Professeur René HEN

Selective serotonin reuptake inhibitors (SSRIs) display a delayed onset of antidepressant action of several weeks. Past work demonstrated evidence that the 5-HT4 receptor may be a direct target for treating depression and a new hope for fast acting antidepressant treatment. However, the 5-HT4 hypothesis still needs to be validated in models of anxiety/depression. We decided to investigate whether 5-HT4 receptor stimulation was necessary for the effects of SSRIs in a mouse model of anxiety/depression and whether hippocampal neurogenesis contributed to these effects. Using the mouse corticosterone (CORT) model of anxiety/depression, we assessed whether chronic treatment with a 5-HT4 receptor agonist (RS67333, 1.5 mg/kg/day) had effects on anxiety and depression-related behaviors as well as on hippocampal neurogenesis in comparison to chronic fluoxetine treatment (18 mg/kg/day). Then, using our model combined with ablation of hippocampal neurogenesis, we investigated whether neurogenesis was necessary for the behavioral effects of subchronic (7-days) or chronic (28-days) RS67333 treatment. We also assessed whether a 5-HT4 receptor antagonist, (GR125487, 1 mg/kg/day) could prevent the behavioral and neurogenic effects of fluoxetine in CORT pre-treated mice. Chronic treatment with RS67333, similar to fluoxetine, induced anxiolytic/antidepressant-like activity and stimulated adult hippocampal neurogenesis. However, unlike fluoxetine, the anxiolytic effects of RS67333 were already present after 7 days and did not require hippocampal neurogenesis. Chronic treatment with GR125487 prevented both anxiolytic/antidepressant-like and neurogenic effects of fluoxetine in CORT pre-treated mice, indicating that 5-HT4 receptor activation is necessary for these effects of SSRIs. We then explored whether the fast onset of action of the 5-HT4 receptor agonist RS67333 could be predicted by expression of a peripheral biomarker. The β-arrestin-signaling cascade which is involved in 5-HT4 receptor desensitization and internalization, has recently gained attention as a potential pre-clinical/clinical bridging biomarker for depressive states and treatment effects. To this end, we developed a new method to assess levels of circulating proteins through immunoblot analyses of mouse peripheral blood mononuclear cells (PBMCs) isolated from whole blood of anesthetized animals. β-arrestin 1 levels was decreased in CORT pre-treated mice. RS67333 restored the level of this protein to control levels after only 7 days of treatment, while fluoxetine did it after 28 days. These results suggest that blood levels of β-arrestin 1 may be a useful biomarker to predict rapid antidepressant/anxiolytic activities. Finally, the activation of 5-HT4 receptors in the brain may represent an innovative and rapid onset therapeutic approach to treat depressive symptoms with comorbid anxiety.