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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Neurol.</journal-id>
<journal-title>Frontiers in Neurology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Neurol.</abbrev-journal-title>
<issn pub-type="epub">1664-2295</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fneur.2023.1108494</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Neurology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Role of PGC-1&#x03B1; mediated synaptic plasticity, mitochondrial function, and neuroinflammation in the antidepressant effect of Zi-Shui-Qing-Gan-Yin</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author"><name><surname>Zhu</surname> <given-names>Wen</given-names></name><xref rid="aff1" ref-type="aff"><sup>1</sup></xref><xref rid="aff2" ref-type="aff"><sup>2</sup></xref><xref rid="fn0001" ref-type="author-notes"><sup>&#x2020;</sup></xref><uri xlink:href="https://loop.frontiersin.org/people/2113099/overview"/>
</contrib>
<contrib contrib-type="author"><name><surname>Zhang</surname> <given-names>Wen</given-names></name><xref rid="aff1" ref-type="aff"><sup>1</sup></xref><xref rid="aff2" ref-type="aff"><sup>2</sup></xref><xref rid="fn0001" ref-type="author-notes"><sup>&#x2020;</sup></xref></contrib>
<contrib contrib-type="author"><name><surname>Yang</surname> <given-names>Feng</given-names></name><xref rid="aff1" ref-type="aff"><sup>1</sup></xref><xref rid="aff2" ref-type="aff"><sup>2</sup></xref><xref rid="fn0001" ref-type="author-notes"><sup>&#x2020;</sup></xref></contrib>
<contrib contrib-type="author"><name><surname>Cai</surname> <given-names>Min</given-names></name><xref rid="aff1" ref-type="aff"><sup>1</sup></xref><xref rid="aff2" ref-type="aff"><sup>2</sup></xref><uri xlink:href="https://loop.frontiersin.org/people/2297671/overview"/></contrib>
<contrib contrib-type="author"><name><surname>Li</surname> <given-names>Xiangting</given-names></name><xref rid="aff1" ref-type="aff"><sup>1</sup></xref><xref rid="aff2" ref-type="aff"><sup>2</sup></xref></contrib>
<contrib contrib-type="author"><name><surname>Xiang</surname> <given-names>Yijin</given-names></name><xref rid="aff1" ref-type="aff"><sup>1</sup></xref><xref rid="aff2" ref-type="aff"><sup>2</sup></xref></contrib>
<contrib contrib-type="author" corresp="yes"><name><surname>Xiang</surname> <given-names>Jun</given-names></name><xref rid="aff1" ref-type="aff"><sup>1</sup></xref><xref rid="aff2" ref-type="aff"><sup>2</sup></xref><xref rid="c001" ref-type="corresp"><sup>&#x002A;</sup></xref></contrib>
<contrib contrib-type="author" corresp="yes"><name><surname>Yang</surname> <given-names>Yunke</given-names></name><xref rid="aff1" ref-type="aff"><sup>1</sup></xref><xref rid="aff2" ref-type="aff"><sup>2</sup></xref><xref rid="c002" ref-type="corresp"><sup>&#x002A;</sup></xref></contrib>
<contrib contrib-type="author" corresp="yes"><name><surname>Cai</surname> <given-names>Dingfang</given-names></name><xref rid="aff1" ref-type="aff"><sup>1</sup></xref><xref rid="aff2" ref-type="aff"><sup>2</sup></xref><xref rid="c003" ref-type="corresp"><sup>&#x002A;</sup></xref><uri xlink:href="https://loop.frontiersin.org/people/2306420/overview"/></contrib>
</contrib-group>
<aff id="aff1"><sup>1</sup><institution>Department of Integrative Medicine, Zhongshan Hospital, Fudan University</institution>, <addr-line>Shanghai</addr-line>, <country>China</country></aff>
<aff id="aff2"><sup>2</sup><institution>Laboratory of Neurology, Institute of Integrative Medicine, Fudan University</institution>, <addr-line>Shanghai</addr-line>, <country>China</country></aff>
<author-notes>
<fn id="fn0002" fn-type="edited-by">
<p>Edited by: Lingyong Xiao, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, China</p>
</fn>
<fn id="fn0003" fn-type="edited-by">
<p>Reviewed by: Zhonghai Yu, Shanghai Jiao Tong University Affiliated Shanghai Sixth People&#x2019;s Hospital, China; Xiumin Liu, National Institute on Drug Dependence, Health Science Centre, Peking University, China</p>
</fn>
<corresp id="c001">&#x002A;Correspondence: Jun Xiang, <email>xiang.jun@zs-hospital.sh.cn</email></corresp>
<corresp id="c002">Yunke Yang, <email>yang.yunke@zs-hospital.sh.cn</email></corresp>
<corresp id="c003">Dingfang Cai, <email>cai.dingfang@zs-hospital.sh.cn</email></corresp>
<fn id="fn0001" fn-type="equal">
<p><sup>&#x2020;</sup>These authors have contributed equally to this work and share first authorship</p>
</fn>
<fn id="fn0004" fn-type="other">
<p>This article was submitted to Neurorehabilitation, a section of the journal Frontiers in Neurology</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>12</day>
<month>05</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="collection">
<year>2023</year>
</pub-date>
<volume>14</volume>
<elocation-id>1108494</elocation-id>
<history>
<date date-type="received">
<day>26</day>
<month>11</month>
<year>2022</year>
</date>
<date date-type="accepted">
<day>15</day>
<month>03</month>
<year>2023</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2023 Zhu, Zhang, Yang, Cai, Li, Xiang, Xiang, Yang and Cai.</copyright-statement>
<copyright-year>2023</copyright-year>
<copyright-holder>Zhu, Zhang, Yang, Cai, Li, Xiang, Xiang, Yang and Cai</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<p>Depression is the most prevalent psychiatric disorder, which needs deeper mechanism research studies and effective therapy. Zi-Shui-Qing-Gan-Yin (ZSQGY) is a traditional Chinese medicine decoction that has been widely used in China in the treatment of depressive symptoms. The aim of the study was to examine the anti-depressive effects of ZSQGY and the possible mechanism of action in the monosodium glutamate (MSG)-induced depressive model and the corticosterone (CORT)-induced PC12 cell model. Liquid chromatography-mass spectrometry (LC&#x2013;MS) was performed to determine the major compounds in the water extract of ZSQGY. The depressive behaviors were evaluated by the field swimming test (FST), the sucrose preference test (SPT), and the open field test (OFT). Golgi staining and transmission electron microscopy (TEM) were performed to display the alterations of synaptic ultrastructure. The mitochondrion function and inflammatory factors were also quantified. The changes in peroxisome proliferator-activated receptor-&#x03B3; co-activator 1&#x03B1; (PGC-1&#x03B1;) expression were evaluated. The results of this study demonstrated that ZSQGY significantly improved depressive behaviors. ZSQGY also reversed the changes in synaptic plasticity, improved mitochondrion function, and reduced the levels of inflammatory factors. The neuroprotective effects were accompanied by the increased expression of PGC-1&#x03B1;. However, the beneficial changes were reversed after the inhibition of PGC-1&#x03B1;. These results indicated that ZSQGY effectively could improve depressive behaviors <italic>via</italic> the mechanisms that regulate synaptic structural plasticity, improve mitochondrion function, and alleviate neuroinflammation, which could, or partly, attribute to the regulation of PGC-1&#x03B1;.</p>
