Fishberg Department of Neuroscience and the Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York 10029, USA; email:
Annu Rev Pharmacol Toxicol. 2018 Jan 6;58:411-428. doi: 10.1146/annurev-pharmtox-010617-052823. Epub 2017 Oct 6.
Mood disorders such as depression are among the most prevalent psychiatric disorders in the United States, but they are inadequately treated in a substantial proportion of patients. Accordingly, neuropsychiatric research has pivoted from investigation of monoaminergic mechanisms to exploration of novel mediators, including the role of inflammatory processes. Subsets of mood disorder patients exhibit immune-related abnormalities, including elevated levels of proinflammatory cytokines, monocytes, and neutrophils in the peripheral circulation; dysregulation of neuroglia and blood-brain barrier function; and disruption of gut microbiota. The field of psychoneuroimmunology is one of great therapeutic opportunity, yielding experimental therapeutics for mood disorders, such as peripheral cytokine targeting antibodies, microglia and astrocyte targeting therapies, and probiotic treatments for gut dysbiosis, and producing findings that identify therapeutic targets for future development.
心境障碍(如抑郁症)是美国最常见的精神障碍之一,但相当一部分患者的治疗效果并不理想。因此,神经精神学研究已经从单胺能机制的研究转向了对新型介质的探索,包括炎症过程的作用。心境障碍患者的亚组表现出与免疫相关的异常,包括外周循环中促炎细胞因子、单核细胞和中性粒细胞水平升高;神经胶质和血脑屏障功能失调;以及肠道微生物群的破坏。心理神经免疫学领域是一个极具治疗潜力的领域,为心境障碍带来了实验治疗方法,如外周细胞因子靶向抗体、小胶质细胞和星形胶质细胞靶向治疗以及针对肠道菌群失调的益生菌治疗,并发现了未来开发的治疗靶点。