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367. DISCOVERING MARKERS OF INTRON RETENTION IN DEPRESSION AND ITS RESPONSE TO KETAMINE

N Okada

The International Journal of Neuropsychopharmacology August 18, 2025 DOI: 10.1093/ijnp/pyaf052.252 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Case-control study with RNA-seq re-analysis Peer reviewed
Population Human peripheral blood mononuclear cells from subjects with self-reported depression in the pre-symptomatic state of major depressive disorder, plus re-analyzed published RNA-seq datasets from patients with MDD and ketamine responders/non-responders
Topics Depression Esketamine Ketamine
Key findings Depression was associated with activation of innate immune response and relative inactivation of T-cell signaling. Intron-retention genes were enriched for sensor and cilia-related functions, and common intron-retention genes were detected across depressed populations. Re-analysis suggested ketamine non-responders had elevated viral infection signatures, and several viral-infection-related intron-retention genes were restored to healthy states by ketamine.

Abstract

Abstract:

Background: Peripheral inflammation is often associated with depressive disorders, and immunological biomarkers of depression remain a focus of investigation. Aims &

Objectives: The purpose of this study is to demonstrate the usefulness of intron retention as a marker for depression.

Method: We performed RNA-seq analysis of RNA transcripts of human peripheral blood mononuclear cells from a case-control study including subjects with self-reported depression in the pre-symptomatic state of major depressive disorder and analyzed differentially expressed genes (DEGs) and the frequency of intron retention (IR) using rMATS.

Results: Among the statistically significant DEGs identified, the 651 upregulated DEGs were particularly enriched in the term “bacterial infection and phagocytosis”, whereas the 820 downregulated DEGs were enriched in the terms “antigen presentation” and “T-cell proliferation and maturation”. We also analyzed 158 genes for which the IR was increased (IncIR) and 211 genes for which the IR was decreased (DecIR) in the depressed subjects. Although the Gene Ontology terms associated with IncIR and DecIR were very similar to those of the up- and downregulated genes, respectively, IR genes appeared to be particularly enriched in genes with sensor functions, with a preponderance of the term “ciliary assembly and function”. The observation that IR genes specifically interact with innate immunity genes suggests that immune-related genes, as well as cilia-related genes, may be excellent markers of depression. Re-analysis of previously published RNA-seq data from patients with MDD showed that common IR genes, particularly our predicted immune- and cilia-related genes, are commonly detected in populations with different levels of depression, providing validity for using IR to detect depression. In addition, we re-analyzed the RNA-seq data of non-responders and responders to ketamine, a drug with specific efficacy for depression, published by Cathomas et al. (2022), and examined IR genes to investigate what the substance of non-responders is. It was found that non-responders were individuals in a state of elevated viral infection. Several IR genes associated with viral infection were restored to a healthy state by ketamine, so it is more reasonable to interpret that the non-responders are not individuals for whom ketamine does not work, but rather that the effects of ketamine do not catch up due to the extremely elevated inflammatory state of the non-responders. This further supports our previous claim that IR genes, but not DEGs, may be useful as markers of depression. Discussion &

Conclusions: Depression was found to be associated with activation of the innate immune response and relative inactivation of T-cell signaling. The DEGs we identified reflect physiological demands that are controlled at the transcriptional level, whereas the IR results reflect a more direct mechanism for monitoring protein homeostasis. Accordingly, an alteration in IR, namely IncIR or DecIR, is a stress response, and intron-retained transcripts are sensors of the physiological state of the cytoplasm. The results demonstrate the potential of relative IR as a biomarker for the immunological stratification of depressed patients and the utility of IR for the discovery of novel pathways involved in recovery from depression.

Comparable studies

Other observational and cohort studies on ketamine for depression, most cited first.

Study Year Design Participants
Concomitant BDNF and sleep slow wave changes indicate ketamine-induced plasticity in major depressive disorder Patients with treatment-resistant major depressive disorder 2012 Observational cohort n = 30
Altered peripheral immune profiles in treatment-resistant depression: response to ketamine and prediction of treatment outcome Healthy controls and actively depressed patients with treatment-resistant depression... 2017 Observational cohort n = 59
Clinical Predictors of Ketamine Response in Treatment-Resistant Major Depression Treatment-resistant inpatients with DSM-IV-TR-diagnosed major depressive disorder or... 2014 Post hoc analysis of pooled data from four studies n = 108
An investigation of amino-acid neurotransmitters as potential predictors of clinical improvement to ketamine in depression Drug-free patients with major depressive disorder 2011 Observational cohort n = 14
Efficacy of ketamine therapy in the treatment of depression Drug-free/naïve men with severe depression, no history of psychotic disorder, head... 2019 Observational cohort n = 25

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