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International Journal of Molecular Sciences logoLink to International Journal of Molecular Sciences
. 2021 Jan 24;22(3):1148. doi: 10.3390/ijms22031148

Transcriptome Changes in Three Brain Regions during Chronic Lithium Administration in the Rat Models of Mania and Depression

Dawid Szczepankiewicz 1,*, Piotr Celichowski 2, Paweł A Kołodziejski 1, Ewa Pruszyńska-Oszmałek 1, Maciej Sassek 1, Przemysław Zakowicz 3, Ewa Banach 4, Wojciech Langwiński 5, Kosma Sakrajda 5, Joanna Nowakowska 5, Magdalena Socha 6, Ewelina Bukowska-Olech 6, Joanna Pawlak 3, Joanna Twarowska-Hauser 3, Leszek Nogowski 1, Janusz K Rybakowski 7, Aleksandra Szczepankiewicz 5,*
Editor: Anastasios Lymperopoulos
PMCID: PMC7865310  PMID: 33498969

Abstract

Lithium has been the most important mood stabilizer used for the treatment of bipolar disorder and prophylaxis of manic and depressive episodes. Despite long use in clinical practice, the exact molecular mechanisms of lithium are still not well identified. Previous experimental studies produced inconsistent results due to different duration of lithium treatment and using animals without manic-like or depressive-like symptoms. Therefore, we aimed to analyze the gene expression profile in three brain regions (amygdala, frontal cortex and hippocampus) in the rat model of mania and depression during chronic lithium administration (2 and 4 weeks). Behavioral changes were verified by the forced swim test, open field test and elevated maze test. After the experiment, nucleic acid was extracted from the frontal cortex, hippocampus and amygdala. Gene expression profile was done using SurePrint G3 Rat Gene Expression whole transcriptome microarrays. Data were analyzed using Gene Spring 14.9 software. We found that chronic lithium treatment significantly influenced gene expression profile in both mania and depression models. In manic rats, chronic lithium treatment significantly influenced the expression of the genes enriched in olfactory and taste transduction pathway and long non-coding RNAs in all three brain regions. We report here for the first time that genes regulating olfactory and taste receptor pathways and long non-coding RNAs may be targeted by chronic lithium treatment in the animal model of mania.

Keywords: manic-like behavior, depressive-like behavior, lithium, animal model, transcriptome, brain

1. Introduction

Bipolar disorder (BD) is a severe, recurrent psychiatric condition characterized by episodes of mania or hypomania and depression. Mania presents with hyperactivity, disinhibited behavior and inflated self-esteem. On the other hand, during depression patients demonstrate anhedonia and loss of motivation and interest in usual activities [1].

Pharmacological treatment of BD includes mostly the use of mood stabilizers. The first drug fulfilling criteria for the mood stabilizer such as preventing manic and depressive episodes was lithium. Its antimanic actions in the acute episode were first discovered by Cade et al. in animal model studies [2]. Its antidepressant potential was reported in the 1970s [3,4] and later it was recommended as an augmentation of antidepressants in the treatment-resistant depression and an effective long-term prophylaxis of recurrences in mood disorders (as recently reviewed by Rybakowski [5]).

Although lithium has been for decades in clinical use, the molecular mechanism of action and normotymic potential of lithium are still not well identified. Moreover, absence of suitable animal model of bipolar disorder impedes studies on lithium action. Previous studies focused on identifying target genes and molecular pathways of lithium indicated its role in reducing inositol signaling [6], phosphorylation of AKT [7] and inhibition of GSK-3β (glycogen synthase kinase 3) signaling [6,8]. The latter two may lead to the changes in the activation of WNT pathway. These findings were possible to discover using pharmacological and pharmacogenetic studies, which showed involvement of lithium in multiple cellular signaling pathways as reviewed previously [9,10].

Animal studies of the brain transcriptome during lithium administration showed that inconsistent results are mainly due to the different duration of lithium administration (1 week, two weeks and 6 weeks), analysis of the whole brain tissue (whole brain homogenates) and the use of different animals (rat or mouse) [11,12]. Moreover, these studies used animals treated with lithium, but without manic-like or depressive-like symptoms, so it is still not known if therapeutic action of lithium in manic and depressive behavior induces changes in the gene expression of similar or different pathways depending on the baseline condition and the brain region.

Therefore, we hypothesized that chronic lithium treatment exerts its therapeutic effect by inducing changes in the brain transcriptome specific for mania and depression. The aim of this study was to investigate if chronic lithium administration in rats presenting manic-like behavior (induced by amphetamine) or depressive like behavior (induced by chronic mild stress) influences specific gene expression profiles in different brain regions (amygdala, frontal cortex and hippocampus).

2. Results

2.1. Behavioral Changes in Amphetamine-Exposed and Stress-Exposed Animals (Models of Mania and Depression)

Manic-like behavior was observed after one week of amphetamine injections using the elevated maze test as compared to the behavior of the same animals before starting the experiment (baseline) (Figure 1).

Figure 1.

Figure 1

The comparison of behavioral changes before and after amphetamine injection in the elevated maze test: (a) number of visits in open arms, (b) time spent in open arms, (c) distance passed by the animals (paired t-test, * defines p < 0.05).

Two-week chronic mild stress protocol resulted in depressive-like behavior measured by behavioral tests (FST and OFT) in analyzed rats as compared to the behavior of the same animals before starting the experiment (baseline) (Figure 2).

Figure 2.

Figure 2

The results of behavioral changes after chronic mild stress protocol: (ad) are parameters measured in an open filed test and (e,f) are parameters measured by a forced swim test (paired t-test, * defines p < 0.05).

2.2. Brain Transcriptome Changes in the Model of Mania and Depression

Significant changes in the behavior following chronic mild stress protocol or amphetamine corresponded to specific gene expression profiles in three brain regions. In rats presenting manic-like behavior, we found 1283 genes differentially expressed in the amygdala, 637 genes in the frontal cortex and 344 genes in the hippocampus as compared to the control group (Figure 3a,b). The altered genes in the amygdala were mainly downregulated and significantly enriched in 23 Gene Ontology (GO) terms including olfactory receptor activity and chemical response to stimuli (Table 1). The genes differentially expressed in the frontal cortex and hippocampus were not significantly enriched in any GO terms or pathways.

Figure 3.

Figure 3

Differentially expressed genes (up- and downregulated) in three analyzed brain regions (amygdala, frontal cortex and hippocampus) in amphetamine-exposed (a,b, respectively) and stress-exposed rats (c,d, respectively) as compared to the control group.

Table 1.

Gene Ontology (GO) terms enriched from significantly downregulated genes between rats with manic-like behavior and control rats in the amygdala.

GO Accession GO Term Corr p No. Genes
GO:0007186 G-protein coupled receptor signaling pathway 0.000 117
GO:0007600 sensory perception 0.000 103
GO:0051606 detection of stimulus 0.000 88
GO:0050906 detection of stimulus involved in sensory perception 0.000 84
GO:0038023 signaling receptor activity 0.000 120
GO:0060089 molecular transducer activity 0.000 120
GO:0009593 detection of chemical stimulus 0.000 81
GO:0050907 detection of chemical stimulus involved in sensory perception 0.000 79
GO:0004888 transmembrane signaling receptor activity 0.000 111
GO:0004930 G-protein coupled receptor activity 0.000 93
GO:0004871 signal transducer activity 0.000 126
GO:0007606 sensory perception of chemical stimulus 0.000 82
GO:0004984 olfactory receptor activity 0.000 74
GO:0050911 detection of chemical stimulus involved in sensory perception of smell 0.000 74
GO:0007608 sensory perception of smell 0.000 75
GO:0007165 signal transduction 0.000 201
GO:0003008 system process 0.000 123
GO:0050877 nervous system process 0.000 106
GO:0023052 signaling 0.000 209
GO:0007154 cell communication 0.000 212
GO:0050896 response to stimulus 0.001 287
GO:0051716 cellular response to stimulus 0.004 238
GO:0005833 hemoglobin complex 0.019 5

In rats with depressive-like behavior, we found 856 differentially expressed genes (either up- or downregulated) in the amygdala, 1910 genes in the frontal cortex and 1942 genes in the hippocampus as compared to the control rats (Figure 3c,d).

The downregulated genes in the amygdala were enriched mainly in locomotor behavior and blood circulation (8 GO terms), whereas the upregulated genes were involved, among others, in animal organ morphogenesis, response to stimuli and signal transduction (8 GO terms) (Table 2). In the frontal cortex and hippocampus the differentially expressed genes (either upregulated or downregulated) were not significantly enriched in any GO terms or pathways.

Table 2.

GO terms significantly enriched from differentially expressed genes between rats with depressive-like behavior and control group in the amygdala.

