Genetic and pharmacological disruption of neurokinin 1 receptor function decreases anxiety-related behaviors and increases serotonergic function

Alterations in serotonin (5-hydroxytriptamine, 5-HT), norepinephrine, and γ-aminobutyric acid have been linked to the pathophysiology of anxiety and depression, and medications that modulate these neurotransmitters are widely used to treat mood disorders. Recently, the neuropeptide substance P (SP) and its receptor, the neurokinin 1 receptor (NK1R), have been proposed as possible targets for new antidepressant and anxiolytic therapies. However, animal and human studies have so far failed to provide a clear consensus on the role of SP in the modulation of emotional states. Here we show that both genetic disruption and acute pharmacological blockade of the NK1R in mice result in a marked reduction of anxiety and stress-related responses. These behavioral changes are paralleled by an increase in the firing rate of 5-HT neurons in the dorsal raphe nucleus, a major source of serotonergic input to the forebrain. NK1R disruption also results in a selective desensitization of 5-HT1A inhibitory autoreceptors, which resembles the effect of sustained antidepressant treatment. Together these results indicate that the SP system powerfully modulates anxiety and suggest that this effect is at least in part mediated by changes in the 5-HT system.

Serotonin regulates mouse cranial neural crest migration.

Serotonergic agents (uptake inhibitors, receptor ligands) cause significant craniofacial malformations in cultured mouse embryos suggesting that 5-hydroxytryptamine (serotonin) (5-HT) may be an important regulator of craniofacial development. To determine whether serotonergic regulation of cell migration might underly some of these effects, cranial neural crest (NC) explants from embryonic day 9 (E9) (plug day = E1) mouse embryos or dissociated mandibular mesenchyme cells (derived from NC) from E12 embryos were placed in a modified Boyden chamber to measure effects of serotonergic agents on cell migration. A dose-dependent effect of 5-HT on the migration of highly motile cranial NC cells was demonstrated, such that low concentrations of 5-HT stimulated migration, whereas this effect was progressively lost as the dose of 5-HT was increased. In contrast, most concentrations of 5-HT inhibited migration of less motile, mandibular mesenchyme cells. To investigate the possible involvement of specific 5-HT receptors in the stimulation of NC migration, several 5-HT subtype-selective antagonists were used to block the effects of the most stimulatory dose of 5-HT (0.01 microM). Only NAN-190 (a 5-HT1A antagonist) inhibited the effect of 5-HT, suggesting involvement of this receptor. Further evidence was obtained by using immunohistochemistry with 5-HT receptor antibodies, which revealed expression of the 5-HT1A receptor but not other subtypes by migrating NC cells in both embryos and cranial NC explants. These results suggest that by activating appropriate receptors 5-HT may regulate migration of cranial NC cells and their mesenchymal derivatives in the mouse embryo.

An investigation of the 5-HT2C receptor gene as a migraine candidate gene

Migraine is a common complex disorder, currently classified into two main subtypes, migraine with aura (MA) and migraine without aura (MO). The strong preponderance of females to males suggests an X-linked genetic component. Recent studies have identified an X chromosomal susceptibility region (Xq24-q28) in two typical migraine pedigrees. This region harbours a potential candidate gene for the disorder, the serotonin receptor 2C (5-HT2C) gene. This study involved a linkage and association approach to investigate two single nucleotide variants in the 5-HT2C gene. In addition, exonic coding regions of the 5-HT2C gene were also sequenced for mutations in X-linked migraine pedigrees. Results of this study did not detect any linkage or association, and no disease causing mutations were identified. Hence, results for this study do not support a significant role of the 5-HT2C gene in migraine predisposition. (C) 2003 Wiley-Liss, Inc.

Using psilocybin to investigate the relationship between attention, working memory, and the serotonin 1A and 2A receptors

Increasing evidence suggests a link between attention, working memory, serotonin (5-HT), and prefrontal cortex activity. In an attempt to tease out the relationship between these elements, this study tested the effects of the hallucinogenic mixed 5-HT1A/2A receptor agonist psilocybin alone and after pretreatment with the 5-HT2A antagonist ketanserin. Eight healthy human volunteers were rested on a multiple-object tracking task and spatial working memory task under the four conditions: placebo, psilocybin (215 mu g/kg), ketanserin (50 mg), and psilocybin and ketanserin. Psilocybin significantly reduced attentional tracking ability, but had no significant effect on spatial working memory, suggesting a functional dissociation between the two tasks. Pretreatment with ketanserin did not attenuate the effect of psilocybin on attentional performance, suggestinga primary involvement of the 5-HT1A receptor in the observed defecit. Based on physiological and pharmacological data,we speculate that this impaired attentional performance may reflect a reduced ability to suppress or ignore distracting stimuli rather than reduced attentional capacity. The clinical relevance of these results is also discussed.

