Asakura M, Nagashima H, Fujii S, Sasuga Y, Misonoh A, Hasegawa H, Osada K
Department of Neuropsychiatry, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki, 216-8511 Japan.
Nihon Shinkei Seishin Yakurigaku Zasshi. 2000 Aug;20(3):97-105.
Chronic mild or moderate stress elicits an adaptive change in central nervous systems that function to maintain homeostasis. The principal components of stress response are the extrahypothalamic corticotropin-releasing hormone (CRH) and the locus coeruleus (LC)-norepinephrine (NE) systems. CRH is known to produce various stress-, anxiety- and arousal-associated behaviors in animals. Moreover, CRH causes an increase in the firing rate and activity of tyrosine hydroxylase in the LC, and NE release in LC projection areas. It is thought that chronic inescapable and unpredictable stress can result in a sustained dysregulation of both CRH neuronal activity and LC-NE systems. One may hypothesize that the NE-CRH interaction occurs in the terminal projection of forebrain NE systems, the hypothalamic paraventricular nucleus (PVN), the bed nucleus of the stria terminalis (BNST) and the central nucleus of the amygdala (CeA) where NE stimulates CRH release. Such CRH-NE-CRH feed-forward systems elicit progressive augmentation of stress responsivity with repeated exposure. The beta-adrenergic receptor down-regulation is induced by acute and chronic exposure to moderate and predictable stress, implying an adaptation to stress. However, chronic unpredictable (variable) stress (CVS), a model for depression, up-regulated the beta-AR. In our laboratory, we found that concurrent treatment with the selective serotonin reuptake inhibitor (SSRI) citalopram caused beta-R down-regulation in the frontal cortex of rats treated with CVS for 14 days. As previously reported by the authors, an increase in 5-HT availability plays a role in preserving beta-R down-regulation by NE potentiating agents. In depressed patients, hyperactivation of the CRH-NE systems caused by the CRH-NE feed-forward system is thought to be involved in generating anxiety, sympathetic activation and hyperarousal. Moreover, a decrease in the 5-HT turnover in depressed patients has been reported. Accordingly, it is proposed that an increase in 5-HT availability by SSRI might contribute to normalize beta-R down-regulation as an adaptive regulatory mechanism against excessive CRH-NE neurotransmission under a "stressful" situation.
慢性轻度或中度应激会引发中枢神经系统的适应性变化,其作用是维持体内平衡。应激反应的主要组成部分是下丘脑外促肾上腺皮质激素释放激素(CRH)和蓝斑(LC)-去甲肾上腺素(NE)系统。已知CRH会在动物身上产生各种与应激、焦虑和觉醒相关的行为。此外,CRH会导致LC中酪氨酸羟化酶的放电频率和活性增加,以及LC投射区域中NE的释放。据认为,慢性不可逃避和不可预测的应激会导致CRH神经元活动和LC-NE系统持续失调。有人可能会假设,NE-CRH相互作用发生在前脑NE系统的终末投射、下丘脑室旁核(PVN)、终纹床核(BNST)和杏仁核中央核(CeA),在这些部位NE刺激CRH释放。这种CRH-NE-CRH前馈系统会随着反复暴露而导致应激反应性逐渐增强。急性和慢性暴露于中度和可预测的应激会诱导β-肾上腺素能受体下调,这意味着对应激的适应。然而,慢性不可预测(可变)应激(CVS),一种抑郁症模型,会上调β-AR。在我们实验室,我们发现,同时使用选择性5-羟色胺再摄取抑制剂(SSRI)西酞普兰治疗,会导致接受14天CVS治疗的大鼠额叶皮质中的β-R下调。正如作者之前所报道的,5-羟色胺可用性的增加在通过NE增强剂维持β-R下调中起作用。在抑郁症患者中,CRH-NE前馈系统引起的CRH-NE系统过度激活被认为与产生焦虑、交感神经激活和过度觉醒有关。此外,据报道抑郁症患者的5-羟色胺周转率降低。因此,有人提出,SSRI增加5-羟色胺可用性可能有助于使β-R下调正常化,作为在“应激”情况下对抗过度CRH-NE神经传递的一种适应性调节机制。