</abstract>
<kwd-group>
<kwd>depression</kwd>
<kwd>Zi-Shui-Qing-Gan-Yin</kwd>
<kwd>synaptic plasticity</kwd>
<kwd>PGC-1&#x03B1;</kwd>
<kwd>neuroinflammation</kwd>
<kwd>mitochondrion</kwd>
</kwd-group>
<counts>
<fig-count count="7"/>
<table-count count="2"/>
<equation-count count="0"/>
<ref-count count="53"/>
<page-count count="13"/>
<word-count count="6932"/>
</counts>
</article-meta>
</front>
<body>
<sec id="sec1" sec-type="intro">
<title>Introduction</title>
<p>Depression is a prevalent psychiatric disease with a high recurrence rate and high suicide rate, which has brought heavy health and economic burden to society (<xref ref-type="bibr" rid="ref1">1</xref>). Approximately 350 million people worldwide suffer from depression, with a lifetime prevalence of 10&#x2013;20% (<xref ref-type="bibr" rid="ref2">2</xref>). Among them, approximately 15&#x2013;25% of the patients eventually died of suicide, accounting for two-thirds of the suicide population (<xref ref-type="bibr" rid="ref2">2</xref>). The World Health Organization estimates that by 2030, the cost of expanded treatment, mainly psychological counseling and antidepressants, will reach 147 billion dollars (<xref ref-type="bibr" rid="ref3">3</xref>). It is indisputable that depression has become a significant global public health concern.</p>
<p>Although there are several antidepressant medications, only approximately half of the patients could benefit from the current options and up to 35% of patients are refractory to treatment (<xref ref-type="bibr" rid="ref4">4</xref>, <xref ref-type="bibr" rid="ref5">5</xref>). Severe side effects also make these antidepressant medications far from ideal (<xref ref-type="bibr" rid="ref6">6</xref>). It is worth noting that the antidepressants currently available are mostly based on the monoamine hypothesis of depression, which cannot explain the delay in therapeutic responses of fast-acting neurotransmitters (<xref ref-type="bibr" rid="ref7">7</xref>, <xref ref-type="bibr" rid="ref8">8</xref>). The imbalance implies that adaptive mechanisms may be involved in the pathogenesis of depression. Therefore, it is necessary to explore the pathogenesis of depression and find more specific and effective therapies.</p>
<p>Decreased synaptic density, mitochondrial dysfunction, and activation of neuroinflammatory factors are closely related to the pathology of depression (<xref ref-type="bibr" rid="ref9">9</xref>). Peroxisome proliferator-activated receptor-&#x03B3; co-activator 1&#x03B1; (PGC-1&#x03B1;) is a crucial co-activator that controls gene expression during mitochondrial biogenesis (<xref ref-type="bibr" rid="ref10">10</xref>). It is also an important coordination factor that participates in the transcriptional regulation of many physiological processes, such as synaptic plasticity and neuroinflammation. The brain is the tissue with high energy demands and extremely depends on mitochondrial function, thus highlighting the crucial role of PGC-1&#x03B1; in the field of neurological disorders (<xref ref-type="bibr" rid="ref11">11</xref>, <xref ref-type="bibr" rid="ref12">12</xref>). Subsequent studies have demonstrated that the expression of PGC-1&#x03B1; is attenuated in depression models and the overexpression of PGC-1&#x03B1; could powerfully improve the synaptic plasticity, mitochondrial function, and inflammatory response (<xref ref-type="bibr" rid="ref13 ref14 ref15">13&#x2013;15</xref>). Considering the role of PGC-1&#x03B1; plays in the physiological and pathological processes, there is a reasonable propose that reduced PGC-1&#x03B1; could contribute to the pathology of depression.</p>
<p>In recent years, increasing studies have reported the efficacy and safety of traditional Chinese medicine (TCM) in relieving symptoms of depression (<xref ref-type="bibr" rid="ref16">16</xref>, <xref ref-type="bibr" rid="ref17">17</xref>). Zi-Shui-Qing-Gan-Yin (ZSQGY) is a TCM decoction that has been widely used in China in the treatment of depressive symptoms for a long history (<xref ref-type="bibr" rid="ref18">18</xref>). Studies have shown that ZSQGY could alleviate the depressive symptoms of depressed patients and increase the levels of neurotransmitters in the hippocampus of depressed rats (<xref ref-type="bibr" rid="ref18 ref19 ref20 ref21">18&#x2013;21</xref>). However, little is known about the mechanisms underlying the antidepressant effects of ZSQGY. The aim of this study was to comprehensively explore the antidepressant effects and mechanism of ZSQGY in the monosodium glutamate (MSG)-induced depressive model and the corticosterone (CORT)-induced PC12 cell model.</p>
</sec>
<sec id="sec2" sec-type="materials|methods">
<title>Materials and methods</title>
<sec id="sec3">
<title>Animal</title>
<p>The neonate Sprague&#x2013;Dawley rats (4&#x2013;8&#x2009;g) from Sino-British SIPPR/BK Lab Animals Ltd. (Shanghai, China) were used. The animals were kept under control conditions (12-h light/dark cycle, temperature 23&#x2009;&#x00B1;&#x2009;1&#x00B0;C, relative humidity 55&#x2009;&#x00B1;&#x2009;10%) with free access to water and food. The experiments were performed according to the guidelines of the National Institutes of Health Guide for the Care and Use of Laboratory Animals and approved by the Animal Care and Use Committee of Fudan University. Efforts were made to reduce the number and suffering of animals used in the study.</p>
</sec>
<sec id="sec4">
<title>Monosodium glutamate (MSG)-induced depressive model</title>
<p>The procedure was performed as previously described (<xref ref-type="bibr" rid="ref22">22</xref>, <xref ref-type="bibr" rid="ref23">23</xref>). MSG (Sigma-Aldrich, St. Louis, MO, United States) was dissolved in 0.9% NaCl solution to the final concentration of 10%. Briefly, the experimental animals were subcutaneously injected with MSG at a dose of 4&#x2009;mg/g on the postnatal 2nd, 4th, 6th, 8th, and 10th days. The control animals received an equimolar concentration of sodium chloride. The animals were weaned on the 21st day, and the female rats were removed from the cage.</p>
</sec>
<sec id="sec5">
<title>ZSQGY preparation and quality control</title>
<p>ZSQGY consists of 12 crude drugs including Radix Rehmanniae, Dioscoreae Rhizoma, Radix Bupleuri, Radix Paeoniae Alba, Radix Angelicae Sinensi, Rhizoma Anemarrhenae, Fructus Corni, Cortex Moutan, Poria, Ziziphi Spinosae Semen, Rhizoma Alismatis, and Gardeniae Fructus. The composition of ZSQGY is listed in <xref rid="tab1" ref-type="table">Table 1</xref>. All crude drugs were obtained from Zhongshan Hospital. Briefly, the crude herbs were boiled in 10 times the volume of drinking water for 1&#x2009;h for three times. Suspensions filtered from three decoctions were mixed and centrifuged at 2,000&#x2009;<italic>g</italic> for 20&#x2009;min. The collected suspension was soaked in 100% ethanol under rapid agitation, followed by stirring overnight. Then the suspension was collected and centrifuged at 2,000&#x2009;<italic>g</italic> for 20&#x2009;min and concentrated to 2&#x2009;g/mL (w/v) before autoclaving.</p>