GO Accession GO Term Corr p No. Genes
Downregulated
GO:0007610 behavior 0.002 26
GO:0007188 adenylate cyclase-modulating G-protein coupled receptor signaling pathway 0.002 12
GO:0007187 G-protein coupled receptor signaling pathway, coupled to cyclic nucleotide second messenger 0.003 12
GO:0044459 plasma membrane part 0.004 53
GO:0003013 circulatory system process 0.004 17
GO:0008015 blood circulation 0.004 17
GO:0007626 locomotory behavior 0.004 14
GO:0007193 adenylate cyclase-inhibiting G-protein coupled receptor signaling pathway 0.037 7
Upregulated
GO:0023052 signaling 0.000 102
GO:0007154 cell communication 0.000 102
GO:0007165 signal transduction 0.000 95
GO:0038023 signaling receptor activity 0.001 55
GO:0060089 molecular transducer activity 0.001 55
GO:0004888 transmembrane signaling receptor activity 0.001 52
GO:0004871 signal transducer activity 0.006 57
GO:0007186 G-protein coupled receptor signaling pathway 0.006 49
GO:0003008 system process 0.006 57
GO:0051606 detection of stimulus 0.017 37
GO:0050896 response to stimulus 0.022 126
GO:0004930 G-protein coupled receptor activity 0.028 40
GO:0009593 detection of chemical stimulus 0.028 34
GO:0050906 detection of stimulus involved in sensory perception 0.045 34
GO:0009653 anatomical structure morphogenesis 0.050 45

2.3. Brain Transcriptome Changes during Chronic Lithium Administration

2.3.1. Two-Week Lithium Administration

Lithium administration for two weeks resulted in significant changes in both, stress-exposed and manic-like rats in all analyzed brain regions. In rats presenting manic-like behavior and receiving lithium for two weeks, we found 4041 differentially expressed genes in the amygdala (all upregulated), 978 genes in the frontal cortex and 386 genes in the hippocampus. In the amygdala upregulated genes were enriched in 40 GO terms, mainly olfactory receptor activity, taste receptor and bitter taste receptor (Table 3). In the frontal cortex, most genes were significantly downregulated and involved in 11 GO terms, including olfactory receptor activity (Table 3). Genes differentially expressed in the hippocampus were not enriched in any GO terms.

Table 3.

Differentially expressed genes enriched in GO terms in amphetamine-exposed rats after two weeks of lithium treatment.

GO Accession GO Term Corr p No. Genes
Amygdala upregulated
GO:0038023 signaling receptor activity 0.000 367
GO:0060089 molecular transducer activity 0.000 367
GO:0004888 transmembrane signaling receptor activity 0.000 352
GO:0007186 G-protein coupled receptor signaling pathway 0.000 344
GO:0007600 sensory perception 0.000 310
GO:0004930 G-protein coupled receptor activity 0.000 299
GO:0007606 sensory perception of chemical stimulus 0.000 285
GO:0051606 detection of stimulus 0.000 281
GO:0050906 detection of stimulus involved in sensory perception 0.000 273
GO:0009593 detection of chemical stimulus 0.000 268
GO:0050907 detection of chemical stimulus involved in sensory perception 0.000 264
GO:0007608 sensory perception of smell 0.000 256
GO:0004984 olfactory receptor activity 0.000 247
GO:0050911 detection of chemical stimulus involved in sensory perception of smell 0.000 247
GO:0004871 signal transducer activity 0.000 379
GO:0050877 nervous system process 0.000 330
GO:0003008 system process 0.000 363
GO:0031224 intrinsic component of membrane 0.000 640
GO:0016021 integral component of membrane 0.000 627
GO:0007165 signal transduction 0.000 509
GO:0042221 response to chemical 0.000 507
GO:0044425 membrane part 0.000 687
GO:0005886 plasma membrane 0.000 521
GO:0005549 odorant binding 0.000 68
GO:0071944 cell periphery 0.000 528
GO:0023052 signaling 0.000 523
GO:0007154 cell communication 0.000 533
GO:0032501 multicellular organismal process 0.000 669
GO:0050896 response to stimulus 0.000 731
GO:0004252 serine-type endopeptidase activity 0.000 44
GO:0051716 cellular response to stimulus 0.000 597
GO:0008236 serine-type peptidase activity 0.000 44
GO:0017171 serine hydrolase activity 0.000 44
GO:0008527 taste receptor activity 0.000 15
GO:0050912 detection of chemical stimulus involved in sensory perception of taste 0.001 17
GO:0050913 sensory perception of bitter taste 0.002 16
GO:0033038 bitter taste receptor activity 0.002 13
GO:0001580 detection of chemical stimulus involved in sensory perception of bitter taste 0.004 15
GO:0004175 endopeptidase activity 0.005 61
GO:0050909 sensory perception of taste 0.007 19
Frontal cortex downregulated
GO:0038023 signaling receptor activity 0.022 80
GO:0060089 molecular transducer activity 0.022 80
GO:0007608 sensory perception of smell 0.022 52
GO:0004984 olfactory receptor activity 0.022 50
GO:0050911 detection of chemical stimulus involved in sensory perception of smell 0.022 50
GO:0009593 detection of chemical stimulus 0.026 52
GO:0050907 detection of chemical stimulus involved in sensory perception 0.026 51
GO:0051606 detection of stimulus 0.029 55
GO:0007606 sensory perception of chemical stimulus 0.033 54
GO:0050906 detection of stimulus involved in sensory perception 0.033 52
GO:0004888 transmembrane signaling receptor activity 0.036 72

Rats presenting depressive-like behavior showed differentially expressed 1650 genes in the amygdala, 481 genes in the frontal cortex and 304 genes in the hippocampus. The significantly altered genes in the amygdala were mainly downregulated and were involved in 206 GO terms, mainly associated with extracellular processes e.g., extracellular matrix organization (top 20 were listed in Table 4). In the frontal cortex differentially expressed genes were not significantly enriched in any GO terms between rats receiving lithium and control group. In the hippocampus, altered genes were significantly enriched in two GO terms, antigen processing and antigen binding (Table 4).

Table 4.

Differentially expressed genes enriched in GO terms in stress-exposed rats after two weeks of lithium treatment.

GO Accession GO Term Corr p No. Genes
Amygdala (top 20 out of 206)
GO:0005578 proteinaceous extracellular matrix 0.000 41
GO:0031012 extracellular matrix 0.000 34
GO:0005576 extracellular region 0.000 117
GO:0044421 extracellular region part 0.000 108
GO:0005615 extracellular space 0.000 104
GO:0044420 extracellular matrix component 0.000 19
GO:0009888 tissue development 0.000 62
GO:0030198 extracellular matrix organization 0.000 21
GO:0009653 anatomical structure morphogenesis 0.000 68
GO:0043062 extracellular structure organization 0.000 21
GO:0007275 multicellular organism development 0.000 112
GO:0030199 collagen fibril organization 0.000 11
GO:0072001 renal system development 0.000 24
GO:0005581 collagen trimer 0.000 13
GO:0032502 developmental process 0.000 122
GO:0048513 animal organ development 0.000 87
GO:0048646 anatomical structure formation involved in morphogenesis 0.000 39
GO:0009887 animal organ morphogenesis 0.000 41
GO:0048731 system development 0.000 104
Hippocampus
GO:0002474 antigen processing and presentation of peptide antigen via MHC class I 0.024 4
GO:0042605 peptide antigen binding 0.024 4

2.3.2. Four-Week Lithium Administration

In rats presenting manic-like behavior and receiving lithium for 4 weeks, we observed 2831 genes differentially expressed in the amygdala, 1964 genes in the frontal cortex and 7412 genes in the hippocampus. In the amygdala, all genes were downregulated after 4 weeks on lithium and were enriched mainly in olfactory receptor activity and bitter taste (Table 5). In the frontal cortex, downregulated genes were enriched in 31 GO terms including, e.g., olfactory receptor activity (Table 5). In the hippocampus significantly upregulated genes were enriched in 57 GO terms (mainly response to chemical stimuli, bitter taste and olfactory receptor activity) (Table 5).

Table 5.

Differentially expressed genes enriched in GO terms in amphetamine-exposed rats after four weeks of lithium treatment.

