Post-awakening salivary alpha-amylase as modulator of treatment response in patients with burnout and major depression

Around 50% of patients with major depression do not respond to standard first-line treatments, such as psychotherapy and pharmacotherapy. At the same time, a subgroup exhibits altered functioning of stress-responsive bodily systems, such as the central locus coeruleus/sympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis. Given that these systems impact arousal and cognition, it is possible that this subgroup contributes to the high rates of non-responders. Our aim was to investigate whether sympathetic and HPA axis activity modulate treatment outcomes in patients with stress-related major depression. A total of N = 74 inpatients (median age: 50, 62% male) with signs of burnout who fulfilled diagnostic criteria for major depression were recruited. Saliva samples were collected at awakening as well as 30 and 45 min later. Alpha-amylase activity and cortisol concentrations were determined before patients underwent evidence-based multimodal treatment. Non-responders were defined as patients exhibiting a <50% decrease in depression on the Beck Depression Inventory. Non-responders had significantly higher post-awakening alpha-amylase activity than responders (p = .025). In addition, alpha-amylase activity increased significantly over the course of treatment (p = .004), irrespective of responder status. Post-awakening cortisol was neither a predictor nor an indicator of treatment response. If future research confirms alpha-amylase activity as a modulator of treatment response, this may indicate a subgroup of patients with major depression which may benefit from augmentative treatments, such as heart rate variability biofeedback and/or cognitive interventions targeting high arousal

Post-awakening salivary alpha-amylase as modulator of treatment response in patients with burnout and major depression.

Around 50% of patients with major depression do not respond to standard first-line treatments, such as psychotherapy and pharmacotherapy. At the same time, a subgroup exhibits altered functioning of stress-responsive bodily systems, such as the central locus coeruleus/sympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis. Given that these systems impact arousal and cognition, it is possible that this subgroup contributes to the high rates of non-responders. Our aim was to investigate whether sympathetic and HPA axis activity modulate treatment outcomes in patients with stress-related major depression. A total of N = 74 inpatients (median age: 50, 62% male) with signs of burnout who fulfilled diagnostic criteria for major depression were recruited. Saliva samples were collected at awakening as well as 30 and 45 min later. Alpha-amylase activity and cortisol concentrations were determined before patients underwent evidence-based multimodal treatment. Non-responders were defined as patients exhibiting a <50% decrease in depression on the Beck Depression Inventory. Non-responders had significantly higher post-awakening alpha-amylase activity than responders (p = .025). In addition, alpha-amylase activity increased significantly over the course of treatment (p = .004), irrespective of responder status. Post-awakening cortisol was neither a predictor nor an indicator of treatment response. If future research confirms alpha-amylase activity as a modulator of treatment response, this may indicate a subgroup of patients with major depression which may benefit from augmentative treatments, such as heart rate variability biofeedback and/or cognitive interventions targeting high arousal

Model Studies Directed Towards the Synthesis of the Oxetane D-Ring of Paclitaxel: Assessment of the Oxyanion Assisted retro-Diels-Alder Reaction as a Means for Generating Oxete

In connection with attempts to generate oxete (8) via anionically assisted retro-Diels-Alder reaction, the oxetanes (11) and (12) have been prepared together with their acyclic analogues (35) and (36). The X-ray crystal structure of compound (11) has been determined. Each of the substrates (11), (12), (35) and (36) was treated with potassium hydride in the presence of 18-crown-6, conditions known to promote retro-Diels-Alder reactions in other systems. However, the first three substrates failed to engage in any such reaction even at temperatures up to 100°C. In contrast, at 18°C compound (36) reacted to give anthrone (13) in quantitative yield. These results indicate, inter alia, that regioelectronic effects play a crucial role in determining the success, or otherwise, of anionically-assisted retro-Diels-Alder reactions leading to polarized alkenes

Syntheses of the D-aldopentoses from non-carbohydrate sources

The cis-1,2-dihydrocatechols 5-7, which are obtained in high yield and ca. 99.8% ee by microbial oxidation of the corresponding aromatic compound, have been converted, via reaction sequences involving three distinct types of one-carbon deletion processes, into the four D-aldopentoses

Macromolecular Compounds Having Controlled Stoichiometry

The following invention is directed to macromolecules having controlled stoichiometry and topology, processes for their production, and applications for their use. The macromolecules have a controlled functional moiety stoichiometry and include at least one dendritic motif having a surface layer formed from at least one surface building unit and at least one subsurface layer formed from at least one building unit, the surface building unit and building units having a hydrocarbon backbone bearing a carbonyl group and at least one amine group; and at least two different functional moieties on the building unit and/or surface building unit; where functional moiety stoichiometry refers to the number and type of functional moieties