5-HT2B Receptors Are Required for Serotonin-Selective Antidepressant
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Molecular Psychiatry (2012) 17, 154–163 & 2012 Macmillan Publishers Limited All rights reserved 1359-4184/12 www.nature.com/mp IMMEDIATE COMMUNICATION 5-HT2B receptors are required for serotonin-selective antidepressant actions SL Diaz1,2,3, S Doly1,2,3, N Narboux-Neˆme1,2,3, S Ferna´ndez1,2,3, P Mazot1,2,3, SM Banas1,2,3, K Boutourlinsky1,2,3, I Moutkine1,2,3, A Belmer1,2,3, A Roumier1,2,3 and L Maroteaux1,2,3 1UMR-S839 INSERM, Paris, France; 2Universite´ Pierre et Marie Curie, Paris, France and 3Institut du Fer a` Moulin, Paris, France The therapeutic effects induced by serotonin-selective reuptake inhibitor (SSRI) antidepres- sants are initially triggered by blocking the serotonin transporter and rely on long-term adaptations of pre- and post-synaptic receptors. We show here that long-term behavioral and neurogenic SSRI effects are abolished after either genetic or pharmacological inactivation of 5-HT2B receptors. Conversely, direct agonist stimulation of 5-HT2B receptors induces an SSRI-like response in behavioral and neurogenic assays. Moreover, the observation that (i) this receptor is expressed by raphe serotonergic neurons, (ii) the SSRI-induced increase in hippocampal extracellular serotonin concentration is strongly reduced in the absence of functional 5-HT2B receptors and (iii) a selective 5-HT2B agonist mimics SSRI responses, supports a positive regulation of serotonergic neurons by 5-HT2B receptors. The 5-HT2B receptor appears, therefore, to positively modulate serotonergic activity and to be required for the therapeutic actions of SSRIs. Consequently, the 5-HT2B receptor should be considered as a new tractable target in the combat against depression. Molecular Psychiatry (2012) 17, 154–163; doi:10.1038/mp.2011.159; published online 13 December 2011 Keywords: serotonin levels; 5-HT2B receptors; antidepressants; neurogenesis 11 Introduction lacking 5-HT2B receptors. Conversely, a 5-HT2B receptor agonist induced an antidepressant-like The most widely used antidepressants, the serotonin- action in the FST, suggesting that this receptor is selective reuptake inhibitors (SSRIs), induce an required for acute SSRI effects and might modulate increase in extracellular serotonin (5-hydroxytrypta- serotonergic tone. mine, 5-HT) concentrations by acutely blocking the 1,2 Blockage of SERT and increase of 5-HT levels are specific serotonin transporter (SERT). The SERT immediately attained after SSRI administration, regulates the extracellular serotonin concentration by 3 whereas therapeutic effects are only observed after removing 5-HT from the synaptic cleft, and diverse weeks of treatment. The delay before the onset of molecules modulate this activity, including the A3 clinical effects in depressive individuals appears to adenosine receptor4 and kinases such as PKG/p38 5 rely on the time required for stabilization of mono- mitogen-activated protein kinase. Previous studies amine levels and other neuroadaptations, including have suggested a functional interaction between neurogenesis.12 As well, regulation of 5-HT receptors SERT and the 5-HT2B receptor—a receptor implicated appears to be required for either the acute or chronic in 5-HT-dependent phenotypes, including impulsiv- 6 effects of SSRIs, as it was largely demonstrated ity, aggressivity and suicidality. Ex vivo studies have 12–16 for 5-HT1A, 5-HT2A, 5-HT2C and 5-HT4 receptors. indicated that 5-HT2B receptors might participate in 7 Importantly, < 50% of all patients with depression the control of SERT in raphe neurons, while in vivo show remission with optimized available antidepres- studies further confirmed that 5-HT2B receptors sant treatments.1 Despite extensive research, the contribute to the behavioral and physiological effects neurobiological mechanisms underlying antidepres- of the SERT-targeting 5-HT releasers, MDMA (the 8–10 sant effects or the resistance to antidepressants are club-drug ecstasy) and dexfenfluramine. Further- not yet well understood.17,18 Therefore, we studied more, we recently reported that the acute response to the chronic actions of SSRIs in behavioral and SSRIs in the forced swimming test (FST), a classical neurogenic assays, and SSRI-induced alterations in test for antidepressant activity, is absent in mice synaptic 5-HT levels in mice with genetic or pharma- cological ablation of 5-HT2B receptors, and demon- Correspondence: Dr L Maroteaux, Institut du Fer a` Moulin, UMR- strate herein that 5-HT2B receptors are required for S839 INSERM/UPMC, 17 rue du Fer a` Moulin, 75005 Paris. SSRI antidepressant acute and long-term effects, E-mail: [email protected] Received 8 June 2011; revised 5 October 2011; accepted 24 possibly by presynaptic modulation of extracellular October 2011; published online 13 December 2011 5-HT levels. 