Department of, Women's and Children's Health, Uppsala University Uppsala, Sweden ; Center for Gender Medicine, Karolinska Institutet Stockholm, Sweden.
Front Pharmacol. 2013 Jun 11;4:74. doi: 10.3389/fphar.2013.00074. eCollection 2013.
There is ample evidence that genetic factors play an important role in anxiety disorders. In support, human genome-wide association studies have implicated several novel candidate genes. However, illumination of such genetic factors involved in anxiety disorders has not resulted in novel drugs over the past decades. A complicating factor is the heterogeneous classification of anxiety disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) and diverging operationalization of anxiety used in preclinical and clinical studies. Currently, there is an increasing focus on the gene × environment (G × E) interaction in anxiety as genes do not operate in isolation and environmental factors have been found to significantly contribute to the development of anxiety disorders in at-risk individuals. Nevertheless, extensive research on G × E mechanisms in anxiety has not resulted in major breakthroughs in drug discovery. Modification of individual genes in rodent models has enabled the specific study of anxiety in preclinical studies. In this context, two extensively studied neurotransmitters involved in anxiety are the gamma-aminobutyric acid (GABA) and 5-HT (5-hydroxytryptamine) system. In this review, we illustrate the complex interplay between genes and environment in anxiety processes by reviewing preclinical and clinical studies on the serotonin transporter (5-HTT), 5-HT1A receptor, 5-HT2 receptor, and GABAA receptor. Even though targets from the serotonin and GABA system have yielded drugs with known anxiolytic efficacy, the relation between the genetic background of these targets and anxiety symptoms and development of anxiety disorders is largely unknown. The aim of this review is to show the vast complexity of genetic and environmental factors in anxiety disorders. In light of the difficulty with which common genetic variants are identified in anxiety disorders, animal models with translational validity may aid in elucidating the neurobiological background of these genes and their possible role in anxiety. We argue that, in addition to human genetic studies, translational models are essential to map anxiety-related genes and to enhance our understanding of anxiety disorders in order to develop potentially novel treatment strategies.
有充分的证据表明,遗传因素在焦虑症中起着重要作用。支持这一观点的有,人类全基因组关联研究已经涉及到几个新的候选基因。然而,在过去的几十年里,这种涉及焦虑症的遗传因素并没有导致新的药物问世。一个复杂的因素是,《精神障碍诊断与统计手册》(DSM-IV-TR)中焦虑症的分类不明确,以及临床前和临床研究中焦虑症的操作定义不同。目前,人们越来越关注焦虑症中的基因与环境(G × E)相互作用,因为基因不是孤立运作的,而且环境因素已被发现会显著导致高危个体发生焦虑症。尽管如此,在焦虑症的 G × E 机制方面的广泛研究并没有在药物发现方面取得重大突破。在啮齿动物模型中对个体基因进行修饰,使人们能够在临床前研究中专门研究焦虑症。在这种情况下,两种广泛研究的与焦虑症有关的神经递质是γ-氨基丁酸(GABA)和 5-羟色胺(5-HT)系统。在这篇综述中,我们通过回顾 5-羟色胺转运体(5-HTT)、5-HT1A 受体、5-HT2 受体和 GABA A 受体的临床前和临床研究,说明了焦虑症中基因与环境之间的复杂相互作用。尽管来自 5-HT 和 GABA 系统的靶点已经产生了具有已知抗焦虑疗效的药物,但这些靶点的遗传背景与焦虑症状和焦虑症发展之间的关系在很大程度上尚不清楚。本综述的目的是展示焦虑症中遗传和环境因素的巨大复杂性。鉴于在焦虑症中难以识别常见遗传变异,具有转化有效性的动物模型可能有助于阐明这些基因的神经生物学背景及其在焦虑症中的可能作用。我们认为,除了人类遗传研究外,转化模型对于绘制与焦虑相关的基因图谱以及增强我们对焦虑症的理解至关重要,以便开发潜在的新治疗策略。