Medical School
Depression is twice more common in women than men, whereas there is evidence for sex differences in antidepressant drug response. Preclinical research that aims to improve antidepressant treatments, should use animal models validated for both sexes (Kokras and Dalla 2014). Our group has studied sex differences in models of depression and antidepressant activity since 2000. We have concluded that preclinical sex differences could have important implications for clinical research (Kokras and Dalla 2017). We have shown that female rats demonstrate enhanced immobility than males in the Forced Swim Test (FST), which is a test commonly used for screening of new antidepressants. Marked sex differences are also observed in the behavior of head swinging in the FST, with females exhibiting lower counts than males. This behavioral index might prove to be important for studying sex differences in antidepressant response (Kokras et al. 2016). Sex differences with several classes of antidepressants have been identified in behavioral, neurochemical and molecular level. Overall, our studies highlight the importance of inclusion of both male and female animals in preclinical research for depression and antidepressant response.
Our lab investigates the role of estrogens and estrogen-related pathways in mood regulation, focusing on their behavioral, neurochemical, and immunological effects in animal models of depression. Two complementary lines of research explore how modulation of estrogen synthesis and estrogen receptor activity can influence depressive phenotypes in a sex-informed manner.
We have been exploring the behavioral and neurochemical consequences of inhibiting estrogen synthesis using aromatase inhibitors such as letrozole. In cycling female rats, subacute letrozole administration reduced immobility in the forced swim test (FST), suggesting antidepressant-like effects. However, one-week treatment failed to produce similar outcomes, highlighting the importance of treatment duration (Kokras et al., 2014). More recent studies extended this work to gonadectomized male and female rats. Neurochemical analyses revealed that letrozole decreased noradrenaline levels and altered dopaminergic turnover in the hippocampus and prefrontal cortex of both sexes, regardless of gonadal status. These findings suggest that aromatase inhibitors may exert psychotropic effects through complex, time- and sex-dependent mechanisms.
In parallel, we are investigating the rapid antidepressant potential of activating the G protein-coupled estrogen receptor 1 (GPER1), a recently characterized membrane-bound estrogen receptor. Ongoing studies aim to validate GPER1 as a novel, rapid, effective, and safe treatment target for female depression. We use brain-specific genetic overexpression and pharmacological activation and chronic mild stress model to examine behavioral and molecular outcomes in both sexes.
Together, these projects seek to expand our understanding of estrogen-mediated mechanisms in depression and to identify new, sex-informed therapeutic strategies that address unmet needs in mental health treatment.
Funder: European Cooperation in Science and Technology, COST actions - CA24130
Funder: European Cooperation in Science and Technology, COST actions - CA24168
In collaboration with Prof. Robert Schoevers, University Medical Center Groningen (UMCG), The Netherlands. 2026–2030. Funder: European Commission – Horizon Europe Programme, Marie Skłodowska-Curie Doctoral Networks.
In collaboration with Dr. Iro Georgousi, NCSR Demokritos, Greece. 2024–2025. Funder: Hellenic Foundation for Research and Innovation (H.F.R.I.).
In collaboration with Dr. Iro Georgousi, NCSR Demokritos, Greece. 2023-2024. Funder: Municipality of Attica, Greece.
In collaboration with Prof. K. Antoniou, University of Ioannina, Greece. 2020-2022. Funder: General Secretariat for Research and Innovation, Ministry of Development Hellenic Republic, and co-funded by the European Union.
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