Dandekar Manoj P, Valvassori Samira S, Dal-Pont Gustavo C, Quevedo Joao
Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) McGovern Medical School, Houston, TX, United States.
Laboratory of Neuronal Signaling and Psychopharmacology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, Santa Catarina, Brazil.
Curr Drug Metab. 2018;19(8):663-673. doi: 10.2174/1389200219666171227203737.
Bipolar disorder (BD) is a debilitating mental ailment characterized by recurrent episodes of mania and depression. Primary mood-stabilizing drugs like lithium and valproate alleviate the hypomanic or mild to moderate manic episodes in patients with BD. One of the extensively studied underlying mechanisms for these pharmacological interventions is inhibition of intracellular signaling cascades associated with glycogen synthase kinase-3 beta (GSK-3β), a multi-functional serine-threonine kinase.
To summarize the different mechanistic aspects associated with GSK-3β signaling involved in the pathophysiology of BD and highlights drug discovery approaches pursued for the development of GSK-3β inhibition with detailed strength, weakness, opportunity, and threat (SWOT) analysis. In this review, we endeavor to establish the correlation between neuronal GSK-3β inhibition and anti-manic response of different therapeutics used for the treatment of patients with BD.
The gene depletion or pharmacological inhibition of GSK-3β reproduces some of the behavioral effects of lithium including reduction of depression- and manic-like behaviors in rodents, which attested the intracellular GSK- 3β inhibition as one of the critical steps in mediating behavioral effect of mood-stabilizers. Furthermore, converging evidence supported the participation of GSK-3β in the regulation of various neurobehavioral functions governed by neurotransmitters dopamine and serotonin. Apart from its crucial involvement in the mechanism of action of mood stabilizers, GSK-3β signaling pathways have also received attention for their role in the effects of psychoactive therapies like antidepressants, antipsychotics, and neurotrophic factors.
We anticipate that the GSK-3β could be a druggable target for several incurable neuropsychiatric disorders including BD.
双相情感障碍(BD)是一种使人衰弱的精神疾病,其特征为躁狂和抑郁反复发作。锂盐和丙戊酸盐等一线心境稳定剂可缓解双相情感障碍患者的轻躁狂或轻度至中度躁狂发作。这些药物干预措施广泛研究的潜在机制之一是抑制与糖原合酶激酶-3β(GSK-3β)相关的细胞内信号级联反应,GSK-3β是一种多功能丝氨酸-苏氨酸激酶。
总结与双相情感障碍病理生理学中涉及的GSK-3β信号传导相关的不同机制方面,并重点介绍为开发GSK-3β抑制剂所采用的药物发现方法,并进行详细的优势、劣势、机会和威胁(SWOT)分析。在本综述中,我们致力于建立神经元GSK-3β抑制与用于治疗双相情感障碍患者的不同疗法的抗躁狂反应之间的相关性。
GSK-3β的基因敲除或药理学抑制重现了锂盐的一些行为效应,包括减少啮齿动物的抑郁样和躁狂样行为,这证明细胞内GSK-3β抑制是介导心境稳定剂行为效应的关键步骤之一。此外,越来越多的证据支持GSK-3β参与由神经递质多巴胺和血清素调节的各种神经行为功能。除了在心境稳定剂作用机制中的关键作用外,GSK-3β信号通路因其在抗抑郁药、抗精神病药和神经营养因子等精神活性疗法的作用中所起的作用也受到关注。
我们预计GSK-3β可能成为包括双相情感障碍在内的几种无法治愈的神经精神疾病的可药物化靶点。