Antidepressant and anti-inflammatory effects of a combined fluoxetine and celecoxib treatment in a rat model of depression

Authors

  • Petcharat Trongtorsak Faculty of Allied Health Sciences, Burapha University, Chonburi
  • Wanida Olankijanunt Faculty of Pharmaceutical Sciences, Burapha University, Chonburi
  • Angkawipa Trongtorsak Chonburi Hospital, Amphoe Mueang, Chonburi
  • Uraiwan Intamaso Faculty of Allied Health Sciences, Burapha University, Chonburi

Keywords:

Depression, fluoxetine, celecoxib, antidepressant, anti-inflammation

Abstract

Background : An evidence suggests a potential therapeutic target of depression toward treating inflammation with nonsteroidal anti-inflammatory drugs (NSAIDs). However, the efficacy of the combined standard antidepressant with NSAID treatment still remains uncertain.

Objective : To examine the effects of fluoxetine (serotonin reuptake inhibitor) in adjunct with celecoxib (specific COX-2 inhibitor) on depression-like behavior and inflammation in rats with chronic mild stress (CMS) induced depression.

Methods : The rats were divided into 4 groups: control, CMS, CMS with fluoxetine treatment (5 mg/kg/d), and CMS with fluoxetine and celecoxib treatment (5 mg/kg/d each). All treatments were continued for 5 weeks. The depression-like behavior was examined using forced swimming test. Blood samples were collected for biochemical analysis of plasma levels of cortisol, prostaglandin E2 (PGE2), interleukin-1gif.latex?\beta(IL-1gif.latex?\beta), tumor necrosis factor-gif.latex?\alpha (TNF-gif.latex?\alpha, C-reactive protein (CRP), and an oxidative stress marker malondialdehyde (MDA).

Results : The combined treatment decreased depression-like behavior to the same extent as fluoxetine treatment alone. However, the adjunctive celecoxib significantly reversed the effect of fluoxetine in lowering the plasma cortisol level which implied the aggravation of hypothalamicpituitary- adrenal axis (HPA axis) dysregulation, and also increased body weight gain compared with fluoxetine, suggesting a possibility of body fluid retention. Both drug treatments showed a comparable degree in lowering the plasma levels of PGE2, TNF-gif.latex?\alpha , CRP and MDA. Nonetheless, fluoxetine showed no significant effect on plasma IL-1gif.latex?\beta level; whereas the adjunctive celecoxib treatment lowered this proinflammatory cytokine to almost normal.

Conclusion : The results suggest that the combined celecoxib treatment shows no synergistic antidepressant effect to fluoxetine, but may exacerbate the HPA axis hyperactivation.

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References

Grippo AJ, Johnson AK. Stress, depression and cardiovascular dysregulation: a review of neurobiological mechanisms and the integration of research from preclinical disease models. Stress 2009;12:1-21. https://doi.org/10.1080/10253890802046281

Brown ES, Rush AJ, McEwen BS. Hippocampal remodeling and damage by corticosteroids: implications for mood disorders. Neuropsychopharmacology 1999;21:474-84.

https://doi.org/10.1016/S0893-133X(99)00054-8

Lee AL, Ogle WO, Sapolsky RM. Stress and depression: possible links to neuron death in the hippocampus. Bipolar Disord 2002;4: 117-28. https://doi.org/10.1034/j.1399-5618.2002.01144.x

Rubinow DR, Post RM, Savard R, Gold PW. Cortisol hypersecretion and cognitive impairment in depression. Arch Gen Psychiatry 1984;41: 279-83. https://doi.org/10.1001/archpsyc.1984.01790140069008

Haapakoski R, Mathieu J, Ebmeier KP, Alenius H, Kivimaki M. Cumulative meta-analysis of interleukins 6 and 1beta, tumour necrosis factor alpha and C-reactive protein in patients with major depressive disorder. Brain Behav Immun 2015;49:206-15. https://doi.org/10.1016/j.bbi.2015.06.001

Howren MB, Lamkin DM, Suls J. Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosom Med 2009; 71:171-86. https://doi.org/10.1097/PSY.0b013e3181907c1b

Kobrosly R, van Wijngaarden E. Associations between immunologic, inflammatory, and oxidative stress markers with severity of depressive symptoms: an analysis of the 2005-2006 National Health and Nutrition Examination Survey. Neurotoxicology 2010; 31:126-33.

