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Targeting TLR4/PPARα-mediated neuroinflammation in the prefrontal cortex: S-ketamine and S-HNK rapidly alleviate depression-like behaviors

Quanfeng Zhu, Xiaoyue Zhou, Huangling Gao, Huili Wu, Yali Zheng

Journal of Neuroimmunology July 1, 2026 DOI: 10.1016/j.jneuroim.2026.579038 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Preclinical animal study Peer reviewed
Population Male C57BL/6J mice
Interventions S-ketamine S-hydroxynorketamine
Topics Depression Esketamine Ketamine
Keywords Neuroinflammation Prefrontal cortex Microglia Central nervous system
Key points S-ketamine and S-hydroxynorketamine reversed depression-like behaviors, restored monoamine levels, and reduced neuroinflammation in mice by modulating the TLR4/PPARα signaling pathway.

Abstract

Neuroinflammation, particularly Toll-like receptor 4 (TLR4)-mediated signaling, plays a critical role in the pathophysiology of depression. This study aimed to investigate the mechanisms by which S-ketamine (S-ket) and S-hydroxynorketamine (S-HNK) modulate TLR4 and peroxisome proliferator-activated receptor alpha (PPARα) signaling in the prefrontal cortex (PFC) to exert antidepressant effects. Male C57BL/6 J mice were subjected to chronic social defeat stress (CSDS) to induce depression-like behaviors. Mice received intraperitoneal administration of S-ket or S-HNK. In a subset of mice, adeno-associated virus expressing TLR4 (AAV-TLR4) or a negative control (NC) was stereotaxically injected into the medial prefrontal cortex (mPFC). Behavioral assessments included the sucrose preference test (SPT), forced swim test (FST), and social interaction test (SIT). Levels of monoaminergic neurotransmitters, including dopamine (DA), serotonin (5-hydroxytryptamine, 5-HT), and norepinephrine (NA), pro-inflammatory cytokines (interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor-α (TNF-α)), TLR4, PPARα, indoleamine 2,3-dioxygenase 1 (IDO1), and kynurenine (Kyn) in the PFC were analyzed. CSDS induced depression-like behaviors, decreased DA, 5-HT, and NA levels in the PFC, and increased the expression of pro-inflammatory cytokines IL-1β, IL-6, IL-8, and TNF-α. Treatment with S-ket or S-HNK significantly reversed these behavioral deficits, neurotransmitter alterations, and neuroinflammatory responses. Both compounds also reduced plasma and PFC Kyn levels, upregulated PPARα expression, and downregulated TLR4 and IDO1. Notably, TLR4 overexpression partially abolished the antidepressant and anti-inflammatory effects of S-ket and S-HNK. S-ket and its metabolite S-HNK exert antidepressant effects by modulating the TLR4/PPARα signaling pathway, restoring monoaminergic neurotransmission, and attenuating neuroinflammation.

Comparable studies

Other preclinical and animal studies on esketamine for depression, most cited first.

Study Year Design Participants
Low-dose S-ketamine exerts antidepressant-like effects via enhanced hippocampal synaptic plasticity in postpartum depression rats. Rat model of postpartum depression induced by reproductive hormone withdrawal 2022 Animal study
Antidepressant effects of esketamine via the BDNF/AKT/mTOR pathway in mice with postpartum depression and their offspring. Mice with postpartum depression and their offspring 2024 Animal study
Electroconvulsive therapy combined with esketamine improved depression through PI3K/AKT/GLT-1 pathway. Human patients with severe depression and a rat model of depression 2025 Randomized controlled trial and animal study n = 12
S-ketamine Alleviates Neuroinflammation and Attenuates Lipopolysaccharide-Induced Depression Via Targeting SIRT2. Lipopolysaccharide (LPS)-induced mouse model 2025 Animal study with in vitro and in vivo experiments
Esketamine alleviates LPS-induced depression-like behavior by activating Nrf2-mediated anti-inflammatory response in adolescent mice. Adolescent male C57BL/6J mice 2025 Preclinical experimental study

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