GO Accession GO Term Corr p No. Genes
Amygdala downregulated
GO:0038023 signaling receptor activity 0.000 228
GO:0060089 molecular transducer activity 0.000 228
GO:0004888 transmembrane signaling receptor activity 0.000 212
GO:0007608 sensory perception of smell 0.000 149
GO:0004984 olfactory receptor activity 0.000 144
GO:0050911 detection of chemical stimulus involved in sensory perception of smell 0.000 144
GO:0007606 sensory perception of chemical stimulus 0.000 159
GO:0007600 sensory perception 0.000 186
GO:0050907 detection of chemical stimulus involved in sensory perception 0.000 147
GO:0050906 detection of stimulus involved in sensory perception 0.000 151
GO:0051606 detection of stimulus 0.000 157
GO:0009593 detection of chemical stimulus 0.000 147
GO:0004930 G-protein coupled receptor activity 0.000 172
GO:0004871 signal transducer activity 0.000 237
GO:0007186 G-protein coupled receptor signaling pathway 0.000 196
GO:0050877 nervous system process 0.000 199
GO:0031224 intrinsic component of membrane 0.000 451
GO:0016021 integral component of membrane 0.000 441
GO:0003008 system process 0.000 220
GO:0044425 membrane part 0.002 488
GO:0005886 plasma membrane 0.003 365
GO:0023052 signaling 0.007 366
GO:0071944 cell periphery 0.008 369
GO:0007165|GO:0023033 signal transduction 0.009 346
GO:0007154 cell communication 0.011 373
GO:0005549 odorant binding 0.020 40
Frontal cortex downregulated
GO:0007606 sensory perception of chemical stimulus 0.000 154
GO:0004984 olfactory receptor activity 0.000 140
GO:0050911 detection of chemical stimulus involved in sensory perception of smell 0.000 140
GO:0009593 detection of chemical stimulus 0.000 145
GO:0050907 detection of chemical stimulus involved in sensory perception 0.000 143
GO:0007608 sensory perception of smell 0.000 142
GO:0007600 sensory perception 0.000 171
GO:0050906 detection of stimulus involved in sensory perception 0.000 144
GO:0051606 detection of stimulus 0.000 148
GO:0004888 transmembrane signaling receptor activity 0.000 183
GO:0004930 G-protein coupled receptor activity 0.000 154
GO:0038023 signaling receptor activity 0.000 190
GO:0060089 molecular transducer activity 0.000 190
GO:0050877 nervous system process 0.000 177
GO:0007186 G-protein coupled receptor signaling pathway 0.000 172
GO:0004871 signal transducer activity 0.000 197
GO:0003008 system process 0.000 195
GO:0031224 intrinsic component of membrane 0.000 340
GO:0016021 integral component of membrane 0.000 334
GO:0071944 cell periphery 0.000 287
GO:0005886 plasma membrane 0.000 281
GO:0042221 response to chemical 0.000 269
GO:0044425 membrane part 0.000 364
GO:0032501 multicellular organismal process 0.001 352
GO:0005549 odorant binding 0.001 34
GO:0036156 inner dynein arm 0.006 4
GO:0007165 signal transduction 0.006 252
GO:0004252 serine-type endopeptidase activity 0.019 22
GO:0023052 signaling 0.030 261
GO:0007154 cell communication 0.030 267
GO:0008236 serine-type peptidase activity 0.043 23
Hippocampus downregulated
GO:0001580 detection of chemical stimulus involved in sensory perception of bitter taste 0.000 1394
GO:0001594 trace-amine receptor activity 0.000 1323
GO:0003008 system process 0.000 1316
GO:0004252 serine-type endopeptidase activity 0.000 1313
GO:0004866 endopeptidase inhibitor activity 0.000 1212
GO:0004867 serine-type endopeptidase inhibitor activity 0.000 1119
GO:0004869 cysteine-type endopeptidase inhibitor activity 0.000 1105
GO:0004871 signal transducer activity 0.000 1083
GO:0004888 transmembrane signaling receptor activity 0.000 1062
GO:0004930 G-protein coupled receptor activity 0.000 1053
GO:0004984 olfactory receptor activity 0.000 1037
GO:0005179 hormone activity 0.000 888
GO:0005549 odorant binding 0.000 877
GO:0005886 plasma membrane 0.000 877
GO:0007154 cell communication 0.000 850
GO:0007165 signal transduction 0.000 845
GO:0007186 G-protein coupled receptor signaling pathway 0.000 835
GO:0007600 sensory perception 0.000 791
GO:0007606 sensory perception of chemical stimulus 0.000 769
GO:0007608 sensory perception of smell 0.000 740
GO:0008527 taste receptor activity 0.000 720
GO:0009593 detection of chemical stimulus 0.000 697
GO:0010466 negative regulation of peptidase activity 0.000 684
GO:0010951 negative regulation of endopeptidase activity 0.000 675
GO:0016020 membrane 0.000 673
GO:0016021 integral component of membrane 0.000 652
GO:0016503 pheromone receptor activity 0.000 644
GO:0017171 serine hydrolase activity 0.000 644
GO:0019236 response to pheromone 0.000 173
GO:0023052 signaling 0.000 1413
GO:0030414 peptidase inhibitor activity 0.000 1507
GO:0030545 receptor regulator activity 0.000 41
GO:0031224 intrinsic component of membrane 0.000 41
GO:0032501 multicellular organismal process 0.000 1583
GO:0033038 bitter taste receptor activity 0.000 27
GO:0038023 signaling receptor activity 0.000 24
GO:0042221 response to chemical 0.000 1644
GO:0042742 defense response to bacterium 0.000 29
GO:0044425 membrane part 0.000 1726
GO:0048018 receptor ligand activity 0.000 26
GO:0050789 regulation of biological process 0.000 26
GO:0050794 regulation of cellular process 0.000 32
GO:0050877 nervous system process 0.000 57
GO:0050896 response to stimulus 0.000 54
GO:0050906 detection of stimulus involved in sensory perception 0.000 54
GO:0050907 detection of chemical stimulus involved in sensory perception 0.000 13
GO:0050909 sensory perception of taste 0.000 40
GO:0050911 detection of chemical stimulus involved in sensory perception of smell 0.001 90
GO:0050912 detection of chemical stimulus involved in sensory perception of taste 0.001 57
GO:0050913 sensory perception of bitter taste 0.001 94
GO:0051606 detection of stimulus 0.001 63
GO:0051716 cellular response to stimulus 0.002 60
GO:0060089 molecular transducer activity 0.010 23
GO:0061134 peptidase regulator activity 0.011 54
GO:0061135 endopeptidase regulator activity 0.014 49
GO:0065007 biological regulation 0.025 28
GO:0071944 cell periphery 0.043 53

Four weeks of lithium treatment in stress-exposed rats, we observed that in the amygdala 778 genes were differentially expressed, in the frontal cortex 779 genes and in the hippocampus 307 genes. In the amygdala the genes were mainly upregulated and enriched in 17 GO terms, e.g., olfactory receptor activity (Table 6), in the frontal cortex altered genes were grouped in 24 GO terms (including nucleosome assembly, DNA-protein complex) and in the hippocampus differentially expressed genes were involved in extracellular matrix/space/region and collagen fibril organization (two upregulated GO terms) (Table 6).

Table 6.

Differentially expressed genes enriched in GO terms in stress-exposed rats after four weeks of lithium treatment.

GO Accession GO Term Corr p No. Genes
Amygdala upregulated
GO:0038023 signaling receptor activity 0.000 63
GO:0060089 molecular transducer activity 0.000 63
GO:0004888 transmembrane signaling receptor activity 0.000 59
GO:0007600 sensory perception 0.000 54
GO:0050907 detection of chemical stimulus involved in sensory perception 0.000 43
GO:0007606 sensory perception of chemical stimulus 0.000 45
GO:0009593 detection of chemical stimulus 0.000 43
GO:0051606 detection of stimulus 0.000 45
GO:0050906 detection of stimulus involved in sensory perception 0.000 43
GO:0007608 sensory perception of smell 0.000 41
GO:0004984 olfactory receptor activity 0.000 40
GO:0050911 detection of chemical stimulus involved in sensory perception of smell 0.000 40
GO:0007186 G-protein coupled receptor signaling pathway 0.000 56
GO:0004871 signal transducer activity 0.002 63
GO:0003008 system process 0.003 63
GO:0050877 nervous system process 0.003 55
GO:0004930 G-protein coupled receptor activity 0.003 46
Frontal cortex upregulated
GO:0000786 nucleosome 0.000 5
GO:0006334 nucleosome assembly 0.000 5
GO:0044815 DNA packaging complex 0.000 5
GO:0045653 negative regulation of megakaryocyte differentiation 0.000 3
GO:0031497 chromatin assembly 0.000 5
GO:0006333 chromatin assembly or disassembly 0.000 5
GO:0034728 nucleosome organization 0.000 5
GO:0006323 DNA packaging 0.000 5
GO:0065004 protein-DNA complex assembly 0.000 5
GO:0006335 DNA replication-dependent nucleosome assembly 0.000 3
GO:0034723 DNA replication-dependent nucleosome organization 0.000 3
GO:0032993 protein-DNA complex 0.000 5
GO:0071824 protein-DNA complex subunit organization 0.000 5
GO:0000788 nuclear nucleosome 0.000 3
GO:0006336 DNA replication-independent nucleosome assembly 0.000 3
GO:0045652 regulation of megakaryocyte differentiation 0.000 3
GO:0034724 DNA replication-independent nucleosome organization 0.000 3
GO:0071103 DNA conformation change 0.001 5
GO:0051290 protein heterotetramerization 0.002 3
GO:0051291 protein heterooligomerization 0.006 4
GO:0030492 hemoglobin binding 0.008 2
GO:0006352 DNA-templated transcription. initiation 0.018 3
GO:0045638 negative regulation of myeloid cell differentiation 0.018 3
GO:0000785 chromatin 0.047 5
Hippocampus upregulated
GO:0005578 proteinaceous extracellular matrix 0.022 10
GO:0031012 extracellular matrix 0.009 13

2.3.3. Molecular Pathways in the Brain during Chronic Lithium Treatment

When we combined together gene sets differentially expressed in rats with depressive-like behavior receiving lithium for two and four weeks, we observed only a few shared genes between these two time points either in the amygdala or frontal cortex and hippocampus as compared to the control rats (Figure 4). These genes were not enriched in any GO terms and pathways.

Figure 4.

Figure 4

Genes differentially expressed in rats depressive-like after 2 weeks and 4 weeks on lithium treatment in the amygdala, frontal cortex and hippocampus. Shared genes between these time points were indicated by purple color.

In rats with manic-like behavior, we observed that chronic lithium treatment (2 and 4 weeks) significantly influenced the expression of the genes from the olfactory and taste transduction pathway (mainly different olfactory and taste receptors) and long non-coding RNAs in all three brain regions in rats receiving lithium as compared to water-receiving animals (Figure 5). Gene-set enrichment analysis showed that the shared genes between 2 and 4 weeks showed different gene expression profile: those upregulated after 2-week lithium treatment were downregulated after 4 weeks in the amygdala and frontal cortex. In the hippocampus, a 4-week lithium treatment upregulated all the genes.

