Effects of antidepressant on FKBP51 mRNA expression and neuroendocrine hormones in patients with panic disorder
Open accessAbstract
OBJECTIVE: The purpose of this study was to investigate the effects of escitalopram on the peripheral expression of hypothalamic-pituitary-adrenal (HPA) axis-related genes (FKBP51, HSP90, NR3C1 and POMC) and HPA-axis hormones in patients with panic disorder (PD). METHODS: Seventy-seven patients with PD were treated with escitalopram for 12 weeks. All participants were assessed for the severity of panic symptoms using the Panic Disorder Severity Scale (PDSS). The expression of HPA-axis genes was measured using real-time quantitative fluorescent PCR, and ACTH and cortisol levels were measured using chemiluminescence at baseline and after 12 weeks of treatment. RESULTS: At baseline, patients with PD had elevated levels of ACTH and cortisol, and FKBP51 expression in comparison to healthy controls (all p < 0.01). Correlation analysis revealed that FKBP51 expression levels were significantly positively related to cortisol levels and the severity of PD (all p < 0.01). Furthermore, baseline ACTH and cortisol levels, and FKBP51 expression levels were significantly reduced after 12 weeks of treatment, and the change in the PDSS score from baseline to post-treatment was significantly and positively related to the change in cortisol (p < 0.01). CONCLUSIONS: The results suggest that PD may be associated with elevated levels of ACTH and cortisol, and FKBP51 expression, and that all three biomarkers are substantially decreased in patients who have received escitalopram treatment.
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Therapeutic strategies shown to normalize FKBP5 methylation include antidepressants, cognitive behavioral therapy (CBT), and mindfulness practices.
“Therapeutic strategies shown to normalize FKBP5 methylation include antidepressants, cognitive behavioral therapy (CBT), and mindfulness practices”
From The clinical use of epigenetics in psychiatry: a narrative review of epigenetic mechanisms, key candidate genes, and precision psychiatry (2025) · cites this paper as [92]
The Discussion reports reduced FKBP51 expression after escitalopram treatment, but says further studies are needed to investigate its effects on DNA methylation. Our copy provides no evidence that antidepressants, CBT, or mindfulness normalize FKBP5 methylation; searches for those treatments and methylation found no such result. (LLM, conf=0.78)
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- Authors
- Zou, Z., Huang, Y., Maes, M., Wang, J., He, Y., Min, W., & Zhou, B.
- Affiliations
- Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital (CN)
- Corresponding author
- Zou, Zhili
- Venue
- BMC Psychiatry
- Published
- 2024-04-10
- Volume
- 24
- Issue
- 1
- Pages
- 269-269
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC11005249
- OpenAlex
- W4394689575
- Cited by
- 4
- References
- 51
- Citations by year
- 2025: 4
- FWCI
- 1.16
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Sichuan Provincial People’s Hospital Translational Medicine Fund (2021LY02)
- The Sichuan Medical Association (Q22021)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Keywords
- panic disorder, escitalopram, FKBP51, hypothalamic-pituitary-adrenal axis, HSP90, NR3C1, proopiomelanocortin, ACTH, cortisol, antidepressant treatment, biomarkers, gene expression
- MeSH terms
- Escitalopram, Adrenocorticotropic Hormone, Antidepressive Agents, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Pituitary-Adrenal System, RNA, Messenger, Panic Disorder
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