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      Erythropoietin Pathway: A Potential Target for the Treatment of Depression

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          Abstract

          During the past decade, accumulating evidence from both clinical and experimental studies has indicated that erythropoietin may have antidepressant effects. In addition to the kidney and liver, many organs have been identified as secretory tissues for erythropoietin, including the brain. Its receptor is expressed in cerebral and spinal cord neurons, the hypothalamus, hippocampus, neocortex, dorsal root ganglia, nerve axons, and Schwann cells. These findings may highlight new functions for erythropoietin, which was originally considered to play a crucial role in the progress of erythroid differentiation. Erythropoietin and its receptor signaling through JAK2 activate multiple downstream signaling pathways including STAT5, PI3K/Akt, NF-κB, and MAPK. These factors may play an important role in inflammation and neuroprogression in the nervous system. This is particularly true for the hippocampus, which is possibly related to learning, memory, neurocognitive deficits and mood alterations. Thus, the influence of erythropoietin on the downstream pathways known to be involved in the treatment of depression makes the erythropoietin-related pathway an attractive target for the development of new therapeutic approaches. Focusing on erythropoietin may help us understand the pathogenic mechanisms of depression and the molecular basis of its treatment.

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          A neurotrophic model for stress-related mood disorders.

          There is a growing body of evidence demonstrating that stress decreases the expression of brain-derived neurotrophic factor (BDNF) in limbic structures that control mood and that antidepressant treatment reverses or blocks the effects of stress. Decreased levels of BDNF, as well as other neurotrophic factors, could contribute to the atrophy of certain limbic structures, including the hippocampus and prefrontal cortex that has been observed in depressed subjects. Conversely, the neurotrophic actions of antidepressants could reverse neuronal atrophy and cell loss and thereby contribute to the therapeutic actions of these treatments. This review provides a critical examination of the neurotrophic hypothesis of depression that has evolved from this work, including analysis of preclinical cellular (adult neurogenesis) and behavioral models of depression and antidepressant actions, as well as clinical neuroimaging and postmortem studies. Although there are some limitations, the results of these studies are consistent with the hypothesis that decreased expression of BDNF and possibly other growth factors contributes to depression and that upregulation of BDNF plays a role in the actions of antidepressant treatment.
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            New approaches to antidepressant drug discovery: beyond monoamines.

            All available antidepressant medications are based on serendipitous discoveries of the clinical efficacy of two classes of antidepressants more than 50 years ago. These tricyclic and monoamine oxidase inhibitor antidepressants were subsequently found to promote serotonin or noradrenaline function in the brain. Newer agents are more specific but have the same core mechanisms of action in promoting these monoamine neurotransmitters. This is unfortunate, because only approximately 50% of individuals with depression show full remission in response to these mechanisms. This review summarizes the obstacles that have hindered the development of non-monoamine-based antidepressants, and provides a progress report on some of the most promising current strategies.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Int J Mol Sci
                Int J Mol Sci
                ijms
                International Journal of Molecular Sciences
                MDPI
                1422-0067
                06 May 2016
                May 2016
                : 17
                : 5
                : 677
                Affiliations
                School of Basic Medical Sciences, Beijing University of Chinese Medicine, School of Basic Medical Sciences, 11 Beisanhuandong Road, Chao Yang District, Beijing 100029, China; machongyang@ 123456live.com (C.M.); fafengcheng@ 123456gmail.com (F.C.); shirlyding@ 123456163.com (X.W.); zhaichangming1989@ 123456163.com (C.Z.); yuewenchao@ 123456bucm.edu.cn (W.Y.); niangkuosir@ 123456bucm.edu.cn (Y.L.)
                Author notes
                [* ]Correspondence: 642006@ 123456bucm.edu.cn ; Tel.: +86-010-6428-6705; Fax: +86-010-6428-6821
                [†]

                These authors contributed equally to this work.

                Article
                ijms-17-00677
                10.3390/ijms17050677
                4881503
                27164096
                6fa37388-343e-45d9-95a9-7bfd4bd69f76
                © 2016 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 05 March 2016
                : 27 April 2016
                Categories
                Review

                Molecular biology
                depression,major depressive disorder,erythropoietin,epo,hippocampal,anti-depressant targets,drug treatment,signaling pathway

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