title: VEGF plasma level variations in duloxetine-treated patients with major depression.
abstract: BACKGROUND
  The vascular endothelial growth factor (VEGF) signaling, which modulates angiogenesis and neurogenesis within the neurovascular unit, might play an important role in the neuro-endocrine-immune (NEI) stress-adaptation system. Recent evidence suggests that VEGF is involved in the pathophysiology of a number of diseases including major depressive disorder (MDD) and is affected by some treatments, including antidepressants. The objective of the study was to investigate the VEGF level variations in MDD patients during antidepressant treatment with duloxetine, a relatively new SNRI.
  
  
  METHODS
  A total of 30 MDD patients and 32 healthy controls were assessed using the Hamilton Depression Scale (HAM-D) and monitored for VEGF plasma levels at baseline, week 6 and week 12 of duloxetine treatment (60 mg/day) and at baseline, respectively.
  
  
  RESULTS
  According to early clinical response to duloxetine (defined at week 6 by reduction>50% of baseline HAM-D score), the MDD patients were divided into early responders (ER) and early non-responders (ENR). During duloxetine treatment, we found an opposite trend in the VEGF levels between ER and ENR: in ER the VEGF levels significantly increased in association with clinical response at W6, while in ENR the VEGF levels significantly decreased in association with an overall clinical response at W12.
  
  
  CONCLUSIONS
  Small sample size.
  
  
  CONCLUSIONS
  The opposite trends in VEGF levels, increasing in ER and decreasing in ENR, might reflect differential Norepinephrine/Serotonin effects of duloxetine on differential neurobiological backgrounds of depressive syndromes. Overall, the modulation of VEGF signaling within the neurovascular unit during antidepressant treatment could hypothetically favor the remodeling of neural circuitry, contributing to adaptive adjustment of the NEI stress-adaptation system.
authors.affiliation: Department of Neuroscience, Section of Psychiatry, IRCCS AOU San Martino-IST, Genoa 16100, Italy; Scienze della Formazione, University of Catania, Catania, Italy. Electronic address: Dott.Fornaro@gmail.com.
authors.forename: Michele
authors.initials: M
authors.lastname: Fornaro
authors.affiliation: Department of Neuroscience, Section of Psychiatry, IRCCS AOU San Martino-IST, Genoa 16100, Italy. Electronic address: giulio.rocchi@hotmail.com.
authors.forename: Giulio
authors.initials: G
authors.lastname: Rocchi
authors.affiliation: Department of Neuroscience, Section of Psychiatry, IRCCS AOU San Martino-IST, Genoa 16100, Italy. Electronic address: andrea.escelsior@live.com.
authors.forename: Andrea
authors.initials: A
authors.lastname: Escelsior
authors.affiliation: Department of Internal Medicine, Section of Immunology, IRCCS AOU San Martino-IST, Genoa, Italy. Electronic address: paola.contini@unige.it.
authors.forename: Paola
authors.initials: P
authors.lastname: Contini
authors.affiliation: Department of Internal Medicine, Section of Immunology, IRCCS AOU San Martino-IST, Genoa, Italy. Electronic address: massimo.ghio@unige.it.
authors.forename: Massimo
authors.initials: M
authors.lastname: Ghio
authors.affiliation: Department of Neurosciences, Catholic University, Rome, Italy. Electronic address: salvatorecolicchio.md@gmail.com.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Colicchio
authors.affiliation: Department of Neuroscience and Imaging, Chair of Psychiatry, University of Chieti, Chieti, Italy. Electronic address: dodebera@aliceposta.it.
authors.forename: Domenico
authors.initials: D
authors.lastname: De Berardis
authors.affiliation: Department of Neuroscience, Section of Psychiatry, IRCCS AOU San Martino-IST, Genoa 16100, Italy. Electronic address: Mario.Amore@unige.it.
authors.forename: Mario
authors.initials: M
authors.lastname: Amore
authors.affiliation: Department of Neuroscience, Section of Psychiatry, IRCCS AOU San Martino-IST, Genoa 16100, Italy. Electronic address: prof.fornaro@gmail.com.
authors.forename: Pantaleo
authors.initials: P
authors.lastname: Fornaro
authors.affiliation: Department of Neuroscience, Section of Psychiatry, IRCCS AOU San Martino-IST, Genoa 16100, Italy. Electronic address: matteomartino9@gmail.com.
authors.forename: Matteo
authors.initials: M
authors.lastname: Martino
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D000068736:Duloxetine Hydrochloride; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013876:Thiophenes / Q000627:therapeutic use*; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: D000928:Antidepressive Agents; D013876:Thiophenes; D042461:Vascular Endothelial Growth Factor A; D000068736:Duloxetine Hydrochloride
keywords: Depression; Duloxetine; Neurovascular unit; VEGF