Di Giovanni Giuseppe, Svob Strac Dubravka, Sole Montse, Unzeta Mercedes, Tipton Keith F, Mück-Šeler Dorotea, Bolea Irene, Della Corte Laura, Nikolac Perkovic Matea, Pivac Nela, Smolders Ilse J, Stasiak Anna, Fogel Wieslawa A, De Deurwaerdère Philippe
Department of Physiology and Biochemistry, University of Malta Msida, Malta.
Division of Molecular Medicine, Rudjer Boskovic Institute Zagreb, Croatia.
Front Neurosci. 2016 Nov 24;10:541. doi: 10.3389/fnins.2016.00541. eCollection 2016.
The monoaminergic systems are the target of several drugs for the treatment of mood, motor and cognitive disorders as well as neurological conditions. In most cases, advances have occurred through serendipity, except for Parkinson's disease where the pathophysiology led almost immediately to the introduction of dopamine restoring agents. Extensive neuropharmacological studies first showed that the primary target of antipsychotics, antidepressants, and anxiolytic drugs were specific components of the monoaminergic systems. Later, some dramatic side effects associated with older medicines were shown to disappear with new chemical compounds targeting the origin of the therapeutic benefit more specifically. The increased knowledge regarding the function and interaction of the monoaminergic systems in the brain resulting from neurochemical and neurophysiological studies indicated new monoaminergic targets that could achieve the efficacy of the older medicines with fewer side-effects. Yet, this accumulated knowledge regarding monoamines did not produce valuable strategies for diseases where no monoaminergic drug has been shown to be effective. Here, we emphasize the new therapeutic and monoaminergic-based strategies for the treatment of psychiatric diseases. We will consider three main groups of diseases, based on the evidence of monoamines involvement (schizophrenia, depression, obesity), the identification of monoamines in the diseases processes (Parkinson's disease, addiction) and the prospect of the involvement of monoaminergic mechanisms (epilepsy, Alzheimer's disease, stroke). In most cases, the clinically available monoaminergic drugs induce widespread modifications of amine tone or excitability through neurobiological networks and exemplify the overlap between therapeutic approaches to psychiatric and neurological conditions. More recent developments that have resulted in improved drug specificity and responses will be discussed in this review.
单胺能系统是多种用于治疗情绪、运动和认知障碍以及神经疾病的药物的作用靶点。在大多数情况下,药物研发进展是偶然取得的,帕金森病除外,其病理生理学几乎立即促使了多巴胺补充剂的引入。广泛的神经药理学研究首先表明,抗精神病药、抗抑郁药和抗焦虑药的主要靶点是单胺能系统的特定组成部分。后来发现,一些与旧药物相关的严重副作用会随着更具针对性地针对治疗益处来源的新化合物而消失。神经化学和神经生理学研究增加了对大脑中单胺能系统功能和相互作用的认识,这表明了新的单胺能靶点,这些靶点可以在副作用较少的情况下达到旧药物的疗效。然而,关于单胺的这些积累知识并没有为尚无单胺能药物显示有效的疾病产生有价值的治疗策略。在此,我们强调基于单胺能的精神疾病治疗新策略。我们将基于单胺参与的证据(精神分裂症、抑郁症、肥胖症)、疾病过程中单胺的识别(帕金森病、成瘾)以及单胺能机制参与的前景(癫痫、阿尔茨海默病、中风)来考虑三类主要疾病。在大多数情况下,临床可用的单胺能药物通过神经生物学网络广泛改变胺能张力或兴奋性,体现了精神疾病和神经疾病治疗方法之间的重叠。本综述将讨论导致药物特异性和反应性改善的最新进展。