Selective serotonin reuptake inhibitors (SSRIs) are the first-line treatment for major
depression. However, the link between inhibition of serotonin reuptake and remission from
depression remains controversial: in spite of the rapid onset of serotonin reuptake
inhibition, remission from depression takes several weeks, presumably reflecting
synaptogenesis/neurogenesis and neuronal rewiring. We compared genome-wide expression
profiles of human lymphoblastoid cell lines from unrelated individuals following treatment
with 1 μM paroxetine for 21 days with untreated control cells and
examined which genes and microRNAs (miRNAs) showed the most profound and consistent
expression changes. ITGB3, coding for integrin beta-3, showed the most consistent
altered expression (1.92-fold increase, P=7.5 ×
10−8) following chronic paroxetine exposure. Using genome-wide miRNA
arrays, we observed a corresponding decrease in the expression of two miRNAs, miR-221 and
miR-222, both predicted to target ITGB3. ITGB3 is crucial for the activity of the
serotonin transporter (SERT), the drug target of SSRIs. Moreover, it is presumably
required for the neuronal guidance activity of CHL1, whose expression was
formerly identified as a tentative SSRI response biomarker. Further genes whose expression
was significantly modulated by chronic paroxetine are also implicated in neurogenesis.
Surprisingly, the expression of SERT or serotonin receptors was not modified. Our findings
implicate ITGB3 in the mode of action of SSRI antidepressants and provide a novel link
between CHL1 and the SERT. Our observations suggest that SSRIs may relieve
depression primarily by promoting neuronal synaptogenesis/neurogenesis rather than by
modulating serotonin neurotransmission per se.