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Yogesh Dwivedi, PhD; Jagadeesh Sridhara Rao, PhD; Hooriyah S. Rizavi, MS; Jacek Kotowski, MD; Robert R. Conley, MD; Rosalinda C. Roberts, PhD; Carol A. Tamminga, MD; Ghanshyam N. Pandey, PhD

Arch Gen Psychiatry. 2003;60:273-282.

Background  Cyclic adenosine monophosphate response element binding protein (CREB) is a transcription factor that, on phosphorylation by protein kinases, is activated, and in response, regulates the transcription of many neuronally expressed genes. In view of the recent observations that catalytic properties and/or expression of many kinases that mediate their physiological responses through the activation of CREB are altered in the postmortem brain of subjects who commit suicide (hereafter referred to as suicide subjects), we examined the status of CREB in suicidal behavior.

Methods  These studies were performed in Brodmann area (BA) 9 and hippocampus obtained from 26 suicide subjects and 20 nonpsychiatric healthy control subjects. Messenger RNA levels of CREB and neuron-specific enolase were determined in total RNA by means of quantitative reverse transcriptase–polymerase chain reaction. Protein levels and the functional characteristics of CREB were determined in nuclear fractions by means of Western blot and cyclic adenosine monophosphate response element (CRE)-DNA binding activity, respectively. In the same nuclear fraction, we determined the catalytic activity of cyclic adenosine monophosphate–stimulated protein kinase A by means of enzymatic assay.

Results  We observed a significant reduction in messenger RNA and protein levels of CREB, CRE-DNA binding activity, and basal and cyclic adenosine monophosphate–stimulated protein kinase A activity in BA 9 and hippocampus of suicide subjects, without any change in messenger RNA levels of neuron-specific enolase in BA 9. Except for protein kinase A activity, changes in CREB expression and CRE-DNA binding activity were present in all suicide subjects, irrespective of diagnosis. These changes were unrelated to postmortem intervals, age, sex, or antidepressant treatment.

Conclusions  Given the significance of CREB in mediating various physiological functions through gene transcription, our results of decreased expression and functional characteristics of CREB in postmortem brain of suicide subjects suggest that CREB may play an important role in suicidal behavior.

From the Psychiatric Institute, Department of Psychiatry, University of Illinois at Chicago (Drs Dwivedi, Rao, Kotowski, and Pandey and Ms Rizavi); and the Maryland Psychiatric Research Center, University of Maryland, Baltimore (Drs Conley, Roberts, and Tamminga).

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