<?xml version="1.0" encoding="utf-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD Journal Publishing DTD v3.0 20080202//EN" "journalpublishing3.dtd">
<article xml:lang="en" article-type="research-article" xmlns:xlink="http://www.w3.org/1999/xlink">
<?release-delay 0|0?>
<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">ETM</journal-id>
<journal-title-group>
<journal-title>Experimental and Therapeutic Medicine</journal-title></journal-title-group>
<issn pub-type="ppub">1792-0981</issn>
<issn pub-type="epub">1792-1015</issn>
<publisher>
<publisher-name>D.A. Spandidos</publisher-name></publisher></journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3892/etm.2014.1938</article-id>
<article-id pub-id-type="publisher-id">etm-08-05-1467</article-id>
<article-categories>
<subj-group>
<subject>Articles</subject></subj-group></article-categories>
<title-group>
<article-title>Evaluation of blood-brain barrier permeability in tryptophan hydroxylase 2-knockout mice</article-title></title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>XU</surname><given-names>CHAO-JIN</given-names></name><xref rid="af1-etm-08-05-1467" ref-type="aff">1</xref><xref ref-type="corresp" rid="c1-etm-08-05-1467"/></contrib>
<contrib contrib-type="author">
<name><surname>PENG-ZHANG</surname></name><xref rid="af2-etm-08-05-1467" ref-type="aff">2</xref></contrib>
<contrib contrib-type="author">
<name><surname>DAI</surname><given-names>TING-LI</given-names></name><xref rid="af1-etm-08-05-1467" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>NIU</surname><given-names>XUE-YUAN</given-names></name><xref rid="af1-etm-08-05-1467" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>WANG</surname><given-names>JUN-LING</given-names></name><xref rid="af3-etm-08-05-1467" ref-type="aff">3</xref></contrib>
<contrib contrib-type="author">
<name><surname>JIN</surname><given-names>MING-SHUN</given-names></name><xref rid="af1-etm-08-05-1467" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author">
<name><surname>MIN-LIAO</surname></name><xref rid="af1-etm-08-05-1467" ref-type="aff">1</xref><xref ref-type="corresp" rid="c1-etm-08-05-1467"/></contrib></contrib-group>
<aff id="af1-etm-08-05-1467">
<label>1</label>Department of Histology and Embryology, Institute of Neuroscience, Wenzhou Medical University, Wenzhou, Zhejiang 325035, P.R. China</aff>
<aff id="af2-etm-08-05-1467">
<label>2</label>Department of Anatomy, Wenzhou Medical University, Wenzhou, Zhejiang 325035, P.R. China</aff>
<aff id="af3-etm-08-05-1467">
<label>3</label>School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, Zhejiang 325035, P.R. China</aff>
<author-notes>
<corresp id="c1-etm-08-05-1467">Correspondence to: Mrs. Chao-Jin Xu or Ms Min Liao, Department of Histology and Embryology, Institute of Neuroscience, 10 Wenzhou Medical University, Wenzhou, Zhejiang 325035, P.R. China, E-mail: <email>xuzhaojin@gmail.com</email>, E-mail: <email>liaomin70@126.com</email></corresp></author-notes>
<pub-date pub-type="ppub">
<month>11</month>
<year>2014</year></pub-date>
<pub-date pub-type="epub">
<day>28</day>
<month>08</month>
<year>2014</year></pub-date>
<volume>8</volume>
<issue>5</issue>
<fpage>1467</fpage>
<lpage>1470</lpage>
<history>
<date date-type="received">
<day>13</day>
<month>03</month>
<year>2014</year></date>
<date date-type="accepted">
<day>01</day>
<month>08</month>
<year>2014</year></date></history>
<permissions>
<copyright-statement>Copyright &#x000A9; 2014, Spandidos Publications</copyright-statement>
<copyright-year>2014</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/3.0">
<license-p>This is an open-access article licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License. The article may be redistributed, reproduced, and reused for non-commercial purposes, provided the original source is properly cited.</license-p></license></permissions>
<abstract>
