Zanoli Paola
Department of Pharmaceutical Sciences, University of Moderna Reggio Emilia, 41100 Modena, Italy.
CNS Drug Rev. 2004 Fall;10(3):203-18. doi: 10.1111/j.1527-3458.2004.tb00022.x.
The phloroglucinol derivative hyperforin has been recently shown to be a major antidepressant component in the extract of Hypericum perforatum. Experimental studies clearly demonstrated its activity in different behavioral models of depression. Moreover clinical studies linked the therapeutic efficacy of Hypericum extracts to their hyperforin content, in a dose-dependent manner. The molecular mechanism of action of hyperforin is still under investigation. Hyperforin has been shown to inhibit, like conventional antidepressants, the neuronal uptake of serotonin, norepinephrine and dopamine. However, hyperforin inhibits also the uptake of gamma-aminobutyric acid (GABA) and L-glutamate. The uptake inhibition by hyperforin does not involve specific binding sites at the transporter molecules; its mechanism of action seems to be related to sodium conductive pathways, leading to an elevation in intracellular Na(+) concentration. Other additional mechanisms of action of hyperforin, involving ionic conductances as well synaptosomal and vesicular function, have been suggested. In addition to its antidepressant activity, hyperforin has many other pharmacological effects in vivo (anxiolytic-like, cognition-enhancing effects) and in vitro (antioxidant, anticyclooxygenase-1, and anticarcinogenic effects). These effects could be of clinical importance. On the other hand, the role of hyperforin in the pharmacological interactions occurring during Hypericum extract therapy must be fully investigated. Hyperforin seems to be responsible for the induction of liver cytochrome oxidase enzymes and intestinal P-glycoprotein. Several pharmacokinetic studies performed in rats and humans demonstrated oral bioavailability of hyperforin from Hypericum extract. Only recently a new chromatographic method for detection of hyperforin in the brain tissue has been developed and validated. Taking into account the chemical instability of hyperforin, current efforts are directed to the synthesis of new neuroactive derivatives.
最近研究表明,间苯三酚衍生物金丝桃素是贯叶连翘提取物中的主要抗抑郁成分。实验研究清楚地证明了其在不同抑郁症行为模型中的活性。此外,临床研究将贯叶连翘提取物的治疗效果与其金丝桃素含量呈剂量依赖性地联系起来。金丝桃素的分子作用机制仍在研究中。与传统抗抑郁药一样,金丝桃素已被证明可抑制血清素、去甲肾上腺素和多巴胺的神经元摄取。然而,金丝桃素也抑制γ-氨基丁酸(GABA)和L-谷氨酸的摄取。金丝桃素对摄取的抑制不涉及转运分子上的特异性结合位点;其作用机制似乎与钠传导途径有关,导致细胞内Na(+)浓度升高。有人提出了金丝桃素的其他作用机制,涉及离子电导以及突触体和囊泡功能。除了其抗抑郁活性外,金丝桃素在体内(抗焦虑样、认知增强作用)和体外(抗氧化、抗环氧化酶-1和抗癌作用)还有许多其他药理作用。这些作用可能具有临床重要性。另一方面,必须充分研究金丝桃素在贯叶连翘提取物治疗期间发生的药理相互作用中的作用。金丝桃素似乎是肝脏细胞色素氧化酶和肠道P-糖蛋白诱导的原因。在大鼠和人类中进行的几项药代动力学研究证明了贯叶连翘提取物中金丝桃素的口服生物利用度。直到最近才开发并验证了一种用于检测脑组织中金丝桃素的新色谱方法。考虑到金丝桃素的化学不稳定性,目前的努力方向是合成新的神经活性衍生物。