Proceedings of the Texas A&M Medical Student Grand Rounds

Ketamine Increases Expression of Brain-Derived Neurotrophic Factor for the Treatment of Depression

June 20, 2022 Megan Mitchell

Megan Mitchell

Introduction. Depressive disorders are a leading cause of disability worldwide. In the US, prevalence ranges from 5-10% with only half receiving adequate treatment.1,2 The Brain-Derived Neurotrophic Factor (BDNF) protein induces survival, development, and function of neurons; it plays a role in hippocampal learning and memory.1 BDNF elevation in patients on antidepressant medications indicates a potential protective feature of the protein.3 DNA methylation of BDNF is hypothesized to play a role in the etiology of depression.3,4. DNA methylation involves the addition of a methyl group to a DNA cytosine which can impact gene expression. DNA methyltransferases (DNMTs) are likely responsible for the methylation of the BDNF gene.4 Methyl-CpG-binding protein 2 (MeCP2) facilitates long-term chromatin condensation of DNA surrounding methylated residues, reducing expression of genes such as BDNF. Methods. Adult rats were classified as Roman Low-Avoidance (RLA) and High-Avoidance (RHA) based on their susceptibility to stress-induced depression.3 Using Western blot, BDNF protein levels were measure and compared between RHA and RLA groups.3 Adult rats were subjected to a spared nerve injury (SNI) procedure known to induce depression in rodents.4 A subset of that group was then injected peritoneally with a ketamine solution (10 mg/kg in 1 ml) and sacrificed 21 days after ketamine administration.4 DNMT and BDNF protein levels were measured using Western Blot.4 BDNF knockout mice were injected with ketamine (5 mg/kg) and then sacrificed 7 days later.5 Hippocampal MeCP2 expression was measured by Western Blot.5 Results. BDNF levels were lower in the hippocampus of depression vulnerable (RLA) rats.3 Elevated DNMT expression in rodent hippocampi was correlated with reduced BDNF expression.4 Ketamine was found to reverse the increase of DNMTs in SNI rat hippocampi, allowing for an increase in BDNF expression.4 MeCP2 was found to be phosphorylated, and thus, inactivated, 7 days after ketamine administration, preventing chromatin condensation of BDNF and increasing its expression in the hippocampus.5 Conclusions. Higher levels of BDNF exert protective effects against symptoms of depression.2 Repression of BDNF expression involves addition of a methyl group to specific nucleotides by DNMTs.4 Methylated residues then undergo chromatin condensation; this is facilitated in part by MeCP2.5 This process reduces BDNF expression in the hippocampus.5 Ketamine increases BDNF expression through repression of DNMTs and MeCP2.4,5 Though further research is needed, early studies suggest that ketamine may be a potential treatment for major depressive disorder.3,4,5

  1. McCarron RM, Shapiro B, Rawles J, Luo J. Depression. Ann Intern Med. 2021;174(5):ITC65-ITC80. doi:10.7326/AITC202105180
  2. Watkins SC, Sibille E. The Role of Dendritic Brain-Derived Neurotrophic Factor Transcripts on Altered Inhibitory Circuitry in Depression. Biol Psychiatry. 2019;85(6):517-526. doi:10.1016/j.biopsych.2018.09.026
  3. Serra MP, Poddighe L, Boi M, et al. Expression of BDNF and trkB in the hippocampus of a rat genetic model of vulnerability (Roman low-avoidance) and resistance (Roman high-avoidance) to stress-induced depression. Brain Behav. 2017;7(10):e00861. Published 2017 Oct 23. doi:10.1002/brb3.861
  4. Liu R, Wu XM, He X, et al. Contribution of DNA methyltransferases to spared nerve injury induced depression partially through epigenetically repressing Bdnf in hippocampus: Reversal by ketamine. Pharmacol Biochem Behav. 2021;200:173079. doi:10.1016/j.pbb.2020.173079
  5. Kim JW, Autry AE, Na ES, et al. Sustained effects of rapidly acting antidepressants require BDNF-dependent MeCP2 phosphorylation. Nat Neurosci. 2021;24(8):1100-1109. doi:10.1038/s41593-021-00868-8

 

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