<p>The blood-brain barrier (BBB) is critical to the health of the central nervous system (CNS). The possibility that 5-hydroxytryptamine (5-HT) participates in the alteration of the BBB has been previously demonstrated. Tryptophan hydroxylase 2 (TPH2) is a unique genetic enzyme isoform that catalyzes the rate-limiting step in the biosynthesis of 5-HT in the CNS; however, its role in the permeability changes of the BBB remains unclear. In the present study, TPH2-knockout mice were utilized in the assessment of BBB disruption, as measured by the Evans Blue (EB) extravasation or fluorescein isothiocyanate-albumin leakage assay in the brain. EB was not found to be retained in the brain in the TPH2-knockout mice or the wild-type controls. The results of the study demonstrate that TPH2 knockout has no effect on BBB permeability, indicating that TPH2 and the 5-HT system in the CNS are not sufficient to influence the BBB leakage.</p></abstract>
<kwd-group>
<kwd>blood-brain barrier</kwd>
<kwd>tryptophan hydroxylase 2</kwd>
<kwd>5-hydroxytryptamine</kwd></kwd-group></article-meta></front>
<body>
<sec sec-type="intro">
<title>Introduction</title>
<p>The blood-brain barrier (BBB) plays an important role in maintaining a stable environment in normal brain and spinal cord function. Changes in BBB permeability have been described in several pathological conditions, including poisoning, immune insults and irradiation, as well as in selected neurological disorders, such as stroke, traumatic brain injury and spinal cord injury (<xref rid="b1-etm-08-05-1467" ref-type="bibr">1</xref>), where the parenchyma of the brain or spinal cord is severely damaged (<xref rid="b2-etm-08-05-1467" ref-type="bibr">2</xref>). Additionally, there have been studies demonstrating that disruption of the BBB can occur in certain depressive disorders (<xref rid="b3-etm-08-05-1467" ref-type="bibr">3</xref>,<xref rid="b4-etm-08-05-1467" ref-type="bibr">4</xref>), including 5-hydroxytryptamine (5-HT)-related diseases. For example, abnormal levels of 5-HT have been demonstrated to result in neuronal malfunction, and a genetics study showed that mice with insufficient 5-HT exhibited anxiety and aggressive behavior (<xref rid="b5-etm-08-05-1467" ref-type="bibr">5</xref>). A number of studies have also reported that antibodies against 5-HT (<xref rid="b6-etm-08-05-1467" ref-type="bibr">6</xref>), inhibitors of 5-HT synthesis (<xref rid="b7-etm-08-05-1467" ref-type="bibr">7</xref>) and 5-HT-modulating compounds (<xref rid="b8-etm-08-05-1467" ref-type="bibr">8</xref>) can influence the permeability of the BBB. 5-HT is synthesized from L-tryptophan in two steps which are catalyzed by tryptophan hydroxylase (TPH). Thus, TPH is able to regulate 5-HT in the peripheral tissues and central nervous system. The genes encoding Tph1 and Tph2 are located on chromosomes 7B5 and 10D1 in the mouse (<xref rid="b9-etm-08-05-1467" ref-type="bibr">9</xref>). TPH1 is mainly expressed and synthesized in the periphery (<xref rid="b10-etm-08-05-1467" ref-type="bibr">10</xref>), but TPH2 is preferentially synthesized in the brain. However, the effect of tryptophan hydroxylase 2 (TPH2), a rate-limiting enzyme of 5-HT biosynthesis, on the integrity of the BBB remains unclear. Therefore, the present experiment investigated the effect of TPH2 on BBB disruption. BBB permeability was evaluated by Evans blue (EB) staining in TPH2-knockout mice.</p></sec>
<sec sec-type="materials|methods">
<title>Materials and methods</title>
<sec sec-type="materials">
<title>Materials</title>
<p>EB (E2129-1G) was purchased from Sigma-Aldrich (St. Louis, MO, USA). PL2000 DNA marker (D501A; 2,000 bp) was purchased from Takara Biotechnology, Co., Ltd. (Dalian, China). Anti-TPH2 antibody (PA1-778) was purchased from Thermo Fisher Scientific, Inc. (Waltham, MA, USA). Fluorescein isothiocyanate (FITC)-albumin (A9771) was purchased from Sigma-Aldrich. Wild-type (C57BL/6) mice were crossed with heterozygous TPH2-flox mice and their offspring generated homozygous TPH2-knockout mice.</p></sec>
<sec>
<title>Animals and treatment</title>
