Spijker Anne T, van Rossum Elisabeth F C
PsyQ, The Hague, the Netherlands.
Ann N Y Acad Sci. 2009 Oct;1179:199-215. doi: 10.1111/j.1749-6632.2009.04985.x.
Previously, it has been suggested that hypothalamic-pituitary-adrenal (HPA) axis dysregulation and, as a consequence, increased cortisol levels, is not only a state phenomenon, but may also be a trait phenomenon in mood disorders. Cortisol exerts its effects mainly by binding to the glucocorticoid receptor (GR) and, of particular interest in certain brain regions, the mineralocorticoid receptor (MR). Several GR polymorphisms have been shown to be associated with altered sensitivity of the HPA axis. Recently, the GR polymorphisms BclI and ER22/23EK have been associated with unipolar depression in several studies. In addition, the ER22/23EK polymorphism seems to be associated with a decreased risk of dementia in healthy individuals. Also, during a depressive episode, carriers of this ER22/23EK variant demonstrated a tendency toward better cognition, as measured by divided attention tests. In this overview, currently known clinically relevant GR and MR polymorphisms are discussed in relation to mood disorders (both unipolar depression and bipolar disorder) and cognitive function.
此前有人提出，下丘脑 - 垂体 - 肾上腺（HPA）轴功能失调以及由此导致的皮质醇水平升高，不仅是一种状态现象，在情绪障碍中也可能是一种特质现象。皮质醇主要通过与糖皮质激素受体（GR）结合发挥作用，在某些脑区，盐皮质激素受体（MR）尤为值得关注。已有多项研究表明，几种GR基因多态性与HPA轴敏感性改变有关。最近，在多项研究中，GR基因多态性BclI和ER22/23EK与单相抑郁症相关。此外，ER22/23EK基因多态性似乎与健康个体患痴呆症的风险降低有关。同样，在抑郁发作期间，通过分散注意力测试测量，该ER22/23EK变体的携带者表现出认知功能较好的倾向。在本综述中，将讨论目前已知的与情绪障碍（单相抑郁症和双相情感障碍）及认知功能相关的临床相关GR和MR基因多态性。
