Participation of the Serotonergic System and Brain-Derived Neurotrophic Factor in the Antidepressant-like Effect of Flavonoids.

Depressive disorders are among the most disabling diseases experienced around the world, and their incidence has significantly increased over the last few decades due to multiple environmental, social, and biological factors. The search for new pharmacological alternatives to treat depression is a global priority. In preclinical research, molecules obtained from plants, such as flavonoids, have shown promising antidepressant-like properties through several mechanisms of action that have not been fully elucidated, including crossing of the blood brain barrier (BBB). This review will focus on discussing the main findings related to the participation of the serotonergic system and brain-derived neurotrophic factor (BDNF) on the antidepressant-like effect of some flavonoids reported by behavioral, neurochemical, and molecular studies. In this sense, evidence shows that depressive individuals have low levels of serotonin and BDNF, while flavonoids can reverse it. Finally, the elucidation of the mechanism used by flavonoids to modulate serotonin and BDNF will contribute to our understanding of the neurobiological bases underlying the antidepressant-like effects produced by these natural compounds.

Pharmacological, Neurochemical, and Behavioral Mechanisms Underlying the Anxiolytic- and Antidepressant-like Effects of Flavonoid Chrysin.

Chrysin (5,7-dihydroxyflavone) is a flavonoid isolated from plants, such as Passiflora coerulea, Passiflora incarnata, and Matricaria chamomilla. This natural molecule exerts diverse pharmacological effects, which includes antioxidant, anti-inflammatory, anti-cancer, neuroprotective, and anti-apoptotic effects. Additionally, in brain structures, such as the hippocampus, prefrontal cortex, raphe nucleus, and striatum, involved in the physiopathology of anxiety and depression disorders, several neuropharmacological activities, including the activation of neurotransmitter systems (GABAergic, serotonergic, dopaminergic, and noradrenergic), neurotrophic factors, such as brain-derived neurotrophic factor and the nerve growth factor, and some signaling pathways are affected. The results showed that the anxiolytic and antidepressant-like effects of chrysin occurs through its interaction with specific neurotransmitter systems, principally the GABAergic and the serotonergic, and activation of other neurotrophic factors. However, it is not possible to discard the antioxidant and anti-inflammatory activities of chrysin while producing its anxiolytic- and antidepressant-like effects. Although these results have been obtained principally from pre-clinical research, they consistently demonstrate the potential therapeutic use of flavonoid chrysin as an anxiolytic and antidepressant agent. Therefore, this flavonoid could be considered as a promising novel therapy for anxiety and depression disorders.

Pomegranate (Punica granatum L.) and its phytochemicals as anxiolytic; an underreported effect with therapeutic potential: A systematic review.

Anxiety is a mental disorder characterized by excessive concern about possible future threats that, if prolonged, becomes a pathology that must be controlled through psychotherapy and medication. Currently, the pharmacological treatment for anxiety involves the use of antidepressants and benzodiazepines; however, these treatments often come with adverse effects. Thus, there is a need to seek natural compounds that can help alleviate anxiety and reduce these side effects. On the other hand, pomegranate (PG) fruit is known to have important health benefits, which have been compiled in several reviews. However, its anxiolytic effect has not been thoroughly studied, and clinical research on this topic is lacking. The aim of this work was to conduct a systematic review of studies exploring the anxiolytic-like effect of PG and its phytochemicals. Databases such as Pubmed, ScienceDirect, Springer link, Google scholar, Worldwide science, and Web of science were searched for articles using predetermined terms. Inclusion criteria were established, and original articles that met these criteria were selected. The data collected included information on PG part and variety, species, sample size, anxiety model, dose, route and time of administration, reference drug, main results, and the mechanisms of action. Fifty-nine studies were found that reported the anxiolytic-like effect of PG and its phytochemicals such as anthocyanins, flavonoids, tannins, organic acids, and xanthonoids. The literature suggests that the mechanisms of action behind this effect involved the inhibition of the GABAergic receptor, NMDA, CaMKII/CREB pathway; the reduction of oxidative stress, inhibiting TLR4 and nNOS; modulation of cytokines and the expression of NFkB, GAD67, and iNOS, as well as the activation of Nrf2 and AMPK. PG and some of its phytochemicals could be considered as a novel alternative for the treatment of pathological anxiety. This review is the first to document the anxiolytic-like effect of PG.

Zebrafish as a Useful Tool in the Research of Natural Products With Potential Anxiolytic Effects.