The antihypertensive drug pindolol attenuates long-term but not short-term binge-like ethanol consumption in mice

Alcohol dependence is a debilitating disorder with current therapies displaying limited efficacy and/or compliance. Consequently, there is a critical need for improved pharmacotherapeutic strategies to manage alcohol use disorders (AUDs). Previous studies have shown that the development of alcohol dependence involves repeated cycles of binge-like ethanol intake and abstinence. Therefore, we used a model of binge-ethanol consumption (drinking-in-the-dark) in mice to test the effects of compounds known to modify the activity of neurotransmitters implicated in alcohol addiction. From this, we have identified the FDA-approved antihypertensive drug pindolol, as a potential candidate for the management of AUDs. We show that the efficacy of pindolol to reduce ethanol consumption is enhanced following long-term (12-weeks) binge-ethanol intake, compared to short-term (4-weeks) intake. Furthermore, pindolol had no effect on locomotor activity or consumption of the natural reward sucrose. Because pindolol acts as a dual beta-adrenergic antagonist and 5-HT1A/1B partial agonist, we examined its effect on spontaneous synaptic activity in the basolateral amygdala (BLA), a brain region densely innervated by serotonin- and norepinephrine-containing fibres. Pindolol increased spontaneous excitatory post-synaptic current frequency in BLA principal neurons from long-term ethanol consuming mice but not naïve mice. Additionally, this effect was blocked by the 5-HT1A/1B receptor antagonist methiothepin, suggesting that altered serotonergic activity in the BLA may contribute to the efficacy of pindolol to reduce ethanol intake following long-term exposure. Although further mechanistic investigations are required, this study demonstrates the potential of pindolol as a new treatment option for AUDs that can be fast-tracked into human clinical studies.

Commentary: Chronic SSRI stimulation of astrocytic 5-HT2B receptors change multiple gene expressions/editings and metabolism of glutamate, glucose and glycogen: A potential paradigm shift

Working on the serotonin (5-hydroxytryptamine, 5-HT) 5-HT2B receptor since several years, we have read with high interest the review by Hertz et al. (2015). Previous studies from our group demonstrated that a direct injection in mouse raphe nucleus of the 5-HT2B agonist BW723C86 has the ability to increase extracellular levels of serotonin, which can be blocked by the selective 5-HT2B receptor antagonist RS127445 (Doly et al., 2008, 2009). We also reported that an acute injection of paroxetine 2 mg/kg in mice knocked out for the 5-HT2B receptor gene or in wild type mice injected with RS127445 (0.5 mg/kg) triggers a strong reduction in extracellular accumulation of 5-HT in hippocampus (Diaz et al., 2012). Following these observations, we showed that acute and chronic BW723C86 injection (3 mg/kg) can mimic the fluoxetine (3 mg/kg) and paroxetine (1 mg/kg) behavioral and biochemical antidepressant effects in mice (Diaz and Maroteaux, 2011; Diaz et al., 2012)...

Binding Site Structure and Stoichiometry in Serotonin Type 3 Receptors

This dissertation primarily describes studies of serotonin type 3 (5-HT₃) receptors of the Cys-loop super-family of ligand gated ion channels. The first chapter provides a general introduction to these important proteins and the methods used to interrogate their structure and function. The second chapter details the delineation of a structural unit of the ligand binding site of homomeric 5-HT₃A receptors on which the ligands serotonin (5-HT) and m-chlorophenyl biguanide (mCPBG) are reliant for effective receptor activation. Unnatural amino acid mutagenesis results show that the details of each ligand’s interaction with this organizing feature of the binding site differ, providing insights into general principles of receptor activation.

