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Keywords: The selective serotonin reuptake inhibitors (SSRIs) fluvoxamine and sertraline show a high affinity for sigma-1
Nerve growth factor receptors. Fluvoxamine enhances nerve growth factor (NGF)-induced neurite outgrowth in PC12 cells via a
Neurite outgrowth sigma-1 receptor-mediated mechanism, which suggests that neurogenesis may be involved in the antidepressant
Sertraline action of fluvoxamine. However, the effects of sertraline on neurite outgrowth remain unclear. Here, we report
Selective serotonin reuptake inhibitor
the effects of sertraline on NGF-induced neurite outgrowth in PC12 cells. At concentrations above 0.3 μM, ser-
Sigma-1 receptor
PC12 cells
traline inhibited neurite outgrowth induced by NGF (50 ng/mL) in PC12 cells in a concentration-dependent
manner. At 0.3–3 μM, sertraline inhibited NGF-induced neurite outgrowth; however, had no effect on cell via-
bility. This suggests that at these concentrations, sertraline inhibits NGF-induced neurite outgrowth without
causing cell toxicity. Because sertraline has a high affinity for the sigma-1 receptor, we investigated whether this
receptor is involved in sertraline's inhibitory effect on NGF-induced neurite outgrowth. The effect was reversed
by both the sigma-1 receptor agonist PRE-084 and the sigma-1 receptor antagonist NE-100. These results suggest
that sertraline inhibits NGF-induced neurite outgrowth in PC12 cells by acting as an inverse agonist of the sigma-
1 receptor in this system.
⁎
Corresponding author.
E-mail address: yumisugi@gm.himeji-du.ac.jp (Y. Sugimoto).
https://doi.org/10.1016/j.ejphar.2019.03.032
Received 25 December 2018; Accepted 18 March 2019
Available online 19 March 2019
0014-2999/ © 2019 Elsevier B.V. All rights reserved.
Y. Matsushima, et al. European Journal of Pharmacology 853 (2019) 129–135
Fig. 1. Effects of SSRIs on neurite outgrowth in the presence and absence of NGF (50 ng/mL). (A) NGF + fluvoxamine. (B) NGF + sertraline. (C) NGF + paroxetine.
(D) Fluvoxamine alone. (E) Sertraline alone. (F) Paroxetine alone. Values represent means ± S.E.M (n = 6). * * P < 0.01 vs. NGF.
neurite outgrowth in PC12 cells through stimulation of the sigma-1 2.2. Cell culture
receptor; its effects are blocked by sigma-1 receptor antagonism (Ishima
et al., 2014; Nishimura et al., 2008). This suggests that the sigma-1 PC12 cells (RIKEN Cell Bank, Tsukuba, Japan) were cultured at
receptor has a role in neuroplasticity, and may be connected to the 37 °C and 5% CO2, in Dulbecco's modified Eagle's medium (DMEM)
antidepressant effects of fluvoxamine. Another SSRI, sertraline, also has (Gibco-Life Technologies, Gaithersburg, MD, USA) supplemented with
an affinity for the sigma-1 receptor. It was previously reported that nutrient mixture F-12 (Gibco-Life Technologies), 10% (v/v) fetal bovine
sertraline inhibits NGF-induced neurite outgrowth in PC12 cells, in serum (FBS) (Gibco-Life Technologies) and 1% (v/v) penicillin/strep-
contrast to fluvoxamine (Ishima et al., 2014). However, whether the tomycin (Nacalai Tesque, Kyoto, Japan). To measure neurite sprouting,
sigma-1 receptor is involved in this effect remains unknown. To address PC12 cells were plated at a density of 1.0 × 105 cells/dish on type 1
this, we investigated the inhibitory effect of sertraline on NGF-induced collagen-coated, 60-mm tissue culture dishes in DMEM/F12 containing
neurite outgrowth in PC12 cells compared to fluvoxamine, and the 10% FBS with 1% penicillin/streptomycin and cultured for 24 h.
involvement of the sigma-1 receptor in this effect.
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Y. Matsushima, et al. European Journal of Pharmacology 853 (2019) 129–135
length is defined as the distance along a neurite, i.e., the distance from (1 μM) (F(3, 20) = 108.41, P < 0.001) (Fig. 5). The inhibitory effect of
the soma to the end of neurite. The total neirute length of 10 cells for sertraline (1 μM) on NGF-induced neurite outgrowth was significantly
each treatment condition was calculated to evaluate the neurite out- reduced by the sigma-1 receptor agonist PRE-084 (0.1 μM) (F(3, 20)
growth (Terada et al., 2014). = 35.81, P < 0.001) (Fig. 6A). Furthermore, the inhibitory effect of
sertraline on NGF-induced neurite outgrowth was also reversed by co-
2.4. Cell viability treatment with the sigma-1 receptor antagonist NE-100 (1 μM) (F(3,
20) = 55.43, P < 0.001) (Fig. 6B).