5-HT2B receptors in antidepressant responses SL Diaz et al 155 Materials and methods laboratory.8–10 All measurements were obtained from freely moving mice following injections of RS127445 Animals (0.5 mg kgÀ1, i.p.) and/or paroxetine (2 mg kgÀ1, i.p.) The 5-HTÀ/À mice used in all experiments are in a 2B (see supplementary Information). 129S2/SvPas (129S2) background,19 while SERTÀ/À and Pet-1À/À mice are on C57Bl/6NCrl background.20,21 À/À À/À Single-cell RT-PCR Adult (7–9-week-old) male 5-HT2B , SERT and Pet-1À/À mice, and their respective wild-type (WT) Pet-1-EGFP mice, generated from a cross of Pet-1- 23 24 control mice (originally obtained from Charles River CRE with RCE:loxP mice, were used for single-cell Laboratories, L’Arbresle, France), were derived from reverse-transcription (RT)-PCR experiments. Mice heterozygous crosses and were bred at our animal were anesthetized and decapitated, and the brain facility. All mice were maintained according to the was rapidly dissected out. Coronal slices (250 m European Directive directive 86/609/CEE. FST was thick) were prepared using a vibratome in artificial conducted as already described.22 The novelty-sup- cerebral spinal fluid supplemented with sucrose. The pressed feeding (NSF) test was basically conducted methodology involving harvesting of cytoplasmic as already described,17 with some modifications (see content and subsequent single-cell PCR amplification 25 Supplementary Information). has been described elsewhere. Chronic treatments, proliferation and survival assays, 5-HT1A receptor quantitative PCR and tissue preparation Raphe nucleus and hippocampus were dissected For all the drugs employed in this study, the lowest and homogenized in 1 ml of RNAsolv. Genomic DNA acute effective dose was selected based on our previous was removed by digestion with Amplification Grade data from WT mice.11 Fluoxetine (3 mg kgÀ1 per day in DNase I (Sigma-Aldrich, St Quentin Falavier, France). 129S2 or 10 mg kgÀ1 per day intraperitoneal (i.p.) in First-strand cDNA was synthesized by reverse trans- C57Bl6/6NCrl mice) or vehicle (0.9% NaCl) was cription of 3 mg of total RNA with Superscript-II injected once daily for 4 weeks. WT mice chronically reverse transcriptase (Invitrogen, Illkirch, France) treated with RS127445 continuously received the according to standard protocols. Reverse transcriptase À1 5-HT2B antagonist at 1 mg kg per day or vehicle (50% was omitted in some samples as negative control. dimethyl sulfoxide) via subcutaneous osmotic pumps Relative expression levels of 5-HT1A mRNA were (Alzets model 2004, L’Arbresle, France) for 4 weeks determined by real time RT-PCR using Absolute SYBR in addition to the daily i.p. injections of Flx or Veh. Green Mix (ABgene, Illkirch, France) and a set of The last day of this 4-week experimental protocol, primers specific for 5-HT1A receptor. 5-HT1A expres- mice received two injections of 150 mg kgÀ1 5-bromo- sion was normalized to mouse CyclophilinB mRNA 0 2 deoxyuridine (BrdU) (2-h interval between injections). expression. Data were analyzed with the 2–DCt Then, 24 h after BrdU administration, a pool of mice method, and values are expressed as the mean of four was perfused and the brains were recovered for cell separate experiments performed in duplicate. proliferation studies. Another pool of mice continued receiving the SSRI or vehicle for 4 more weeks after In situ hybridization BrdU administration, and was finally perfused and the Coronal sections from the same experimental subjects brains were recovered for cell survival studies. Similar used in immunohistochemistry studies were em- experimental protocols were conducted for cell prolif- ployed for in situ hybridization, which was perfor- eration induced by paroxetine (2 mg kgÀ1) or BW723C86 med as previously described26 on a pool of two (3 mg kgÀ1 per day in 129S2 or 10 mg kgÀ1 per day i.p. in coronal free-floating sections per mouse from each C57Bl6/6NCrl mice). All these drugs were injected once experimental group (WT-Veh; WT-Flx; 5-HTÀ/À-Veh daily, and at the end of the chronic treatments (24 h and 2B and 5-HTÀ/À-Flx). 5-HT (IMAGE:8861702) dig-UTP- 4 weeks after BrdU, respectively, for proliferation and 2B 1A labeled probe was used and detected using an anti- survival assays), mice were anesthetized and their body coupled to alkaline phosphatase (1/2000, Roche, brains were removed, fixed and processed for immu- Meylan, France). Alkaline phosphatase activity was nohistochemistry. See Supplementary Information. revealed using 4-nitroblue tetrazolium chloride/ Immunohistochemistry and immunofluorescence 5-bromo 4-chloro 3-indolyl phosphate. Newborn cells were detected by classical peroxidase immunostaining of BrdU, an exogenous marker of cell 8-OH-DPAT-induced hypothermia