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The changes in,and relationship between,plasma nitric oxide and corticotropin‐releasing hormone in patients with major depressive disorder
Authors:Yun‐Rong Lu  Yan Zhang  Ying‐Bo Rao  Xi Chen  Han‐Fen Lou  Yu Zhang  Hai‐Yan Xie  Ping Fang  Li‐Wei Hu
Affiliation:1. Department of Psychiatry, The Fourth Affiliated Hospital, Zhejiang University, School of Medicine, Yiwu, Zhejiang, China;2. Department of Psychiatry, The Second Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, Zhejiang, China;3. Department of Clinical Laboratory, The Fourth Affiliated Hospital, Zhejiang University, School of Medicine, Yiwu, Zhejiang, China
Abstract:There is strong evidence of roles of the hypothalamus‐pituitary‐adrenal axis and nitric oxide (NO) synthase‐NO system in depression, but the relationship between them is unknown. The aim of this study, therefore, was to elucidate whether there is any correlation between NO and corticotropin‐releasing hormone (CRH) in major depressive disorder (MDD) patients. In 16 outpatients with MDD and 18 healthy controls, the plasma amino acids citrulline (Cit) and arginine (Arg) were determined by high‐performance liquid chromatography, and CRH levels was measured by radioimmunoassay. The Cit/Arg ratio was calculated as an index of NO synthesis. Correlations between NO and CRH were examined with the Spearman test. Before treatment, no significant correlation was observed between the plasma NO level and CRH levels in MDD patients. The plasma NO levels were significantly higher in MDD patients. A significant correlation was found between NO levels and Hamilton Depression Rating Scale (HAMD) scores in MDD patients. The plasma CRH levels were significantly higher in MDD patients than in controls. After monotherapy for 2 months, the NO levels had dramatically declined but were also higher than those in the controls. This study is the first report of the absence of a significant correlation between plasma NO and CRH levels, although both levels are elevated in MDD patients. Furthermore, the strong links between the plasma NO levels and the HAMD scores, as well as the increased NO reduction after remission, suggest that NO plays a key role in depression and may be an indicator of therapeutic success.
Keywords:arginine  citrulline  corticotropin‐releasing hormone  major depressive disorder  nitric oxide
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