https://doi.org/10.1016/j.neuro.2009.10.005

Maes M, Scharpé S, Meltzer HY, Bosmans E, Suy E, Calabrese J, et al. Relationships between interleukin-6 activity, acute phase proteins, and function of the hypothalamicpituitary-adrenal axis in severe depression. Psychiatry Res 1993;49:11-27. https://doi.org/10.1016/0165-1781(93)90027-E

Loftis JM, Huckans M, Morasco BJ. Neuroimmune mechanisms of cytokine-induced depression: current theories and novel treatment strategies. Neurobiol Dis 2010;37:519-33.

https://doi.org/10.1016/j.nbd.2009.11.015

Christmas DM, Potokar J, Davies SJ. A biological pathway linking inflammation and depression: activation of indoleamine 2, 3-dioxygenase. Neuropsychiatr Dis Treat 2011;7:431-9.

https://doi.org/10.2147/NDT.S17573

Abbott R, Whear R, Nikolaou V, Bethel A, Coon JT, Stein K, et al. Tumour necrosis factor-alpha inhibitor therapy in chronic physical illness: A systematic review and meta-analysis of the effect on depression and anxiety. J Psychosom Res 2015;79:175-84. https://doi.org/10.1016/j.jpsychores.2015.04.008

Ohishi K, Ueno R, Nishino S, Sakai T, Hayaishi O. Increased level of salivary prostaglandins in patients with major depression. Biol Psychiatry 1988;23:326-34. https://doi.org/10.1016/0006-3223(88)90283-1

Linnoila M, Whorton AR, Rubinow DR, Cowdry RW, Ninan PT, Waters RN. CSF prostaglandin levels in depressed and schizophrenic patients. Arch Gen Psychiatry 1983;40: 405-6.

https://doi.org/10.1001/archpsyc.1983.01790040059008

Watanabe T, Morimoto A, Sakata Y, Murakami N. ACTH response induced by interleukin-1 is mediated by CRF secretion stimulated by hypothalamic PGE. Experientia 1990;46: 481-4.

https://doi.org/10.1007/BF01954238

Köhler O, Benros ME, Nordentoft M, Farkouh ME, Iyengar RL, Mors O, et al. Effect of antiinflammatory treatment on depression, depressive symptoms, and adverse effects: a systematic review and meta-analysis of randomized clinical trials. JAMA Psychiatry 2014;71:1381-91.

https://doi.org/10.1001/jamapsychiatry.2014.1611

Müller N, Schwarz MJ, Dehning S, Douhe A, Cerovecki A, Goldstein-Müller B, et al. The cyclooxygenase-2 inhibitor celecoxib has therapeutic effects in major depression: results of a double-blind, randomized, placebo controlled, add-on pilot study to reboxetine. Mol Psychiatry 2006;11:680-4.

https://doi.org/10.1038/sj.mp.4001805

Warner-Schmidt JL, Vanover KE, Chen EY, Marshall JJ, Greengard P. Antidepressant effects of selective serotonin reuptake inhibitors (SSRIs) are attenuated by antiinflammatory drugs in mice and humans. Proc Natl Acad Sci U S A 2011;108:9262-7. https://doi.org/10.1073/pnas.1104836108

Gallagher PJ, Castro V, Fava M, Weilburg JB, Murphy SN, Gainer VS, et al. Antidepressant response in patients with major depression exposed to NSAIDs: a pharmacovigilance study. Am J Psychiatry 2012;169:1065-72. https://doi.org/10.1176/appi.ajp.2012.11091325

Andreatini R, Bacellar LF. The relationship between anxiety and depression in animal models: a study using the forced swimming test and elevated plus-maze. Braz J Med Biol Res 1999;32:1121-6.

https://doi.org/10.1590/S0100-879X1999000900011

Deussing JM. Animal models of depression. Drug Discov Today Dis Models 2006;3:375-83.

https://doi.org/10.1016/j.ddmod.2006.11.003

Willner P. Chronic mild stress (CMS) revisited: consistency and behavioural-neurobiological concordance in the effects of CMS. Neuropsychobiology 2005;52:90-110.

https://doi.org/10.1159/000087097

Gamble-George JC, Baldi R, Halladay L, Kocharian A, Hartley N, Silva CG, et al. Cyclooxygenase-2 inhibition reduces stressinduced affective pathology. Elife 2016;5: e14137.

https://doi.org/10.7554/eLife.14137

Harirforoosh S, Aghazadeh-Habashi A, Jamali F. Extent of renal effect of cyclo-oxygenase-2- selective inhibitors is pharmacokinetic dependent. Clin Exp Pharmacol Physiol 2006;33:917-24.

https://doi.org/10.1111/j.1440-1681.2006.04464.x

Hörl WH. Nonsteroidal anti-inflammatory drugs and the kidney. Pharmaceuticals (Basel) 2010;3:2291-321. https://doi.org/10.3390/ph3072291

Trongtorsak P, Intamaso U, Olankijanunt W. Combined NSAID to antidepressant treatment induces cardiovascular alterations in an animal model of depression [ABS0206]. J Physiol Sci 2015;65:S-A120.

