Mizrahi Romina
Research Imaging Centre, PET Centre, Centre for Addiction and Mental Health (CAMH)-Clarke Division and University of Toronto, Toronto, ON, Canada.
Neuropsychopharmacology. 2016 Feb;41(3):666-74. doi: 10.1038/npp.2015.274. Epub 2015 Sep 9.
Environmental risk factors have been implicated in the etiology of psychotic disorders, with growing evidence showing the adverse effects of migration, social marginalization, urbanicity, childhood trauma, social defeat, and other adverse experiences on mental health in vulnerable populations. Collectively, social stress may be one mechanism that could link these environmental risk factors. The exact mechanism(s) by which social stress can affect brain function, and in particular the molecular targets involved in psychosis (such as the dopaminergic (DA) system), is (are) not fully understood. In this review, we will discuss the interplay between social environmental risk factors and molecular changes in the human brain; in particular, we will highlight the impact of social stress on three specific neurochemical systems: DA, neuroinflammation/immune, and endocannabinoid (eCB) signaling. We have chosen the latter two molecular pathways based on emerging evidence linking schizophrenia to altered neuroinflammatory processes and cannabis use. We further identify key developmental periods in which social stress interacts with these pathways, suggesting window(s) of opportunities for novel interventions. Taken together, we suggest that they may have a key role in the pathogenesis and disease progression, possibly provide novel treatment options for schizophrenia, and perhaps even prevent it.
环境风险因素已被认为与精神障碍的病因有关,越来越多的证据表明,移民、社会边缘化、城市化、童年创伤、社会挫败及其他不良经历对弱势群体的心理健康具有不利影响。总体而言,社会压力可能是连接这些环境风险因素的一种机制。社会压力影响大脑功能的确切机制,尤其是与精神病相关的分子靶点(如多巴胺能(DA)系统),尚未完全明确。在本综述中,我们将讨论社会环境风险因素与人类大脑分子变化之间的相互作用;特别是,我们将重点阐述社会压力对三种特定神经化学系统的影响:多巴胺、神经炎症/免疫和内源性大麻素(eCB)信号传导。基于将精神分裂症与神经炎症过程改变及大麻使用联系起来的新证据,我们选择了后两种分子途径。我们进一步确定了社会压力与这些途径相互作用的关键发育时期,为新型干预措施提供了机会窗口。综上所述,我们认为它们可能在发病机制和疾病进展中起关键作用,可能为精神分裂症提供新的治疗选择,甚至可能预防该病。