<table-wrap position="float" id="tab1">
<label>Table 1</label>
<caption>
<p>Composition of ZSQGY.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="top">Ingredients (Latin name)</th>
<th align="left" valign="top">Ingredients (Chinese name)</th>
<th align="left" valign="top">Family</th>
<th align="left" valign="top">Part used</th>
<th align="center" valign="top">Ratio (g)</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top">Radix Rehmanniae</td>
<td align="left" valign="top">Di Huang</td>
<td align="left" valign="top">Scrophulariaceae</td>
<td align="left" valign="top">Root</td>
<td align="center" valign="top">12</td>
</tr>
<tr>
<td align="left" valign="top">Dioscoreae Rhizoma</td>
<td align="left" valign="top">Shan Yao</td>
<td align="left" valign="top">Dioscoreaceae</td>
<td align="left" valign="top">Root and rhizome</td>
<td align="center" valign="top">12</td>
</tr>
<tr>
<td align="left" valign="top">Radix Bupleuri</td>
<td align="left" valign="top">Chai Hu</td>
<td align="left" valign="top">Umbelliferae</td>
<td align="left" valign="top">Root</td>
<td align="center" valign="top">10</td>
</tr>
<tr>
<td align="left" valign="top">Radix Paeoniae Alba</td>
<td align="left" valign="top">Bai Shao</td>
<td align="left" valign="top">Ranunculaceae</td>
<td align="left" valign="top">Root</td>
<td align="center" valign="top">10</td>
</tr>
<tr>
<td align="left" valign="top">Radix Angelicae Sinensi</td>
<td align="left" valign="top">Dang Gui</td>
<td align="left" valign="top">Umbelliferae</td>
<td align="left" valign="top">Root</td>
<td align="center" valign="top">10</td>
</tr>
<tr>
<td align="left" valign="top">Rhizoma Anemarrhenae</td>
<td align="left" valign="top">Zhi Mu</td>
<td align="left" valign="top">Liliaceae</td>
<td align="left" valign="top">Root and rhizome</td>
<td align="center" valign="top">12</td>
</tr>
<tr>
<td align="left" valign="top">Fructus Corni</td>
<td align="left" valign="top">Shan Zhu Yu</td>
<td align="left" valign="top">Cornaceae</td>
<td align="left" valign="top">Flesh</td>
<td align="center" valign="top">12</td>
</tr>
<tr>
<td align="left" valign="top">Cortex Moutan</td>
<td align="left" valign="top">Mu Dan Pi</td>
<td align="left" valign="top">Ranuculaceae</td>
<td align="left" valign="top">Velamen</td>
<td align="center" valign="top">10</td>
</tr>
<tr>
<td align="left" valign="top">Poria</td>
<td align="left" valign="top">Fu Ling</td>
<td align="left" valign="top">Polyporaceae</td>
<td align="left" valign="top">Sclerotium</td>
<td align="center" valign="top">10</td>
</tr>
<tr>
<td align="left" valign="top">Ziziphi Spinosae Semen</td>
<td align="left" valign="top">Suan Zao Ren</td>
<td align="left" valign="top">Rhamnaceae</td>
<td align="left" valign="top">Seed</td>
<td align="center" valign="top">15</td>
</tr>
<tr>
<td align="left" valign="top">Rhizoma Alismatis</td>
<td align="left" valign="top">Ze Xie</td>
<td align="left" valign="top">Alismatales</td>
<td align="left" valign="top">Stem</td>
<td align="center" valign="top">10</td>
</tr>
<tr>
<td align="left" valign="top">Gardeniae Fructus</td>
<td align="left" valign="top">Zhi Zi</td>
<td align="left" valign="top">Rubiaceae</td>
<td align="left" valign="top">Seed</td>
<td align="center" valign="top">10</td>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
<sec id="sec6">
<title>LC&#x2013;MS analysis of ZSQGY</title>
<p>Liquid chromatography-mass spectrometry (LC&#x2013;MS) was established for the qualitative analysis of chemical compounds of ZSQGY. The API 4000 tandem mass spectrometer (Applied Biosystems/MDS SCIEX, United States) equipped with an electrospray ionization source (ESI) was used in the LC&#x2013;MS analysis. All targeted analyses were performed in positive and negative ion modes. The curtain gas (CUR) and collision gas (CAD) used high-purity (99.99%) nitrogen. The ionspray voltage (IS) was set 3,500&#x2009;V and the ionspray temperature (TEM) was 450&#x00B0;C. The 100&#x2009;&#x03BC;L samples were dissolved in a 1&#x2009;mL solution containing methanol and filtered through a 0.22&#x2009;&#x03BC;m membrane. The content of the components in ZSQGY was calculated using the point external standard method.</p>
</sec>
<sec id="sec7">
<title>Experimental groups of animals and drug administration</title>
<p>The animals (8&#x2009;weeks old) were randomly divided into the control group, the model group, the L-ZSQGY group, the M-ZSQGY group, the H-ZSQGY group, and the FXT group. The dose of ZSQGY that translated from human beings to animals in this study was established using the body surface area normalization method. For ZSQGY treatment, the common human daily dose in the present study is 133&#x2009;g/70&#x2009;kg bodyweight. According to the formula drat&#x2009;=&#x2009;human&#x2009;&#x00D7;&#x2009;0.71/0.11, we selected 12, 24, and 48&#x2009;g/kg/day as low, middle, and high doses, respectively. For fluoxetine treatment, the daily dose required for an adult is 20&#x2009;mg/70&#x2009;kg, which is converted to 0.184&#x2009;mg/100&#x2009;g for a rat. The treatment dosage for rats was 6.45 times that of patients. The animals in the control group and mode group were taken in the same volume as that of normal saline. All drugs were given once daily continuously for 4&#x2009;weeks.</p>
</sec>
<sec id="sec8">
<title>Forced swimming test (FST)</title>
<p>The rats were placed in an acrylic cylinder (height 40&#x2009;cm, and diameter 20&#x2009;cm) filled with water (depth 20&#x2009;cm) at a temperature of 25&#x2009;&#x00B1;&#x2009;1&#x00B0;C for 15&#x2009;min (the pretest session). After 24&#x2009;h, the rats were forced to swim again for 5&#x2009;min. The duration of immobility (s) was analyzed. The rats remained floating in an upright position, with small movements of the four limbs to keep its head above the water surface, and were judged to be immobile.</p>
</sec>
<sec id="sec9">
<title>Sucrose preference test (SPT)</title>
<p>Briefly, the rats were presented with two bottles containing 1% sucrose solution in the home cage for 24&#x2009;h. Then, either water or 1% sucrose solution was placed in a random order in the home cage for another 24&#x2009;h and the bottle order was exchanged every 12&#x2009;h to account for side preference. The animals were deprived of water for 12&#x2009;h before the test and then presented with two pre-weighed bottles containing 1% sucrose solution or water. The intake of water, sucrose solution, and total fluid intake were measured after 18&#x2009;h. The percentage of sucrose solution intake in relation to the total fluid intake was calculated. The impaired sucrose intake was indicative of the depression-like behavior.</p>
