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精神药物研发中的生物标志物。

Biomarkers in development of psychotropic drugs.

作者信息

Wiedemann K

机构信息

University Hospital Hamburg Eppendorf, Hamburg, Germany.

出版信息

Dialogues Clin Neurosci. 2011;13(2):225-34. doi: 10.31887/DCNS.2011.13.2/kwiedemann.

Abstract

Biomarkers have been receiving increasing attention, especially in the field of psychiatry In contrast to the availability of potent therapeutic tools including pharmacotherapy, psychotherapy, and biological therapies, unmet needs remain in terms of onset of action, stability of response, and further improvement of the clinical course. Biomarkers are objectively measured characteristics which serve as indicators of the causes of illnesses, their clinical course, and modification by treatment. There exist a variety of markers: laboratory markers which comprise the determination of genetic and epigenetic markers, neurotransmitters, hormones, cytokines, neuropeptides, enzymes, and others as single measures; electrophysiological markers which usually comprise electroencephalography (EEG) measures, and in particular sleep EEG and evoked potentials, magnetic encephalography, electrocardiogram, facial electromyography, skin conductance, and others; brain imaging techniques such as cranial computed tomography, magnetic resonance imaging, functional MRI, magnetic resonance spectroscopy, positron emission tomography, and single photon emission computed tomography; and behavioral approaches such as cue exposure and challenge tests which can be used to induce especially emotional processes in anxiety and depression. Examples for each of these domains are provided in this review. With a view to developing more individually tailored therapeutic strategies, the characterization of patients and the courses of different types of treatment will become even more important in the future.

摘要

生物标志物越来越受到关注,尤其是在精神病学领域。与包括药物治疗、心理治疗和生物治疗在内的有效治疗工具的可用性相比,在作用起效、反应稳定性以及临床病程的进一步改善方面仍存在未满足的需求。生物标志物是客观测量的特征,可作为疾病病因、临床病程以及治疗改变的指标。存在多种标志物:实验室标志物,包括作为单一测量指标的基因和表观遗传标志物、神经递质、激素、细胞因子、神经肽、酶等的测定;电生理标志物,通常包括脑电图(EEG)测量,特别是睡眠EEG和诱发电位、脑磁图、心电图、面部肌电图、皮肤电导等;脑成像技术,如头颅计算机断层扫描、磁共振成像、功能磁共振成像、磁共振波谱、正电子发射断层扫描和单光子发射计算机断层扫描;以及行为方法,如线索暴露和挑战测试,可用于在焦虑和抑郁中诱发特别是情绪过程。本综述提供了这些领域中每个领域的示例。为了制定更个性化的治疗策略,患者特征和不同类型治疗过程的表征在未来将变得更加重要。

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