TY  - JOUR
A1  - Gottschalk, Michael G.
A1  - Richter, Jan
A1  - Ziegler, Christiane
A1  - Schiele, Miriam A.
A1  - Mann, Julia
A1  - Geiger, Maximilian J.
A1  - Schartner, Christoph
A1  - Homola, György A.
A1  - Alpers, Georg W.
A1  - Büchel, Christian
A1  - Fehm, Lydia
A1  - Fydrich, Thomas
A1  - Gerlach, Alexander L.
A1  - Gloster, Andrew T.
A1  - Helbig-Lang, Sylvia
A1  - Kalisch, Raffael
A1  - Kircher, Tilo
A1  - Lang, Thomas
A1  - Lonsdorf, Tina B.
A1  - Pané-Farré, Christiane A.
A1  - Ströhle, Andreas
A1  - Weber, Heike
A1  - Zwanzger, Peter
A1  - Arolt, Volker
A1  - Romanos, Marcel
A1  - Wittchen, Hans-Ulrich
A1  - Hamm, Alfons
A1  - Pauli, Paul
A1  - Reif, Andreas
A1  - Deckert, Jürgen
A1  - Neufang, Susanne
A1  - Höfler, Michael
A1  - Domschke, Katharina
T1  - Orexin in the anxiety spectrum: association of a HCRTR1 polymorphism with panic disorder/agoraphobia, CBT treatment response and fear-related intermediate phenotypes
JF  - Translational Psychiatry
N2  - Preclinical studies point to a pivotal role of the orexin 1 (OX1) receptor in arousal and fear learning and therefore suggest the HCRTR1 gene as a prime candidate in panic disorder (PD) with/without agoraphobia (AG), PD/AG treatment response, and PD/AG-related intermediate phenotypes. Here, a multilevel approach was applied to test the non-synonymous HCRTR1 C/T Ile408Val gene variant (rs2271933) for association with PD/AG in two independent case-control samples (total n = 613 cases, 1839 healthy subjects), as an outcome predictor of a six-weeks exposure-based cognitive behavioral therapy (CBT) in PD/AG patients (n = 189), as well as with respect to agoraphobic cognitions (ACQ) (n = 483 patients, n = 2382 healthy subjects), fMRI alerting network activation in healthy subjects (n = 94), and a behavioral avoidance task in PD/AG pre- and post-CBT (n = 271). The HCRTR1 rs2271933 T allele was associated with PD/AG in both samples independently, and in their meta-analysis (p = 4.2 × 10−7), particularly in the female subsample (p = 9.8 × 10−9). T allele carriers displayed a significantly poorer CBT outcome (e.g., Hamilton anxiety rating scale: p = 7.5 × 10−4). The T allele count was linked to higher ACQ sores in PD/AG and healthy subjects, decreased inferior frontal gyrus and increased locus coeruleus activation in the alerting network. Finally, the T allele count was associated with increased pre-CBT exposure avoidance and autonomic arousal as well as decreased post-CBT improvement. In sum, the present results provide converging evidence for an involvement of HCRTR1 gene variation in the etiology of PD/AG and PD/AG-related traits as well as treatment response to CBT, supporting future therapeutic approaches targeting the orexin-related arousal system.
KW  - human behaviour
KW  - molecular neuroscience
KW  - personalized medicine
KW  - predictive markers
KW  - psychiatric disorders
Y1  - 2019
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-227479
VL  - 9
ER  - 
TY  - JOUR
A1  - Menke, Andreas
T1  - Is the HPA axis as target for depression outdated, or is there a new hope?
JF  - Frontiers in Psychiatry
N2  - Major depressive disorder (MDD) is a very common stress-related mental disorder that carries a huge burden for affected patients and the society. It is associated with a high mortality that derives from suicidality and the development of serious medical conditions such as heart diseases, diabetes, and stroke. Although a range of effective antidepressants are available, more than 50% of the patients do not respond to the first treatment they are prescribed and around 30% fail to respond even after several treatment attempts. The heterogeneous condition of MDD, the lack of biomarkers matching patients with the right treatments and the situation that almost all available drugs are only targeting the serotonin, norepinephrine, or dopamine signaling, without regulating other potentially dysregulated systems may explain the insufficient treatment status. The hypothalamic-pituitary-adrenal (HPA) axis is one of these other systems, there is numerous and robust evidence that it is implicated in MDD and other stress-related conditions, but up to date there is no specific drug targeting HPA axis components that is approved and no test that is routinely used in the clinical setting identifying patients for such a specific treatment. Is there still hope after these many years for a breakthrough of agents targeting the HPA axis? This review will cover tests detecting altered HPA axis function and the specific treatment options such as glucocorticoid receptor (GR) antagonists, corticotropin-releasing hormone 1 (CRH1) receptor antagonists, tryptophan 2,3-dioxygenase (TDO) inhibitors and FK506 binding protein 5 (FKBP5) receptor antagonists.
KW  - precision medicine
KW  - personalized medicine
KW  - biomarker
KW  - depression
KW  - HPA axis
KW  - glucocorticoid receptor
KW  - CRH1
KW  - FKBP5
Y1  - 2019
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-195780
SN  - 1664-0640
VL  - 10
IS  - 101
ER  -