</sec>
<sec id="sec10">
<title>Open field test (OFT)</title>
<p>Central and peripheral areas were divided in the open field apparatus. The animal was placed individually in the open field area (50&#x2009;&#x00D7;&#x2009;50&#x2009;&#x00D7;&#x2009;50&#x2009;cm) for 5&#x2009;min, and the locomotor activity was videotaped (Ethovision 9.0, Noldus). Time spent in center (s) and latency to center (s) were analyzed.</p>
</sec>
<sec id="sec11">
<title>Golgi staining</title>
<p>Golgi staining and spine density analysis were performed according to the manufacturer&#x2019;s instructions (Hito Golgi-Cox OptimStain kit, Hitobiotec Corp, Kingsport, TN, United States). The medial prefrontal cortex (mPFC) was cut into 80&#x2009;&#x03BC;m thickness coronal tissue sections using a freezing microtome (Microm HM 450, Waldorf, Germany). Neurons in the mPFC area were analyzed. Dendritic spine density was counted by randomly selecting the secondary and tertiary apical dendrites and was shown as the number of thorns/10&#x2009;&#x03BC;m dendrite. In total, three segments were counted per section, and three slides were chosen from each rat.</p>
</sec>
<sec id="sec12">
<title>Transmission electron microscopy (TEM)</title>
<p>The rats were given anesthesia with sodium pentobarbital (40&#x2009;mg/kg) intraperitoneal injection, and the mPFC were removed and incubated in 2.5% glutaraldehyde at 4&#x00B0;C for 24&#x2009;h. Then, the mPFC were cut into 1&#x2009;mm<sup>3</sup> segments and fixed in 1% osmium tetroxide for 2&#x2009;h. The tissue segments were rinsed and dehydrated in a series of graded aqueous ethanol and embedded in Epon. A total of 70&#x2009;nm ultrathin sections were prepared and stained with 3% uranyl acetate and 0.5% lead citrate. Images were taken using the TEM (6,200&#x00D7; magnification) and analyzed using Image Pro Plus.</p>
</sec>
<sec id="sec13">
<title>Immunohistochemistry (IHC)</title>
<p>The rats were anesthetized with sodium pentobarbital (40&#x2009;mg/kg) intraperitoneal injection and then transcardially perfused with 4% paraformaldehyde. The brains were removed and then paraffin was embedded. Then the mPFC slides (10&#x2009;&#x03BC;m) were incubated in PBS containing 0.03% H<sub>2</sub>O<sub>2</sub> for 10&#x2009;min and in 5% goat serum for 30&#x2009;min, followed by the incubation with anti-PGC-1&#x03B1; (1:100; Abcam, Cambridge, United Kingdom) at 4&#x00B0;C overnight. After washing with PBS, the sections were incubated with a secondary antibody (1:200) for 1&#x2009;h. Then slices were added an appropriate amount of horseradish enzyme and incubated at 37&#x00B0;C for 30&#x2009;min. After washing with PBS, the slides were incubated in DAB. The nuclei were stained with hematoxylin. The slices were dehydrated with ethanol, sealed with gum, and further observed under the microscope for observation and analysis (Olympus BX51, Tokyo, Japan).</p>
</sec>
<sec id="sec14">
<title>qRT-PCR</title>
<p>The total RNA was extracted using a Trizol Reagent (Introgen, Carlsbad, CA, United States) according to the instructions. The total RNA was reverse transcribed into cDNA using the cDNA synthesis kit (Thermo Fisher Scientific, Waltham, MA, United States). A real-time quantitative PCR analyzer was used to detect the expressions of PGC-1&#x03B1; mRNA and PSD95 mRNA. The obtained genes were normalized to GAPDH. The primers sequences were listed as follows: GAPDH, AACTCCCATTCCTCCACCTT, and GAGGGCCTCTCTCTTGCTCT; PGC-1&#x03B1;, AGGCAAGCAAGCAGGTCT, and GTCATCAAACAGGCCATCC; and PSD95, GCAGGTTGCAGATCGGAGAC, and CCAGGTGCTGAGAATATGAGGTT.</p>
</sec>
<sec id="sec15">
<title>Measurement of mitochondrial DNA (mtDNA)</title>
<p>The analysis of the mtDNA amount was measured by quantitative PCR. The copy numbers of mtDNA were normalized to a nuclear-encoded gene RBM15.</p>
</sec>
<sec id="sec16">
<title>Enzyme-linked immunosorbent assay</title>
<p>The concentrations of malondialdehyde (MDA), 8-hydroxy-2-deoxyguanosine (8-OHdG), tumor necrosis factor-&#x03B1; (TNF-&#x03B1;), interferon-&#x03B3; (IFN-&#x03B3;), interleukin-1 (IL-1), 6 (IL-6) from the mPFC of rats, and cell serum were quantified using enzyme-linked immunosorbent assay (ELISA) kits (Shanghai Enzyme-linked Biotechnology, Shanghai, China).</p>
</sec>
<sec id="sec17">
<title>Measurement of mitochondrial ATP level</title>
<p>The mitochondrial ATP level was detected using the ATP Assay kit (Beyotime Biotechnology, Shanghai, China) according to the manufacturer&#x2019;s instructions.</p>
</sec>
<sec id="sec18">
<title>Preparation of the ZSQGY-containing serum</title>
<p>The rats were administered with the ZSQGY (24&#x2009;g/kg/day) for 3 consecutive days. After anesthetized with sodium pentobarbital (40&#x2009;mg/kg), the abdominal aorta blood of the animals was collected 2&#x2009;h after the treatments and centrifuged at 4&#x00B0;C for 20&#x2009;min, followed by sterilization through a 0.22&#x2009;&#x03BC;m microporous membrane. The serum was stored at &#x2212;80&#x00B0;C.</p>
</sec>
<sec id="sec19">
<title>Cell culture and drug treatment</title>
<p>High concentrations of CORT can induce the neurotoxicity of PC12 cells, which has been widely used as an <italic>in vitro</italic> model for depression. In this study, differentiated PC12 cells were maintained (at a density of 1&#x2009;&#x00D7;&#x2009;105 cells/mL) in RPMI-1640 supplemented with 10% heat-inactivated fetal bovine serum and 1% penicillin&#x2013;streptomycin at 37&#x00B0;C under a humidified atmosphere of 5% CO<sub>2</sub> and 95% air (v/v) for 24&#x2009;h. Plated PC12 cells were exposed to CORT (Sigma-Aldrich, St. Louis, MO, United States) at the level of 200 and 400&#x2009;&#x03BC;M for 24&#x2009;h, and then the PC12 cells were treated with different concentrations of the ZSQGY-containing serum (5, 10, and 20%) to determine the suitable doses of CORT and ZSQGY-containing serum by assessing with the CCK-8 kit (Beyotime Biotechnology, Shanghai, China).</p>
</sec>
<sec id="sec20">
<title>Viability assay</title>
<p>PC12 cells were treated with the CCK-8 solution and incubated at 37&#x00B0;C for 4&#x2009;h. The optimal density at 450&#x2009;nm was measured with a microplate reader (Bio-Rad Laboratories, Hercules, CA, United States). Cell viability was presented as a percentage of control cells.</p>
</sec>
<sec id="sec21">
<title>Grouping of PC12 cells and PGC-1&#x03B1; siRNA transfection</title>
<p>The PC12 cells were divided into the control group, the model group, the ZSQGY + PGC-1&#x03B1; siRNA group, and the ZSQGY + con-siRNA group. For the control group, PC12 cells were cultured under the abovementioned normal conditions. For the model group, PC12 cells were exposed to 200&#x2009;&#x03BC;M CORT for 24&#x2009;h. For the ZSQGY + PGC-1&#x03B1; siRNA group, PC12 cells were treated with PGC-1&#x03B1; siRNA before modeling and ZSQGY-containing serum treatment. For the ZSQGY + con-siRNA group, PC12 cells were treated with con-siRNA before modeling and ZSQGY-containing serum treatment. The PGC-1&#x03B1; siRNA and con-siRNA (Jikai Biology, Shanghai, China) were transfected with Lipofectamine 2000 (Invitrogen, Carlsbad, CA, United States).</p>