Cell viability assay was determined using a the [3-(4,5-di-
methylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay (MTT; 4. Discussion
Nacalai tesque, Kyoto, Japan), following the method modifying de-
scribed(Lombardi et al., 2017; Ogra et al., 2016). Cell viability was also In this study, we found that sertraline inhibited the NGF-induced
determined using a commercially available kit, CellTiter-Glo Lumines- neurite outgrowth without affecting their viability. The effect of ser-
cent Cell Viability Assay (Promega KK, Tokyo, Japan) with small traline was completely blocked by the sigma-1 receptor antagonist.
modification (Setoguchi et al., 2018). Both assays were conducted These findings are the first report that sertraline inhibited the NGF-
under the same conditions. Briefly, PC12 cells were seeded at a density induced neurite outgrowth by via the sigma-1 receptor. Some anti-
of 1.0 × 104 cells /well. After 24 h, cells were treated with different depressants classified as SSRIs show a high affinity for the sigma-1 re-
concentrations of each drug to another 24 h, and the cell viability was ceptor (Ishima et al., 2014; Narita et al., 1996), including fluvoxamine,
measured using each reagent. Results are expressed as a percentage of which has the highest affinity of these (Ki = 36 nM), and sertraline (Ki
the absorbance of vehicle-treated culture wells. = 57 nM) (Narita et al., 1996). In contrast, the potent SSRI paroxetine
has a low affinity with the sigma-1 receptor (Ki = 1893 nM) (Narita
2.5. Statistical analysis et al., 1996). Fluvoxamine is a typical antidepressant and is used for
treating depression, obsessive compulsive disorder, and anxiety
All numerical data are presented as the mean ± S.E.M. Statistical (Carrasco and Sandner, 2005). Fluvoxamine enhances NGF-induced
analysis was performed using an analysis of variance followed by neurite outgrowth in PC12 cells, and this effect is mediated by the
Tukey's post-hoc or Dunnett's tests. sigma-1 receptor (Nishimura et al., 2008). This observation indicates
that the sigma-1 receptor may be involved in fluvoxamine's mechanism
3. Results of action, as it is important in neuronal plasticity and neuropsychiatric
disease (Hashimoto, 2009; Niitsu et al., 2012). Sertraline, another SSRI
3.1. Effects of SSRIs on NGF-induced neurite outgrowth with a high affinity for the sigma-1 receptor, inhibits NGF-induced
neurite outgrowth in PC12 cells (Ishima et al., 2014). However, it was
NGF (50 ng/mL)-induced neurite outgrowth was enhanced by flu- not clear whether these inhibitory effects of sertraline are mediated by
voxamine (F(4, 25) = 48.56, P < 0.001) (Fig. 1A), and inhibited by the sigma-1 receptor. Therefore, we examined the involvement of the
sertraline (F(5, 30) = 572.64, P < 0.001) (Fig. 1B), in a concentration- sigma-1 receptor in the inhibitory effects of sertraline on NGF-induced
dependent manner. Paroxetine did not affect NGF-neurite outgrowth (F neurite outgrowth in PC12 cells compared with fluvoxamine and par-
(4, 25) = 0.17, P > 0.05) (Fig. 1C). In addition, none of the drugs oxetine, using a sigma-1 receptor agonist and antagonist.
changed neurite outgrowth in the absence of NGF (Fluvoxamine; F(4, Fluvoxamine significantly enhanced NGF-induced neurite out-
25) = 1.38, P > 0.05, Sertraline; F(5, 30) = 0.87, P > 0.05, Parox- growth in PC12 cells at concentrations above 0.1 μM, consistent with
etine; F(4, 25) = 2.57, P > 0.05) (Fig. 1D–F). results reported by Nishimura et al. (2008). Fluvoxamine had no affect
Typical Representative image of phase-contrast photomicrographs neurite outgrowth in PC12 cells in the absence of NGF. These results
are shown in Fig. 2A-D. suggest that fluvoxamine does not act as an NGF-like agonist but en-
hances the stimulation induced by NGF. Sertraline, which has a high
3.2. Effects of SSRIs on PC12 cell viability affinity for the sigma-1 receptor, significantly inhibited NGF-induced
neurite outgrowth at concentrations over 0.3 μM, but did not affect
The viability of PC12 cells was significantly decreased by treatment neurite outgrowth in the absence of NGF. Ishima et al. (2014) reported
with fluvoxamine at concentrations of 100–300 μM (MTT assay; F(8, that sertraline did not inhibit NGF (2.5 ng/mL)-induced neurite out-
36) = 24.80, P < 0.001, CellTiter assay; F(8, 45) = 286.40, growth at 1 μM and had a significant inhibitory effect at 10 μM (Ishima
P < 0.001), sertraline at 10–300 μM (MTT assay; F(8, 36) = 132.78, et al., 2014). This discrepancy in sertraline concentrations that inhibit
P < 0.001, CellTiter assay; F(8, 45) = 275.76, P < 0.001), and par- neurite outgrowth may be due to differences in experimental condi-
oxetine at 30–500 μM (MTT assay; F(8, 36) = 60.28, P < 0.001, tions, such as NGF concentration (2.5 vs. 50 ng/mL) or duration in
CellTiter assay; F(8, 45) = 916.27, P < 0.001) (Fig. 3). culture (5 days vs. 24 h). We examined neurite outgrowth after 2.5 ng/
mL NGF for 5 days which is the same condition as Ishima et al. (2014).
