Vian João, Pereira Círia, Chavarria Victor, Köhler Cristiano, Stubbs Brendon, Quevedo João, Kim Sung-Wan, Carvalho André F, Berk Michael, Fernandes Brisa S
Psychiatry and Mental Health Department, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.
Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal.
BMC Med. 2017 Aug 1;15(1):144. doi: 10.1186/s12916-017-0916-3.
Depression remains a debilitating condition with an uncertain aetiology. Recently, attention has been given to the renin-angiotensin system. In the central nervous system, angiotensin II may be important in multiple pathways related to neurodevelopment and regulation of the stress response. Studies of drugs targeting the renin-angiotensin system have yielded promising results. Here, we review the potential beneficial effects of angiotensin blockers in depression and their mechanisms of action. Drugs blocking the angiotensin system have efficacy in several animal models of depression. While no randomised clinical trials were found, case reports and observational studies showed that angiotensin-converting enzyme inhibitors or angiotensin receptor blockers had positive effects on depression, whereas other antihypertensive agents did not. Drugs targeting the renin-angiotensin system act on inflammatory pathways implicated in depression. Both preclinical and clinical data suggest that these drugs possess antidepressant properties. In light of these results, angiotensin system-blocking agents offer new horizons in mood disorder treatment.
抑郁症仍然是一种病因不明的使人衰弱的疾病。最近，肾素-血管紧张素系统受到了关注。在中枢神经系统中，血管紧张素II在与神经发育和应激反应调节相关的多种途径中可能起重要作用。针对肾素-血管紧张素系统的药物研究已取得了有前景的结果。在此，我们综述血管紧张素阻滞剂在抑郁症中的潜在有益作用及其作用机制。阻断血管紧张素系统的药物在几种抑郁症动物模型中具有疗效。虽然未找到随机临床试验，但病例报告和观察性研究表明，血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂对抑郁症有积极作用，而其他抗高血压药物则没有。针对肾素-血管紧张素系统的药物作用于与抑郁症相关的炎症途径。临床前和临床数据均表明这些药物具有抗抑郁特性。鉴于这些结果，血管紧张素系统阻断剂为情绪障碍的治疗提供了新的前景。
