Abstract

Major depressive disorder is the most prevalent mental illness worldwide, still its pharmacological treatment is limited by various challenges, such as the large heterogeneity in treatment response and the lack of insight into the neurobiological pathways underlying this phenomenon. To decode the molecular mechanisms shaping antidepressant response and to distinguish those from general paroxetine effects, we used a previously established approach targeting extremes (i.e., good vs poor responder mice). We focused on the dentate gyrus (DG), a subregion of major interest in the context of antidepressant mechanisms. Transcriptome profiling on micro-dissected DG granule cells was performed to (i) reveal cell-type-specific changes in paroxetine-induced gene expression (paroxetine vs vehicle) and (ii) to identify molecular signatures of treatment response within a cohort of paroxetine-treated animals. We identified 112 differentially expressed genes associated with paroxetine treatment. The extreme group comparison (good vs poor responder) yielded 211 differentially expressed genes. General paroxetine effects could be distinguished from treatment response-associated molecular signatures, with a differential gene expression overlap of only 4.6% (15 genes). Biological pathway enrichment and cluster analyses identified candidate mechanisms associated with good treatment response, e.g., neuropeptide signaling, synaptic transmission, calcium signaling, and regulation of glucocorticoid secretion. Finally, we examined glucocorticoid receptor (GR)-dependent regulation of selected response-associated genes to analyze a hypothesized interplay between GR signaling and good antidepressant treatment response. Among the most promising candidates, we suggest potential targets such as the developmental gene Otx2 or Htr2c for further investigations into antidepressant treatment response in the future.

Highlights

  • Pharmacological treatment of major depressive disorder (MDD), the most prevalent mental illness worldwide with a still increasing burden of disease on Western societies[1], faces several major drawbacks

  • We confirmed the specificity of dentate gyrus (DG) dissection by quantitative polymerase chain reaction (qPCR) of the DG-specific gene TDO2 and the Cornu ammonis-specific gene Lphn[2] (Fig. S2)

  • Using RNAseq analysis of DG tissue comparing paroxetine- and vehicletreated animals, we revealed 91 upregulated differentially expressed genes (DEGs) and 21 downregulated DEGs (Fig. 2A)

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Summary

Introduction

Pharmacological treatment of major depressive disorder (MDD), the most prevalent mental illness worldwide with a still increasing burden of disease on Western societies[1], faces several major drawbacks. The large heterogeneity of antidepressant treatment response leaves >30% of the patients without full remission of symptoms[2,3]. We still lack clinically useful biomarkers that could either improve diagnostic accuracy, monitor disease state, or predict antidepressant response[4]. A well-recognized shortcoming of currently available antidepressants is that significant difference from placebo can only be identified reliably some 6 weeks after initiating treatment, leading to “trial and error” approaches for each individual treatment decision[5]. The neurobiological pathways that drive antidepressant response, in contrast to the average pharmacological drug effects, are far from being understood. Improving our knowledge about the neurobiological mechanisms shaping individual response to Herzog et al Translational Psychiatry (2021)11:4 antidepressants could open up the opportunity to characterize putative novel targets mediating a more rapid onset of action

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