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转化互惠:弥合临床前研究与临床治疗压力对青少年大脑影响之间的差距。

Translational reciprocity: bridging the gap between preclinical studies and clinical treatment of stress effects on the adolescent brain.

机构信息

Department of Psychiatry and Behavioral Sciences, Emory University, 101 Woodruff Circle, Suite 4000, Atlanta, GA 30322, United States.

出版信息

Neuroscience. 2013 Sep 26;249:139-53. doi: 10.1016/j.neuroscience.2012.09.075. Epub 2012 Oct 13.

Abstract

The genetic, biological, and environmental backgrounds of an organism fundamentally influence the balance between risk and resilience to stress. Sex, age, and environment transact with responses to trauma in ways that can mitigate or exacerbate the likelihood that post-traumatic stress disorder will develop. Translational approaches to modeling affective disorders in animals will ultimately provide novel treatments and a better understanding of the neurobiological underpinnings behind these debilitating disorders. The extant literature on trauma/stress has focused predominately on limbic and cortical structures that innervate the hypothalamic-pituitary-adrenal axis and influence glucocorticoid-mediated negative feedback. It is through these neuroendocrine pathways that a self-perpetuating fear memory can propagate the long-term effects of early life trauma. Recent work incorporating translational approaches has provided novel pathways that can be influenced by early life stress, such as the glucocorticoid receptor chaperones, including FKBP51. Animal models of stress have differing effects on behavior and endocrine pathways; however, complete models replicating clinical characteristics of risk and resilience have not been rigorously studied. This review discusses a four-factor model that considers the importance of studying both risk and resilience in understanding the developmental response to trauma/stress. Consideration of the multifactorial nature of clinical populations in the design of preclinical models and the application of preclinical findings to clinical treatment approaches comprise the core of translational reciprocity, which is discussed in the context of the four-factor model.

摘要

生物体的遗传、生物和环境背景从根本上影响了其对压力的风险和适应能力之间的平衡。性别、年龄和环境会以各种方式影响对创伤的反应,从而减轻或加剧创伤后应激障碍的发展可能性。在动物中对情感障碍进行转化研究的方法最终将提供新的治疗方法,并更好地了解这些使人衰弱的疾病背后的神经生物学基础。现有的关于创伤/压力的文献主要集中在支配下丘脑-垂体-肾上腺轴并影响糖皮质激素介导的负反馈的边缘和皮质结构上。正是通过这些神经内分泌途径,自我维持的恐惧记忆可以传播早期生活创伤的长期影响。最近结合转化方法的工作提供了新的途径,可以通过早期生活压力来影响,例如糖皮质激素受体伴侣,包括 FKBP51。应激动物模型对行为和内分泌途径有不同的影响;然而,尚未严格研究完全复制风险和适应能力的临床特征的模型。这篇综述讨论了一个四因素模型,该模型考虑了研究风险和适应能力在理解对创伤/压力的发展反应中的重要性。在设计临床前模型时考虑临床人群的多因素性质,并将临床前研究结果应用于临床治疗方法,构成了转化互惠的核心,本文在四因素模型的背景下进行了讨论。

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