Zebrafish (Danio rerio) is a popular and valuable species used in many different biomedical research areas. The complex behavior that fish exhibit in response to different stimuli allows researchers to explore the biological and pharmacological basis of affective and mood disorders. In this sense, anxiety is commonly studied in preclinical research with animal models in rodents. During the last decade, those models have been successfully adapted to zebrafish. Stressful stimuli, such as novel environments, chemical substances, light conditions, and predator images, can trigger defensive behaviors considered indicators of an anxiety-like state. In the first stage, models were adapted and validated with different stressors and anxiolytic drugs with promising results and are now successfully used to generate scientific knowledge. In that sense, zebrafish allows several routes of administration and other methodological advantages to explore the anxiolytic effects of natural products in behavioral tests as novel tank, light-dark chamber, and black/white maze, among others. The present work will review the main findings on preclinical research using adult zebrafish to explore anxiolytics effects of natural products as plant secondary metabolites such as flavonoids, alkaloids and terpenes or standardized extracts of plants, among others. Scientific literature confirms the utility of zebrafish tests to explore anxiety-like states and anxiolytic-like effects of plant secondary metabolites, which represent a useful and ethical tool in the first stages of behavioral.

Differential effects of acute and chronic treatment with the flavonoid chrysin on anxiety-like behavior and Fos immunoreactivity in the lateral septal nucleus in rats.

The aim of this study was to compare the effects of acute (a single injection) and chronic (21 consecutive days) treatments with chrysin 2, 4, and 8 µmol kg-1 on anxiety-like behavior and Fos immunoreactivity in the lateral septum nucleus (LSN), a structure that is involved in the regulation of anxiety, in male Wistar rats. These effects were compared with the clinically effective anxiolytic diazepam 7 µmol kg-1. The results showed that acute, but not chronic treatment, with 4 µmol kg-1 chrysin exerted anxiolytic- and anti- depressant-like effects with these effects being similar to that of diazepam. Also, none of the above-mentioned treatments did alter Fos immunoreactivity in the LSN, but a tendency towards the reduction of this variable was detected with chrysin 4 µmol kg-1 and diazepam 7 µmol kg-1. Altogether, results suggest that chrysin exerts anxiolytic-like effects, however, it can produce pharmacological tolerance after repeated use, similar to benzodiazepines.

Chrysin, but not flavone backbone, decreases anxiety-like behavior in animal screens.

Chrysin (5,7-dihydroxyflavone), a nutraceutical flavonoid present in diverse plants, has a backbone structure shared with the flavone backbone, with additional hydroxyl groups that confers its antioxidant properties and effects at the GABAA receptor complex. However, whether these effects are due to the hydroxyl groups is unknown. Here we report the effects of chrysin or the flavone backbone (1 mg/kg) in rats subjected to the elevated plus-maze and the locomotor activity test, as well as in the zebrafish evaluated in light/dark model. Chrysin, but not flavone, increased entries and time in the open arms of the elevated plus-maze, as well as time on white compartment of the light/dark model in zebrafish. These effects were comparable to diazepam, and were devoid of motor effects in both tests, as well as in the locomotor activity test. On the other hand, flavone decreased risk assessment in the light/dark test but increased rearing in the locomotor activity test in rats, suggesting effects threat information gathering; important species differences suggest new avenues of research. It is suggested that the specific effects of chrysin in relation to flavone include more of a mechanism of action in which in addition to its action at the GABAA/benzodiazepine receptor complex also could be involved its free radical scavenging abilities, which require specific research. Preprint: https://doi.org/10.1101/575514; Data and scripts:https://github.com/lanec-unifesspa/chrysin.

Long-term ovariectomy increases anxiety- and despair-like behaviors associated with lower Fos immunoreactivity in the lateral septal nucleus in rats.

In woman, surgical menopause is associated with anxiety and depression symptoms. Ovariectomy in rats has been proposed as an experimental model of surgical menopause, but its long-term effects on anxiety- and depression-like behaviors and relationship with cellular changes in specific brain structures are unknown. The effects of ovariectomy on anxiety- and despair-like behavior 1, 3, 6, 9, 12, and 15-weeks postovariectomy were evaluated. Fos-immunoreactivity was evaluated in the lateral septal nucleus (LSN). The effects were compared with rats in the proestrus-estrus and metestrus-diestrus phases of the ovarian cycle and with ovariectomized rats that received 17ß-estradiol (OVXE). Three weeks postovariectomy, the rats exhibited an increase in anxiety-like behavior compared with PE and OVXE groups. Decreases in the locomotor activity and time spent grooming and rearing were detected in all the ovariectomized rats. In the forced swim test, the rats exhibited an increase in immobility time 6-weeks postovariectomy compared with control groups. The Fos-immunoreactivity in the LSN was significantly lower in all groups of ovariectomized rats compared with control groups. These findings indicate that rats develop anxiety-like behavior 3-weeks postovariectomy. Six weeks postovariectomy, the rats also developed despair-like behavior, which was associated with a reduction of Fos immunoreactivity in the LSN. Long-term ovariectomy may be considered a useful tool for understanding the development of neurobiological changes associated with surgical menopause. This model may also be useful for evaluating potential anxiolytic and antidepressant effects of diverse substances to ameliorate typical emotional and affective disorders during surgical menopause in women.