The third chapter describes a study in which florescent protein fusions of the A and B subunits of the heteromeric 5-HT₃AB receptor are employed to determine the subunit stoichiometry and order within functional receptors. Strong evidence is found for an A₃B₂ stoichiometry with A-A-B-A-B order. The fourth chapter investigates the potential for ligand binding across heteromeric binding sites in the 5-HT₃AB receptor. Unlike serotonin, mCPBG is found to bind the receptor at heteromeric binding sites. Further mCPBG is capable of allosterically modulating the response of serotonin on the 5-HT₃AB receptor from these heteromeric sites.

Finally, the fifth chapter describes progress towards the application of unnatural amino acid mutagenesis to an important new class of proteins, transcription factors. Experiments optimizing novel methods for the detection of function are described, using RARα of the nuclear receptor family of transcription factors.

Interaction between the 5-HT system and the basal ganglia: functional implication and therapeutic perspective in Parkinson's disease

The neurotransmitter serotonin (5-HT) has a multifaceted function in the modulation of information processing through the activation of multiple receptor families, including G-protein-coupled receptor subtypes (5-HT1, 5-HT2, 5-HT4-7) and ligand-gated ion channels (5-HT3). The largest population of serotonergic neurons is located in the midbrain, specifically in the raphe nuclei. Although the medial and dorsal raphe nucleus (DRN) share common projecting areas, in the basal ganglia (BG) nuclei serotonergic innervations come mainly from the DRN. The BG are a highly organized network of subcortical nuclei composed of the striatum (caudate and putamen), subthalamic nucleus (STN), internal and external globus pallidus (or entopeduncular nucleus in rodents, GPi/EP and GPe) and substantia nigra (pars compacta, SNc, and pars reticulata, SNr). The BG are part of the cortico-BG-thalamic circuits, which play a role in many functions like motor control, emotion, and cognition and are critically involved in diseases such as Parkinson's disease (PD). This review provides an overview of serotonergic modulation of the BG at the functional level and a discussion of how this interaction may be relevant to treating PD and the motor complications induced by chronic treatment with L-DOPA.

Changes in midbrain pain receptor expression, gait and behavioral sensitivity in a rat model of radiculopathy.

Intervertebral disc herniation may contribute to inflammatory processes that associate with radicular pain and motor deficits. Molecular changes at the affected dorsal root ganglion (DRG), spinal cord, and even midbrain, have been documented in rat models of radiculopathy or nerve injury. The objective of this study was to evaluate gait and the expression of key pain receptors in the midbrain in a rodent model of radiculopathy. Radiculopathy was induced by harvesting tail nucleus pulposus (NP) and placing upon the right L5 DRG in rats (NP-treated, n=12). Tail NP was discarded in sham-operated animals (n=12). Mechanical allodynia, weight-bearing, and gait were evaluated in all animals over time. At 1 and 4 weeks after surgery, astrocyte and microglial activation was tested in DRG sections. Midbrain sections were similarly evaluated for immunoreactivity to serotonin (5HT(2B)), mu-opioid (µ-OR), and metabotropic glutamate (mGluR4 and 5) receptor antibodies. NP-treated animals placed less weight on the affected limb 1 week after surgery and experienced mechanical hypersensitivity over the duration of the study. Astroctye activation was observed at DRGs only at 4 weeks after surgery. Findings for pain receptors in the midbrain of NP-treated rats included an increased expression of 5HT(2B) at 1, but not 4 weeks; increased expression of µ-OR and mGluR5 at 1 and 4 weeks (periaqueductal gray region only); and no changes in expression of mGluR4 at any point in this study. These observations provide support for the hypothesis that the midbrain responds to DRG injury with a transient change in receptors regulating pain responses.

Addressing Selective Polypharmacology of Antipsychotic Drugs Targeting the Bioaminergic Receptors through the Receptor Dynamic Conformational Ensembles

