Department of Education and Psychology, The Open University of Israel, Ra'anana, Israel.
Department of Education and Psychology, The Open University of Israel, Ra'anana, Israel; School of Behavioral Sciences, The Academic College Tel Aviv Yaffo, Tel Aviv, Israel.
Eur Neuropsychopharmacol. 2017 Oct;27(10):945-958. doi: 10.1016/j.euroneuro.2017.07.008. Epub 2017 Aug 12.
Traditional herbal medicine can offer efficacious and safe alternative pharmacotherapies for depression. The ability of an herbal medicine to produce neuroadaptive processes, that enhance neuroplasticity and cellular resilience in response to chronic stress, may point to its antidepressant potential. We suggest that among many investigated herbal medicines, those that can enhance neuroplasticity may have stronger therapeutic potential. The current article presents a summary of traditional herbal medicines, which are thought to exert antidepressant-like effects in chronic stress models via neuroplasticity enhancement. Brain-derived neurotrophic factor (BDNF) is a biomarker for neuroplasticity-related mechanisms compromised in depression and recovered by conventional antidepressants, including synaptic plasticity, cell survival, neurogenesis and spine formation. We therefore presumed that if an herbal medicine up-regulates BDNF in the hippocampus and/or prefrontal cortex (PFC), its antidepressant-like effect is mediated, at least partially, via neuroplasticity-related mechanisms. Literature search was performed using the general terms depression, stress, neuroplasticity and herbal medicines. Screening of retrieved preclinical studies revealed 30 traditional herbal medicines: 8 single herbs, 15 bioactive constituents, and 7 herbal formulas. The antidepressant-like effects of these medicines were associated with reversal of chronic stress-induced impairment in neuroplasticity, most notably by BDNF up-regulation, activation of BDNF downstream signaling pathways and increase in neurogenesis in the hippocampus and/or PFC/frontal cortex. In light of the ability of these medicines to enhance neuroplasticity, we suggest that they may be suitable candidates for clinical investigation in depressed individuals. Once their efficacy, tolerability and safety will be substantiated, they may serve as natural alternatives to conventional antidepressants.
传统草药可以提供有效的、安全的替代药物疗法，治疗抑郁症。草药具有产生神经适应过程的能力，这种过程可以增强神经可塑性和细胞对慢性应激的适应能力，这可能表明其具有抗抑郁的潜力。我们认为，在许多经过研究的草药中，那些能够增强神经可塑性的草药可能具有更强的治疗潜力。本文综述了传统草药，这些草药被认为通过增强神经可塑性在慢性应激模型中发挥抗抑郁样作用。脑源性神经营养因子（BDNF）是一种生物标志物，与抑郁症相关的机制受损，包括突触可塑性、细胞存活、神经发生和棘突形成，而常规抗抑郁药可以恢复这些机制。因此，我们假设如果一种草药能上调海马体和/或前额叶皮质（PFC）中的 BDNF，那么其抗抑郁样作用至少部分是通过与神经可塑性相关的机制介导的。使用“抑郁、应激、神经可塑性和草药”等一般术语进行文献检索。对检索到的临床前研究进行筛选，发现了 30 种传统草药：8 种单味草药、15 种生物活性成分和 7 种草药配方。这些药物的抗抑郁样作用与逆转慢性应激引起的神经可塑性损伤有关，尤其是通过上调 BDNF、激活 BDNF 下游信号通路以及增加海马体和/或 PFC/前额叶皮质中的神经发生。鉴于这些药物增强神经可塑性的能力，我们认为它们可能是适合在抑郁患者中进行临床研究的候选药物。一旦证实其疗效、耐受性和安全性，它们可能成为传统抗抑郁药的天然替代品。