<p>All animal protocols used in this study were approved by the Animal Committee of Tongji University School of Medicine (TJmed-010&#x02013;10; Shanghai, China) (<xref rid="b11-etm-08-05-1467" ref-type="bibr">11</xref>). Adult (12 weeks old, weighing ~25 g) TPH2-knockout (n=6) and wild-type (n=6) mice were used for this study. For immunocytochemistry (n=3 from each group) (<xref rid="b12-etm-08-05-1467" ref-type="bibr">12</xref>), mice were anesthetized with pentobarbital &#x0005B;50 mg/kg, intraperitoneal (i.p.)&#x0005D; prior to undergoing transcardial perfusion with 4&#x00025; paraformaldehyde. The brain was removed and placed in a 10&#x00025; sucrose solution overnight. The following day, the brain was placed in a 20&#x00025; sucrose solution for 2 h and then transferred into a 30&#x00025; sucrose solution. The brain was subsequently sectioned on a microtome at a thickness of 40 &#x003BC;m. The sections through the brainstem were collected in a cell culture plate containing cryoprotectant &#x0005B;30&#x00025; glycerol, 30&#x00025; ethylene glycol and 40 &#x003BC;m phosphate-buffered saline (PBS)&#x0005D; (<xref rid="b13-etm-08-05-1467" ref-type="bibr">13</xref>). Serial sections were collected and placed individually into each of the six wells. This sectioning protocol resulted in six series of sections in total (~40 sections/series) through the brainstem that were 240 &#x003BC;m apart (40 &#x003BC;m &#x000D7; 6). Two wells from each animal were assayed for TPH2 expression.</p></sec>
<sec>
<title>Immunocytochemistry</title>
<p>Brain sections (40-mm) were incubated with primary antibody (anti-TPH2; 1:1,000) (<xref rid="b14-etm-08-05-1467" ref-type="bibr">14</xref>) at 4&#x000B0;C overnight. Subsequent to washing in PBS, the sections were incubated with rhodamine-conjugated affinity pure goat anti-rabbit immunoglobulin G (IgG) (Heavy and Light chain; 1:100; Jackson ImmunoResearch Laboratories, Inc., West Grove, PA, USA) secondary antibody for 2 h at room temperature and then washed in PBS. No immunostaining signals were observed when the primary antibody was omitted or replaced with normal IgG. Stained sections were observed and scanned under a fluorescence microscope (Olympus BX53; Olympus, Tokyo, Japan).</p></sec>
<sec>
<title>EB extravasation</title>
<p>The BBB permeability was measured using EB (<xref rid="b14-etm-08-05-1467" ref-type="bibr">14</xref>). In brief, TPH2-knockout mice and their age-matched controls were weighed and injected (i.p.) with 50 &#x003BC;g/g EB dye in PBS. Twelve hours after injection, the mice were anesthetized and perfused with PBS for 5 min. Following perfusion, the brains were dissected and the olfactory bulbs and cerebella were removed. For the inspection of EB extravasation, the brains were placed in PBS containing 30&#x00025; sucrose overnight, and 40-&#x003BC;m coronal sections were then cut on a cryostat and mounted onto gelatin-coated glass slides. All mice used in this study exhibited high levels of EB dye in the liver.</p></sec>
<sec>
<title>FITC-albumin leakage assay</title>
<p>The permeability of the BBB was analyzed using an FITC-albumin leakage assay, as previously described (<xref rid="b15-etm-08-05-1467" ref-type="bibr">15</xref>). Animals were injected intravenously with 100 mg/kg FITC-albumin 1.5 h after lipopolysaccharide injection (i.p.). At 2.5 h after the FITC-albumin injection, the mice were anesthetized and the brains were harvested. The left hemi-brains were fixed with paraformaldehyde and cut using a cryostat at a 40-&#x003BC;m thickness for histological analysis. The right hemi-brains were homogenized in five volumes (wt/vol) of cold PBS with a Teflon-glass homogenizer (Thomas Scientific, Swedesboro, NJ, USA). The samples were centrifuged at 10,000 &#x000D7; g for 30 min. The supernatant was collected and the optical densities of the homogenates supernatant were read at 488 nm excitation and 525 nm emission with a fluorescent plate reader (Ascent, Thermo Scientific, Waltham, MA, USA).</p></sec>
<sec>
<title>Polymerase chain reaction (PCR)</title>