Advances in the Preclinical Study of Some Flavonoids as Potential Antidepressant Agents.

Flavonoids are phenolic compounds found commonly in plants that protect them against the negative effects of environmental insults. These secondary metabolites have been widely studied in preclinical research because of their biological effects, particularly as antioxidant agents. Diverse flavonoids have been studied to explore their potential therapeutic effects in the treatment of disorders of the central nervous system, including anxiety and depression. The present review discusses advances in the study of some flavonoids as potential antidepressant agents. We describe their behavioral, physiological, and neurochemical effects and the apparent mechanism of action of their preclinical antidepressant-like effects. Natural flavonoids produce antidepressant-like effects in validated behavioral models of depression. The mechanism of action of these effects includes the activation of serotonergic, dopaminergic, noradrenergic, and γ-aminobutyric acid-ergic neurotransmitter systems and an increase in the production of neural factors, including brain-derived neurotrophic factor and nerve growth factor. Additionally, alterations in the function of tropomyosin receptor kinase B and activity of the enzyme monoamine oxidase A have been reported. In conclusion, preclinical research supports the potential antidepressant effects of some natural flavonoids, which opens new possibilities of evaluating these substances to develop complementary therapeutic alternatives that could ameliorate symptoms of depressive disorders in humans.

Effectiveness evaluation of online Mindfulness in mental health and alcohol consumption in medical students during the COVID-19 pandemic / Evaluación de la eficacia del Mindfulness online en la salud mental y el consumo de alcohol en estudiantes de medicina durante la pandemia de COVID-19

Abstract Introduction As a result of the COVID-19 pandemic, the prevalence of stress, anxiety, depression, and alcohol consumption has increased among medical students. Mindfulness is an intervention to decrease these psychopathologies and alcohol consumption; however, evidence has shown unclear results regarding its efficacy. Objective To evaluate the effectiveness of an online Mindfulness-based intervention (MBI) on stress, anxiety, and depression symptomatology levels, as well as on alcohol consumption and mindfulness status in medical students during the COVID-19 pandemic. Method A quasi-experimental study was conducted on 237 students, obtaining sociodemographic data. In addition the levels of psychopathology, alcohol consumption, and state of mindfulness: were measured pre-and post-intervention through the DASS-21, AUDIT, and MASS instruments. Eight online Mindfulness sessions were conducted once a week for approximately one hour each. Results MBI did not reduce levels of psychopathologies or alcohol consumption, nor did the mindfulness status improve. High levels of psychopathologies, dropout rate, and lack of voluntary participation were the main factors limiting the effectiveness of the online MBI. Discussion and conclusion The online MBI wasn't effective among the population under study: we recommend generation strategies where students are involved in and complete intervention programs. Results from this research will help enhance future online mindfulness interventions.

Resumen Introducción Derivado de la pandemia del COVID-19, la prevalencia de estrés, ansiedad, depresión y consumo de alcohol ha incrementado entre los estudiantes de medicina. La intervención por Mindfulness ha reportado disminuir estas psicopatologías y el consumo de alcohol; no obstante, la evidencia muestra resultados poco claros respecto a su eficacia. Objetivo Evaluar la eficacia de la intervención basada en Mindfulness online (IBM) sobre los niveles de sintomatología de estrés, ansiedad y depresión, así como en el consumo de alcohol y el estado de atención plena en estudiantes de medicina durante la pandemia por COVID-19. Método Se realizó una investigación cuasi-experimental en 237 estudiantes de medicina, de los cuales se obtuvieron datos sociodemográficos; además, se midieron los niveles de psicopatologías, consumo de alcohol, y el estado de atención plena pre y post intervención a través de los instrumentos DASS-21, AUDIT, y MASS. Se llevaron a cabo ocho sesiones de Mindfulness online, una vez por semana, de aproximadamente una hora cada una. Resultados La IBM no redujo los niveles de psicopatologías ni de consumo de alcohol ni mejoró el estado de atención plena. Los altos niveles de psicopatologías, la tasa de abandono y la falta de participación voluntaria, fueron los principales factores que limitan la eficacia del IBM online. Discusión y conclusión La IBM online no fue efectiva entre la población estudiada: se recomienda la generación de estrategias en las que los estudiantes se involucren y completen los programas de intervención, los resultados de esta investigación ayudarán a mejorar futuras intervenciones de mindfulness online.