Abstract

Suicide is the most severe consequence of depression which has become a leading cause of disability and a global disease burden. Recent evidence indicates a central role of small molecules in the pathogenesis of depression and associated suicidal behaviors. However, there lacks a systemic exploration of small molecules in the development of depression-associated suicide, and it remains unclear how they affect an individual’s behavior. In order to compare the metabonomic profiles between drug-naïve patients with depression-associated suicidal behaviors and healthy individuals, we conducted a systemic database search for studies of metabolic characteristics in depression-associated suicidal behavior. Manual data curation and statistical analysis and integration were performed in Excel. We further performed an enrichment analysis of signaling pathway prediction using the Reactome Pathway Analysis tool. We have identified 17 metabolites that expressed differently between drug-naïve patients with depression-associated suicidal behaviors and healthy controls. We have integrated these metabolites into biological signaling pathways and provided a visualized signaling network in depressed suicidal patients. We have revealed that “transport of small molecules”, “disease”, “metabolism” and “metabolism of proteins” were the most relevant signaling sections, among which “transport of inorganic cations/anions and amino acids/oligopeptides”, “SLC-mediated transmembrane transport”, and “metabolism of amino acids and derivatives” should be further studied to elucidate their potential pathogenic mechanism in the development of depression and associated suicidal behavior. In conclusion, our findings of these 17 metabolites and associated signaling pathways could provide an insight into the molecular pathogenesis of depression-associated suicidal behavior and potential targets for new drug inventions.

Highlights

  • Depression is a common mental disease that affects approximately 350 million individuals globally [1]

  • 17 metabolites were found differentially expressed between depressed suicide attempters and healthy controls

  • An initial purpose of this study was to identify all metabolites that expressed significantly different between drug-naïve depression patients with suicidal behavior and healthy population, according to current metabonomic studies

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Summary

Introduction

Depression is a common mental disease that affects approximately 350 million individuals globally [1]. Depression has become one of leading causes of disability and global disease burdens [3]. Suicide is the most severe consequence of depression [4], of which the incidence is estimated around 2~9% among depressed patients [5]. Some consider the number to be far underestimated because suicidal ideation, plans or attempts have not been fully included [6]. The prevalence of depression in physicians [7, 8] and the risk of depressionassociated suicide in physicians [9,10,11] are considerably higher than those in the ordinary population

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