<p>The toes from all mice were removed according to toe numbering scheme (<ext-link xlink:href="http://research.fhcrc.org/fero/en/fero-lab-protocols/mouse-toe-identification.html" ext-link-type="uri">http://research.fhcrc.org/fero/en/fero-lab-protocols/mouse-toe-identification.html</ext-link>) at the postnatal stage P7 and immediately frozen on dry ice. DNA was extracted using protocols provided by the Dr Yu-Qiang Ding of Tongji University. The extracted DNA was stored at &#x02212;20&#x000B0;C until required. TPH2 was analyzed using a PCR detection system (Biometra 070&#x02013;851; Analytik Jena, Jena, Germany). The TPH2 or Cre gene fragments were amplified using previously described primers (<xref rid="b11-etm-08-05-1467" ref-type="bibr">11</xref>). The 10 &#x003BC;l total reaction mixture contained 1 &#x003BC;l genomic DNA, 1 &#x003BC;l of each primer, 3.5 &#x003BC;l 2xTaq PCR MasterMix (Tiangen Biotech, Co., Ltd., Beijing, China) and 3.5 &#x003BC;l ddH<sub>2</sub>O. The reaction mixture was initially denatured at 94&#x000B0;C for 2 min, followed by 30 cycles at 94&#x000B0;C for 30 sec, 58&#x02013;60&#x000B0;C for 30 sec and 72&#x000B0;C for 45 sec. The PCR was completed by a final extension cycle at 72&#x000B0;C for 5 min. Successful amplification of the fragments was confirmed by detection of a 213 or 384 bp band for Tph2, or 400 bp strand for Cre on a 1.5&#x00025; agarose gel.</p></sec>
<sec>
<title>Statistical analysis</title>
<p>All data are expressed as the mean &#x000B1; standard deviation. Two-group comparisons were performed by the Student&#x02019;s t-test. P&lt;0.05 was considered to indicate a statistically significant difference.</p></sec></sec>
<sec sec-type="other">
<title>Results and Discussion</title>
<p>Disturbances in the BBB are becoming a common denominator in depressive disorders (<xref rid="b3-etm-08-05-1467" ref-type="bibr">3</xref>,<xref rid="b4-etm-08-05-1467" ref-type="bibr">4</xref>). A dysfunctional BBB can lead to the leakage of various neurotoxic substances into the brain, resulting in neuronal damage (<xref rid="b14-etm-08-05-1467" ref-type="bibr">14</xref>) and brain dysfunction. In the present study, it was demonstrated using EB staining that BBB impairment does not occur in TPH2-knockout mice.</p>
<p>In order to ensure that the TPH2 gene was knocked out in the experiment, PCR and immunocytochemistry methods were performed, as illustrated in <xref rid="f1-etm-08-05-1467" ref-type="fig">Fig. 1</xref>. Mice were genotyped by PCR with primers against Cre (forward, TCG ATG CAA CGA GTG ATGAG; reverse, TCC ATG AGT GAA CGA ACC TG), resulting in a 400-bp product, as well as against TPH2-flox (forward, CAG GTA GAG AGC CAA TCA AAG AGTG; reverse, CTG GGC TGG CCG ATA GTA ACAC), resulting in 213-bp wild-type and 384-bp heterozygote products. All mice carrying the Cre gene were found to be viable, without any evident abnormalities. <xref rid="f1-etm-08-05-1467" ref-type="fig">Fig. 1A</xref> shows the DNA detection results of the wild-type and homozygous TPH2-knockout mice (Cre, 400 bp; wild-type, 213 bp; and heterozygous TPH2-knockout, 384 bp). TPH2-positive neurons were observed in the wild-type mice (<xref rid="f1-etm-08-05-1467" ref-type="fig">Fig. 1B</xref>), but not in the knockout mice (<xref rid="f1-etm-08-05-1467" ref-type="fig">Fig. 1C</xref>). Thus, the results showed that all the knockout mice used in the study exhibited TPH2 gene absence.</p>
<p>As shown in <xref rid="f2-etm-08-05-1467" ref-type="fig">Fig. 2A and B</xref>, no EB stain could be observed in the whole brain in the TPH2-knockout or wild-type groups after 12 h EB i.p. injection. Similarly, no differences were observed in the tissue sections between the two groups (<xref rid="f3-etm-08-05-1467" ref-type="fig">Fig. 3</xref>). Notably, when the mouse abdominal spaces were open, it was observed that the lung, heart, kidney and liver were all stained blue by EB. Furthermore, in order to verify the effect of the TPH2 gene on the BBB integrity, the permeability of the BBB was examined using the FITC-albumin leakage assay. FITC-labeled albumin was injected from the tail vein, and leakage of dye into