3.3. Effect of sigma-1 receptor stimulation on NGF-induced neurite We confirmed that its neurite outgrowth was similar to 50 ng/mL NGF
outgrowth in PC12 cells for 24 h culture in our present experiments (data is not shown).
Therefore, our experimental condition of 50 ng/mL NGF for 24 h is
The sigma-1 receptor agonist PRE-084 (0.01–10 μM) enhanced sufficient time and NGF concentration. Paroxetine, which has a low
neurite outgrowth caused by NGF in a concentration-dependent manner affinity for the sigma-1 receptor, had no effects on PC12 cell neurite
(F(4, 25) = 73.56, P < 0.001) (Fig. 4A). The potentiating effect of outgrowth in the presence or absence of NGF.
PRE-084 (1 μM) on NGF-induced neurite outgrowth was blocked by the SSRIs show cytotoxicity in several cell lines (Levkovitz et al., 2005;
sigma-1 receptor antagonist NE-100 (1 μM) (F(3, 20) = 224.04, Nordenberg et al., 1999). In addition, sertraline has been suggested to
P < 0.001) (Fig. 4B). show cytotoxicity at lower concentrations than other SSRIs (Kuwahara
et al., 2015). For example, the IC50 value of sertraline for reducing cell
3.4. Involvement of the sigma-1 receptor in the effects of fluvoxamine and viability in HT29 cells is 14.7 μM, and potency is sertraline >
sertraline in NGF-induced neurite outgrowth paroxetine > clomipramine > fluoxetine (Irit et al., 2008). The IC50
value of anticancer effects on HepG2 cells induced by sertraline is
The enhancing effect of fluvoxamine (1 μM) on NGF-induced neurite 1.24 ± 0.0551 μM, which is 25 times lower than that of fluvoxamine
outgrowth was blocked by the sigma-1 receptor antagonist NE-100 (Kuwahara et al., 2015). The concentrations of sertraline that
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Y. Matsushima, et al. European Journal of Pharmacology 853 (2019) 129–135
Fig. 2. Representative image of phase-contrast photomicrographs. (A) NGF (50 ng/mL) only. (B) NGF + fluvoxamine (1 μM). (C) NGF + sertraline (1 μM). (D)
NGF + paroxetine (1 μM). Scale bars: 50 µm.
significantly inhibit NGF-induced neurite outgrowth are in the same above 30 μM significantly decreased the viability of PC12 cells.
range as those eliciting cytotoxic effects in other cell lines. Therefore, Sertraline had significant inhibitory effects on NGF-induced neurite
there is a possibility that the inhibitory effects of sertraline on NGF- outgrowth above concentrations of 0.3 μM, which are lower than those
induced neurite outgrowth may be caused by cytotoxic effects on PC12 decreasing cell viability in PC12 cells. These results indicate that at
cells. However, the cytotoxic effects of SSRI on PC12 cells are not yet lower concentrations, sertraline inhibits NGF-induced neurite out-
clear. Therefore, we examined their effects on PC12 cell viability. growth in PC12 cells without affecting their viability. The inhibitory
Fluvoxamine above 100 μM, sertraline above 10 μM and paroxetine effects on NGF-induced neurite outgrowth over sertraline 10 μM may be
Fig. 3. Effects of SSRIs on PC12 cell viability. Cell viability is expressed as a percentage of control. (A) Fluvoxamine. (B) Sertraline. (C) Paroxetine. Data represent
means ± S.E.M (n = 9). *P < 0.05, **P < 0.01 vs. control (without SSRI), MTT assay. # P < 0.05, ##P < 0.01 vs. control (without SSRI), CellTiter assay.
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Declaration of interest Nishimura, T., Ishima, T., Iyo, M., Hashimoto, K., 2008. Potentiation of nerve growth
factor-induced neurite outgrowth by fluvoxamine: role of sigma-1 receptors, IP3 re-
ceptors and cellular signaling pathways. PLoS One 3, e2558.
None. Nordenberg, J., Fenig, E., Landau, M., Weizman, R., Weizman, A., 1999. Effects of psy-
chotropic drugs on cell proliferation and differentiation. Biochem. Pharmacol. 58,
1229–1236.
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