Figure 5.

Figure 5

Gene-set enrichment analysis indicated that the genes from olfactory transduction pathway are influenced by chronic lithium administration in manic-like rats in analyzed brain areas (amygdala, frontal cortex and hippocampus).

2.4. Brain Transcriptome Changes in Lithium Responders

We also compared the gene expression profile before and after chronic lithium administration (2 and 4 weeks) in lithium responders. These rats showed changes in behavioral tests (open field test and elevated maze test) corresponding to reduced manic or depressive symptoms, e.g., reduced number of visits and time spent in open arms in manic rats after lithium and increased exploration time and number of line crossing in depressive rats after lithium (Figure 6).

Figure 6.

Figure 6

The comparison of behavioral changes before and after lithium administration in: (ac) rats with manic-like behavior using elevated maze test and (df) rats with depressive-like behavior using open field test (one-way analysis of variance).

Gene expression analysis in rats responding to lithium showed that in after chronic lithium administration gene expression was mainly upregulated in the amygdala and frontal cortex, but downregulated in the hippocampus in manic rats responding to lithium as compared to rats before lithium treatment. Interestingly, depressive rats responding to lithium showed the opposite trend, with mostly downregulated gene expression in the amygdala and frontal cortex, but upregulated in the hippocampus as compared to depressive rats before lithium. These genes were significantly enriched in GO terms related i.a. to olfactory receptor pathway, sensory perception of smell, G-protein coupled receptor and detection of stimulus (Table 7 and Table 8).

Table 7.

Differentially expressed genes enriched in GO terms in amphetamine-exposed rats responding to chronic lithium in comparison to rats before lithium.

Go Accession GO Term Corr p No. Genes
upregulated in the amygdala
GO:0007606 sensory perception of chemical stimulus 0.000 232
GO:0009593 detection of chemical stimulus 0.000 220
GO:0050907 detection of chemical stimulus involved in sensory perception 0.000 216
GO:0051606 detection of stimulus 0.000 232
GO:0050906 detection of stimulus involved in sensory perception 0.000 220
GO:0004930 G-protein coupled receptor activity 0.000 252
GO:0007608 sensory perception of smell 0.000 210
GO:0004984 olfactory receptor activity 0.000 205
GO:0050911 detection of chemical stimulus involved in sensory perception of smell 0.000 205
GO:0007186 G-protein coupled receptor signaling pathway 0.000 291
GO:0007600 sensory perception 0.000 261
GO:0004888 transmembrane signaling receptor activity 0.000 293
GO:0038023 signaling receptor activity 0.000 306
GO:0060089 molecular transducer activity 0.000 306
GO:0004871 signal transducer activity 0.000 317
GO:0050877 nervous system process 0.000 275
GO:0003008 system process 0.000 306
GO:0031224 intrinsic component of membrane 0.000 556
GO:0016021 integral component of membrane 0.000 548
GO:0007165 signal transduction 0.000 436
GO:0032501 multicellular organismal process 0.000 596
GO:0007154 cell communication 0.000 464
GO:0023052 signaling 0.000 452
GO:0044425 membrane part 0.000 596
GO:0005886 plasma membrane 0.000 447
GO:0042221 response to chemical 0.000 429
GO:0071944 cell periphery 0.000 455
GO:0030414 peptidase inhibitor activity 0.000 35
GO:0005549 odorant binding 0.001 50
GO:0004252 serine-type endopeptidase activity 0.001 34
GO:0004866 endopeptidase inhibitor activity 0.001 32
GO:0061135 endopeptidase regulator activity 0.003 32
GO:0061134 peptidase regulator activity 0.005 35
GO:0010466 negative regulation of peptidase activity 0.011 38
GO:0008236 serine-type peptidase activity 0.019 34
GO:0017171 serine hydrolase activity 0.025 34
GO:0050896 response to stimulus 0.026 631
GO:003024 carbohydrate binding 0.041 38
GO:0010951 negative regulation of endopeptidase activity 0.044 35
GO:0004869 cysteine-type endopeptidase inhibitor activity 0.046 15
upregulated in the frontal cortex
GO:0004930 G-protein coupled receptor activity 0.000 44
GO:0004888 transmembrane signaling receptor activity 0.000 49
GO:0007186 G-protein coupled receptor signaling pathway 0.000 49
GO:0038023 signaling receptor activity 0.001 51
GO:0060089 molecular transducer activity 0.001 51
GO:0004871 signal transducer activity 0.003 53
downregulated in the hippocampus
GO:0007186 G-protein coupled receptor signaling pathway 0.000 87
GO:0004888 transmembrane signaling receptor activity 0.000 85
GO:0038023 signaling receptor activity 0.000 89
GO:0060089 molecular transducer activity 0.000 89
GO:0004930 G-protein coupled receptor activity 0.000 68
GO:0004871| signal transducer activity 0.000 92
GO:0007600 sensory perception 0.003 67
GO:0050906 detection of stimulus involved in sensory perception 0.007 54
GO:0050907 detection of chemical stimulus involved in sensory perception 0.008 52
GO:0051606 detection of stimulus 0.009 56
GO:0007606 sensory perception of chemical stimulus 0.011 55
GO:0009593 detection of chemical stimulus 0.011 52
GO:0003008 system process 0.011 86
GO:0004984 olfactory receptor activity 0.014 49
GO:0050911 detection of chemical stimulus involved in sensory perception of smell 0.014 49
GO:0007608 sensory perception of smell 0.031 49
GO:0050877 nervous system process 0.071 71

Table 8.

Differentially expressed genes enriched in GO terms in stress-exposed rats responding to chronic lithium treatment in comparison to rats before lithium.

Go Accession GO Term Corr p No. Genes
downregulated in the amygdala
GO:0044425 membrane part 0.000 1150
GO:0032501| multicellular organismal process 0.000 1107
GO:0031224 intrinsic component of membrane 0.000 1098
GO:0016021 integral component of membrane 0.000 1090
GO:0007154 cell communication 0.000 941
GO:0023052 signaling 0.000 930
GO:0007165 signal transduction 0.000 909
GO:0042221 response to chemical 0.000 895
GO:0071944 cell periphery 0.000 881
GO:0005886 plasma membrane 0.000 874
GO:0004871 signal transducer activity 0.000 773
GO:0038023 signaling receptor activity 0.000 762
GO:0060089 molecular transducer activity 0.000 762
GO:0004888 transmembrane signaling receptor activity 0.000 749
GO:0007186 G-protein coupled receptor signaling pathway 0.000 736
GO:0003008 system process 0.000 720
GO:0050877 nervous system process 0.000 683
GO:0007600 sensory perception 0.000 667
GO:0004930 G-protein coupled receptor activity 0.000 652
GO:0007606 sensory perception of chemical stimulus 0.000 632
GO:0051606 detection of stimulus 0.000 593
GO:0050906 detection of stimulus involved in sensory perception 0.000 586
GO:0009593 detection of chemical stimulus 0.000 578
GO:0050907 detection of chemical stimulus involved in sensory perception 0.000 578
GO:0007608 sensory perception of smell 0.000 565
GO:0004984 olfactory receptor activity 0.000 556
GO:0050911 detection of chemical stimulus involved in sensory perception of smell 0.000 556
GO:0005549 odorant binding 0.000 164
GO:0051716 cellular response to stimulus 0.000 1009
GO:0050896 response to stimulus 0.000 1174
GO:0016503 pheromone receptor activity 0.000 48
GO:0019236 response to pheromone 0.000 47
GO:0016020 membrane 0.000 1232
GO:0050789 regulation of biological process 0.000 1346
GO:0065007 biological regulation 0.000 1417
GO:0050794 regulation of cellular process 0.000 1286
GO:0033038 bitter taste receptor activity 0.000 19
GO:0008527 taste receptor activity 0.000 20
GO:0001580 detection of chemical stimulus involved in sensory perception of bitter taste 0.000 21
GO:0050909 sensory perception of taste 0.000 27
GO:0050912 detection of chemical stimulus involved in sensory perception of taste 0.000 22
GO:0050913 sensory perception of bitter taste 0.000 21
GO:0030414 peptidase inhibitor activity 0.000 47
GO:0004866 endopeptidase inhibitor activity 0.000 44
GO:0061135 endopeptidase regulator activity 0.001 44
GO:0004252 serine-type endopeptidase activity 0.001 45
GO:0008227 G-protein coupled amine receptor activity 0.003 22
GO:0017171 serine hydrolase activity 0.003 49
GO:0008236 serine-type peptidase activity 0.004 48
GO:0061134 peptidase regulator activity 0.006 47
GO:0004867 serine-type endopeptidase inhibitor activity 0.016 25
GO:0019373 epoxygenase P450 pathway 0.030 10
GO:0010466 negative regulation of peptidase activity 0.037 50
downregulated in the frontal cortex
GO:0004930 G-protein coupled receptor activity 0.000 50
GO:0007606 sensory perception of chemical stimulus 0.000 45
GO:0009593 detection of chemical stimulus 0.000 43
GO:0038023 signaling receptor activity 0.000 61
GO:0060089 molecular transducer activity 0.000 61
GO:0007600 sensory perception 0.000 51
GO:0050907 detection of chemical stimulus involved in sensory perception 0.000 42
GO:0007608 sensory perception of smell 0.000 41
GO:0004984 olfactory receptor activity 0.000 40
GO:0050911 detection of chemical stimulus involved in sensory perception of smell 0.000 40
GO:0051606 detection of stimulus 0.000 44
GO:0050906 detection of stimulus involved in sensory perception 0.000 42
GO:0004888 transmembrane signaling receptor activity 0.000 56
GO:0007186 G-protein coupled receptor signaling pathway 0.001 54
GO:0003008 system process 0.001 63
GO:0004871 signal transducer activity 0.002 62
GO:0050877 nervous system process 0.002 54
GO:0016021 integral component of membrane 0.006 112
GO:0031224 intrinsic component of membrane 0.007 113
upregulated in the hippocampus
GO:0004930 G-protein coupled receptor activity 0.000 118
GO:0007606 sensory perception of chemical stimulus 0.000 108
GO:0050907 detection of chemical stimulus involved in sensory perception 0.000 102
GO:0009593 detection of chemical stimulus 0.000 103
GO:0050906 detection of stimulus involved in sensory perception 0.000 104
GO:0004984 olfactory receptor activity 0.000 98
GO:0050911 detection of chemical stimulus involved in sensory perception of smell 0.000 98
GO:0051606 detection of stimulus 0.000 105
GO:0007608 sensory perception of smell 0.000 98
GO:0004888 transmembrane signaling receptor activity 0.000 129
GO:0038023 signaling receptor activity 0.000 135
GO:0060089 molecular transducer activity 0.000 135
GO:0007186 G-protein coupled receptor signaling pathway 0.000 127
GO:0007600 sensory perception 0.000 115
GO:0004871 signal transducer activity 0.000 136
GO:0050877 nervous system process 0.000 119
GO:0003008 system process 0.000 127
GO:0016021 integral component of membrane 0.000 217
GO:0031224 intrinsic component of membrane 0.000 219
GO:0007165 signal transduction 0.000 173
GO:0023052 signaling 0.000 178
GO:0044425 membrane part 0.000 225
GO:0007154 cell communication 0.000 179
GO:0042221 response to chemical 0.000 167
GO:0071944 cell periphery 0.000 174
GO:0005886 plasma membrane 0.000 171
GO:0032501 multicellular organismal process 0.000 214
GO:0005549 odorant binding 0.000 25
GO:0051716 cellular response to stimulus 0.000 193