</sec>
<sec id="sec22">
<title>Statistical analysis</title>
<p>Data are expressed as mean&#x2009;&#x00B1;&#x2009;standard error. Data were analyzed by one-way analysis of variance (ANOVA) followed by the LSD multiple comparison test using software SPSS 20.0. Data were considered statistically significant at a value of <italic>p</italic> of less than 0.05.</p>
</sec>
</sec>
<sec id="sec23" sec-type="results">
<title>Results</title>
<sec id="sec24">
<title>Qualitative and quantitative analysis of components in water extract of ZSQGY</title>
<p>Qualitative analysis of compounds in water extract of ZSQGY was carried out by LC&#x2013;MS. A total of six compounds, including geniposide, paeoniflorin, albiflorin, ferulic acid, saikosaponin A, and ursolic acid in water extract were used for quantitative analysis (<xref rid="fig1" ref-type="fig">Figure 1</xref>). After calculation, this water extract contained 533.682 &#x03BC;g/mL of geniposide, 474.789 &#x03BC;g/mL of paeoniflorin, 225.892 &#x03BC;g/mL of albiflorin, 280.147 &#x03BC;g/mL of ferulic acid, 30.411 &#x03BC;g/mL of saikosaponin A, and 11.468 &#x03BC;g/mL of ursolic acid, respectively (<xref rid="tab2" ref-type="table">Table 2</xref>).</p>
<fig position="float" id="fig1">
<label>Figure 1</label>
<caption>
<p>The ion chromatograms (TICs) of geniposide, paeoniflorin, albiflorin, ferulic acid, saikosaponin A and ursolic acid in ZSQGY. <bold>(A)</bold> Geniposide; <bold>(B)</bold> Paeoniflorin; <bold>(C)</bold> Albiflorin; <bold>(D)</bold> Ferulic acid; <bold>(E)</bold> Aaikosaponin A; <bold>(F)</bold> Fursolic acid.</p>
</caption>
<graphic xlink:href="fneur-14-1108494-g001.tif"/>
</fig>
<table-wrap position="float" id="tab2">
<label>Table 2</label>
<caption>
<p>Quantitative analysis of six major compounds in ZSQGY water extract analyzed by LC&#x2013;MS.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="top">Chemical ingredients</th>
<th align="center" valign="top">Liner range (&#x03BC;g/mL)</th>
<th align="center" valign="top">Regression equation</th>
<th align="center" valign="top">Correlation coefficient<sup>&#x00AE;</sup></th>
<th align="center" valign="top">Actual concentration (&#x03BC;g/mL)</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top">Geniposide</td>
<td align="center" valign="top">1&#x2013;100</td>
<td align="center" valign="top"><italic>Y</italic> =&#x2009;3221.15&#x2009;+&#x2009;9301.68x</td>
<td align="center" valign="top">0.9933</td>
<td align="center" valign="top">533.682</td>
</tr>
<tr>
<td align="left" valign="top">Paeoniflorin</td>
<td align="center" valign="top">0.1&#x2013;50</td>
<td align="center" valign="top"><italic>Y</italic> =&#x2009;&#x2212;28193.1&#x2009;+&#x2009;1.18247e+006x</td>
<td align="center" valign="top">0.9922</td>
<td align="center" valign="top">474.789</td>
</tr>
<tr>
<td align="left" valign="top">Albiflorin</td>
<td align="center" valign="top">0.01&#x2013;100</td>
<td align="center" valign="top"><italic>Y</italic> =&#x2009;&#x2212;2638.02&#x2009;+&#x2009;65,849x</td>
<td align="center" valign="top">0.9953</td>
<td align="center" valign="top">225.892</td>
</tr>
<tr>
<td align="left" valign="top">Ferulic acid</td>
<td align="center" valign="top">1&#x2013;100</td>
<td align="center" valign="top"><italic>Y</italic> =&#x2009;&#x2212;69442.4&#x2009;+&#x2009;193,791x</td>
<td align="center" valign="top">0.9922</td>
<td align="center" valign="top">280.147</td>
</tr>
<tr>
<td align="left" valign="top">Saikosaponin A</td>
<td align="center" valign="top">0.01&#x2013;10</td>
<td align="center" valign="top"><italic>Y</italic> =&#x2009;1507.57&#x2009;+&#x2009;2.39811e+006x</td>
<td align="center" valign="top">0.9911</td>
<td align="center" valign="top">30.411</td>
</tr>
<tr>
<td align="left" valign="top">Ursolic acid</td>
<td align="center" valign="top">0.1&#x2013;10</td>
<td align="center" valign="top"><italic>Y</italic> =&#x2009;&#x2212;2287.96&#x2009;+&#x2009;136,156x</td>
<td align="center" valign="top">0.9993</td>
<td align="center" valign="top">11.468</td>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
<sec id="sec25">
<title>ZSQGY improved the depressive behaviors in the MSG-induced depressive model</title>
<p>The forced swimming test, the sucrose preference test, and the open field test were administrated to evaluate the effects of ZSQGY against depressive behaviors. In the forced swimming test, the rats in the model group spent longer immobility time during the test (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05; <xref rid="fig2" ref-type="fig">Figure 2A</xref>). The rats in the ZSQGY group and fluoxetine group spent shorter immobility time than the rats in the model group (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05; <xref rid="fig2" ref-type="fig">Figure 2A</xref>). In the sucrose preference test, we observed that compared with the control group, the consumption of sucrose in the model group decreased (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05; <xref rid="fig2" ref-type="fig">Figure 2B</xref>). However, the consumption of sucrose in rats that received ZSQGY or fluoxetine treatment increased significantly (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05; <xref rid="fig2" ref-type="fig">Figure 2B</xref>). In the open field test, the rats in the model group spent less time in the central area than those in the control group (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05; <xref rid="fig2" ref-type="fig">Figures 2C</xref>&#x2013;<xref rid="fig2" ref-type="fig">E</xref>). The rats in the model group also traveled a shorter distance than those in the control group. In contrast, the rats who received ZSQGY or fluoxetine treatment spent a longer time in the central area and traveled a longer distance (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05; <xref rid="fig2" ref-type="fig">Figures 2C</xref>&#x2013;<xref rid="fig2" ref-type="fig">E</xref>).</p>
<fig position="float" id="fig2">
<label>Figure 2</label>
<caption>
<p>ZSQGY improved depressive behaviors in the MSG-induced depressive model. <bold>(A)</bold> Immobility time in the forced swimming test. <bold>(B)</bold> Sucrose preference (%) in the sucrose preference test. <bold>(C)</bold> Time spent in center (s) in the open field test. <bold>(D)</bold> Total distance traveled in the open field test. <bold>(E)</bold> Trace plot of the open field test. Data are presented as mean&#x2009;&#x00B1;&#x2009;SE. #<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05 vs. control group. &#x002A;<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05 vs. model group (<italic>n</italic>&#x2009;=&#x2009;12 in each group).</p>
