Leukocyte Gene Expression in Patients with Medication Refractory Depression before and after Treatment with ECT or Isoflurane Anesthesia: A Pilot Study.
Objective. To evaluate leukocyte gene expression for 9 selected genes (mRNAs) as biological markers in patients with medication refractory depression before and after treatment with ECT or isoflurane anesthesia (ISO). Methods. In a substudy of a nonrandomized open-label trial comparing effects of ECT to ISO therapy, blood samples were obtained before and after treatment from 22 patients with refractory depression, and leukocyte mRNA was assessed by quantitative PCR. Patients' mRNAs were also compared to 17 healthy controls. Results. Relative to controls, patients before treatment showed significantly higher IL10 and DBI and lower ADRA2A and ASIC3 mRNA (P < 0.025). Both ECT and ISO induced significant decreases after treatment in 4 genes: IL10, NR3C1, DRD4, and Sult1A1. After treatment, patients' DBI, ASIC3, and ADRA2A mRNA remained dysregulated. Conclusion. Significant differences from controls and/or significant changes after ECT or ISO treatment were observed for 7 of the 9 mRNAs studied. Decreased expression of 4 genes after effective treatment with either ECT or ISO suggests possible overlap of underlying mechanisms. Three genes showing dysregulation before and after treatment may be trait-like biomarkers of medication refractory depression. Gene expression for these patients has the potential to facilitate diagnosis, clarify pathophysiology, and identify potential biomarkers for treatment effects.
Department of Anesthesiology, University of Utah Health Sciences Center, Salt Lake City, UT, USA ; Neuroscience Program, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
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Iacob
Department of Anesthesiology, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
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Tadler
Department of Anesthesiology, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
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Light
Department of Anesthesiology, University of Utah Health Sciences Center, Salt Lake City, UT, USA ; Department of Psychiatry, University of Utah, Salt Lake City, UT, USA.
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Weeks
Department of Anesthesiology, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
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Smith
Department of Anesthesiology, University of Utah Health Sciences Center, Salt Lake City, UT, USA ; Department of Exercise and Sport Science, University of Utah, Salt Lake City, UT, USA.
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White
Department of Anesthesiology, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
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Hughen
Department of Exercise and Sport Science, University of Utah, Salt Lake City, UT, USA.
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VanHaitsma
Department of Psychiatry, University of Utah, Salt Lake City, UT, USA.
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Bushnell
Department of Anesthesiology, University of Utah Health Sciences Center, Salt Lake City, UT, USA ; Neuroscience Program, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
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