3. Discussion

The main observation of this study shows that the brain transcriptome is influenced by chronic lithium administration. The important finding is that the differentially expressed genes specific for the mania model are involved in olfactory receptor transduction and taste receptor pathways and show altered expression of long non-coding RNA genes.

Comparing depressive-like and manic-like animals, we found that in the depression model, the gene expression profile is more region-specific (different pathways regulated upon lithium in the amygdala, frontal cortex and hippocampus) and time-dependent (2 weeks versus 4 weeks). In the model of mania, on the other hand, lithium significantly affected olfactory receptor and bitter taste receptor pathways, independent of the brain region or time of lithium administration suggesting their role in antimanic action. The genes from these pathways also showed significantly altered expression in “manic” rats before lithium administration. Our observation is consistent with the previous human studies in bipolar disorder patients that presented several olfactory and gustatory dysfunctions [13] and the sensory enhancement and dysregulation of taste were often reported during an acute manic episode in BD patients [14].

Previous animal studies of lithium showed that mice chronically fed with lithium accumulated it mainly in neurogenic brain regions including olfactory bulb [15]. Similarly, chronic lithium effects in the neurogenic brain region (hippocampus) were also observed in human BD studies showing that lithium influenced hippocampal volume and structural plasticity in BD patients [16,17,18]. These findings suggest that chronic lithium treatment targets olfactory bulb and alters associated pathways (e.g., olfactory transduction).

On the contrary, in “depressive” rats we observed the upregulated expression of genes regulating olfactory receptor activity after 4-week lithium administration in the amygdala, which is consistent with the previous observations that bipolar patients during depressive episode experienced sensory blunting and olfactory deficits [14]. Thus chronic lithium treatment seems to restore olfactory function in rats presenting depressive-like behavior. Moreover, previous study showed that olfactory bulbectomy induced depressive-like behavior in rodents [19], in particular when taking into account the close anatomical links between the olfactory system and the brain circuits involved in memory [20] and emotion [21]. The recent studies reported the presence of sensory changes during mood swings in BD [22] and that olfactory assessment may be useful to screen unipolar and bipolar depression [23]. These genes involved in olfactory receptors activity were also differentially expressed in either manic and depressive rats responding to chronic lithium treatment and showed the opposite effect that also depended on tissue: in the amygdala they were upregulated after chronic lithium in mania, but downregulated in depression; in the hippocampus they showed downregulated expression in mania, but upregulated in depression after chronic lithium. This opposite gene expression profiles between amygdala and hippocampus after chronic lithium treatment may be further supported by results of the recent study that showed the opposite temporal profiles of protein expression between amygdala and hippocampal neurons in long-term response to acute stress [24].

Our findings from the animal model indicating the involvement of the taste receptor pathway were further supported by the observations in our clinical sample of bipolar and unipolar patients showing altered expression of taste receptor genes in peripheral blood leukocytes during depressive episode (Dmitrzak-Węglarz et al., under review). However, this pathway was not previously reported in the chronic lithium mechanism of action.

Another pathway significantly influenced by chronic lithium treatment in our animal mania model was bitter taste receptor pathway. Recent transcriptome study by Lee et al. [25] showed altered taste receptors gene expression during manic episodes. These genes included bitter taste receptors, TAS2R5 and TAS2R3, that were suggested as potential markers specific for the manic state [25]. These receptors were previously found downregulated (together with olfactory receptors) in the dorsolateral prefrontal cortex of schizophrenia postmortem brain tissues [26] and this downregulation influenced altered cognition. The taste alteration was also related to psychosocial and cognitive performance in bipolar patients [13]. However, the previous studies did not investigate the effects of mood stabilizers on taste-related gene expression. Our observation that chronic lithium influences the regulation of the olfactory and taste receptors’ pathway is supported by the previous case studies reporting long lasting impaired taste (dysgeusia) and smell (hyposmia) in lithium users: cluster headache patient [27] and bipolar patient [28].

Our study revealed that a number of differentially expressed genes influenced by chronic lithium treatment in the brain were long non-coding RNAs. The paper by ConLiGen showed significant associations for two long non-coding RNAs (lncRNAs) localized on chromosome 21 with lithium prophylactic efficacy supporting their involvement in modulating a clinical response [29]. Several studies reported that lncRNAs expression was dysregulated in psychiatric conditions, including BD [30] whereas Lee et al. found recently that lncRNAs were the predominant category showing upregulation during an acute manic episode [25]. Here, we report for the first time that lncRNAs expression is altered by chronic lithium treatment and suggest they may be regulators of antimanic lithium action.

Comparing the 2-week and 4-week gene expression profile, we found that the longer the treatment was, the more differentially expressed genes were observed, independent of the brain region. A previous study comparing microarrays from rat brains after 7 and 42 days of lithium treatment showed that, although plasma Li concentration reached therapeutic levels after 2 days of treatment, it required 2 weeks to reach therapeutic levels in the brain [11]. This finding suggested that the long-term lithium treatment and associated gene expression profile changes better represent the downstream Li effects, which are more relevant to its clinical effect. The other report in the rat fed for 21 days with lithium led to significant changes in the transcriptome in the frontal cortex [31].

To investigate the chronic lithium effect in the brain that mimics changes during the episode of depression or mania, we aimed to model mania and depression separately as the animal model of bipolar disorder does not exist [32]. Animal models are relevant platforms to evaluate the intracellular mechanisms in the brain associated with the pathogenesis of psychiatric disorders and drug studies, including lithium discovery [2,33,34]. In our study, we applied a chronic mild stress (CMS) protocol, the most extensively validated [35], to induce depressive-like behavior. Moreover, the CMS protocol was also suitable to model recurrent depression (a hallmark of bipolar disorder) [36]. The choice of amphetamine to mimic mania was supported by the previous preclinical studies that used repeated intraperitoneal injections of psychostimulants, such as amphetamine, to mimic acute manic episodes in rodents, including hyperactivity and risk-taking behavior due to increased sustained dopamine efflux [37,38,39,40,41,42]. Moreover, these behaviors were reversed by the administration of mood stabilizers, including lithium [40,43]. This chronic amphetamine-induced mania model showed recently good face, predictive and construct validity in modeling mania in Wistar rats [44,45,46,47].

4. Materials and Methods

4.1. Experimental Animals

All experimental procedures were performed in agreement with 3R rule and the study was approved by local ethical committee Poznan University of Life Sciences, Poland (agreement no. 22/2017, 23 June 2017). We used male Wistar rats with the baseline weight of 180 ± 10 g. The rats were housed five animals per cage with food and water available ad libitum and were maintained in a 12 h light/dark cycle (lights on at 7:00 a.m.) at a temperature of 22 ± 1 °C. All experiments were performed at the same time each day to avoid circadian variations. The animals were kept for one week of acclimatization and then were randomly divided into experimental groups with 5 animals in each group (amphetamine-exposed and control group, chronic mild stress-exposed and non-stressed rats; amphetamine-exposed rats receiving lithium or water and stress-exposed rats receiving lithium or water). After the acclimatization period, animals underwent baseline behavioral tests. The experimental design was shown in Figure 7.

