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Review
. 2008 Feb 15;32(2):315-31.
doi: 10.1016/j.pnpbp.2007.07.001. Epub 2007 Jul 10.

The neurobiology of retinoic acid in affective disorders

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Review

The neurobiology of retinoic acid in affective disorders

J Douglas Bremner et al. Prog Neuropsychopharmacol Biol Psychiatry. .

Abstract

Current models of affective disorders implicate alterations in norepinephrine, serotonin, dopamine, and CRF/cortisol; however treatments targeted at these neurotransmitters or hormones have led to imperfect resolution of symptoms, suggesting that the neurobiology of affective disorders is incompletely understood. Until now retinoids have not been considered as possible contributors to affective disorders. Retinoids represent a family of compounds derived from vitamin A that perform a large number of functions, many via the vitamin A product, retinoic acid. This signaling molecule binds to specific retinoic acid receptors in the brain which, like the glucocorticoid and thyroid hormone receptors, are part of the nuclear receptor superfamily and regulate gene transcription. Research in the field of retinoic acid in the CNS has focused on the developing brain, in part stimulated by the observation that isotretinoin (13-cis retinoic acid), an isomer of retinoic acid used in the treatment of acne, is highly teratogenic for the CNS. More recent work has suggested that retinoic acid may influence the adult brain; animal studies indicated that the administration of isotretinoin is associated with alterations in behavior as well as inhibition of neurogenesis in the hippocampus. Clinical evidence for an association between retinoids and depression includes case reports in the literature, studies of health care databases, and other sources. A preliminary PET study in human subjects showed that isotretinoin was associated with a decrease in orbitofrontal metabolism. Several studies have shown that the molecular components required for retinoic acid signaling are expressed in the adult brain; the overlap of brain areas implicated in retinoic acid function and stress and depression suggest that retinoids could play a role in affective disorders. This report reviews the evidence in this area and describes several systems that may be targets of retinoic acid and which contribute to the pathophysiology of depression.

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Figures

Figure 1
Figure 1
Chemical structures of retinoid family members. The double headed arrow between retinol (structure 1) and retinaldehyde (structure 2) indicates the interconversion between the two retinoids catalyzed by retinol dehydrogenase, either oxidising retinol to retinaldehyde or catalyzing the reverse reductive reaction. The single arrow between retinaldehyde (structure 2) and retinoic acid (structure 3) indicates the irreversible oxidation catalyzed by retinaldehyde dehydrogenase. Common retinyl esters (structure 4) include retinyl acetate (R = CH3) and retinyl palmitate (R = C15H31)
Figure 2
Figure 2
PET FDG measurement of brain metabolism before and after treatment with isotretinoin. There is a visible decrease in function of the orbitofrontal cortex in this representative patient after four months of treatment with isotretinoin. This patient developed headache and subtle behavioral changes, but not clinical depression.

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References

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