Selective polypharmacology, where a drug acts on multiple rather than single molecular targets involved in a disease, emerges to develop a structure-based system biology approach to design drugs selectively targeting a disease-active protein network. We focus on the bioaminergic receptors that belong to the group of integral membrane signalling proteins coupled to the G protein and represent targets for therapeutic agents against schizophrenia and depression. Among them, it has been shown that the serotonin (5-HT2A and 5-HT6), dopamine (D2 and D3) receptors induce a cognition-enhancing effect (group 1), while the histamine (H1) and serotonin (5-HT2C) receptors lead to metabolic side effects and the 5-HT2B serotonin receptor causes pulmonary hypertension (group 2). Thus, the problem arises to develop an approach that allows identifying drugs targeting only the disease-active receptors, i.e. group 1. The recent release of several crystal structures of the bioaminergic receptors, involving the D3 and H1 receptors provides the possibility to model the structures of all receptors and initiate a study of the structural and dynamic context of selective polypharmacology. In this work, we use molecular dynamics simulations to generate a conformational space of the receptors and subsequently characterize its binding properties applying molecular probe mapping. All-against-all comparison of the generated probe maps of the selected diverse conformations of all receptors with the Tanimoto similarity coefficient (Tc) enable to separate the receptors of group 1 from group 2. The pharmacophore built based on the Tc-selected receptor conformations, using the multiple probe maps discovers structural features that can be used to design molecules selective towards the receptors of group 1. The importance of several predicted residues to ligand selectivity is supported by the available mutagenesis and ligand structure-activity relationships studies. In addition, the Tc-selected conformations of the receptors for group 1 show good performance in isolation of known ligands from a random decoy. Our computational structure-based protocol to tackle selective polypharmacology of antipsychotic drugs could be applied for other diseases involving multiple drug targets, such as oncologic and infectious disorders.

Substance P, récepteurs NK1 et neurones à sérotonine : relations anatomiques et fonctionnelles dans le noyau raphe dorsalis

Nous avons étudié les relations anatomiques entre les systèmes de neurotransmission à substance P (SP) et à sérotonine (5-hydroxytryptamine, 5-HT) dans le noyau du raphé dorsal (NRD) du rongeur, afin de mieux comprendre les interactions entre ces systèmes durant la régulation de l’humeur. Le NRD reçoit une innervation SP provenant de l’habenula, et le blocage pharmacologique des récepteurs neurokinine-1 (rNK1) de la SP aurait des effets antidépresseurs. Chez le rongeur, le traitement par les antagonistes des rNK1 s’accompagne d’une désensibilisation des autorécepteurs 5-HT1A de la 5-HT et d’une hausse de l’activité des neurones 5-HT dans le NRD, suggérant des interactions locales entre ces deux systèmes. Dans un premier temps, nous avons démontré par doubles marquages immunocytochimiques en microscopies optique, confocale et électronique, la présence du rNK1 dans une sous-population de neurones 5-HT du NRD caudal. Lors de l’analyse en microscopie électronique, nous avons pu constater que les rNK1 étaient principalement cytoplasmiques dans les neurones 5-HT et membranaires sur les neurones non 5-HT du noyau. Grâce à d’autres doubles marquages, nous avons aussi pu identifier les neurones non-5-HT porteurs de rNK1 comme étant GABAergiques. Nous avons ensuite combiné l’immunomarquage de la SP avec celui du rNK1, dans le but d’examiner les relations entre les terminaisons (varicosités *) axonales SP et les neurones 5-HT (pourvus de rNK1 cytoplasmiques du NRD caudal. En simple marquage de la SP, nous avons pu estimer à 41% la fréquence avec laquelle les terminaisons SP font synapse. Dans le matériel doublement marqué pour la SP et son récepteur, les terminaisons SP ont été fréquemment retrouvées en contact direct ou à proximité des dendrites munies de rNK1 cytoplasmiques, mais toujours éloignées des dendrites à rNK1 membranaires. Pour tester l’hypothèse d’une internalisation soutenue des rNK1 par la SP dans les neurones 5-HT, nous avons ensuite examiné la localisation subcellulaire du récepteur chez le rat traité avec un antagoniste du rNK1, le RP67580. La densité du marquage des rNK1 a été mesurée dans le cytoplasme et sur la membrane des deux types de dendrites (5-HT: rNK1 cytoplasmiques; non 5-HT: rNK1 membranaires). Une heure après une injection unique de l’antagoniste, la distribution du rNK1 est apparue inchangée dans les deux types de neurones (5-HT et non 5-HT). Par contre, après un traitement quotidien de 7 ou 21 jours avec l’antagoniste, nous avons mesuré une augmentation significative des densités cytoplasmique et membranaire du rNK1 dans les neurones 5-HT, sans aucun changement dans les neurones non 5-HT. Ces traitements ont aussi augmenté l’expression du gène rNK1 dans le NRD. Enfin, nous avons mesuré une hausse de la densité membranaire du rNK1 dans les neurones 5-HT, sans hausse de densité cytoplasmique, par suite d’une lésion bilatérale de l’habenula. Ces résultats confortent l’hypothèse d’une activation et d’une internalisation soutenues des rNK1 par la SP dans les neurones 5-HT du NRD caudal. Ils suggèrent aussi que le trafic des rNK1 dans les neurones 5-HT du NRD représente un mécanisme cellulaire en contrôle de l’activation du système 5-HT par les afférences SP en provenance de l’habenula.

