Centre de Psychiatrie et Neurosciences (Inserm U894), Université Paris Descartes, 102-108 rue de la santé, 75014, Paris, France.
Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands.
Psychopharmacology (Berl). 2018 Aug;235(8):2195-2220. doi: 10.1007/s00213-018-4950-4. Epub 2018 Jun 30.
Depression is a major health problem with a high prevalence and a heavy socioeconomic burden in western societies. It is associated with atrophy and impaired functioning of cortico-limbic regions involved in mood and emotion regulation. It has been suggested that alterations in neurotrophins underlie impaired neuroplasticity, which may be causally related to the development and course of depression. Accordingly, mounting evidence suggests that antidepressant treatment may exert its beneficial effects by enhancing trophic signaling on neuronal and synaptic plasticity. However, current antidepressants still show a delayed onset of action, as well as lack of efficacy. Hence, a deeper understanding of the molecular and cellular mechanisms involved in the pathophysiology of depression, as well as in the action of antidepressants, might provide further insight to drive the development of novel fast-acting and more effective therapies. Here, we summarize the current literature on the involvement of neurotrophic factors in the pathophysiology and treatment of depression. Further, we advocate that future development of antidepressants should be based on the neurotrophin theory.
抑郁症是一个主要的健康问题，在西方社会中具有较高的患病率和沉重的社会经济负担。它与涉及情绪和情感调节的皮质-边缘区域的萎缩和功能障碍有关。有人认为，神经营养因子的改变是神经可塑性受损的基础，这可能与抑郁症的发展和病程有关。因此，越来越多的证据表明，抗抑郁治疗可能通过增强对神经元和突触可塑性的营养信号来发挥其有益作用。然而，目前的抗抑郁药仍然显示出起效缓慢，并且疗效不佳。因此，深入了解抑郁症的病理生理学以及抗抑郁药作用中的分子和细胞机制，可能会为开发新型快速作用和更有效的治疗方法提供进一步的见解。在这里，我们总结了神经生长因子在抑郁症的病理生理学和治疗中的作用的最新文献。此外，我们主张未来抗抑郁药的开发应该基于神经营养因子理论。
