Comparative metabolomic analysis in plasma and cerebrospinal fluid of humans and in plasma and brain of mice following antidepressant-dose ketamine administration
Ruin Moaddel, Panos Zanos, Cristan A Farmer, Bashkim Kadriu, Patrick J. Morris, Jacqueline Lovett, Elia E. Acevedo-Diaz, Grace W. Cavanaugh, Peixiong Yuan, Mani Yavi, Craig J. Thomas, Lawrence T. Park, Luigi Ferrucci, Todd D Gould, Carlos A. Zarate
Translational Psychiatry May 2, 2022 DOI: 10.1038/s41398-022-01941-x (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Exploratory targeted metabolomic analysis Peer reviewed |
|---|---|
| Sample size | 9 |
| Population | Healthy volunteers |
| Intervention | Ketamine |
| Dose | 0.5 mg/kg |
| Duration | 40-minute infusion |
| Topics | Ketamine Esketamine |
| Keywords | Cerebrospinal fluid Antidepressant Pharmacology Schizophrenia object-oriented programming Metabolomics Plasma levels Anesthesia Hippocampus Chromatography |
| Citations | 32 |
| Key points | Ketamine and (2R,6R)-HNK both affect multiple inflammatory pathways, with LAT1, IDO1, NAD+, nitric oxide signaling, and sphingolipid rheostat consistently implicated across humans and mice. |
Abstract
Abstract Subanesthetic-dose racemic ( R,S )-ketamine (ketamine) produces rapid, robust, and sustained antidepressant effects in major depressive disorder (MDD) and bipolar disorder (BD) and has also been shown to effectively treat neuropathic pain, complex regional pain syndrome, and post-traumatic stress disorder (PTSD). However, to date, its mechanism of action remains unclear. Preclinical studies found that (2 R ,6 R ;2 S ,6 S )-hydroxynorketamine (HNK), a major circulating metabolite of ketamine, elicits antidepressant effects similar to those of ketamine. To help determine how (2 R ,6 R )-HNK contributes to ketamine’s mechanism of action, an exploratory, targeted, metabolomic analysis was carried out on plasma and CSF of nine healthy volunteers receiving a 40-minute ketamine infusion (0.5 mg/kg). A parallel targeted metabolomic analysis in plasma, hippocampus, and hypothalamus was carried out in mice receiving either 10 mg/kg of ketamine, 10 mg/kg of (2 R ,6 R )-HNK, or saline. Ketamine and (2 R ,6 R )-HNK both affected multiple pathways associated with inflammatory conditions. In addition, several changes were unique to either the healthy human volunteers and/or the mouse arm of the study, indicating that different pathways may be differentially involved in ketamine’s effects in mice and humans. Mechanisms of action found to consistently underlie the effects of ketamine and/or (2 R ,6 R )-HNK across both the human metabolome in plasma and CSF and the mouse arm of the study included LAT1, IDO1, NAD + , the nitric oxide (NO) signaling pathway, and sphingolipid rheostat.