the brain parenchyma was measured as an index of BBB permeability. FITC-albumin was restricted to the inside of the brain blood vessels and no significant signals were detected in the brain parenchyma in the two genotypes following PBS injection (data not shown). Quantification of the FITC-albumin leakage revealed that the severity of the BBB breakdown was not significantly different in the TPH2-knockout and wild-type mice. Therefore, it was speculated that the knockout of the TPH2 gene had no effect on the BBB. By contrast, BBB permeability has been shown to be influenced by the elevation of circulating 5-HT levels (<xref rid="b16-etm-08-05-1467" ref-type="bibr">16</xref>), neutralization of endogenous 5-HT activity and/or the blocking of its receptors (<xref rid="b6-etm-08-05-1467" ref-type="bibr">6</xref>,<xref rid="b17-etm-08-05-1467" ref-type="bibr">17</xref>). Therefore, the data on the effect of serotonin on BBB permeability are contradictory. This may be due to differences in the species used, the dose regimen applied or the animal model.</p>
<p>The BBB is known to change in major depressive disorder (MDD), which is a severe psychiatric syndrome with a high prevalence and socioeconomic impact (<xref rid="b18-etm-08-05-1467" ref-type="bibr">18</xref>). MDD (lifetime prevalence 13&#x02013;16&#x00025;) is also a complex combination of disturbances in cognition, behaviour and physical functioning. MDD is the third leading cause of global disease and a leading cause of disability worldwide as depression is clinically and aetiologically heterogeneous (<xref rid="b19-etm-08-05-1467" ref-type="bibr">19</xref>). However, the underlying pathophysiology of MDD has yet to be fully elucidated. Despite this, it has been indicated that a disturbance in central 5-HT activity is a key factor (<xref rid="b18-etm-08-05-1467" ref-type="bibr">18</xref>). In the present study, when TPH2 was knocked out and the 5-HT neurons were lost, abnormal behavior was observed, but no difference was identified in the EB staining. Thus, we hypothesized that BBB permeability in 5-HT-related MDD is influenced by a number of factors (<xref rid="b4-etm-08-05-1467" ref-type="bibr">4</xref>).</p>
<p>In conclusion, the 5-HT system offers numerous possibilities to develop novel treatments for MDD. Understanding the association between TPH2 (a 5-HT synthesis rate-limiting enzyme in the central nervous system) and BBB permeability may be beneficial for the identification of novel therapeutic and preventative approaches in MDD.</p></sec></body>
<back>
<ack>
<title>Acknowledgements</title>
<p>This study was supported by the Zhejiang Provincial Natural Science Foundation of China (no. LY13H090007) and the Scientific Research Foundation of Wenzhou Medical College (QTJ12007).</p></ack>
<ref-list>
<title>References</title>
<ref id="b1-etm-08-05-1467"><label>1</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Xu</surname><given-names>CJ</given-names></name><name><surname>Xu</surname><given-names>L</given-names></name><name><surname>Huang</surname><given-names>LD</given-names></name><etal/></person-group><article-title>Combined NgR vaccination and neural stem cell transplantation promote functional recovery after spinal cord injury in adult rats</article-title><source>Neuropathol Appl Neurobiol</source><volume>37</volume><fpage>135</fpage><lpage>155</lpage><year>2011</year></element-citation></ref>
<ref id="b2-etm-08-05-1467"><label>2</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ovadia</surname><given-names>H</given-names></name><name><surname>Abramsky</surname><given-names>O</given-names></name><name><surname>Feldman</surname><given-names>S</given-names></name><name><surname>Weidenfeld</surname><given-names>J</given-names></name></person-group><article-title>Evaluation of the effect of stress on the blood-brain barrier: critical role of the brain perfusion time</article-title><source>Brain Res</source><volume>905</volume><fpage>21</fpage><lpage>25</lpage><year>2001</year></element-citation></ref>
