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mTOR-Dependent Synapse Formation Underlies the Rapid Antidepressant Effects of NMDA Antagonists Nanxin Li, et al. Science 329, 959 (2010) R1 黃泰翰 V.S. 洪成志 2010.09.21 Ketamine • Antagonist of Glutamate NMDA receptor • analgesia, anesthesia, sedation • Psychological effects similar to phencyclidine (PCP) – Dissociative state – Hallucination • Schizophrenia like symptoms Behavior model of depression • Despair – Forced Swim Test (FST) – Learned hopelessness(LH) • Anxiety – Novelty-Suppressed Feeding Test (NSFT) Forced Swim Test (FST) • • • • 1st swim for 15 mins - 24 hrs later drug treatment - 24hrs later 2nd swim for 5 mins Duration of Immobility Learned-Helplessness (LH) • Inescapable footshock (IES) – 60 footshocks, – duration: 15 s, – intershock interval: 60 s • -24hrs- drug treatment -24hrs• Active avoidance testing – 30 trials of escapable footshock – duration: 35s – Number of escape failure recorded Novelty-Suppressed Feeding Test (NSFT) • • • • • food-deprived for 24hrs placed in an open field 76.5 cm X 76.5 cm X 40 cm food in the center latency to feed A Randomized Trial of an NMDA Antagonist in Treatment-Resistant Major Depression • Placebo controlled, double-blinded trial • 18 subjects with treatment refractory MDD • A single low dose of Ketamine (0.5mg/Kg) C. A. Zarate Jr. et al., Arch. Gen. Psychiatry 63, 856 (2006). Ketamine Signaling Pathway? Anti-depression effects mTOR Signaling Pathway • Mammalian target of rapamycin – Rapamycin = Sirolimus • Immunosuppresant • Ubiquitous • Protein kinase • translation regulation – S6K – 4E-BP Translation Regulation • Protein Synthesis • Translation from mRNA – Initiation, elongation, termination • Regulation – eIF (eukaryotic initiation factor) – eEF • Ribosome • S6K – S6K phosphorylates ribosomal protein S6, – component of the small, 40S ribosomal subunit. • 4E-BP – eIF4E binding protein Methods • Ketamine – intraperitoneal injection • Measurement • Synaptoneurosome in Prefrontal Cortex Ketamine (ip) induce transient, dose-dependent mTOR signaling in synaptoneurosome of PFC 10 mg/Kg 1 hr ECS Electroconvulsive seizure, imipramine, or fluoxetine did not significantly influence mTOR signaling Acute (1hr) Chronic (21D) Ketamine 4E-BP mTOR S6K mTOR and growth factor signaling pathway • MAPK/ERK cascade – Extracellular signal–regulated kinase – Mitogen-activated protein kinase – MAP3K -> MAP2K -> MAPK • Akt/PKB pathway – PI3K -> PDK -> Akt C. A. Hoeffer, E. Klann, Trends Neurosci. 33, 67 (2010) 10 mg/Kg 1 hr Ketamine transiently and dosedependently increases pERK & pAkt Pretreatment (30 mins before Ketamine): U0126 (20 nmol, ICV): inhibitors of ERK LY294002 (20 nmol, ICV): inhibitor of PI-3k/Akt Ketamine ERK, Akt 4E-BP mTOR S6K Glutamate receptor • Ionotropic Glutamate receptor – NMDA receptor – AMPA receptor – Kainate receptor • Metabotropic Glutamate receptor Antidepressant actions of ketamine & AMPA receptor • Glutamate AMPA receptor • NBQX – a selective AMPA receptor inhibitor – it attenuate the reduction in immobility time induced by ketamine – Pretreatment (10 min before Ketamine) with NBQX (10 mg/kg, ip) S. Maeng et al., Biol. Psychiatry 63, 349 (2008). NBQX blocked ketamine activation of mTOR signaling and upstream ERK & Akt Ketamine AMPA ERK, Akt 4E-BP mTOR S6K mTOR and synaptic protein synthesis • Presynaptic protein: – Synapsin I • Postsynaptic proteins: – PSD95, GluR1 • Arc: – activity-regulated cytoskeletal-associated protein C. A. Hoeffer, E. Klann, Trends Neurosci. 33, 67 (2010). • Ketamine induces intermediate (1-2 hr) but transient increase of Arc • Ketamine induces delayed (2-72 hr) increase of synaptic proteins • Pretreatment (30 min) with a selective mTOR inhibitor, rapamycin (0.2 nmol, ICV) block the effect Synape Formation ? Dendritic spine formation Y. Yoshihara, M. De Roo, D. Muller, Curr. Opin. Neurobiol. 19, 146 (2009). Spine density analysis • Layer V Pyramidal Cell in PFC • Tips of tuft branches approaching the pial membrane • Proximal tuft dendrites just distal to the bifurcation • Density • Head diameter • Length ketamine increased spine density in distal and proximal segments of the apical tuft Head diameter Spine length Excitatory postsynaptic current (EPSC) • Apical dendrites of Layer V pyramidal cells in mPFC – 5-HT and Hypocretin Increase EPSCs • Restraint stress – 5-HT and hypocretin-induced EPSCs decreased – Apical tuft dendritic branch length and spine density decreased R. J. Liu, G. K. Aghajanian, Proc. Natl. Acad. Sci. U.S.A. 105, 359 (2008). EPSC measurement • Rapamycin was infused (0.2 nmol, ICV) 30 min before ketamine (10 mg/kg, ip) • Rapid behavioral actions of ketamine require mTOR signaling • Infusion of rapamycin (0.01 nmol) into the mPFC blocked the antidepressant actions of ketamine (10 mg/kg, ip) in the FST and NSFT • Pretreatment with inhibitors of – ERK (U0126, 20 nmol, ICV) or – PI3 kinase / Akt (LY294002, 20 nmol, ICV) • block of ketamine effects in FST and NSFT • Learned helpless with Inescapable Shock (IES) – Synapsin I, PSD95 and GluR1 • Ketamine given 24hr after IES • Tissue collected 24 hr after ketamine • Single dose of ketamine reverse this effect • Pretreatment with rapamycin (ICV, 30 min before) block ketamine effect Dose-dependent ketamine antidepressant action • FST • Low dose – 10 mg/kg • high anesthetic dose – 80 mg/kg • Similar with dose of ERK, Akt, and mTOR induction Ketamine for Depression ? • Risk of abuse and adverse effects • Ro 25-6981 – selective NMDA receptor subunit 2B (NR2B) antagonists • NMDA Receptor = 2 NR1 + 2 NR2 – NR1: 8 subtype – NR2: 4 subtype • NR2A, NR2B, NR2C, NR2D • Ro 25-6981 produced rapid (24 hr before), dose-dependent antidepressant action in the FST • Pretreatment with rapamycin (0.2 nmol, ICV) abolished the actions of Ro 25-6981 (10 mg/kg, ip) in FST and NSFT • mTOR signaling – 4E-BP1, p70S6K, mTOR • ERK and Akt signaling • synaptic proteins – Arc, – PSD95, GluR1, synapsin I Conclusion • Rapid antidepressant actions of ketamine • Fast activation of mTOR signaling in PFC • Rapid and sustained elevation of synapse associated proteins and spine number • Elevated 5-HT neurotransmission Discussion • Rapid antidepressant therapy – mTOR signal pathway Thank you for listening !