Julia-Lou Consoloni a, b, c, El Chérif Ibrahimb, c, d, Marie-Noëlle Lefebvre e, Xavier Zendjidjian a, f,
Emilie Olié c, g, h, Pascale Mazzola-Pomietto d, Thomas Desmidt i, j, Ludovic Samalin c, k, Pierre-Michel Llorca c, k, Mocrane Abbar l, Jorge Lopez-Castroman h, l, Emmanuel Haffen c, m, n, q, Karine Baumstarck f, Jean Naudin a, Jean-Michel Azorina, c, d, Wissam El-Hage i, j, o, Philippe Courtet c, g, h,1, Raoul Belzeaux a, b, c, p, ,1,
a APHM, Department of psychiatry, Marseille, France
b Aix Marseille Univ, CNRS, CRN2M, UMR 7286, Marseille, France
c Fondation FondaMental, Fondation de Recherche et de Soins en Santé Mentale, Créteil, France
d Aix Marseille Univ, CNRS, INT, Inst Neurosci Timone, Marseille, France
e CIC-CPCET, APHM, Hôpital La Timone, Marseille, France
f Aix Marseille Univ, SPMC, EA 3279, Public Health, Chronic Diseases and Quality of Life - Research Unit, Marseille, France
g Department of Emergency Psychiatry and Acute Care, CHU Montpellier, France
h Inserm, U1061, University of Montpellier, Montpellier, France
i CHRU de Tours, Clinique Psychiatrique Universitaire, Tours, France
j Inserm U1253 Imaging & Brain, Université de Tours, Tours, France
k CHU Clermont-Ferrand, Department of Psychiatry, EA 7280, University of Clermont Auvergne, Clermont-Ferrand, France
l Department of Adult Psychiatry, CHRU Nimes, Nimes, France
m Department of Clinical Psychiatry, University Hospital, Besançon, France
n EA 481, Laboratory of Neurosciences, University of Franche-Comté, Besançon, France
o Inserm CIC 1415, Centre d'Investigation Clinique, CHRU de Tours, Tours, France
p McGill Group for Suicide Studies, Department of Psychiatry, McGill University, Douglas Mental Health University Institute, Montreal, QC, Canada
q CIC-1431 Inserm, University Hospital, Besançon, France
European Neuropsychopharmacology
Available online 27 December 2017
In Press, Corrected Proof — Note to users
Abstract
The
quest for biomarkers in suicidal behaviors has been elusive so far,
despite their potential utility in clinical practice. One of the most
robust biological findings in suicidal behaviors is the alteration of
the serotonin transporter function in suicidal individuals. Our main
objective was to investigate the predictive value of the serotonin
transporter gene expression (SLC6A4) for suicidal ideation and
as secondary, for suicide attempts in individuals with a major
depressive episode (MDE). A 30-week prospective study was conducted on
148 patients with a MDE and 100 healthy controls including 4 evaluation
times (0, 2, 8 and 30 weeks). Blood samples and clinical data were
collected and SLC6A4 mRNA levels were measured from peripheral
blood mononuclear cells using RT-qPCR. We first demonstrated the
stability and reproducibility of SLC6A4 mRNA expression measures over time in healthy controls (F=0.658; p=0.579; η2=0.008; ICC=0.91, 95% CI [0.87–0.94]). Baseline SLC6A4 expression level (OR=0.563 [0.340–0.932], p=0.026) as well as early changes in SLC6A4 expression between baseline and the 2nd week (β=0.200, p=0.042) predicted the worsening of suicidal ideation (WSI) in the following 8 weeks. Moreover, changes in SLC6A4 expression between the 2nd and 8th weeks predicted the occurrence of a suicide attempt within 30 weeks (OR=10.976 [1.438–83.768], p=0.021). Altogether, the baseline level and the changes in SLC6A4
mRNA expression during a MDE might predict the WSI and the occurrence
of suicidal attempts and could be a useful biomarker in clinical
practice.