Key result
A combination of ADAR gene expression and PDE8A RNA editing biomarkers in blood accurately discriminated between HCV patients who developed treatment-emergent depression and those who did not during antiviral therapy.
Why the study?
Treatment-emergent depression is common in HCV patients treated with IFN-alpha and ribavirin, and whether RNA editing-related biomarkers in white blood cells can identify risk of this depression was unknown.
Does A-to-I RNA editing activity on the PDE8A gene predict treatment-emergent depression in HCV patients receiving pegylated interferon alpha-2a and ribavirin?
Cohort (n=10)
Yes
Does A-to-I RNA editing activity on the PDE8A gene predict treatment-emergent depression in HCV patients receiving pegylated interferon alpha-2a and ribavirin?
A-to-I RNA editing biomarkers in white blood cells, specifically on the PDE8A gene, may serve as an objective biological test to identify patients at risk of interferon-induced depression.
Hypothesis-generating for blood biomarkers predicting depression risk in HCV therapy; prospective validation required before clinical adoption.
Treatment-emergent depression is a common complication in patients with chronic hepatitis C virus (HCV) infection undergoing antiviral combination therapy with IFN-α and ribavirin. It has recently been shown that changes in A-to-I RNA editing rates are associated with various pathologies such as inflammatory disorders, depression and suicide. Interestingly, IFN-α induces gene expression of the RNA editing enzyme ADAR1-1 (ADAR1a-p150) and alters overall RNA editing activity. In this study, we took advantage of the high prevalence of pharmacologically induced depression in patients treated with IFN-α and ribavirin to test the interest of RNA editing-related biomarkers in white blood cells of patients. In this 16-week longitudinal study, a small cohort of patients was clinically evaluated using standard assessment methods prior to and during antiviral therapy and blood samples were collected to analyse RNA editing modifications. A-I RNA editing activity on the phosphodiesterase 8A (PDE8A) gene, a previously identified RNA editing hotspot in the context of lupus erythematosus, was quantified by using an ultra-deep next-generation sequencing approach. We also monitored gene expression levels of the ADAR enzymes and the PDE8A gene during treatment by qPCR. As expected, psychiatric evaluation could track treatment-emergent depression, which occurred in 30% of HCV patients. We show that PDE8A RNA editing is increased in all patients following interferon treatment, but differently in 30% of patients. This effect was mimicked in a cellular model using SHSY-5Y neuroblastoma cells. By combining the data of A-I RNA editing and gene expression, we generated an algorithm that allowed discrimination between the group of patients who developed a treatment-emergent depression and those who did not. The current model of drug-induced depression identified A-I RNA editing biomarkers as useful tools for the identification of individuals at risk of developing depression in an objective, quantifiable biological blood test.
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Salvetat et al. (2019) conducted a cohort in Chronic hepatitis C virus (HCV) infection (n=10). Pegylated interferon alpha-2a and ribavirin vs. Patients without treatment-emergent depression was evaluated on Treatment-emergent depression and its association with PDE8A RNA editing and ADAR gene expression. A combination of ADAR gene expression and PDE8A RNA editing biomarkers in blood accurately discriminated between HCV patients who developed treatment-emergent depression and those who did not during antiviral therapy.
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