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精神疾病和药物成瘾中髓鞘损伤病因的趋同与分歧

Convergence and divergence in the etiology of myelin impairment in psychiatric disorders and drug addiction.

作者信息

Feng Yue

机构信息

Department of Pharmacology, Emory University School of Medicine, 1510 Clifton Road, Atlanta, GA 30322, USA.

出版信息

Neurochem Res. 2008 Oct;33(10):1940-9. doi: 10.1007/s11064-008-9693-x. Epub 2008 Apr 11.

Abstract

Impairment of oligodendroglia (OL)-dependent myelination in the central nervous system (CNS) is a remarkable parallel recently identified in major psychiatric disorders and chronic drug abuse. Neuroimaging and neuropathological studies revealed myelin defects and microarray-profiling analysis demonstrated aberrant expression of myelin-related genes in schizophrenia (SZ), bipolar disorder (BD), major depressive disorder (MDD) and cocaine addiction. However, the etiology underlying myelin impairment in these clinically distinct subjects remains elusive. This article reviews myelin impairment in line with dopaminergic dysfunction, a prime neuropathophysiological trait shared in psychiatric disorders and drug abuse, as well as the genetic and epigenetic alterations associated with these diseases. The current findings support the hypothesis that aberrant dopamine (DA) action on OLs is a common pathologic mechanism for myelin impairment in the aforementioned mental morbidities, whereas inherited genetic variations that specifically affect OL development and myelinogenesis may further increase myelin vulnerability in psychiatric disorders. Importantly, OL defect is not only a pathological consequence but also a causative factor for dopaminergic dysfunction. Hence, myelin impairment is a key factor in the pathogenic loop of psychiatric diseases and drug addiction.

摘要

中枢神经系统(CNS)中少突胶质细胞(OL)依赖性髓鞘形成受损是近期在主要精神疾病和慢性药物滥用中发现的一个显著共同点。神经影像学和神经病理学研究揭示了髓鞘缺陷,微阵列分析表明精神分裂症(SZ)、双相情感障碍(BD)、重度抑郁症(MDD)和可卡因成瘾中髓鞘相关基因表达异常。然而,这些临床特征各异的患者中髓鞘损伤的病因仍不清楚。本文结合多巴胺能功能障碍(这是精神疾病和药物滥用共有的主要神经病理生理特征)以及与这些疾病相关的遗传和表观遗传改变,对髓鞘损伤进行综述。目前的研究结果支持这样一种假说,即多巴胺(DA)对OL的异常作用是上述精神疾病中髓鞘损伤的常见病理机制,而特异性影响OL发育和髓鞘形成的遗传变异可能会进一步增加精神疾病中髓鞘的易损性。重要的是,OL缺陷不仅是一种病理结果,也是多巴胺能功能障碍的一个致病因素。因此,髓鞘损伤是精神疾病和药物成瘾致病循环中的一个关键因素。

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