Parekh Amy, Smeeth Demelza, Milner Yasmin, Thure Sandrine
Basic and Clinical Neuroscience, Institute of Psychology, Psychiatry and Neuroscience, King's College London, 125 Coldharbour Lane, London SE5 9NU, UK.
Healthcare (Basel). 2017 Feb 3;5(1):5. doi: 10.3390/healthcare5010005.
In the UK, the lifetime-documented prevalence of major depressive disorder (MDD) is currently 10%. Despite its increasing prevalence and devastating impact on quality of life, the pathophysiological mechanisms underpinning MDD remain to be fully elucidated. Current theories of neurobiological components remain incomplete and protein-centric, rendering pharmacological treatment options suboptimal. In this review, we highlight the pivotal role of lipids in intra- and inter-neuronal functioning, emphasising the potential use of lipids as biomarkers for MDD. The latter has significant implications for improving our understanding of MDD at the cellular and circuit level. There is particular focus on cholesterol (high and low density lipoprotein), omega-3, and omega-6 polyunsaturated fatty acids due to established evidence in the literature of a link between atherosclerotic disease and major depression. We argue that there is significant potential scope for the use of such peripheral biomarkers in the diagnosis, stratification and treatment of MDD.
在英国,有记录的重度抑郁症(MDD)终生患病率目前为10%。尽管其患病率不断上升且对生活质量产生了毁灭性影响,但MDD的病理生理机制仍有待充分阐明。目前关于神经生物学成分的理论仍不完整且以蛋白质为中心,导致药物治疗选择并不理想。在本次综述中,我们强调了脂质在神经元内和神经元间功能中的关键作用,强调了脂质作为MDD生物标志物的潜在用途。后者对于在细胞和回路水平增进我们对MDD的理解具有重要意义。由于文献中已有确凿证据表明动脉粥样硬化疾病与重度抑郁症之间存在联系,因此特别关注胆固醇(高密度脂蛋白和低密度脂蛋白)、ω-3和ω-6多不饱和脂肪酸。我们认为,此类外周生物标志物在MDD的诊断、分层和治疗中具有巨大的潜在应用范围。