Clinic for Affective Disorders, Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet 6211, Blegdamsvej 9, 2100 Copenhagen, Denmark.
Psychopharmacology (Berl). 2012 Feb;219(3):687-98. doi: 10.1007/s00213-011-2511-1. Epub 2011 Sep 23.
Current pharmacological treatments for depression have a significant treatment-onset-response delay, an insufficient efficacy for many patients and fail to reverse cognitive dysfunction. Erythropoietin (EPO) has neuroprotective and neurotrophic actions and improves cognitive function in animal models of acute and chronic neurodegenerative conditions and in patients with cognitive decline.
We systematically reviewed the published findings from animal and human studies exploring the potential of EPO to treat depression-related cognitive dysfunction and depression.
We identified five animal studies (two in male rats, two in male mice and one in male rats and mice) and seven human proof-of-concept studies (five in healthy volunteers and two in depressed patients) that investigated the above. All of the reviewed animal studies but one and all human studies demonstrated beneficial effects of EPO on hippocampus-dependent memory and antidepressant-like effects. These effects appear to be mediated through direct neurobiological actions of EPO rather than upregulation of red cell mass.
The reviewed studies demonstrate beneficial effects of EPO on hippocampus-dependent memory function and on depression-relevant behavior, thus highlighting EPO as a candidate agent for future management of cognitive dysfunction and mood symptoms in depression. Larger-scale clinical trials of EPO as a treatment for mood and neurocognitive symptoms in patients with mood disorder are therefore warranted.
目前用于治疗抑郁症的药物在治疗开始时反应缓慢,对许多患者的疗效不足,并且无法逆转认知功能障碍。促红细胞生成素(EPO)具有神经保护和神经营养作用,并可改善急性和慢性神经退行性疾病动物模型以及认知能力下降患者的认知功能。
我们系统地回顾了已发表的动物和人类研究结果,这些研究探索了 EPO 治疗与抑郁相关的认知功能障碍和抑郁的潜力。
我们确定了五项动物研究(两项在雄性大鼠中,两项在雄性小鼠中,一项在雄性大鼠和小鼠中)和七项人类概念验证研究(五项在健康志愿者中,两项在抑郁症患者中)。所有已审查的动物研究中除一项外,以及所有人类研究均表明 EPO 对海马依赖性记忆和抗抑郁样作用具有有益影响。这些作用似乎是通过 EPO 的直接神经生物学作用介导的,而不是通过增加红细胞质量来介导的。
已审查的研究表明 EPO 对海马依赖性记忆功能和与抑郁相关的行为具有有益影响,从而突出了 EPO 作为未来管理抑郁症患者认知功能障碍和情绪症状的候选药物。因此,有必要进行更大规模的 EPO 治疗情绪和神经认知症状的临床试验。