Major Depressive Disorder and Anxiety Disorders from the Glial Perspective: T Etiological Mechanisms, Intervention and Monitoring ⁎ Mari Silda,B, Edward S
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Neuroscience and Biobehavioral Reviews 83 (2017) 474–488 Contents lists available at ScienceDirect Neuroscience and Biobehavioral Reviews journal homepage: www.elsevier.com/locate/neubiorev Review article Major depressive disorder and anxiety disorders from the glial perspective: T Etiological mechanisms, intervention and monitoring ⁎ Mari Silda,b, Edward S. Ruthazerc, Linda Booija,b,d, a Concordia University, 7141 Sherbrooke St W., H4B 1R6 Montreal, Québec, Canada b Sainte-Justine Hospital Research Center, 3175 Côte-Sainte-Catherine, H3T 1C5 Montreal, Québec, Canada c Montreal Neurological Institute, McGill University, 3801 University St., H3A 2B4 Montreal, Québec, Canada d Department of Psychiatry, McGill University, 1033 Pine Avenue W., H3A 1A1 Montreal, Québec, Canada ARTICLE INFO ABSTRACT Keywords: Despite intense ongoing research efforts, the etiology of psychiatric disorders remains incompletely understood. Glia Among biological factors playing a role in Major Depressive Disorder (MDD) and Anxiety Disorders (ANX), Major depressive disorder emerging evidence points to the relevance of different types of glia cells and efficient neuron-glia interactions. Anxiety disorders Here, we review recent findings highlighting the involvement of central nervous system (CNS) glia in MDD and Early trauma ANX etiology and treatment response. Additionally, several relatively underexplored topics will be discussed: (1) Brain imaging glial response to non-pharmacological therapies, (2) impact of early life adversity on glia, (3) influence of Astrocyte Oligodendrocyte lifestyle factors on glia in the context of MDD and ANX, and (4) monitoring glial functions in patients. It can be Microglia concluded that despite the sequence of events is still unclear, alterations in glial cell types are common and Radial glia somewhat overlapping in ANX, MDD and corresponding animal models. Furthermore, glia are responsive to a Psychiatric disorders variety of treatment and lifestyle options. Looking forward, new research developments can lead to novel types of therapeutic or symptom-relieving approaches targeting glia. 1. Introduction over the years (Booij et al., 2015), it has also become increasingly clear that alterations in monoamine systems are not sufficient to explain the Psychiatric illnesses constitute a major disease burden in the world, full spectra of MDD and ANX phenotypes and treatment responses. with Major Depressive Disorder (MDD; all abbreviations found in In the search for underlying mechanisms, the importance of non- Table 1) being the single leading cause of time loss due to disability for neuronal cell types, most notably immune cells and glia, has been in- both males and females (Kessler et al., 2005b; World Health creasingly recognized (Di Benedetto and Rupprecht, 2013). Glia com- Organization, 2016). MDD has lifetime prevalence of around 16%, and prise several morphologically and functionally distinct cell types that this number is projected to increase (Kessler et al., 2003; Lopez et al., are found in central and peripheral nervous system and are at least as 2006; World Health Organization, 2016). Anxiety disorders (ANX) have abundant as neurons (Hilgetag and Barbas, 2009). Glia are crucially lifetime prevalence of around 28% (Kessler et al., 2005a). While MDD involved in the regulation of nervous system development (Rakic, 1971, and ANX are highly heterogeneous diagnostic categories (Nandi et al., 1972), formation of vasculature and blood-brain-barrier (BBB) 2009), they display significant comorbidity and may share some etio- (Siqueira et al., 2017), signal transmission (Baumann and Pham-Dinh, logical mechanisms (Avenevoli et al., 2001; Gorwood, 2004; Ruscio and 2001; Bunge et al., 1962; Pomeranz et al., 1968), synapse formation Khazanov, 2017). (Ango et al., 2008; Elmariah et al., 2005; Pfrieger and Barres, 1997; Sild A fundamental obstacle to treating MDD and ANX effectively has et al., 2016) and neuroplasticity (Araque et al., 1999; Panatier et al., been an incomplete understanding of the underlying biological me- 2006; Papouin et al., 2017). Such variety of functions has prompted chanisms and of exactly how drugs and other interventions work at the research of glial participation in the etiology of psychiatric disorders molecular-cellular level. The earliest evidence-based theories on MDD and as possible drug targets (Di Benedetto and Rupprecht, 2013; Manev and ANX focused on a deficit of monoamines, in particular, serotonin et al., 2003). Accumulating evidence points to glial alterations in all (Dell'osso and Lader, 2013; Hyman, 2013). While monoaminergic the- major psychiatric conditions, although schizophrenia