</caption>
<graphic xlink:href="fneur-14-1108494-g002.tif"/>
</fig>
</sec>
<sec id="sec26">
<title>ZSQGY ameliorated impaired synaptic structural plasticity in mPFC in the MSG-induced depressive model</title>
<p>Results from the Golgi staining showed that compared with the control group, the density of dendritic spines in mPFC in the MSG group induced decreased significantly (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05; <xref rid="fig3" ref-type="fig">Figures 3A</xref>,<xref rid="fig3" ref-type="fig">B</xref>). The treatments of ZSQGY and FXT significantly reversed a decrease in dendritic spine density induced by MSG (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05; <xref rid="fig3" ref-type="fig">Figures 3A</xref>,<xref rid="fig3" ref-type="fig">B</xref>). To further corroborate the results from Golgi staining, the mPFC neuronal ultrastructure was examined by TEM. The PSD thickness in asymmetric synapses in the model group was significantly thinner than those in the control group (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05, <xref rid="fig3" ref-type="fig">Figures 3C</xref>,<xref rid="fig3" ref-type="fig">E</xref>). However, the treatments of ZSQGY and FXT remarkably ameliorated the reduction of the PSD thickness (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05, <xref rid="fig3" ref-type="fig">Figures 3C</xref>,<xref rid="fig3" ref-type="fig">E</xref>). In addition, the number of docked vesicles in asymmetric synapses was decreased in the model group (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05, <xref rid="fig3" ref-type="fig">Figures 3D</xref>,<xref rid="fig3" ref-type="fig">E</xref>). However, the reduction was reversed by the treatment of ZSQGY or FXT (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05, <xref rid="fig3" ref-type="fig">Figures 3D</xref>,<xref rid="fig3" ref-type="fig">E</xref>).</p>
<fig position="float" id="fig3">
<label>Figure 3</label>
<caption>
<p>ZSQGY ameliorated impaired synaptic structural plasticity in mPFC in the MSG-induced depressive model. <bold>(A)</bold> Golgi staining of the apical dendritic spine (scale bar, 5&#x2009;&#x03BC;m). <bold>(B)</bold> Apical dendritic spine density (number/&#x03BC;m). <bold>(C)</bold> Asymmetric synaptic PSD thickness (nm). <bold>(D)</bold> Docked vesicle number of asymmetric synapses. <bold>(E)</bold> Ultrastructure of asymmetric synapses in the mPFC (scale bar, 1&#x2009;&#x03BC;m). Data are presented as mean&#x2009;&#x00B1;&#x2009;SE. #<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05 vs. control group. &#x002A;<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05 vs. model group (<italic>n</italic>&#x2009;=&#x2009;6 in each group).</p>
</caption>
<graphic xlink:href="fneur-14-1108494-g003.tif"/>
</fig>
</sec>
<sec id="sec27">
<title>ZSQGY attenuated the damaged mitochondrial function in the MSG-induced depressive model</title>
<p>As shown in <xref rid="fig4" ref-type="fig">Figure 4</xref>, the levels of 8-OHdG and MDA in the model group were higher when compared with those in the control group (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05; <xref rid="fig4" ref-type="fig">Figures 4A</xref>,<xref rid="fig4" ref-type="fig">B</xref>). Contrarily, the levels of 8-OHdG and MDA decreased in rats that received the treatment of ZSQGY or FXT (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05; <xref rid="fig4" ref-type="fig">Figures 4A</xref>,<xref rid="fig4" ref-type="fig">B</xref>). In addition, the ATP content and mtDNA copy number of the model group were significantly decreased when compared with those in the control group (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05; <xref rid="fig4" ref-type="fig">Figures 4C</xref>,<xref rid="fig4" ref-type="fig">D</xref>). The application of ZSQGY eminently counteracted the decrease of ATP content and mtDNA copy number (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05; <xref rid="fig4" ref-type="fig">Figures 4C</xref>,<xref rid="fig4" ref-type="fig">D</xref>).</p>
<fig position="float" id="fig4">
<label>Figure 4</label>
<caption>
<p>ZSQGY attenuated the damage of mitochondrial function in the MSG-induced depressive model. <bold>(A)</bold> ELISA of MDA. <bold>(B)</bold> ELISA of 8-OHdG. <bold>(C)</bold> ATP content. <bold>(D)</bold> mtDNA copy number. Data are presented as mean&#x2009;&#x00B1;&#x2009;SE. #<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05 vs. control group. &#x002A;<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05 vs. model group (<italic>n</italic>&#x2009;=&#x2009;6 in each group).</p>
</caption>
<graphic xlink:href="fneur-14-1108494-g004.tif"/>
</fig>
</sec>
<sec id="sec28">
<title>ZSQGY attenuated the level of inflammatory cytokines in the MSG-induced depressive model</title>
<p>As shown in <xref rid="fig5" ref-type="fig">Figure 5</xref>, the levels of IL-1&#x03B2;, IL-6, TNF-&#x03B1;, and IFN-&#x03B3; were elevated in the model group compared to those in the control group (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05; <xref rid="fig5" ref-type="fig">Figures 5A</xref>&#x2013;<xref rid="fig5" ref-type="fig">D</xref>). Notably, ZSQGY and FXT reduce the content of inflammatory cytokines induced by MSG (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05; <xref rid="fig5" ref-type="fig">Figures 5A</xref>&#x2013;<xref rid="fig5" ref-type="fig">D</xref>).</p>
<fig position="float" id="fig5">
<label>Figure 5</label>
<caption>
<p>ZSQGY attenuated the level of inflammatory cytokines. <bold>(A)</bold> Level of IL-1&#x03B2;. <bold>(B)</bold> Level of IL-6. <bold>(C)</bold> Level of TNF-&#x03B1;. <bold>(D)</bold> Level of IFN-&#x03B3;. Data are presented as mean&#x2009;&#x00B1;&#x2009;SE. #<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05 vs. control group. &#x002A;<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05 vs. model group (<italic>n</italic>&#x2009;=&#x2009;6 in each group).</p>
</caption>
<graphic xlink:href="fneur-14-1108494-g005.tif"/>
</fig>
</sec>
<sec id="sec29">
<title>ZSQGY attenuated the reduction of PGC-1&#x03B1; in the MSG-induced depressive model</title>
<p>As shown in <xref rid="fig6" ref-type="fig">Figure 6</xref>, the level of PGC-1&#x03B1; mRNA significantly decreased in the model group compared with those in the control group (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05; <xref rid="fig6" ref-type="fig">Figure 6A</xref>). However, the level of PGC-1&#x03B1; mRNA significantly increased in the rats that received ZSQGY or FXT (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05; <xref rid="fig6" ref-type="fig">Figure 6A</xref>). The results of IHC showed that PGC-1&#x03B1; is stained brownish yellow or brown and expressed in both the nucleus and cytoplasm. In comparison with the control group, the mean optical density of PGC-1&#x03B1; was significantly decreased (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05; <xref rid="fig6" ref-type="fig">Figures 6A</xref>,<xref rid="fig6" ref-type="fig">B</xref>). In contrast, the mean optical density of PGC-1&#x03B1; was increased remarkably in the ZSQGY group and in the FXT group (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05; <xref rid="fig6" ref-type="fig">Figures 6A</xref>,<xref rid="fig6" ref-type="fig">B</xref>).</p>
