Bosia Marta, Pigoni Alessandro, Cavallaro Roberto
IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences , Via Stamira d'Ancona 20, 20127 Milano , Italy +390 226 433 218 ; +390 226 433 265 ;
Expert Opin Drug Discov. 2015 Feb;10(2):125-39. doi: 10.1517/17460441.2015.976552. Epub 2014 Oct 25.
Schizophrenia is a major psychiatric disorder that afflicts about 1% of the world's population, falling into the top 10 medical disorders causing disability. Existing therapeutic strategies have had limited success; they have poor effects on core cognitive impairment and long-term disability. They are also burdened by relevant side effects. Although new antipsychotic medications have been launched in the past decades, there has been a general lack of significant innovation over the past 60 years. This lack of significant progress in the pharmacotherapy of schizophrenia is a reflection of the complexity and heterogeneity of its etiopathogenetic mechanisms.
In this article, the authors briefly review genetic models of schizophrenia, focusing on examples of how new therapeutic strategies have been developed from them. They report on the evidence of epigenetic alterations in schizophrenia and their relevance to pharmacological studies. Further, they describe the implications of epigenetic mechanisms in the etiopathogenesis of the disease and the effects of current antipsychotic drugs on epigenetic processes. Finally, they provide their perspective of using epigenetic drugs for treating schizophrenia.
Current genetic and epigenetic studies are finally shedding light on the biomolecular mechanisms linked to the core pathogenetic alterations in schizophrenia, rather than just their symptoms. These advancements in the understanding of the physiopathology of schizophrenia provide exciting new perspectives for treatments. Indeed, the possibility of looking directly at the biomolecular level allows us to bypass the age-old issues of animal studies pertaining to their questionable validity as behavioral models.
精神分裂症是一种主要的精神障碍,影响着全球约1%的人口,跻身导致残疾的十大医学疾病之列。现有的治疗策略成效有限;它们对核心认知障碍和长期残疾的效果不佳。它们还受到相关副作用的困扰。尽管在过去几十年中推出了新的抗精神病药物,但在过去60年里总体上缺乏重大创新。精神分裂症药物治疗缺乏重大进展反映了其病因发病机制的复杂性和异质性。
在本文中,作者简要回顾了精神分裂症的遗传模型,重点关注从中开发新治疗策略的实例。他们报告了精神分裂症中表观遗传改变的证据及其与药理学研究的相关性。此外,他们描述了表观遗传机制在该疾病病因发病中的作用以及当前抗精神病药物对表观遗传过程的影响。最后,他们阐述了使用表观遗传药物治疗精神分裂症的观点。
当前的遗传和表观遗传学研究终于开始揭示与精神分裂症核心致病改变相关的生物分子机制,而不仅仅是其症状。对精神分裂症生理病理学理解的这些进展为治疗提供了令人兴奋的新视角。的确,直接在生物分子水平上进行研究的可能性使我们能够避开动物研究中由来已久的问题,即其作为行为模型的有效性存疑。