Department of Psychiatry, University of California San Diego, La Jolla, California; Center of Excellence for Stress and Mental Health, Veterans Affairs Hospital, La Jolla, California.
Department of Behavioural Neurobiology, Institute of Experimental Medicine, Hungarian Academy of Sciences, Budapest, Hungary.
Biol Psychiatry. 2018 May 15;83(10):895-907. doi: 10.1016/j.biopsych.2017.11.019. Epub 2017 Nov 20.
Increasing predictability of animal models of posttraumatic stress disorder (PTSD) has required active collaboration between clinical and preclinical scientists. Modeling PTSD is challenging, as it is a heterogeneous disorder with ≥20 symptoms. Clinical research increasingly utilizes objective biological measures (e.g., imaging, peripheral biomarkers) or nonverbal behaviors and/or physiological responses to complement verbally reported symptoms. This shift toward more-objectively measurable phenotypes enables refinement of current animal models of PTSD, and it supports the incorporation of homologous measures across species. We reviewed >600 articles to examine the ability of current rodent models to probe biological phenotypes of PTSD (e.g., sleep disturbances, hippocampal and fear-circuit dysfunction, inflammation, glucocorticoid receptor hypersensitivity) in addition to behavioral phenotypes. Most models reliably produced enduring generalized anxiety-like or depression-like behaviors, as well as hyperactive fear circuits, glucocorticoid receptor hypersensitivity, and response to long-term selective serotonin reuptake inhibitors. Although a few paradigms probed fear conditioning/extinction or utilized peripheral immune, sleep, and noninvasive imaging measures, we argue that these should be incorporated more to enhance translation. Data on female subjects, on subjects at different ages across the life span, or on temporal trajectories of phenotypes after stress that can inform model validity and treatment study design are needed. Overall, preclinical (and clinical) PTSD researchers are increasingly incorporating homologous biological measures to assess markers of risk, response, and treatment outcome. This shift is exciting, as we and many others hope it not only will support translation of drug efficacy from animal models to clinical trials but also will potentially improve predictability of stage II for stage III clinical trials.
为了提高创伤后应激障碍 (PTSD) 动物模型的可预测性,临床科学家和临床前科学家之间需要进行积极的合作。 PTSD 的建模具有挑战性,因为它是一种具有≥20 种症状的异质疾病。临床研究越来越多地利用客观的生物学指标(例如,成像、外周生物标志物)或非言语行为和/或生理反应来补充口头报告的症状。这种向更可测量的表型的转变使当前 PTSD 动物模型得以精细化,并支持在物种间纳入同源测量。我们审查了超过 600 篇文章,以检查当前啮齿动物模型探测 PTSD 的生物学表型(例如,睡眠障碍、海马和恐惧回路功能障碍、炎症、糖皮质激素受体超敏性)的能力,除了行为表型。大多数模型可靠地产生持久的广泛性焦虑样或抑郁样行为,以及过度活跃的恐惧回路、糖皮质激素受体超敏性和对长期选择性 5-羟色胺再摄取抑制剂的反应。尽管有几个范式探测了恐惧条件反射/消退或使用了外周免疫、睡眠和非侵入性成像测量,但我们认为应该更多地纳入这些方法,以提高转化。需要关于女性受试者、在整个生命周期的不同年龄的受试者、或应激后表型的时间轨迹的数据,这些数据可以为模型的有效性和治疗研究设计提供信息。总体而言,临床前(和临床)PTSD 研究人员越来越多地纳入同源生物学指标来评估风险、反应和治疗结果的标志物。这种转变令人兴奋,因为我们和许多其他人希望它不仅将支持从动物模型到临床试验的药物疗效的转化,而且还可能提高 III 期临床试验的 II 期的可预测性。