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用于评估与应激和适应相关的人群和个体健康及疾病的生物标志物。

Biomarkers for assessing population and individual health and disease related to stress and adaptation.

机构信息

Harold and Margaret Milliken Hatch, Laboratory of Neuroendocrinology, The Rockefeller University, 1230 York Avenue, New York, NY 10065.

出版信息

Metabolism. 2015 Mar;64(3 Suppl 1):S2-S10. doi: 10.1016/j.metabol.2014.10.029. Epub 2014 Oct 30.


DOI:10.1016/j.metabol.2014.10.029
PMID:25496803
Abstract

Biomarkers are important in stress biology in relation to assessing individual and population health. They facilitate tapping meaningfully into the complex, non-linear interactions that affect the brain and multiple systems of the body and promote adaptation or, when dysregulated, they can accelerate disease processes. This has demanded a multifactorial approach to the choice of biomarkers. This is necessary in order to adequately describe and predict how an individual embedded in a particular social and physical environment, and with a unique genotype and set of lifetime experiences, will fare in terms of health and disease risk, as well as how that individual will respond to an intervention. Yet, at the same time, single biomarkers can have a predictive or diagnostic value when combined with carefully designed longitudinal assessment of behavior and disease related to stress. Moreover, the methods of brain imaging, themselves the reflection of the complexity of brain functional architecture, have provided new ways of diagnosing, and possibly differentiating, subtypes of depressive illness and anxiety disorders that are precipitated or exacerbated by stress. Furthermore, postmortem assessment of brain biomarkers provides important clues about individual vulnerability for suicide related to depression and this may lead to predictive biomarkers to better treat individuals with suicidal depression. Once biomarkers are available, approaches to prevention and treatment should take advantage of the emerging evidence that activating brain plasticity together with targeted behavioral interventions is a promising strategy.

摘要

生物标志物在应激生物学中对于评估个体和人群健康很重要。它们有助于深入了解影响大脑和身体多个系统的复杂、非线性相互作用,并促进适应,或者在失调时加速疾病进程。这就要求对生物标志物的选择采用多因素方法。这是必要的,以便充分描述和预测一个人在特定的社会和物理环境中,具有独特的基因型和一生经历,在健康和疾病风险方面的表现,以及该个体对干预的反应。然而,与此同时,当与精心设计的关于应激相关的行为和疾病的纵向评估相结合时,单个生物标志物也可以具有预测或诊断价值。此外,脑成像方法本身反映了大脑功能结构的复杂性,为诊断和可能区分由应激引发或加重的抑郁性疾病和焦虑障碍的亚型提供了新方法。此外,对大脑生物标志物的死后评估为与抑郁相关的自杀个体易感性提供了重要线索,这可能会导致预测生物标志物,以便更好地治疗有自杀倾向的抑郁症患者。一旦有了生物标志物,预防和治疗方法应该利用新兴证据,即激活大脑可塑性和靶向行为干预相结合是一种很有前途的策略。

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