Figure 7.

Figure 7

The experimental design of the study showing the (a) procedure of inducing manic-like behavior, (b) procedure of inducing depressive-like behavior, (c) lithium administration in rats with manic-like behavior and (d) lithium administration in animals showing depressive-like behavior. CMS—chronic mild stress protocol; EMT—elevated maze test, FST—forced swim test, OFT—open field test.

4.2. Animal Model of Mania

Manic-like behavior was induced by daily intraperitoneal (i.p) injections of dextroamphetamine (d-AMPH) 2 mg/kg for 2 weeks as described previously [37,42]. The control group were animals receiving daily intraperitoneal injection with saline (0.9% NaCl, 1 mL/kg) for 14 days. After seven days, the behavior of all animals was assessed (Figure 7).

4.3. Animal Model of Depression

Animal model of depression was developed by the chronic mild stress protocol (CMS) as described previously [48]. To induce depressive behavior the animals were exposed for 4 weeks to different stress stimuli according to the CMS protocol described by Papp [49]. The control group were rats kept in standard conditions for 4 weeks that were not exposed to CMS. After two weeks of the start of the experiment, behavior of all animals was assessed (Figure 7).

4.4. Lithium Administration

The animals for the lithium study, after one week of amphetamine injections or two weeks of the chronic mild stress protocol and behavioral assessment, were randomly divided into lithium treated amphetamine-exposed group (n = 15) and amphetamine-exposed control group (rats receiving water, n = 15) and lithium-treated stress-exposed group (n = 15) and a stress-exposed control group (rats receiving water, n = 15). The animals were receiving the daily lithium solution in the dose of 1 mg/kg body mass or the same amount of water into the mouth with a syringe [50]. To minimize the side effects of lithium on kidney function, a saline bottle was provided in all lithium and control cages, as previously reported [51]. To assess the short term and long term lithium effects on brain transcriptome, the animals (n = 15 at each time in each group) were sacrificed by decapitation without euthanasia at two time points of chronic lithium administration, 14 and 30 days (long-term effect) after the first dose. The each control group (for stress-exposed and amphetamine-exposed rats) consisted of animals receiving water (Figure 7).

4.5. Behaviour Assessment

All the behavioral tests were performed during the light phase (between 08:00 a.m. and 12:00 p.m.), at room temperature in a separate quiet room. A blind evaluator assessed all behavioral parameters. To assess depressive-like or manic-like behavior we used a forced-swim test, open field test and elevated maze test at baseline and after induction of stress-induced depression or amphetamine-induced mania.

A forced swim test was performed to measure despair behavior and the hopelessness in the animal [52,53]. Each rat was placed in a glass cylinder 40 cm tall filled with water to a depth of 30 cm (24 ± 1 °C) so the rats could not support themselves by touching the bottom. Two swimming sessions were conducted: a 15-min pretest followed by a 5-min test 24 h later. For each animal, we recorded time spent immobilized (no additional activity other than that required to keep the rat’s head above the water) and active climbing time (upward-directed movements of the forepaws along the side of the swim chamber. The data were analyzed using the video tracking system (Videomot2, AnimaLab, Poznan, Poland). The water in the cylinders was replaced after each trial to remove urine or feces and to avoid confounding results.

Open field test was performed to evaluate the spontaneous locomotory activity in a new environment and exploration [54,55,56]. The rat was placed in the middle of the plastic box measuring 100 cm in diameter with 50-cm walls, divided into 25 squares of 20 × 20-cm size on the bottom (AnimaLab, Poland) and allowed to explore it for 5 min. We recorded the following parameters: time spent immobilized, time spent in center, total distance and exploration time and analyzed the data with the video tracking system (Videomot2, AnimaLab, Poland). After the end of each test, the open field was cleaned to remove any remaining materials (such as feces, urine or smell) that could interfere with the test results.

The elevated maze test was used to test the anxiety level and risk-taking behavior in the rats [42]. The apparatus consisted of two opposite open arms, two opposite closed arms and a central platform connecting the four arms. The maze was propped up 50 cm away from the ground by the maze feet. The test room was maintained with constant temperature, humidity and illumination. The rats were placed in the central platform facing one of the open arms. The number of entries into the open and closed arms and the total time spent in each arm during a 5-min exploration period were recorded by the video tracking system (Videomot2, AnimaLab, Poznań, Poland). After the end of each test, the open field was cleaned to remove any remaining materials (such as feces, urine or smell) that could interfere with the test results.

4.6. Microarray-Based Gene Expression Analysis

The different regions of brain tissue (amygdala, hippocampus, prefrontal cortex and hypothalamus) were collected immediately after decapitation (without anesthesia). The skull was opened, and the cerebral content was excised and rapidly dissected on a chilled Petri dish. The frontal cortex, hippocampus and amygdala were isolated and cleaned from the subcortical structures and white matter, immediately snap frozen in liquid nitrogen and kept frozen in −80 °C for further processing. Frozen tissues were used for RNA extraction using Nucleospin RNA/Protein kit (Macherey Nagel, Dylan, Germany). RNA integrity (RIN) was assessed using Tape Station 2200 (Agilent) and RNA concentration was measured using fluorimeter (Quantus, Promega). Total RNA from amygdala, hippocampus and frontal cortex in the starting amount of 50 ng was used for microarray experiments. We used SurePrint G3 Rat Gene Expression v2 Microarray Kit in format 8 × 60 k and one-color Low Input Quick Amp Labeling Kit (Agilent Technologies, Cedar Creek, TX, USA) to analyze gene expression profile following the standard protocol provided by the manufacturer. The hybridization signals were detected with SureScan Dx Microarray Scanner (Agilent Technologies, Santa Clara, CA, USA). The images obtained after scanning were analyzed with Agilent Feature extraction software v.12.0.3.1.

4.7. Statistical Analysis

Behavioral data were analyzed using a t-test for paired samples after checking normality of data distribution using the Shapiro–Wilk test. A cut-off value p < 0.05 was regarded as significant. Data were shown as mean ± SEM in figures and text if not otherwise stated. For behavioral measurements and gene expression data, 5 animals per experimental group were sufficient to achieve power of 80% (as calculated by the G-power calculator available at https://stats.idre.ucla.edu/other/gpower). To conform to the 3R’s rule, we included the minimal required number of animals (n = 5) in the study.

Bioinformatic analysis of gene expression data was analyzed with the use of Gene Spring 14.9 software (Agilent Technologies, Santa Clara, CA, USA). To identify differentially expressed genes, moderated t-statistics from the empirical Bayes method on normalized fluorescence signal was used for the fold of change (FC) calculation. FC was calculated in relation to the adequate control group. The list of significantly differentially expressed transcripts (p < 0.05 and FC > 2.0) was generated using statistical filtering (moderated t-test with multiple test correction FDR). Then, separate lists of up- and downregulated genes were used for functional analysis to identify Gene Ontology (GO) terms and pathways significantly enriched by the set of differentially expressed genes, either upregulated or downregulated (p < 0.05). Gene Ontology and pathway analyses were done in Gene Spring.

To identify the genes and pathways shared during lithium administration, we used Venn diagrams using a tool freely available at: http://bioinformatics.psb.ugent.be/webtools/Venn. For shared genes, we used G:Profiler tool (available at: https://biit.cs.ut.ee/gprofiler/gost) to perform functional enrichment analysis (gene set enrichment analysis) including GO and pathways from KEGG Reactome and Wiki Pathways [57]. Heat maps were drawn using the Heatmapper tool available at: http://www.heatmapper.ca.

5. Conclusions

We reported here for the first time that genes regulating olfactory and taste receptor pathways and long non-coding RNAs, that were implicated in BD pathogenesis, might be targeted by chronic lithium treatment in animals presenting manic-like behavior. Further functional studies of these pathways are warranted to elucidate the exact therapeutic molecular mechanism of lithium.

Acknowledgments

We would like to thank the staff of the Department of Medical Genetics, Poznan University of Medical Sciences for access to the laboratory equipment for microarrays experiments.

Author Contributions

D.S. participated in the study design and conceptualization, performed animal experiments, data interpretation and drafted the manuscript; P.C., P.A.K., E.P.-O., M.S. (Maciej Sassek), P.Z., E.B. and W.L. performed animal experiments, analyzed the data and revised the manuscript; K.S. and J.N. performed molecular analysis and revised the manuscript; M.S. (Magdalena Socha) and E.B.-O. optimized the microarray experiment and revised the manuscript; J.P. participated in the study design and supervised the experiments; J.T.-H. acquired the funding and supervised the experiments, L.N. and J.K.R. supervised the experiments and revised the manuscript, A.S. participated in the study design, administered the project, performed microarray experiments, analyzed and interpreted the data and revised the manuscript. All authors have read and agreed to the published version of the manuscript.

Funding

This research was funded by National Science Centre, Poland, grant number 2016/21/B/NZ5/00148.

Institutional Review Board Statement

The study was approved by local ethical committee at Poznan University of Life Sciences, Poland (agreement no. 22/2017, 23 June 2017).

Data Availability Statement

The detailed data used to support the findings of this study are available from the corresponding author upon written request.

