich der Effekte von Antidepressiva auf Zytokine. Die meisten Studien berichten nur über die Veränderungen einzelner Zytokine und keine hat bis jetzt über Effekte von Antidepressiva auf IL-22 berichtet. Wir haben systematisch die Wirkung von drei Antidepressiva, nämlich Citalopram, Escitalopram und Mirtazapin auf die Sekretion der Zytokine IL-1β, IL-2, IL-4, IL-6, IL-17, IL-22 und TNF-α in einem Vollblutverfahren in-vitro untersucht. Als Immunstimulanzien wurden der gegen humanes CD3 gerichtete monoklonale Antikörper OKT3 und der gegen CD40 gerichtete monoklonale Antikörper 5C3 verwendet. Es zeigte sich, dass es unter Citalopram zu einer erhöhten IL-1β, I-6, IL-22 und TNF-α-Produktion und unter Mirtazapin zu einer erhöhten Produktion von IL-1β, IL-22 und TNF-α gegenüber der Kontrollbedingung, in der keine Antidepressiva zugesetzt wurden, kam. Unter Escitalopram kam es zu einer gegenüber der Kontrollbedingung verringerten IL-17-Produktion. Der Einfluss der Antidepressiva auf IL-2 und IL-4 war für alle drei Psychopharmaka nicht signifikant. Verglichen mit Escitalopram führte Citalopram zu höheren IL-1β-, IL-6-, IL-17- und IL-22-Konzentrationen und Mirtazapin führte zu einer höheren IL-1β-, IL-17-, IL-22- und TNF-α-Produktion. Möglicherweise besteht ein Bezug zwischen dem Profil der Zytokinproduktion eines Antidepressivums und seinen therapeutischen Effekten, Nebenwirkungen und seinem Rückfallrisiko. Zur Überprüfung dieser Hypothese sind jedoch in-vivo Studien notwendig. / The interplay between immune and nervous systems plays a pivotal role in the pathophysiology of depression. In depressive episodes, patients show increased production of pro-inflammatory cytokines such as interleukin (IL)-1β and tumor necrosis factor (TNF)-α. There is limited information on the effect of antidepressant drugs on cytokines, most studies report on a limited sample of cytokines and none have reported effects on IL-22. We systematically investigated the effect of three antidepressant drugs, citalopram, escitalopram and mirtazapine, on secretion of cytokines IL-1β, IL-2, IL-4, IL-6, IL-17, IL-22 and TNF-α in a whole blood assay in vitro, using murine anti-human CD3 monoclonal antibody OKT3, and 5C3 monoclonal antibody against CD40, to stimulate T and B cells respectively.Citalopram increased production of IL-1β, IL-6, TNF-α and IL-22. Mirtazapine increased IL-1β, TNF-α and IL-22. Escitalopram decreased IL-17 levels. The influence of antidepressants on IL-2 and IL-4 levels was not significant for all three drugs. Compared to escitalopram, citalopram led to higher levels of IL-1β, IL-6, IL-17 and IL-22; and mirtazapine to higher levels of IL-1β, IL-17, IL-22 and TNF-α. Mirtazapine and citalopram increased IL-22 production. The differing profile of cytokine production may relate to differences in therapeutic effects, risk of relapse and side effects.

ithium is an important psychopharmacologi- cal agent for the treatment of unipolar as well as bipolar affective disorders. Lithium has a number of side effects such as hypothyroidism and aggravation of psoriasis. On the other hand, lithium has pro-inflammatory effects, which appear beneficial in some disorders associated with immunological deficits, such as human immunodeficiency virus (HIV) infection and systemic lupus erythematosus (SLE). Therefore, immunological characteristics of lithium may be an important consideration in individualized ther- apeutic decisions. We measured the levels of the cytokines interleukin (IL)-1ß, IL-2, IL-4, IL-6, IL-22, IL-17 and tumour necrosis factor (TNF)-a in the stimulated blood of thirty healthy subjects supplemented with lithium alone, the antidepressants citalopram, escitalopram or mirtazapine alone, the combination of each antidepressant with lithium, and a no drug control. These drugs were tested under three blood stimulant conditions: murine anti-human CD3 monoclonal antibody OKT3 and the 5C3 monoclonal antibody (OKT3/5C3), phytohemagglutinin (PHA), and unstimulated blood. Lithium, alone and in combination with any of the tested antidepressants, led to a consistent increase of IL-1ß, IL-6 and TNF-a levels in the unstimulated as well as the stimulated blood. In the OKT3/ 5C3- and PHA-stimulated blood, IL-17 production was significantly enhanced by lithium. Lithium additionally increased IL-2 concentrations significantly in PHA-stimu- lated blood. The data support the view that lithium has pro- inflammatory properties. These immunological character- istics may contribute to side effects of lithium, but may also explain its beneficial effects in patients suffering from HIV infection or SLE.