45,46 Augmented maternal care was associated with reduced hypothalamic response to stress in rat pups and altered expression of CRH into adulthood.51 Suggestive human data compatible with these mechanisms have been reported.28,52 Oberlander et al,53 for example, found that

prenatal exposure to third trimester maternal depression was associated with increased methylation of the glucocorticoid receptor gene at 3 months of age in the newborn child, while McGowan45 reported decreased levels of GR expression in the hippocampus of suicide victims with a history Inhibitors,research,lifescience,medical of childhood abuse, in comparison with those without such history and to controls. Tyrka and colleagues54 have also shown that variants in the CRH1 receptor gene appear to interact with a history of childhood abuse in determining cortical response to CRH. A separate body of research has focused on genetic investigations in components of serotonergic

function, most commonly Inhibitors,research,lifescience,medical on a variant in the serotonin promoter (5HTTLPR), and, to a lesser extent, on serotonin receptor genes.55 In a small-scale study that remains controversial, Caspi et al56 reported that the effect of a variant in 5HTTLPR on increasing risk of depression was dependent upon a history of previous life stresses; several large-scale attempts Inhibitors,research,lifescience,medical at replication failed to support these conclusions and subsequent meta-analyses have been both positive and negative.57,58 Ressler et al59 have suggested that gene x gene x environment interactions may be involved, and reported that 5-HTTLPR alleles interacted with CRH1 haplotypes and child abuse history in Luminespib solubility dmso predicting Inhibitors,research,lifescience,medical depressive symptoms.

Others, however, have found Inhibitors,research,lifescience,medical it hard to demonstrate such effects.55 Yet another example of a potential GxGxE interaction was found in a study by Kauffman et al60 of child abuse victims, in whom BDNF and 5-HTTLPR genotypes interacted with maltreatment history in predicting depression, with social support showing some moderating influence. Despite the persuasive empirical animal data, the clinical relevance of epigenetic effects of stress on human emotional behavior is yet to be convincingly established. Biochemical mediators Glucocorticoids Elevated circulating GC levels are often observed in depressed individuals (especially in those with severe, melancholic, Cell press psychotic, or inpatient depressions), although considerable variability exists between studies, between individuals, and even within individuals over time, and some individuals are even hypocortisolemic.61,62 The physiological significance of increased circulating GC levels remains unknown, and it is debatable whether hypercortisolemia results in hypercortisolism at the cellular level, or, rather, in hypocortisolism, perhaps due to downregulation of the GR (often referred to as “GC resistance”).