Wamsley J K, Byerley W F, McCabe R T, McConnell E J, Dawson T M, Grosser B I
J Clin Psychiatry. 1987 Mar;48 Suppl:19-25.
Controversy exists concerning whether receptor down-regulation is involved in the efficacy of antidepressants. Many investigators believe that norepinephrine (NE) receptor down-regulation is more important than serotonin (5-HT) receptor down-regulation. The ability to accurately determine which receptor types or subtypes have been down-regulated has been impaired by the lack of sufficiently specific ligands for labeling these receptor subtypes. Studies that have attempted to examine 5-HT2 receptor down-regulation have used [3H]-ketanserin as the ligand of choice to label 5-HT2 receptors, but this ligand also labels a nondescript site. The binding of [3H]-ketanserin to sites other than 5-HT2 receptors can be examined and controlled for by autoradiographic techniques. The authors briefly review potential problems involved in analyzing receptor binding after antidepressant treatment and present new findings of receptor alterations in rat brain as examined by autoradiographic techniques following chronic exposure to fluoxetine (a selective 5-HT uptake inhibitor that has been shown to be an effective antidepressant). Laboratory animals injected with fluoxetine showed receptor down-regulation (reduced density) in the serotonergic system. A provocative and potentially important finding of this study is that this selective 5-HT uptake blocker also down-regulates beta-adrenergic receptors in the CNS.
关于受体下调是否与抗抑郁药的疗效有关存在争议。许多研究人员认为去甲肾上腺素(NE)受体下调比5-羟色胺(5-HT)受体下调更重要。由于缺乏足够特异性的配体来标记这些受体亚型,准确确定哪些受体类型或亚型已被下调的能力受到了损害。试图研究5-HT2受体下调的研究使用[3H]-酮色林作为标记5-HT2受体的首选配体,但这种配体也标记一个未明确的位点。[3H]-酮色林与5-HT2受体以外位点的结合可以通过放射自显影技术进行检测和控制。作者简要回顾了抗抑郁药治疗后分析受体结合所涉及的潜在问题,并展示了通过放射自显影技术在慢性暴露于氟西汀(一种已被证明是有效的抗抑郁药的选择性5-HT摄取抑制剂)后对大鼠脑内受体改变的新发现。注射氟西汀的实验动物在血清素能系统中显示出受体下调(密度降低)。这项研究一个引人关注且可能重要的发现是,这种选择性5-HT摄取阻滞剂也会下调中枢神经系统中的β-肾上腺素能受体。