<ref id="b3-etm-08-05-1467"><label>3</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Niklasson</surname><given-names>F</given-names></name><name><surname>Agren</surname><given-names>H</given-names></name></person-group><article-title>Brain energy metabolism and blood-brain barrier permeability in depressive patients: analyses of creatine, creatinine, urate, and albumin in CSF and blood</article-title><source>Biol Psychiatry</source><volume>19</volume><fpage>1183</fpage><lpage>1206</lpage><year>1984</year></element-citation></ref>
<ref id="b4-etm-08-05-1467"><label>4</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Najjar</surname><given-names>S</given-names></name><name><surname>Pearlman</surname><given-names>DM</given-names></name><name><surname>Devinsky</surname><given-names>O</given-names></name><name><surname>Najjar</surname><given-names>A</given-names></name><name><surname>Zagzag</surname><given-names>D</given-names></name></person-group><article-title>Neurovascular unit dysfunction with blood-brain barrier hyperpermeability contributes to major depressive disorder: a review of clinical and experimental evidence</article-title><source>J Neuroinflammation</source><volume>10</volume><fpage>142</fpage><year>2013</year></element-citation></ref>
<ref id="b5-etm-08-05-1467"><label>5</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ding</surname><given-names>YQ</given-names></name><name><surname>Marklund</surname><given-names>U</given-names></name><name><surname>Yuan</surname><given-names>W</given-names></name><etal/></person-group><article-title>Lmx1b is essential for the development of serotonergic neurons</article-title><source>Nat Neurosci</source><volume>6</volume><fpage>933</fpage><lpage>938</lpage><year>2003</year></element-citation></ref>
<ref id="b6-etm-08-05-1467"><label>6</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Sharma</surname><given-names>HS</given-names></name><name><surname>Patnaik</surname><given-names>R</given-names></name><name><surname>Patnaik</surname><given-names>S</given-names></name><name><surname>Mohanty</surname><given-names>S</given-names></name><name><surname>Sharma</surname><given-names>A</given-names></name><name><surname>Vannemreddy</surname><given-names>P</given-names></name></person-group><article-title>Antibodies to serotonin attenuate closed head injury induced blood brain barrier disruption and brain pathology</article-title><source>Ann NY Acad Sci</source><volume>1122</volume><fpage>295</fpage><lpage>312</lpage><year>2007</year></element-citation></ref>
<ref id="b7-etm-08-05-1467"><label>7</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Sharma</surname><given-names>HS</given-names></name><name><surname>Winkler</surname><given-names>T</given-names></name><name><surname>St&#x000E5;lberg</surname><given-names>E</given-names></name><name><surname>Mohanty</surname><given-names>S</given-names></name><name><surname>Westman</surname><given-names>J</given-names></name></person-group><article-title>p-Chlorophenylalanine, an inhibitor of serotonin synthesis reduces blood-brain barrier permeability, cerebral blood flow, edema formation and cell injury following trauma to the rat brain</article-title><source>Acta Neurochir Suppl</source><volume>76</volume><fpage>91</fpage><lpage>95</lpage><year>2000</year></element-citation></ref>
<ref id="b8-etm-08-05-1467"><label>8</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Polo</surname><given-names>PA</given-names></name><name><surname>Reis</surname><given-names>RO</given-names></name><name><surname>Cedraz-Mercez</surname><given-names>PL</given-names></name><etal/></person-group><article-title>Behavioral and neuropharmacological evidence that serotonin crosses the blood-brain barrier in <italic>Coturnix japonica</italic> (Galliformes; Aves)</article-title><source>Braz J Biol</source><volume>67</volume><fpage>167</fpage><lpage>171</lpage><year>2007</year></element-citation></ref>
