Abstract summary 

The aim of this study was to repurpose a drug for the treatment of bipolar depression.A gene expression signature representing the overall transcriptomic effects of a cocktail of drugs widely prescribed to treat bipolar disorder was generated using human neuronal-like (NT2-N) cells. A compound library of 960 approved, off-patent drugs were then screened to identify those drugs that affect transcription most similar to the effects of the bipolar depression drug cocktail. For mechanistic studies, peripheral blood mononuclear cells were obtained from a healthy subject and reprogrammed into induced pluripotent stem cells, which were then differentiated into co-cultured neurons and astrocytes. Efficacy studies were conducted in two animal models of depressive-like behaviours (Flinders Sensitive Line rats and social isolation with chronic restraint stress rats).The screen identified trimetazidine as a potential drug for repurposing. Trimetazidine alters metabolic processes to increase ATP production, which is thought to be deficient in bipolar depression. We showed that trimetazidine increased mitochondrial respiration in cultured human neuronal-like cells. Transcriptomic analysis in induced pluripotent stem cell-derived neuron/astrocyte co-cultures suggested additional mechanisms of action via the focal adhesion and MAPK signalling pathways. In two different rodent models of depressive-like behaviours, trimetazidine exhibited antidepressant-like activity with reduced anhedonia and reduced immobility in the forced swim test.Collectively our data support the repurposing of trimetazidine for the treatment of bipolar depression.

Authors & Co-authors:  Bortolasci Chiara C CC Kidnapillai Srisaiyini S Spolding Briana B Truong Trang T T TTT Connor Timothy T Swinton Courtney C Panizzutti Bruna B Liu Zoe S J ZSJ Sanigorski Andrew A Dean Olivia M OM Crowley Tamsyn T Richardson Mark M Bozaoglu Kiymet K Vlahos Katerina K Cowdery Stephanie S Watmuff Brad B Steyn Stephan F SF Wolmarans De Wet W Engelbrecht Barend J BJ Perry Christina C Drummond Katherine K Pang Terence T Jamain Stéphane S Gray Laura L McGee Sean L SL Harvey Brian H BH Kim Jee Hyun JH Leboyer Marion M Berk Michael M Walder Ken K

Study Outcome 

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