Conflicts of Interest

The authors declare no conflict of interest. The funding body had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Footnotes

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

  • 1.American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Pub.; Washington, DC, USA: 2013. [Google Scholar]
  • 2.Cade J.F. Lithium salts in the treatment of psychotic excitement. Med. J. Aust. 1949;2:349–352. doi: 10.5694/j.1326-5377.1949.tb36912.x. [DOI] [PubMed] [Google Scholar]
  • 3.Rybakowski J. Lithium carbonate in endogenous depression. Psychiatr. Pol. 1972;6:547–550. [PubMed] [Google Scholar]
  • 4.Mendels J. Lithium in the treatment of depression. Am. J. Psychiatry. 1976;133:373–378. doi: 10.1176/ajp.133.4.373. [DOI] [PubMed] [Google Scholar]
  • 5.Rybakowski J.K. Lithium-past, present, future. Int J. Psychiatry Clin. Pr. 2020;24:330–340. doi: 10.1080/13651501.2020.1775855. [DOI] [PubMed] [Google Scholar]
  • 6.Harwood A.J. Lithium and bipolar mood disorder: The inositol-depletion hypothesis revisited. Mol. Psychiatry. 2005;10:117–126. doi: 10.1038/sj.mp.4001618. [DOI] [PubMed] [Google Scholar]
  • 7.Chalecka-Franaszek E., Chuang D.M. Lithium activates the serine/threonine kinase akt-1 and suppresses glutamate-induced inhibition of akt-1 activity in neurons. Proc. Natl. Acad. Sci. USA. 1999;96:8745–8750. doi: 10.1073/pnas.96.15.8745. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 8.De Sarno P., Li X., Jope R.S. Regulation of akt and glycogen synthase kinase-3 beta phosphorylation by sodium valproate and lithium. Neuropharmacology. 2002;43:1158–1164. doi: 10.1016/S0028-3908(02)00215-0. [DOI] [PubMed] [Google Scholar]
  • 9.Severino G., Squassina A., Costa M., Pisanu C., Calza S., Alda M., Del Zompo M., Manchia M. Pharmacogenomics of bipolar disorder. Pharmacogenomics. 2013;14:655–674. doi: 10.2217/pgs.13.51. [DOI] [PubMed] [Google Scholar]
  • 10.Alda M. Lithium in the treatment of bipolar disorder: Pharmacology and pharmacogenetics. Mol. Psychiatry. 2015;20:661–670. doi: 10.1038/mp.2015.4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11.Bosetti F., Seemann R., Bell J.M., Zahorchak R., Friedman E., Rapoport S.I., Manickam P. Analysis of gene expression with cdna microarrays in rat brain after 7 and 42 days of oral lithium administration. Brain Res. Bull. 2002;57:205–209. doi: 10.1016/S0361-9230(01)00744-4. [DOI] [PubMed] [Google Scholar]
  • 12.McQuillin A., Rizig M., Gurling H.M. A microarray gene expression study of the molecular pharmacology of lithium carbonate on mouse brain mrna to understand the neurobiology of mood stabilization and treatment of bipolar affective disorder. Pharm. Genom. 2007;17:605–617. doi: 10.1097/FPC.0b013e328011b5b2. [DOI] [PubMed] [Google Scholar]
  • 13.Kazour F., Richa S., Desmidt T., Lemaire M., Atanasova B., El Hage W. Olfactory and gustatory functions in bipolar disorders: A systematic review. Neurosci. Biobehav. Rev. 2017;80:69–79. doi: 10.1016/j.neubiorev.2017.05.009. [DOI] [PubMed] [Google Scholar]
  • 14.Parker G., Paterson A., Romano M., Granville Smith I. Suprasensory phenomena in those with a bipolar disorder. Australas. Psychiatry. 2018;26:384–387. doi: 10.1177/1039856218762306. [DOI] [PubMed] [Google Scholar]
  • 15.Zanni G., Michno W., Di Martino E., Tjarnlund-Wolf A., Pettersson J., Mason C.E., Hellspong G., Blomgren K., Hanrieder J. Lithium accumulates in neurogenic brain regions as revealed by high resolution ion imaging. Sci. Rep. 2017;7:40726. doi: 10.1038/srep40726. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 16.Bertolino A., Frye M., Callicott J.H., Mattay V.S., Rakow R., Shelton-Repella J., Post R., Weinberger D.R. Neuronal pathology in the hippocampal area of patients with bipolar disorder: A study with proton magnetic resonance spectroscopic imaging. Biol. Psychiatry. 2003;53:906–913. doi: 10.1016/S0006-3223(02)01911-X. [DOI] [PubMed] [Google Scholar]
  • 17.Colla M., Schubert F., Bubner M., Heidenreich J.O., Bajbouj M., Seifert F., Luborzewski A., Heuser I., Kronenberg G. Glutamate as a spectroscopic marker of hippocampal structural plasticity is elevated in long-term euthymic bipolar patients on chronic lithium therapy and correlates inversely with diurnal cortisol. Mol. Psychiatry. 2009;14:696–704. doi: 10.1038/mp.2008.26. [DOI] [PubMed] [Google Scholar]
  • 18.Giakoumatos C.I., Nanda P., Mathew I.T., Tandon N., Shah J., Bishop J.R., Clementz B.A., Pearlson G.D., Sweeney J.A., Tamminga C.A., et al. Effects of lithium on cortical thickness and hippocampal subfield volumes in psychotic bipolar disorder. J. Psychiatr. Res. 2015;61:180–187. doi: 10.1016/j.jpsychires.2014.12.008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 19.Poretti M.B., Rask-Andersen M., Kumar P., Rubiales de Barioglio S., Fiol de Cuneo M., Schioth H.B., Carlini V.P. Ghrelin effects expression of several genes associated with depression-like behavior. Prog. Neuropsychopharmacol. Biol. Psychiatry. 2015;56:227–234. doi: 10.1016/j.pnpbp.2014.09.012. [DOI] [PubMed] [Google Scholar]
  • 20.Savic I., Gulyas B., Larsson M., Roland P. Olfactory functions are mediated by parallel and hierarchical processing. Neuron. 2000;26:735–745. doi: 10.1016/S0896-6273(00)81209-X. [DOI] [PubMed] [Google Scholar]
  • 21.Anderson A.K., Christoff K., Stappen I., Panitz D., Ghahremani D.G., Glover G., Gabrieli J.D., Sobel N. Dissociated neural representations of intensity and valence in human olfaction. Nat. Neurosci. 2003;6:196–202. doi: 10.1038/nn1001. [DOI] [PubMed] [Google Scholar]
  • 22.Parker G., Paterson A., Romano M., Graham R. Altered sensory phenomena experienced in bipolar disorder. Am. J. Psychiatry. 2017;174:1146–1150. doi: 10.1176/appi.ajp.2017.16121379. [DOI] [PubMed] [Google Scholar]
  • 23.Kazour F., Richa S., Abi Char C., Surget A., Elhage W., Atanasova B. Olfactory markers for depression: Differences between bipolar and unipolar patients. PLoS ONE. 2020;15:e0237565. doi: 10.1371/journal.pone.0237565. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 24.Madan J.S., Gupta K., Chattarji S., Bhattacharya A. Hippocampal and amygdalar cell-specific translation is similar soon after stress but diverge over time. Hippocampus. 2018;28:441–452. doi: 10.1002/hipo.22845. [DOI] [PubMed] [Google Scholar]
  • 25.Lee Y.C., Chao Y.L., Chang C.E., Hsieh M.H., Liu K.T., Chen H.C., Lu M.L., Chen W.Y., Chen C.H., Tsai M.H., et al. Transcriptome changes in relation to manic episode. Front. Psychiatry. 2019;10:280. doi: 10.3389/fpsyt.2019.00280. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 26.Ansoleaga B., Garcia-Esparcia P., Pinacho R., Haro J.M., Ramos B., Ferrer I. Decrease in olfactory and taste receptor expression in the dorsolateral prefrontal cortex in chronic schizophrenia. J. Psychiatr. Res. 2015;60:109–116. doi: 10.1016/j.jpsychires.2014.09.012. [DOI] [PubMed] [Google Scholar]
  • 27.De Coo I.F., Haan J. Long lasting impairment of taste and smell as side effect of lithium carbonate in a cluster headache patient. Headache. 2016;56:1201–1203. doi: 10.1111/head.12872. [DOI] [PubMed] [Google Scholar]
  • 28.Terao T., Watanabe S., Hoaki N., Hoaki T. Strange taste and mild lithium intoxication. BMJ Case Rep. 2011;2011 doi: 10.1136/bcr.05.2011.4267. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 29.Hou L., Heilbronner U., Degenhardt F., Adli M., Akiyama K., Akula N., Ardau R., Arias B., Backlund L., Banzato C.E.M., et al. Genetic variants associated with response to lithium treatment in bipolar disorder: A genome-wide association study. Lancet. 2016;387:1085–1093. doi: 10.1016/S0140-6736(16)00143-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 30.Akula N., Barb J., Jiang X., Wendland J.R., Choi K.H., Sen S.K., Hou L., Chen D.T., Laje G., Johnson K., et al. Rna-sequencing of the brain transcriptome implicates dysregulation of neuroplasticity, circadian rhythms and gtpase binding in bipolar disorder. Mol. Psychiatry. 2014;19:1179–1185. doi: 10.1038/mp.2013.170. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 31.Fatemi S.H., Reutiman T.J., Folsom T.D. The role of lithium in modulation of brain genes: Relevance for aetiology and treatment of bipolar disorder. Biochem. Soc. Trans. 2009;37:1090–1095. doi: 10.1042/BST0371090. [DOI] [PubMed] [Google Scholar]