<fig position="float" id="fig6">
<label>Figure 6</label>
<caption>
<p>ZSQGY attenuated the reduction of PGC-1&#x03B1; in the MSG-induced depressive model. <bold>(A)</bold> Level of PGC-1&#x03B1; mRNA. <bold>(B)</bold> Mean optical density of PGC-1&#x03B1;. <bold>(C)</bold> IHC of PGC-1&#x03B1;. Data are presented as mean&#x2009;&#x00B1;&#x2009;SE. #<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05 vs. control group. &#x002A;<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05 vs. model group (<italic>n</italic>&#x2009;=&#x2009;6 in each group).</p>
</caption>
<graphic xlink:href="fneur-14-1108494-g006.tif"/>
</fig>
</sec>
<sec id="sec30">
<title>ZSQGY protects PC12 cells against CORT-induced injury</title>
<p>To screen out the appropriate concentration of CORT to damage PC12 cells as well as the cytoprotective effects of ZSQGY against CORT-induced injury, the PC12 cells were treated with high concentrations of CORT (200 and 400&#x2009;&#x03BC;M) for 24&#x2009;h, followed by treatment with different concentrations of ZSQGY-containing serum (5, 10, and 20%) for 24&#x2009;h. As shown in <xref rid="fig7" ref-type="fig">Figure 7A</xref>, 200&#x2009;&#x03BC;M CORT treatment caused a decrease of approximately 50% of viable cells. In addition, 10% ZSQGY-containing serum significantly increased cell viability, while there were no significant changes in the viability of cells in PC-12 cells treated with 5 and 20% ZSQGY-containing serum. Therefore, 200&#x2009;&#x03BC;M CORT and 10% ZSQGY-containing serum were selected for the following studies.</p>
<fig position="float" id="fig7">
<label>Figure 7</label>
<caption>
<p>ZSQGY protects PC12 cells against CORT-induced injury. <bold>(A)</bold> Cell activity measured CCK8 assay. <bold>(B)</bold> Level of PSD95 mRNA. <bold>(C)</bold> ELISA of MDA. <bold>(D)</bold> ELISA of 8-OHdG. <bold>(E)</bold> ATP content. <bold>(F)</bold> mtDNA copy number. <bold>(G)</bold> Level of IL-1&#x03B2;. <bold>(H)</bold> Level of IL-6. <bold>(I)</bold> Level of TNF-&#x03B1;. <bold>(J)</bold> Level of IFN-&#x03B3;. Data are presented as mean&#x2009;&#x00B1;&#x2009;SE. #<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05 vs. control group. &#x002A;<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05 vs. model group. ^<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05 vs. ZSQGY&#x2009;+&#x2009;con-siRNA group (<italic>n</italic>&#x2009;=&#x2009;6 in each group).</p>
</caption>
<graphic xlink:href="fneur-14-1108494-g007.tif"/>
</fig>
<p>To further explore whether PGC-1&#x03B1; is implicated in the beneficial effects of ZSQGY, the PGC-1&#x03B1; siRNA was used to inhibit its functions and then the levels of postsynaptic density 95 (PSD95), oxidative stress markers, and inflammatory cytokines were determined. As shown in <xref rid="fig7" ref-type="fig">Figures 7B</xref>&#x2013;<xref rid="fig7" ref-type="fig">J</xref>, compared to the control group, the levels of oxidative stress markers (8-OHdG, MDA) and inflammatory cytokines (IL-1&#x03B2;, IL-6, TNF-&#x03B1;, and IFN-&#x03B3;) were significantly increased in the CORT-induced PC12 cells, while the levels of PSD95 mRNA, ATP, and mtDNA were decreased in the CORT-induced PC12 cells (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05; <xref rid="fig7" ref-type="fig">Figures 7B</xref>&#x2013;<xref rid="fig7" ref-type="fig">J</xref>). The ZSQGY-containing serum treatment notably decreased the levels of 8-OHdG, MDA, and inflammatory cytokines (IL-1&#x03B2;, IL-6, TNF-&#x03B1;, and IFN-&#x03B3;) (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05; <xref rid="fig7" ref-type="fig">Figures 7B</xref>&#x2013;<xref rid="fig7" ref-type="fig">J</xref>). This treatment also significantly increased the levels of PSD95 mRNA, ATP, and mtDNA (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05; <xref rid="fig7" ref-type="fig">Figures 7B</xref>&#x2013;<xref rid="fig7" ref-type="fig">J</xref>). However, the beneficial effects of ZSQGY in synaptic plasticity, mitochondrial function, and neuroinflammation were blocked after the administration of PGC-1&#x03B1; siRNA (<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05; <xref rid="fig7" ref-type="fig">Figures 7B</xref>&#x2013;<xref rid="fig7" ref-type="fig">J</xref>).</p>
</sec>
</sec>
<sec id="sec31" sec-type="discussions">
<title>Discussion</title>
<p>In this study, we evaluated the antidepressant effects and mechanism of ZSQGY. The results showed that ZSQGY could improve depressive behaviors in the MSG-induced depressive model. In addition, ZSQGY significantly improved the damaged synaptic structural plasticity, attenuated the dysfunction of the mitochondrion, and reduced the level of inflammatory cytokines in <italic>in vivo</italic> and <italic>in vitro</italic> depression models. However, the beneficial changes were reversed after the inhibition of PGC-1&#x03B1;.</p>
<p>One of the important pathological features of patients with depression is the damaged synaptic density, which could lead to the interruption of neural circuits and the abnormality of brain structure caused (<xref ref-type="bibr" rid="ref24">24</xref>, <xref ref-type="bibr" rid="ref25">25</xref>). Studies have reported that a reduced size of the prefrontal cortex (PFC) and decreased neuronal synapses are associated with depression (<xref ref-type="bibr" rid="ref26">26</xref>). The dendritic spine is the morphological specialization that protrudes from the dendritic shaft. Structural changes in the dendritic spine are considered the basis of synaptic plasticity. Converging evidence from clinical and experimental studies indicates that the impaired dendritic spine is involved in the pathology of multiple diseases (<xref ref-type="bibr" rid="ref27">27</xref>). The loss of dendritic spines is accompanied by depression-like behaviors, suggesting that the structural changes and neuronal atrophy in mPFC are associated with depression (<xref ref-type="bibr" rid="ref28 ref29 ref30">28&#x2013;30</xref>). Moreover, synaptic ultrastructural alterations, such as decreased PSD thickness, are associated with depressive behavioral changes (<xref ref-type="bibr" rid="ref31">31</xref>, <xref ref-type="bibr" rid="ref32">32</xref>). In this study, ZSQGY remarkably increased the dendritic spine density, the PSD thickness, and the number of docked vesicles, indicating that ZSQGY administration could improve the damaged synaptic structural plasticity.</p>
