Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, Canada.
Department of Stress Neurobiology and Neurogenetics, Max Planck Institute of Psychiatry, Munich, Germany.
Curr Opin Psychiatry. 2018 Jan;31(1):7-16. doi: 10.1097/YCO.0000000000000379.
Major depressive disorder (MDD) is among the most prevalent and disabling medical conditions worldwide. Despite its considerable burden, our understanding of its pathophysiology remains rudimentary, and a validated biomarker has yet to be identified. Antidepressants are the most common treatment for MDD, yet roughly one-third of patients experience an inadequate response. Thus, there is a great need for not only identifying biomarkers of MDD but also those that can predict and monitor or just monitor response to treatment.
MicroRNAs (miRNAs) act as endogenous fine-tuners and on-off switches of gene expression. Several lines of evidence now suggest that miRNAs are involved in the pathogenesis of neuropsychiatric disorders. As such, miRNAs offer great hope as biomarkers of disease and response to treatment.
In this review, we discuss the growing field, investigating peripheral miRNAs as potential biomarkers of major depression and treatment response. A noninvasive and validated biomarker of MDD or treatment response will help clinicians guide treatment selection. Ultimately, these findings provide important steps in the development of early diagnostic tools, preventive strategies, and effective pharmacological treatment for psychiatric disorders.
重度抑郁症(MDD)是全球最普遍和致残的医学疾病之一。尽管它的负担很大,但我们对其病理生理学的理解仍然很基础,尚未确定有效的生物标志物。抗抑郁药是治疗 MDD 的最常用方法,但大约三分之一的患者反应不足。因此,不仅需要确定 MDD 的生物标志物,还需要确定那些可以预测和监测或仅监测治疗反应的生物标志物。
microRNAs (miRNAs) 作为内源性微调器和基因表达的开/关开关。现在有几条证据表明 miRNAs 参与了神经精神疾病的发病机制。因此,miRNAs 作为疾病和治疗反应的生物标志物带来了很大的希望。
在这篇综述中,我们讨论了这个不断发展的领域,探讨了外周血 miRNAs 作为重度抑郁症和治疗反应的潜在生物标志物。MDD 或治疗反应的非侵入性和经过验证的生物标志物将有助于临床医生指导治疗选择。最终,这些发现为开发精神疾病的早期诊断工具、预防策略和有效药物治疗提供了重要步骤。