Cognitive remission: a novel objective for the treatment of major depression?

BACKGROUND: Cognitive dysfunction in major depressive disorder (MDD) encompasses several domains, including but not limited to executive function, verbal memory, and attention. Furthermore, cognitive dysfunction is a frequent residual manifestation in depression and may persist during the remitted phase. Cognitive deficits may also impede functional recovery, including workforce performance, in patients with MDD. The overarching aims of this opinion article are to critically evaluate the effects of available antidepressants as well as novel therapeutic targets on neurocognitive dysfunction in MDD.

DISCUSSION: Conventional antidepressant drugs mitigate cognitive dysfunction in some people with MDD. However, a significant proportion of MDD patients continue to experience significant cognitive impairment. Two multicenter randomized controlled trials (RCTs) reported that vortioxetine, a multimodal antidepressant, has significant precognitive effects in MDD unrelated to mood improvement. Lisdexamfetamine dimesylate was shown to alleviate executive dysfunction in an RCT of adults after full or partial remission of MDD. Preliminary evidence also indicates that erythropoietin may alleviate cognitive dysfunction in MDD. Several other novel agents may be repurposed as cognitive enhancers for MDD treatment, including minocycline, insulin, antidiabetic agents, angiotensin-converting enzyme inhibitors, S-adenosyl methionine, acetyl-L-carnitine, alpha lipoic acid, omega-3 fatty acids, melatonin, modafinil, galantamine, scopolamine, N-acetylcysteine, curcumin, statins, and coenzyme Q10. The management of cognitive dysfunction remains an unmet need in the treatment of MDD. However, it is hoped that the development of novel therapeutic targets will contribute to 'cognitive remission', which may aid functional recovery in MDD.

Microencapsulation of flaxseed oil in flaxseed protein and flaxseed gum complex coacervates

Flaxseed oil, a rich source of omega-3 fatty acids, was microencapsulated in a novel matrix formed by complex coacervation between flaxseed protein isolate (FPI) and flaxseed gum (FG). This matrix was crosslinking with glutaraldehyde. Liquid microcapsules with three core (oil)-to-wall ratios (1:2, 1:3 and 1:4) were prepared and spray-dried or freeze-dried to produce powders. The microencapsulation efficiency, surface oil, morphology and oxidative stability of these microcapsules were determined. The spray-dried solid microcapsules had higher oil microencapsulation efficiency, lower surface oil content, smoother surface morphology and higher oxidation stability than the freeze-dried microcapsules. The highest microencapsulation efficiency obtained in spray-dried microcapsules was 87% with a surface oil of 2.78% at core-to-wall ratio 1:4 and oil load 20%. The oxidation stability obtained from spray-dried microcapsules at core-to-wall ratio of 1:4 was nearly double that of the unencapsulated flaxseed oil.

Biocatalysis of Soybean 15-Lipoxygenase for the production of lipid mediators of Inflammation

This thesis describes the application of a plant enzyme, soybean 15-lipoxygenase-1, in the production of lipid-based mediators of inflammation from omega-3 fatty acids. Several methods for the biosynthesis and characterisation of such compounds have been developed, which have also provided further insight into the catalytic mechanism of the enzyme.

Effects of different forms of docosahexaenoic acid supplementations on human neuronal cells

My study showed that Docosahexaenoic Acid (DHA), a major dietary omega-3 polyunsaturated fatty acid, inhibited cell death and promoted electro-physiological activity in cultured neuronal cells. The free fatty acid form was more effective than DHA-phospholipids and DHA-nanoliposomes. This study provides insights into the beneficial effects of dietary omega-3 fatty acids.

Dietary intakes and food sources of Omega-6 and Omega-3 polyunsaturated fatty acids.

Both n−6 and n−3 polyunsaturated fatty acids (PUFA) are recognized as essential nutrients in the human diet, yet reliable data on population intakes are limited. The aim of the present study was to ascertain the dietary intakes and food sources of individual n−6 and n−3 PUFA in the Australian population. An existing database with fatty acid composition data on 1690 foods was updated with newly validated data on 150 foods to estimate the fatty acid content of foods recorded as eaten by 10,851 adults in the 1995 Australian National Nutrition Survey. Average daily intakes of linoleic (LA), arachidonic (AA), α-linolenic (LNA), eicosapentaenoic (EPA), docosapentaenoic (DPA), and docosahexaenoic (DHA) acids were 10.8, 0.052, 1.17, 0.056, 0.026, and 0.106 g, respectively, with longchain (LC) n−3 PUFA (addition of FPA, DPA, and DHA) totaling 0.189 g; median intakes were considerably lower (9.0 g LA, 0.024 g AA, 0.95 g LNA, 0.008 g EPA, 0.006 g DPA, 0.015 g DHA, and 0.029 g LC n−3 PUFA). Fats and oils, meat and poultry, cereal-based products and cereals, vegetables, and nuts and seeds were important sources of n−6 PUFA, while cereal-based products, fats and oils, meat and poultry, cereals, milk products, and vegetable products were sources of LNA. As expected, seafood was the main source of LC n−3 PUFA, contributing 71%, while meat and eggs contributed 20 and 6%, respectively. The results indicate that the majority of Australians are failing to meet intake recommendations for LC n−3 PUFA (>0.2 g per day) and emphasize the need for strategies, to increase the availability and consumption of n−3-containing foods.