Mécanismes cellulaires de l'induction du facteur de transcription Nur77 après un traitement aux antipsychotiques

Les antipsychotiques sont utilisés en clinique depuis plus de 50 ans pour pallier aux symptômes de la schizophrénie. Malgré une recherche intensive, les mécanismes cellulaires et moléculaires responsables de l’effet clinique de cette médication demeurent encore nébuleux. Ces drogues sont reconnues comme des antagonistes des récepteurs D2 de la dopamine et peuvent moduler la transcription génique dans le striatum. Au cours des recherches qui ont mené à l'écriture de cette thèse, nous avons exploré l’expression de Nur77, un facteur de transcription de la famille des récepteurs nucléaires, afin de caractériser le rôle de la dopamine, la sérotonine, l’adénosine et le glutamate dans la régulation génique contrôlée par les antagonistes D2. En premier lieu, nous avons examiné l’impact de la co-administration d’agents sérotonergiques et adrénergiques sur l’expression de l’ARNm de Nur77 induite par l’halopéridol, un antipsychotique de première génération. Nous avons observé que le 8-OH-DPAT et le MDL11939 préviennent partiellement l’induction de Nur77 dans le striatum. Au contraire, l’idazoxan potentialise l’effet de l’halopéridol sur l’expression de Nur77 alors que le prazosin reste sans effet. Ces résultats démontrent que l’expression striatale de Nur77 induite par l’halopéridol peut être modulée à la baisse avec un agoniste 5-HT1A ou un antagoniste 5-HT2A. Par la suite, nous avons évalué dans divers paradigmes expérimentaux l’effet de l’éticlopride, un antagoniste spécifique D2, afin d’explorer davantage le mécanisme de l’effet transcriptionnel des antagonistes D2. Étonnamment, la suppression de l’isoforme D2L chez la souris D2L KO ne réduit pas la réponse de l’éticlopride dans le striatum. Par contre, une lésion corticale avec l’acide iboténique bloque l’effet de l’éticlopride sur la transcription de Nur77, suggérant un rôle du glutamate. La combinaison d’un antagoniste des récepteurs métabotropes du glutamate de types 5 (mGluR5) et d’un antagoniste des récepteurs de l’adénosine A2A abolit complètement l’augmentation de la transcription de Nur77 induit par l’éticlopride dans le striatum. La modulation directe de l’expression striatale de Nur77 par les récepteurs mGluR5 et A2A a été confirmée dans un modèle de cultures organotypiques de tranches cérébrales. Ces résultats démontrent clairement que la modulation de l’expression génique dans le striatum, à la suite d’un traitement avec un antagoniste D2 pourrait être indépendante d’une interaction directe avec les récepteurs D2 post-synaptiques, et reposerait plutôt sur son interaction avec les récepteurs D2 hétérosynaptiques des afférences corticostriées et l’activation subséquente des récepteurs post-synaptiques du glutamate et de l’adénosine. En résumé, nos résultats suggèrent que l’interaction des antipsychotiques atypiques avec les récepteurs 5-HT2A et 5-HT1A pourrait expliquer la différence dans le patron d’expression génique induit par ces drogues en comparaison avec les antipsychotiques typiques. De plus, nos résultats révèlent un nouveau mécanisme d’action des antagonistes D2 et supportent un rôle primordial du glutamate et de l’adénosine dans les effets des antipsychotiques de première génération.