  • 32.Kato T., Kasahara T., Kubota-Sakashita M., Kato T.M., Nakajima K. Animal models of recurrent or bipolar depression. Neuroscience. 2016;321:189–196. doi: 10.1016/j.neuroscience.2015.08.016. [DOI] [PubMed] [Google Scholar]
  • 33.Beyer D.K.E., Freund N. Animal models for bipolar disorder: From bedside to the cage. Int. J. Bipolar Disord. 2017;5:35. doi: 10.1186/s40345-017-0104-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 34.Lan A., Einat H. Questioning the predictive validity of the amphetamine-induced hyperactivity model for screening mood stabilizing drugs. Behav. Brain Res. 2019;362:109–113. doi: 10.1016/j.bbr.2019.01.006. [DOI] [PubMed] [Google Scholar]
  • 35.Willner P. Reliability of the chronic mild stress model of depression: A user survey. Neurobiol. Stress. 2017;6:68–77. doi: 10.1016/j.ynstr.2016.08.001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 36.Remus J.L., Jamison D., Johnson J.D. An animal model of recurrent depression: Sensitized depression-like behavior when rats are re-exposed to chronic mild stress. Brain Behav. Immun. 2013;32:e4–e5. doi: 10.1016/j.bbi.2013.07.026. [DOI] [Google Scholar]
  • 37.Frey B.N., Martins M.R., Petronilho F.C., Dal-Pizzol F., Quevedo J., Kapczinski F. Increased oxidative stress after repeated amphetamine exposure: Possible relevance as a model of mania. Bipolar Disord. 2006;8:275–280. doi: 10.1111/j.1399-5618.2006.00318.x. [DOI] [PubMed] [Google Scholar]
  • 38.Szabo S.T., Machado-Vieira R., Yuan P., Wang Y., Wei Y., Falke C., Cirelli C., Tononi G., Manji H.K., Du J. Glutamate receptors as targets of protein kinase c in the pathophysiology and treatment of animal models of mania. Neuropharmacology. 2009;56:47–55. doi: 10.1016/j.neuropharm.2008.08.015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 39.Feier G., Valvassori S.S., Varela R.B., Resende W.R., Bavaresco D.V., Morais M.O., Scaini G., Andersen M.L., Streck E.L., Quevedo J. Lithium and valproate modulate energy metabolism in an animal model of mania induced by methamphetamine. Pharm. Biochem. Behav. 2013;103:589–596. doi: 10.1016/j.pbb.2012.09.010. [DOI] [PubMed] [Google Scholar]
  • 40.Zhou Z., Wang Y., Tan H., Bharti V., Che Y., Wang J.F. Chronic treatment with mood stabilizer lithium inhibits amphetamine-induced risk-taking manic-like behaviors. Neurosci. Lett. 2015;603:84–88. doi: 10.1016/j.neulet.2015.07.027. [DOI] [PubMed] [Google Scholar]
  • 41.Valvassori S.S., Resende W.R., Dal-Pont G., Sangaletti-Pereira H., Gava F.F., Peterle B.R., Carvalho A.F., Varela R.B., Dal-Pizzol F., Quevedo J. Lithium ameliorates sleep deprivation-induced mania-like behavior, hypothalamic-pituitary-adrenal (hpa) axis alterations, oxidative stress and elevations of cytokine concentrations in the brain and serum of mice. Bipolar Disord. 2017;19:246–258. doi: 10.1111/bdi.12503. [DOI] [PubMed] [Google Scholar]
  • 42.Valvassori S.S., Gava F.F., Dal-Pont G.C., Simoes H.L., Damiani-Neves M., Andersen M.L., Boeck C.R., Quevedo J. Effects of lithium and valproate on erk/jnk signaling pathway in an animal model of mania induced by amphetamine. Heliyon. 2019;5:e01541. doi: 10.1016/j.heliyon.2019.e01541. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 43.Valvassori S.S., Tonin P.T., Varela R.B., Carvalho A.F., Mariot E., Amboni R.T., Bianchini G., Andersen M.L., Quevedo J. Lithium modulates the production of peripheral and cerebral cytokines in an animal model of mania induced by dextroamphetamine. Bipolar Disord. 2015;17:507–517. doi: 10.1111/bdi.12299. [DOI] [PubMed] [Google Scholar]
  • 44.Menegas S., Dal-Pont G.C., Cararo J.H., Varela R.B., Aguiar-Geraldo J.M., Possamai-Della T., Andersen M.L., Quevedo J., Valvassori S.S. Efficacy of folic acid as an adjunct to lithium therapy on manic-like behaviors, oxidative stress and inflammatory parameters in an animal model of mania. Metab. Brain Dis. 2020;35:413–425. doi: 10.1007/s11011-019-00503-3. [DOI] [PubMed] [Google Scholar]
  • 45.Varela R.B., Resende W.R., Dal-Pont G.C., Gava F.F., Nadas G.B., Tye S.J., Andersen M.L., Quevedo J., Valvassori S.S. Role of epigenetic regulatory enzymes in animal models of mania induced by amphetamine and paradoxical sleep deprivation. Eur J. Neurosci. 2020 doi: 10.1111/ejn.14922. [DOI] [PubMed] [Google Scholar]
  • 46.Valvassori S.S., Tonin P.T., Dal-Pont G.C., Varela R.B., Cararo J.H., Garcia A.F., Gava F.F., Menegas S., Soares J.C., Quevedo J. Coadministration of lithium and celecoxib reverses manic-like behavior and decreases oxidative stress in a dopaminergic model of mania induced in rats. Transl. Psychiatry. 2019;9:297. doi: 10.1038/s41398-019-0637-9. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 47.Bristot G., Ascoli B.M., Scotton E., Gea L.P., Pfaffenseller B., Kauer-Sant’Anna M. Effects of lithium on inflammatory and neurotrophic factors after an immune challenge in a lisdexamfetamine animal model of mania. Braz. J. Psychiatry. 2019;41:419–427. doi: 10.1590/1516-4446-2017-0001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 48.Willner P., Muscat R., Papp M. Chronic mild stress-induced anhedonia: A realistic animal model of depression. Neurosci. Biobehav. Rev. 1992;16:525–534. doi: 10.1016/S0149-7634(05)80194-0. [DOI] [PubMed] [Google Scholar]
  • 49.Papp M. Models of affective illness: Chronic mild stress in the rat. Curr. Protoc. Pharm. 2012;57 doi: 10.1002/0471141755.ph0509s57. [DOI] [PubMed] [Google Scholar]
  • 50.Atcha Z., Rourke C., Neo A.H., Goh C.W., Lim J.S., Aw C.C., Browne E.R., Pemberton D.J. Alternative method of oral dosing for rats. J. Am. Assoc. Lab. Anim. Sci. 2010;49:335–343. [PMC free article] [PubMed] [Google Scholar]
  • 51.Chen G., Rajkowska G., Du F., Seraji-Bozorgzad N., Manji H.K. Enhancement of hippocampal neurogenesis by lithium. J. Neurochem. 2000;75:1729–1734. doi: 10.1046/j.1471-4159.2000.0751729.x. [DOI] [PubMed] [Google Scholar]
  • 52.Porsolt R.D., Bertin A., Jalfre M. Behavioral despair in mice: A primary screening test for antidepressants. Arch. Int. Pharm. 1977;229:327–336. [PubMed] [Google Scholar]
  • 53.Willner P., Bergman J., Vanderschuren L., Ellenbroek B. Pharmacological approaches to the study of social behaviour. Behav. Pharm. 2015;26:501–504. doi: 10.1097/FBP.0000000000000180. [DOI] [PubMed] [Google Scholar]
  • 54.Jindal A., Mahesh R., Bhatt S. Etazolate rescues behavioral deficits in chronic unpredictable mild stress model: Modulation of hypothalamic-pituitary-adrenal axis activity and brain-derived neurotrophic factor level. Neurochem. Int. 2013;63:465–475. doi: 10.1016/j.neuint.2013.08.005. [DOI] [PubMed] [Google Scholar]
  • 55.Belovicova K., Bogi E., Csatlosova K., Dubovicky M. Animal tests for anxiety-like and depression-like behavior in rats. Interdiscip. Toxicol. 2017;10:40–43. doi: 10.1515/intox-2017-0006. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 56.Sun H.L., Zhou Z.Q., Zhang G.F., Yang C., Wang X.M., Shen J.C., Hashimoto K., Yang J.J. Role of hippocampal p11 in the sustained antidepressant effect of ketamine in the chronic unpredictable mild stress model. Transl. Psychiatry. 2016;6:e741. doi: 10.1038/tp.2016.21. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 57.Raudvere U., Kolberg L., Kuzmin I., Arak T., Adler P., Peterson H., Vilo J. G:Profiler: A web server for functional enrichment analysis and conversions of gene lists (2019 update) Nucleic Acids Res. 2019;47:W191–W198. doi: 10.1093/nar/gkz369. [DOI] [PMC free article] [PubMed] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The detailed data used to support the findings of this study are available from the corresponding author upon written request.


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