<p>The energy metabolism disorder caused by mitochondrial dysfunction contributes to the pathogenesis of depression (<xref ref-type="bibr" rid="ref33">33</xref>). As the energy factory of cells, mitochondria participates in maintaining calcium homeostasis and regulating the generation of reactive oxygen species (ROS) and cell apoptosis (<xref ref-type="bibr" rid="ref34">34</xref>). Moreover, mitochondria in the central nervous system can enable synaptic plasticity and promote neural differentiation and neurotransmitter release (<xref ref-type="bibr" rid="ref35">35</xref>). Internal and external cues can lead to the reduction of ATP synthesis and excessive production of ROS, which may affect behaviors by interfering with synaptic plasticity. In addition, internal and external stimuli could induce damage to mtDNA and mitochondrial dysfunction (<xref ref-type="bibr" rid="ref36">36</xref>). Patients with severe depression usually demonstrate mitochondrial energy metabolism disorder, such as a lower level of ATP and a higher level of ROS, as well as the reduction of mitochondrial copy number (<xref ref-type="bibr" rid="ref37">37</xref>). The results of our study suggested ZSQGY could attenuate the level of 8-OHdG and MDA, which are markers of oxidative stress during mitochondrial disturbance. In addition, ZSQGY could improve the decrease of ATP content and mtDNA copy number in the MSG-induced depression model. These findings indicate that ZSQGY could restore mitochondrial function.</p>
<p>It is well established that patients with depression exhibit increased circulating levels of inflammatory factors (<xref ref-type="bibr" rid="ref38">38</xref>, <xref ref-type="bibr" rid="ref39">39</xref>). Inflammatory cytokines are key regulators of neuronal functions, and they play an important role in maintaining synaptic plasticity (<xref ref-type="bibr" rid="ref40">40</xref>). Long-term exposure to psychosocial pressure disturbs the inflammatory cascade, leading to excess or prolonged inflammatory cytokines that interfere with synaptic plasticity and eventually leading to depressive symptoms (<xref ref-type="bibr" rid="ref41">41</xref>, <xref ref-type="bibr" rid="ref42">42</xref>). Excessive ROS production and mtDNA damage induced by stress also trigger an inflammation response (<xref ref-type="bibr" rid="ref43">43</xref>). Notably, ZSQGY was able to reduce the levels of IL-1&#x03B2;, IL-6, TNF-&#x03B1;, and IFN-&#x03B3;, which demonstrated the anti-inflammatory effects of ZSQGY in the central nervous system in the MSG-induced depression model.</p>
<p>PGC-1&#x03B1; is a well-known ligand-activated transcription co-activator that mainly expresses in high energy demand tissues, e.g., brain, heart, and kidney (<xref ref-type="bibr" rid="ref44">44</xref>). Once activated by different stimuli, PGC-1&#x03B1; translocates from the cytoplasm to the nucleus, where it interacts with nuclear respiratory factor 1 (NRF-1) and NRF-2 (<xref ref-type="bibr" rid="ref45">45</xref>). As a result, mitochondrial transcription factor A (TFAM) is activated, increasing the expression of nuclear genes and further promoting mtDNA replication and transcription (<xref ref-type="bibr" rid="ref46">46</xref>). It has been reported that PGC-1&#x03B1; deficiency could influence oxidative metabolism, then leading to axonal degeneration in the brain. PGC-1&#x03B1; also participates in the procedure of synaptogenesis. PGC-1&#x03B1; can enhance the expression of synaptic proteins, such as PSD95 (<xref ref-type="bibr" rid="ref47">47</xref>, <xref ref-type="bibr" rid="ref48">48</xref>). In addition, PGC-1&#x03B1; is engaged in the process of macrophage polarization from the proinflammatory M1 phenotype to the anti-inflammatory M2 phenotype and then participates in the inflammation responses (<xref ref-type="bibr" rid="ref49">49</xref>, <xref ref-type="bibr" rid="ref50">50</xref>). In this study, we found that ZSQGY could increase the expression of PGC-1&#x03B1;, accompanied by improvements in synaptic plasticity, mitochondrial function, and inflammation responses. Our findings are in line with the previous studies in which upregulating the level of PGC-1&#x03B1; could improve depression-like behaviors (<xref ref-type="bibr" rid="ref51">51</xref>, <xref ref-type="bibr" rid="ref52">52</xref>). Moreover, the beneficial effects of ZSQGY were reversed after the administration of PGC-1&#x03B1; siRNA in the CORT-induced PC12 cell model. These results indicated that ZSQGY effectively could improve depressive behaviors <italic>via</italic> the mechanisms that regulate synaptic structural plasticity, improve mitochondrion function and alleviate neuroinflammation, which could, or partly, attribute to the regulation of PGC-1&#x03B1;.</p>
<p>The water extract of ZSQGY contains many bioactive compounds, however, in which chemical ingredients responsible for the beneficial effects of ZSQGY remain unknown. Here, we detected six major compounds of ZSQGY, including saikosaponin A, ferulic acid, albiflorin, paeoniflorin, geniposide, and ursolic acid. Previous studies have demonstrated that these chemical ingredients displayed anti-depressive effects in models of depression and the therapeutic mechanisms underlying these ingredients involve neuroendocrine, neuroinflammation, and neurotrophic systems (<xref ref-type="bibr" rid="ref53">53</xref>). These findings provided evidence for the therapeutic effects of ZSQGY. In future, more studies are needed to discover the mechanisms that are underlying the synergistic antidepressant effects of these chemical ingredients.</p>
</sec>
<sec id="sec32" sec-type="data-availability">
<title>Data availability statement</title>
<p>The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.</p>
</sec>
<sec id="sec33">
<title>Ethics statement</title>
<p>The animal study was reviewed and approved by Institutional Ethics Committee of Zhongshan Hospital, Fudan University.</p>
</sec>
<sec id="sec34">
<title>Author contributions</title>
<p>WZhu and FY contributed to study design, data interpretation, and revision of the manuscript. WZha contributed to revision of the manuscript. MC and YX contributed to data interpretation. JX and XL contributed to statistical analysis and data interpretation. YY and DC provided final approval to submit the manuscript for publication. All authors reviewed the manuscript and approved the final manuscript.</p>
</sec>
<sec id="sec35" sec-type="funding-information">
<title>Funding</title>
<p>This work was supported by the Development Project of Shanghai Peak Disciplines-Integrative Medicine (No. 20180101).</p>
</sec>
<sec id="conf1" sec-type="COI-statement">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec id="sec100" sec-type="disclaimer">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
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