ALPHA2 Adrenergic and High Affinity Serotonergic Receptor Changes in the Brain Stem of Streptozotocin induced Diabetic Rats

The brain stems (13S) of streptozotocin (STZ)-diabetic rats were studied lo see the changes in neurotransmitter content and their receptor regulation. The norepinephrine (NE) content determined in the diabetic brain stems did ^ control. an E showed la while PI turnover hri content increased significantly compared N^r eNveFa o the recep significant increase. The alpha2 adrenergic receptor IneP utisoulinntreat d ratsetheNE contentt dec^ sled was significantly reduced during diabetes. in versedcto reanorm sed ulcrea e tK reatment the state. while EPI content remained increased as in die diabetic B,, for a]pha2 adrenergic receptors slw^nificantly while Unlabelled clonidine inhibited [31-I]NE binding in BS of control, diabetic and insulin treated ulations bindi diabetic rats showed that alpha2 adrenergicre^ punks cojnidiabetic animal the ligand bound sites with Hill slopes significantly away from unity. weaker to the low affinity site than in controls. Insulin treatment reversed[ this allumbmn to control levels. The displacement analysis using (-)-epinephrine age in control and diabetic animals revealed two populations of receptor affinidtyo=tat ss. In control animals, when GTP analogue added with epinephrine, the curve nagnlde caofnfitnroit yS model; but in the diabetic BS this effect `not aobserved. In bintact oth the diabetic data thus showlthat the effects of monovalent cations on affinity alphaz adrenergic receptors have a reduced affinity v due in stem ialtered Itscppeomson(5- regulation. The serotonin (5-HT) coat hydroxy) tryptophan (5-HTP) showed an increase and its breakdown metabolite (5-hydroxy) indoleacetic acid (5-I{IAA) showed a significant decrease. This showed that in serotonergic which l nerves there is a disturbance in both synthetic and breankduomwnbers pretma'med ana increased 5-HT. The high affinity serotonin receptor um ese serotonerg decrease in the receptor affinity. The insulin ^treatmentsturtiy showsha decreased serotonergic receptor kinetic parameters to control level. receptor function. These changes in adrenergic and serotonergic receptor function were suggested to be important in insulin function during STZ diabetes.

Brain 5HT2A Receptor Regulation by Tryptophan Supplementation in Streptozotocin Diabetic Rats

5-HT2A receptor binding parameters were studied in the cerebral cortex and brain stem of control, diabetic, insulin, insulin + tryptophan and tr3yptophan treated streptozotocin diabetic rats. Scatchard analysis using selective antagonist, [-H](±)2,3-dimethoxyphenyl-l-[2-(4-piperidine)- methanol] ([3H]MDL100907) in cerebral cortex of diabetic rats showed a significant decrease in dissociation constant (Kd) without any change in maximal binding (Bm). Competition binding studies in cerebral cortex using ketanserin against [3H]MDL100907 showed the appearance of an additional site in the low affinity region during diabetes. In the brain stem, Scatchard analysis showed a significant increase in Bmax and Kd. Displacement studies showed a shift in the receptor affinity towards a low affinity state. All these altered parameters in diabetes were reversed to control level by insulin, insulin + tryptophan and tryptophan treatments. Tryptophan treatment is suggested to reverse the altered 5-HT2Abinding and blood glucose level to control status by increasing the brain 5-HT content.

S100 beta Protein Expression: Gender- and Age-Related Daily Changes

S100 beta is a soluble protein released by glial cells mainly under the activation of the 5-HT1A receptor. It has been reported as a neuro-trophic and -tropic factor that promotes neurite maturation and outgrowth during development. This protein also plays a role in axonal stability and the plasticity underlying long-term potentiation in adult brains. The ability of S100 beta to rapidly regulate neuronal morphology raises the interesting point of whether there are daily rhythm or gender differences in S100 beta level in the brain. To answer this question, the S100 beta expression in adult female and male rats, as well as in adult female CD-21 and S100 beta -/- female mice, were investigated. Scintillation counting and morphometric analysis of the immunoreactivity of S100 beta, showed rhythmic daily expression. The female and male rats showed opposite cycles. Females presented the highest value at the beginning of the rest phase (5:00 h), while in males the maximum value appeared in the beginning of the motor activity period (21:00 h). These results confirm previous S100 beta evaluations in human serum and cerebrospinal fluid reporting the protein`s function as a biomarker for brain damage (Gazzolo et al. in Clin Chem 49:967-970, 2003; Clin Chim Acta 330:131-133, 2003; Pediatr Res 58:1170-1174, 2005), similar behavior was also observed for GFAP in relation to Alzheimer Disease (Fukuyama et al. in Eur Neurol 46:35-38, 2001). The data should be taken into account when considering S100 beta as a biomarker of health condition. In addition, the results raise questions on which structure or condition imposes these rhythms as well as on the physiological meaning of the observed gender differences.