<ref id="b9-etm-08-05-1467"><label>9</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Gutknecht</surname><given-names>L</given-names></name><name><surname>Kriegebaum</surname><given-names>C</given-names></name><name><surname>Waider</surname><given-names>J</given-names></name><name><surname>Schmitt</surname><given-names>A</given-names></name><name><surname>Lesch</surname><given-names>KP</given-names></name></person-group><article-title>Spatio-temporal expression of tryptophan hydroxylase isoforms in murine and human brain: convergent data from Tph2 knockout mice</article-title><source>Eur Neuropsychopharmacol</source><volume>19</volume><fpage>266</fpage><lpage>282</lpage><year>2009</year></element-citation></ref>
<ref id="b10-etm-08-05-1467"><label>10</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Zhang</surname><given-names>X1</given-names></name><name><surname>Beaulieu</surname><given-names>JM</given-names></name><name><surname>Sotnikova</surname><given-names>TD</given-names></name><name><surname>Gainetdinov</surname><given-names>RR</given-names></name><name><surname>Caron</surname><given-names>MG</given-names></name></person-group><article-title>Tryptophan hydroxylase-2 controls brain serotonin synthesis</article-title><source>Science</source><volume>305</volume><fpage>217</fpage><year>2004</year></element-citation></ref>
<ref id="b11-etm-08-05-1467"><label>11</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Song</surname><given-names>NN</given-names></name><name><surname>Xiu</surname><given-names>JB</given-names></name><name><surname>Huang</surname><given-names>Y</given-names></name><etal/></person-group><article-title>Adult raphe-specific deletion of Lmx1b leads to central serotonin deficiency</article-title><source>PLoS One</source><volume>6</volume><fpage>e15998</fpage><year>2011</year></element-citation></ref>
<ref id="b12-etm-08-05-1467"><label>12</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Bach</surname><given-names>H</given-names></name><name><surname>Arango</surname><given-names>V</given-names></name><name><surname>Huang</surname><given-names>YY</given-names></name><name><surname>Leong</surname><given-names>S</given-names></name><name><surname>Mann</surname><given-names>JJ</given-names></name><name><surname>Underwood</surname><given-names>MD</given-names></name></person-group><article-title>Neuronal tryptophan hydroxylase expression in BALB/cJ and C57Bl/6J mice</article-title><source>J Neurochem</source><volume>118</volume><fpage>1067</fpage><lpage>1074</lpage><year>2011</year></element-citation></ref>
<ref id="b13-etm-08-05-1467"><label>13</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Watson</surname><given-names>RE</given-names><suffix>Jr</suffix></name><name><surname>Wiegand</surname><given-names>SJ</given-names></name><name><surname>Clough</surname><given-names>RW</given-names></name><name><surname>Hoffman</surname><given-names>GE</given-names></name></person-group><article-title>Use of cryoprotectant to maintain long-term peptide immunoreactivity and tissue morphology</article-title><source>Peptides</source><volume>7</volume><fpage>155</fpage><lpage>159</lpage><year>1986</year></element-citation></ref>
<ref id="b14-etm-08-05-1467"><label>14</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Dickstein</surname><given-names>DL</given-names></name><name><surname>Biron</surname><given-names>KE</given-names></name><name><surname>Ujiie</surname><given-names>M</given-names></name><name><surname>Pfeifer</surname><given-names>CG</given-names></name><name><surname>Jeffries</surname><given-names>AR</given-names></name><name><surname>Jefferies</surname><given-names>WA</given-names></name></person-group><article-title>Abeta peptide immunization restores blood-brain barrier integrity in Alzheimer disease</article-title><source>FASEB J</source><volume>20</volume><fpage>426</fpage><lpage>433</lpage><year>2006</year></element-citation></ref>
