Walker Adam G, Conn P Jeffrey
Department of Pharmacology and Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, USA.
Department of Pharmacology and Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, USA.
Curr Opin Pharmacol. 2015 Feb;20:40-5. doi: 10.1016/j.coph.2014.11.003. Epub 2014 Nov 27.
Recently, there has been a shift in the schizophrenia field focusing on restoring glutamate signaling. Extensive preclinical data suggests that mGlu5 PAMs could have efficacy in all three symptom domains but there is concern of potential adverse effects. New insights into mechanisms underlying this toxicity may provide a path for discovery of safe mGlu5 PAMs. Genetic mutations in mGlu1 have been described in schizophrenics creating interest in this receptor as a therapeutic target. Preclinical data demonstrated the antipsychotic potential of mGlu2/3 agonists but clinical trials were not successful. However, studies have suggested that mGlu2 is the subtype mediating antipsychotic effects and selective mGlu2 PAMs are now in clinical development. Finally, recent genetic studies suggest mGlu3 modulators may be pro-cognitive.
最近,精神分裂症领域出现了一种转变,重点是恢复谷氨酸信号传导。大量临床前数据表明,代谢型谷氨酸受体5(mGlu5)的正向变构调节剂(PAMs)可能对所有三个症状领域都有效,但人们担心其潜在的不良反应。对这种毒性潜在机制的新见解可能为发现安全的mGlu5 PAMs提供一条途径。在精神分裂症患者中已发现代谢型谷氨酸受体1(mGlu1)的基因突变,这使得人们对该受体作为治疗靶点产生了兴趣。临床前数据证明了mGlu2/3激动剂的抗精神病潜力,但临床试验并不成功。然而,研究表明mGlu2是介导抗精神病作用的亚型,选择性mGlu2 PAMs目前正在进行临床开发。最后,最近的基因研究表明,mGlu3调节剂可能具有促认知作用。