Kalkman Hans O
Novartis Pharma AG, Novartis Institutes of Biomedical Research Basel, WSJ-386.11.40, Postfach, CH-4002 Basel, Switzerland.
Pharmacol Ther. 2009 Jan;121(1):115-22. doi: 10.1016/j.pharmthera.2008.11.002. Epub 2008 Nov 20.
In recent years evidence has accumulated that the activity of the signaling cascades of Neuregulin-1, Wnt, TGF-beta, BDNF-p75 and DISC1 is different between control subjects and patients with schizophrenia. These pathways are involved in embryonic and adult neurogenesis and neuronal maturation. A review of the clinical data indicates that in schizophrenia the Wnt pathway is most likely hypoactive, whereas the Nrg1-ErbB4, the TGF-beta- and the BDNF-p75-pathways are hyperactive. Haplo-insuffiency of the DISC1 gene is currently the best established schizophrenia risk factor. Preclinical experiments indicate that suppression of DISC1 signaling leads to accelerated dendrite development in neuronal stem cells, accelerated migration and aberrant integration into the neuronal network. Other preclinical experiments show that increasing NRG1-, BDNF- and TGF-beta signaling and decreasing Wnt signaling, also promotes adult neuronal differentiation and migration. Thus deviations in these pathways detected in schizophrenia could contribute to premature neuronal differentiation, accelerated migration and inappropriate insertion into the neuronal network. Initial clinical findings are confirmatory: neuronal stem cells isolated from nasal biopsies from schizophrenia patients display signs of accelerated development, whilst increased erosion of telomeres and bone age provide further support for accelerated cell maturation in schizophrenia.
近年来,越来越多的证据表明,在对照受试者与精神分裂症患者之间,神经调节蛋白-1、Wnt、转化生长因子-β、脑源性神经营养因子-p75和精神分裂症相关断裂基因1(DISC1)的信号级联活性存在差异。这些信号通路参与胚胎期和成年期的神经发生及神经元成熟过程。对临床数据的回顾表明,在精神分裂症中,Wnt信号通路很可能活性不足,而神经调节蛋白1-表皮生长因子受体4(Nrg1-ErbB4)、转化生长因子-β和脑源性神经营养因子-p75信号通路则活性亢进。目前,DISC1基因单倍体不足是最明确的精神分裂症风险因素。临床前实验表明,抑制DISC1信号传导会导致神经元干细胞的树突发育加速、迁移加速以及异常整合到神经网络中。其他临床前实验表明,增强神经调节蛋白1、脑源性神经营养因子和转化生长因子-β信号传导以及减弱Wnt信号传导,也会促进成年神经元的分化和迁移。因此,在精神分裂症中检测到的这些信号通路的偏差可能导致神经元过早分化、迁移加速以及不恰当地插入神经网络。初步临床研究结果证实了这一点:从精神分裂症患者的鼻腔活检中分离出的神经元干细胞显示出发育加速的迹象,而端粒侵蚀增加和骨龄增长则为精神分裂症中细胞成熟加速提供了进一步支持。
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