<ref id="b15-etm-08-05-1467"><label>15</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Takeda</surname><given-names>S</given-names></name><name><surname>Sato</surname><given-names>N</given-names></name><name><surname>Ikimura</surname><given-names>K</given-names></name><name><surname>Nishino</surname><given-names>H</given-names></name><name><surname>Rakugi</surname><given-names>H</given-names></name><name><surname>Morishita</surname><given-names>R</given-names></name></person-group><article-title>Increased blood-brain barrier vulnerability to systemic inflammation in an Alzheimer disease mouse model</article-title><source>Neurobiol Aging</source><volume>34</volume><fpage>2064</fpage><lpage>2070</lpage><year>2013</year></element-citation></ref>
<ref id="b16-etm-08-05-1467"><label>16</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Sharma</surname><given-names>HS</given-names></name><name><surname>Olsson</surname><given-names>Y</given-names></name><name><surname>Dey</surname><given-names>PK</given-names></name></person-group><article-title>Changes in blood-brain barrier and cerebral blood flow following elevation of circulating serotonin level in anesthetized rats</article-title><source>Brain Res</source><volume>517</volume><fpage>215</fpage><lpage>223</lpage><year>1990</year></element-citation></ref>
<ref id="b17-etm-08-05-1467"><label>17</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Sharma</surname><given-names>HS</given-names></name><name><surname>Westman</surname><given-names>J</given-names></name><name><surname>Navarro</surname><given-names>JC</given-names></name><name><surname>Dey</surname><given-names>PK</given-names></name><name><surname>Nyberg</surname><given-names>F</given-names></name></person-group><article-title>Probable involvement of serotonin in the increased permeability of the blood-brain barrier by forced swimming. An experimental study using Evans blue and <sup>131</sup>I-sodium tracers in the rat</article-title><source>Behav Brain Res</source><volume>72</volume><fpage>189</fpage><lpage>196</lpage><year>1995</year></element-citation></ref>
<ref id="b18-etm-08-05-1467"><label>18</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Artigas</surname><given-names>F</given-names></name></person-group><article-title>Serotonin receptors involved in antidepressant effects</article-title><source>Pharmacol Ther</source><volume>137</volume><fpage>119</fpage><lpage>131</lpage><year>2013</year></element-citation></ref>
<ref id="b19-etm-08-05-1467"><label>19</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Zhao</surname><given-names>YJ</given-names></name><name><surname>Du</surname><given-names>MY</given-names></name><name><surname>Huang</surname><given-names>XQ</given-names></name><etal/></person-group><article-title>Brain grey matter abnormalities in medication-free patients with major depressive disorder: a meta-analysis</article-title><source>Psychol Med</source><fpage>1</fpage><lpage>11</lpage><year>2014</year></element-citation></ref></ref-list></back>
<floats-group>
<fig id="f1-etm-08-05-1467" position="float">
<label>Figure 1</label>
<caption>
<p>Polymerase chain reaction and immunocytochemistry results. (A) Expression of the Cre (left) and TPH2 (right) marker genes. (B) Immunofluorescence in 5-HT-positive neurons in the wild-type group (magnification, &#x000D7;20). (C) 5-HT-positive neurons were lost in the TPH2-knockout group (magnification, &#x000D7;20). Scale bar=20 &#x003BC;m. Mlf, medial longitudinal fasciculus; 5-HT, 5-hydroxytryptamine; TPH2, tryptophan hydroxylase 2.</p></caption>
<graphic xlink:href="ETM-08-05-1467-g00.gif"/></fig>
<fig id="f2-etm-08-05-1467" position="float">
<label>Figure 2</label>
<caption>
<p>Mouse brains 12 h after Evans Blue intraperitoneal injection. (A) Wild-type group. (B) Tryptophan hydroxylase 2-knockout group.</p></caption>
<graphic xlink:href="ETM-08-05-1467-g01.gif"/></fig>
<fig id="f3-etm-08-05-1467" position="float">
<label>Figure 3</label>
<caption>
<p>Mouse brain coronal sections 12 h after Evans Blue intraperitoneal injection (magnification, &#x000D7;20). (A) Wild-type group. (B) Tryptophan hydroxylase 2-knockout group. Scale bar=40 &#x003BC;m.</p></caption>
<graphic xlink:href="ETM-08-05-1467-g02.gif"/></fig></floats-group></article>