and MDD have ories of the etiological mechanisms of these diseases have been refined received the most research attention in this context (Bernstein et al., ⁎ Corresponding author at: Concordia University, Dept. of Psychology, 7141 Sherbrooke St. West, SP 253.03, Montreal, Québec H4B 1R6, Canada. E-mail addresses: [email protected] (M. Sild), [email protected] (E.S. Ruthazer), [email protected] (L. Booij). http://dx.doi.org/10.1016/j.neubiorev.2017.09.014 Received 3 July 2017; Received in revised form 8 August 2017; Accepted 11 September 2017 Available online 14 September 2017 0149-7634/ © 2017 Elsevier Ltd. All rights reserved. M. Sild et al. Neuroscience and Biobehavioral Reviews 83 (2017) 474–488 Table 1 multiple perspectives of how glial cells may participate in the etiology Abbreviations. and treatment of MDD and ANX. This review starts with a brief introduction to central nervous Abbreviation Meaning system (CNS) glia development and subtypes, followed by an overview 5-HT 5-Hydroxytryptamine of findings of glial alterations in MDD, ANX and related animal models. ACC Anterior Cingulate Cortex Next, since exposure to early life adversity is a major risk factor for AD Antidepressant development of MDD and ANX in later life (Heim and Nemeroff, 2001; ANX Anxiety Disorders ff ATP Adenosine Triphosphate Kessler et al., 2010), a section is devoted to glial responses to di erent BBB Blood-Brain Barrier types of early life stress. We will discuss how glia are affected by BDNF Brain-Derived Neurotrophic Factor pharmacological and non-pharmacological MDD and ANX treatments CNS Central Nervous System and lifestyle factors. Some means of monitoring glial function in living EE Environmental Enrichment humans will be covered. The overarching hypothesis of this review FGF Fibroblast Growth Factor GAD Generalized Anxiety Disorder article is that glial alterations that are present in MDD and ANX may GDNF Glial Cell Line-Derived Neurotrophic Factor serve as important cues for the disease etiology and as targets for GFAP Glial Fibrillary Acidic Protein therapeutic approaches. GLAST Glutamate Aspartate Transporter GLT-1 Glutamate Transporter 1 GR Glucocorticoid Receptor 2. Overview of central nervous system glia and their functions HDAC Histone Deacetylase HDACi Histone Deacetylase Inhibitor Central nervous system (CNS) glia, which include astrocytes, oli- LPS Bacterial Lipopolysaccharide − MDD Major Depressive Disorder godendrocytes, NG2 cells, radial glia, microglia and ependymal cells mPFC Medial Prefrontal Cortex carry out a number of crucial support and regulatory functions in the NG2 Neural/Glial Antigen 2 mature CNS that are outlined in Table 2. Importantly, glia are also OCD Obsessive Compulsive Disorder critically involved in the development of the CNS from very early OD Oligodendrocyte PFC Prefrontal Cortex prenatal stages. Radial glia derive directly from the nervous system RG Radial Glia stem cells (neuroepithelial cells) and are already present when the first SAD Seasonal Affective Disorder immature neurons form in the CNS (in humans around gestational week SNRI Serotonin-Norepinephrine Reuptake Inhibitor 4) (Barry et al., 2014; Gotz and Huttner, 2005; Rakic, 1972). From there SSRI Selective Serotonin Reuptake Inhibitor on, radial glia serve as guidance substrates for neuronal migration TSPO 18 kDa Translocator Protein VEGF Vascular Endothelial Growth Factor (Rakic, 1972), direct growing axons to their target locations (Norris and VGF VGF Nerve Growth Factor Inducible Kalil, 1991; Silver et al., 1982) and induce angiogenesis (Siqueira et al., 2017) thus structurally organizing the CNS neural network. Further- more, radial glia themselves are progenitors for neurons (Kriegstein and 2015; Dallerac and Rouach, 2016; Di Benedetto and Rupprecht, 2013; Alvarez-Buylla, 2009; Noctor et al., 2001) and other glia (i.e., astro- Elsayed and Magistretti, 2015; Laskaris et al., 2016; Rajkowska and cytes, oligodendrocytes and ependymal cells) that appear slightly later Stockmeier, 2013; Rial et al., 2015; Takahashi and Sakurai, 2013; Wang in the development (Budday et al., 2015; Pinto and Gotz, 2007). In et al., 2017). contrast, microglia are not derived from radial glia but from yolk sac fi The present review focuses speci cally on glial roles in the most macrophage precursors, and enter the brain around the time of neu- common mental disorders, MDD and ANX. Furthermore, the notion that rogenesis (Ginhoux et al., 2010; Reemst et al., 2016). Deviations in glial these two psychiatric conditions are often co-morbid may imply some functions during development have already been shown to cause major commonalities in glial alterations. However, roles of glia have been neurodevelopmental diseases like lissencephaly (Wu and Wang, 2012). much less explored in ANX than in MDD. In addition to a broad over- Lissencephaly patients experience