Effects of dietary omega-3 polyunsaturated fatty acids on brain gene expression

Polyunsaturated fatty acids (PUFA) are essential structural components of the central nervous system. Their role in controlling learning and memory has been well documented. A nutrigenomic approach with high-density microarrays was used to reveal brain gene-expression changes in response to different PUFA-enriched diets in rats. In aged rats fed throughout life with PUFA-enriched diets, genes with altered expressions included transthyretin, α-synuclein, and calmodulins, which play important roles in synaptic  plasticity and learning. The effect of perinatal omega-3 PUFA supply on gene expression later in life also was studied. Several genes showed similar changes in expression in rats fed omega-3-deficient diets in the perinatal period, regardless of whether they or their mothers were fed omega-3 PUFA-sufficient diets after giving birth. In this experiment, among the down-regulated genes were a kainate glutamate receptor and a DEAD-box polypeptide. Among the up-regulated genes were a chemokine-like factor, a tumor necrosis factor receptor, and cytochrome c. The possible involvement of the genes with altered expression attributable to different diets in different brain regions in young and aged rats and the possible mode of regulatory action of PUFA also are discussed. We conclude that PUFA-enriched diets lead to significant changes in expression of several genes in the central nervous tissue, and these effects appear to be mainly independent of their effects on membrane composition. The direct effects of PUFA on transcriptional modulators, the downstream developmentally and tissue-specifically activated elements might be one of the clues to understanding the beneficial effects of the omega-3 PUFA on the nervous system.

Inhibition of platelet aggregation by omega-3 polyunsaturated fatty acids is gender specific — redefining platelet response to fish oils

Existence of gender differences in cardiovascular disease (CVD) following long-chain omega-3 polyunsaturated fatty acid (LCn-3 PUFA) supplementation have suggested that sex hormones play a role in cardio-protection. The objective of this study was to determine gender specific responses in the efficacy of LCn-3 PUFA to inhibit platelet aggregation in vitro. Blood was analyzed for collagen-induced platelet aggregation following pre-incubation with LCn-3 PUFA in healthy adults (n=42). Eicosapentaenoic acid (EPA) was significantly more effective in reducing platelet aggregation compared with docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA). When grouped by gender, this differential pattern was followed in males only. In females, DHA, DPA and EPA were all equally effective. Between group analyses (LCn-3 PUFA vs. gender) showed that both DHA and DPA were significantly less effective in males compared with females. EPA was equally effective in reducing platelet aggregation in both groups. These findings show that significant gender differences exist in platelet aggregation in response to various LCn-3 PUFA treatments.

Experimental reduction in dietary omega-3 polyunsaturated fatty acids depresses sperm competitiveness

 The health benefits of diets containing rich sources of long-chain omega-3 polyunsaturated fatty acids (n-3 LC-PUFA) are well documented and include reductions in the risk of several diseases typical of Western societies. The dietary intake of n-3 LC-PUFA has also been linked to fertility, and there is abundant evidence that a range of ejaculate traits linked to fertility in humans, livestock and other animals depend on an adequate intake of n-3 LC-PUFA from dietary sources. However, relatively few studies have explored how n-3 LC-PUFA influence reproductive fitness, particularly in the context of sexual selection. Here, we show that experimental reduction in the level of n-3 LC-PUFA in the diet of guppies (Poecilia reticulata) depresses a male’s share of paternity when sperm compete for fertilization, confirming that the currently observed trend for reduced n-3 LC-PUFA in western diets has important implications for individual reproductive fitness.

Bioavailability of long chain omega-3 polyunsaturated fatty acids

It has been well documented that the ingestion of omega-3 polyunsaturated fatty acids (n-3 LC-PUFA) can improve health. However, little scientific attention has been paid on the actual bioavailability of n-3 LC-PUFA. In this thesis, several nutritional questions related to bioavailability of n-3 LC-PUFA have been answered.

Omega-3 polyunsaturated fatty acid contents of canned meats avaialbe in Australia

Total lipid content of 20 species of canned meats available in Australia ranged from 2% in chicken (Hormel, USA) to 41% in stewed pork (Ma Ling, China). Total n-3 polyunsaturated fatty acids (PUFA) ranged from 30 in canned chicken (Hormel) to 659 mg/100 g in chicken hot dog (Tulip, Denmark). The 18:2n-6 was the predominant PUFA, ranging from 187 in corned beef (Hamper, Australia) to 2832 mg/100 g in chicken luncheon meat (Tulip). Other main PUFA, in order of concentration, were 18:3n-3, ranging from 14 in canned chicken (Hormel) to 590 mg/100 g in chicken hot dog (Tulip); conjugated 18:2n-6 (CLA) from 1 in chicken (Hormel) to 135 mg/100 g in corned mutton (Colonial, Australia); 20:4n- 6 from 11 in camp pie (Tom Piper, Australia) to 73 mg/100 g in spiced ham (Hormel); and 22:5n-3 from 5 in chicken (Hormel) and chicken luncheon (Almaraai, Jordan) to 45 mg/100 g in stewed pork (Ma Ling). Total saturated fatty acids (SFA) ranged from 598 to 14 660 mg/100 g, with 16:0 predominant followed by 18:0. Total monounsaturated fatty acid concentration ranged between 813 to 20 218 mg/100 g with 18:1 the major fatty acid. Trans 18:1 ranged from 10 to 698 mg/100 g. The canned meats contained 20 and 22-carbon long chain n-3 PUFA at levels comparable with or greater than those in fresh lean meat.