# Brain exosome biomarker targets to optimize pharmacologic treatment of depression in pregnancy

> **NIH NIH R21** · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · 2022 · $234,000

## Abstract

This proposal aims to determine whether biomarkers in central nervous system-derived
exosomes are useful predictors of functional drug activity in the maternal and fetal brain in women
treated for depression during pregnancy with selective-serotonin reuptake inhibitors (SSRIs).
PAR-20-299 specifically requests translational projects that will enhance the usage of existing
drugs for safer and more effective treatment. Barriers to pharmacologic studies to optimize drug
treatment in pregnant women include changes in maternal physiology, circulating binding
proteins, biologically available drug levels, and drug metabolism. Real-time measurements of fetal
drug levels are not currently feasible. Purification of CNSEs from maternal blood allows non-
invasive independent evaluation of both the maternal and fetal CNS SSRI targets without
significant contamination from each other or non-CNS sources. The goal of this pilot project is to
develop a new testing paradigm to rapidly identify women who are poor responders to SSRIs and
to investigate the relationship between SSRI treatment, exosome marker levels, and maternal
clinical response at a steady state for a given SSRI dose. We will use fetal CNSEs isolated from
the same maternal samples to determine if fetuses at risk for neonatal withdrawal symptoms can
be identified prior to delivery. This would allow for improved evidence-based management of
maternal SSRI treatment in the third trimester based on individualized fetal/neonatal risk and
ultimately has the potential to avoid unnecessary medication discontinuation. Completion of this
project can change the paradigm for how we assess the safety and efficacy of psychoactive
medications in pregnancy.

## Key facts

- **NIH application ID:** 10543638
- **Project number:** 1R21HD106779-01A1
- **Recipient organization:** UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
- **Principal Investigator:** Laura Goetzl
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $234,000
- **Award type:** 1
- **Project period:** 2022-08-01 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10543638

## Citation

> US National Institutes of Health, RePORTER application 10543638, Brain exosome biomarker targets to optimize pharmacologic treatment of depression in pregnancy (1R21HD106779-01A1). Retrieved via AI Analytics 2026-06-05 from https://api.ai-analytics.org/grant/nih/10543638. Licensed CC0.

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