Refojo Damian, Holsboer Florian
Max-Planck Institute of Psychiatry, Munich, Germany.
Ann N Y Acad Sci. 2009 Oct;1179:106-19. doi: 10.1111/j.1749-6632.2009.04983.x.
There is an urgent need to generate new drugs or improve existing ones in the pharmacology of mood disorders. The corticotropin-releasing hormone (CRH) system is closely involved in the development and course of depression, and drugs targeting this system arguably offer hope to improve the current tools for drug treatment of depression. Recent clinical studies in depressed patients showed that CRHR1 antagonists improve clinical symptoms of anxiety and depression and reduce stress hormone release following psychosocial stress. These effects of CRHR1 antagonists were not associated with reduced secretory capacity of corticotrophic cells because of CRH receptor abundance at the pituitary level, which contrasts with CRH receptors in the brain. This is in accordance with previous studies showing that CRH injections into the mouse brain activate MAPK pathways in a brain region-specific manner pointing toward differences in signaling pathways beyond the receptor level. We will highlight this and discuss how these brain area-specific differences may offer opportunities for drug discovery. An additional puzzle in the search of new targets for depression is the lack of bona fide animal models helping to discover the antidepressants that are not monoamine based. We recently developed a conditional mouse model that overexpresses CRH in a spatio-temporal-regulated fashion and permits to dissect precisely the contribution of different brain areas to the CRH-dependent behaviors. Recent findings obtained with this mouse model and its usefulness in the context of the CRH-dependent, region-specific changes in depression will be discussed.
在情绪障碍药理学领域,迫切需要研发新药物或改进现有药物。促肾上腺皮质激素释放激素(CRH)系统与抑郁症的发生和发展密切相关,针对该系统的药物有望改善目前抑郁症的药物治疗手段。近期对抑郁症患者的临床研究表明,CRHR1拮抗剂可改善焦虑和抑郁的临床症状,并减少心理社会应激后应激激素的释放。由于垂体水平的CRH受体丰富,CRHR1拮抗剂的这些作用与促肾上腺皮质细胞分泌能力降低无关,这与大脑中的CRH受体情况不同。这与之前的研究一致,即向小鼠脑内注射CRH会以脑区特异性方式激活MAPK通路,表明受体水平之外的信号通路存在差异。我们将强调这一点,并讨论这些脑区特异性差异如何为药物研发提供机会。寻找抑郁症新靶点的另一个难题是缺乏有助于发现非单胺类抗抑郁药的可靠动物模型。我们最近开发了一种条件性小鼠模型,该模型以时空调节的方式过表达CRH,并能精确剖析不同脑区对CRH依赖性行为的贡献。将讨论用该小鼠模型获得的最新发现及其在抑郁症中CRH依赖性、区域特异性变化背景下的实用性。