Schiepers OJ, Wichers MC, Maes M. Cytokines and major depression. Prog Neuropsychopharmacol Biol Psychiatry 2005;29:201-17. https://doi.org/10.1016/j.pnpbp.2004.11.003

Pasco JA, Nicholson GC, Williams LJ, Jacka FN, Henry MJ, Kotowicz MA, et al. Association of high-sensitivity C-reactive protein with de novo major depression. Br J Psychiatry 2010; 197:372-7.

https://doi.org/10.1192/bjp.bp.109.076430

Jazayeri S, Keshavarz SA, Tehrani-Doost M, Djalali M, Hosseini M, Amini H, et al. Effects of eicosapentaenoic acid and fluoxetine on plasma cortisol, serum interleukin-1beta and interleukin-6 concentrations in patients with major depressive disorder. Psychiatry Res 2010;178:112-5.

https://doi.org/10.1016/j.psychres.2009.04.013

Anisman H, Gibb J, Hayley S. Influence of continuous infusion of interleukin-1beta on depression-related processes in mice: corticosterone, circulating cytokines, brain monoamines, and cytokine mRNA expression. Psychopharmacology (Berl) 2008;199:231-44. https://doi.org/10.1007/s00213-008-1166-z

Pineda EA, Hensler JG, Sankar R, Shin D, Burke TF, Mazarati AM. Interleukin-1beta causes fluoxetine resistance in an animal model of epilepsy-associated depression. Neurotherapeutics 2012;9:477-85.

https://doi.org/10.1007/s13311-012-0110-4

Hawkey CJ. COX-1 and COX-2 inhibitors. Best Pract Res Clin Gastroenterol 2001;15:801-20.

https://doi.org/10.1053/bega.2001.0236

Aïd S, Bosetti F. Targeting cyclooxygenases-1 and -2 in neuroinflammation: Therapeutic implications. Biochimie 2011;93:46-51. https://doi.org/10.1016/j.biochi.2010.09.009

Choi SH, Aid S, Choi U, Bosetti F. Cyclooxygenases-1 and -2 differentially modulate leukocyte recruitment into the inflamed brain. Pharmacogenomics J 2010;10:448-57.

https://doi.org/10.1038/tpj.2009.68

Rawdin BJ, Mellon SH, Dhabhar FS, EpelES, Puterman E, Su Y, et al. Dysregulated relationship of inflammation and oxidative stress in major depression. Brain Behav Immun 2013;31:143-52.

https://doi.org/10.1016/j.bbi.2012.11.011

Chung CP, Schmidt D, Stein CM, Morrow JD, Salomon RM. Increased oxidative stress in patients with depression and its relationship to treatment. Psychiatry Res 2013;206:213-6.

https://doi.org/10.1016/j.psychres.2012.10.018

Lindqvist D, Dhabhar FS, James SJ, Hough CM, Jain FA, Bersani FS, et al. Oxidative stress, inflammation and treatment response in major depression. Psychoneuroendocrinology 2017;76:197-205.

https://doi.org/10.1016/j.psyneuen.2016.11.031

Ozgocmen S, Ardicoglu O, Erdogan H, Fadillioglu E, Gudul H. In vivo effect of celecoxib and tenoxicam on oxidant/antioxidant status of patients with knee osteoarthritis. Ann Clin Lab Sci 2005;35:137-143.

Aïd S, Langenbach R, Bosetti F. Neuroinflammatory response to lipopolysaccharide is exacerbated in mice genetically deficient in cyclooxygenase-2. J Neuroinflammation 2008;5:17.

https://doi.org/10.1186/1742-2094-5-17

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Published

2023-08-16

How to Cite

1.
Trongtorsak P, Olankijanunt W, Trongtorsak A, Intamaso U. Antidepressant and anti-inflammatory effects of a combined fluoxetine and celecoxib treatment in a rat model of depression. Chula Med J [Internet]. 2023 Aug. 16 [cited 2024 Nov. 22];62(4). Available from: https://he05.tci-thaijo.org/index.php/CMJ/article/view/355