Abstract

Treatment-resistant depression (TRD) complicates the management of major depression (MD). The underlying biology of TRD involves interplay between genetic propensity and chronic and/or early life adversity. By combining a genetic animal model of MD and post-weaning social isolation rearing (SIR), we sought to produce an animal that displays more severe depressive- and social anxiety-like manifestations resistant to standard antidepressant treatment. Flinders Sensitive Line (FSL) pups were social or isolation reared from weaning [postnatal day (PND) 21], receiving fluoxetine (FLX) from PND 63 (10 mg/kg × 14 days), and compared to Sprague Dawley (SD) controls. Depressive-, anxiety-like, and social behaviour were assessed from PND 72 in the forced swim test (FST) and social interaction test (SIT). Post-mortem cortico-hippocampal norepinephrine (NE), serotonin (5-HT), and dopamine (DA), as well as plasma interleukin 6 (IL-6), tumour necrosis factor alpha (TNF-α), corticosterone (CORT), and dopamine-beta-hydroxylase (DBH) levels were assayed. FSL rats displayed significant cortico-hippocampal monoamine disturbances, and depressive- and social anxiety-like behaviour, the latter two reversed by FLX. SIR-exposed FSL rats exhibited significant immobility in the FST and social impairment which were, respectively, worsened by or resistant to FLX. In SIR-exposed FSL rats, FLX significantly raised depleted NE and 5-HT, significantly decreased DBH and caused a large effect size increase in DA and decrease in CORT and TNF-α. Concluding, SIR-exposed FSL rats display depressive- and social anxiety-like symptoms that are resistant to, or worsened by, FLX, with reduced plasma DBH and suppressed cortico-hippocampal 5-HT, NE and DA, all variably altered by FLX. Exposure of a genetic animal model of MD to post-weaning SIR results in a more intractable depressive-like phenotype as well as changes in TRD-related biomarkers, that are resistant to traditional antidepressant treatment. Given the relative absence of validated animal models of TRD, these findings are especially promising and warrant study, especially further predictive validation.

Highlights

  • While major depression (MD) affects approximately 216–322 million people worldwide [1], up to a third are non-responsive to an antidepressant [2] with up to a half failing to reach remission [3]

  • Based on the above premise, this study aimed to develop a gene-x-environmental model of Treatment-resistant depression (TRD) by exposing Flinders Sensitive Line (FSL) rats to post-weaning social isolation rearing (SIR) and to evaluate antidepressant response in the resulting model

  • Since FSL rats are derived from the Sprague-Dawley (SD) strain, either Sprague Dawley (SD) or Flinders Resistant Line (FRL) rats are used as healthy, control animals [29]

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Summary

Introduction

While major depression (MD) affects approximately 216–322 million people worldwide [1], up to a third are non-responsive to an antidepressant [2] with up to a half failing to reach remission [3]. In such cases of treatment-resistant depression (TRD), approximately 30% remain non-responsive to treatment after several treatment interventions [4] with that number decreasing with subsequent trials [5]. Fluoxetine (FLX) is a selective serotonin reuptake inhibitor (SSRI) widely regarded as a standard-of-care treatment for MD and various anxiety disorders [15]. FLX increases serotonin (5-HT) while moderately increasing frontocortical and hypothalamic norepinephrine (NE) and dopamine (DA) [16]

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