孕烷醇酮与生殖精神病学：概述。
Allopregnanolone and reproductive psychiatry: an overview.
机构信息
a Department of Psychiatry & Behavioral Sciences , Women's Mood Disorders Center, Johns Hopkins University School of Medicine , Baltimore , MD , USA.
b Department of of Gynecology & Obstetrics , Women's Mood Disorders Center, Johns Hopkins University School of Medicine , Baltimore , MD , USA.
出版信息
Int Rev Psychiatry. 2019 May;31(3):237-244. doi: 10.1080/09540261.2018.1553775. Epub 2019 Jan 31.
Abstract
Psychiatric symptoms that coincide with reproductive transitions are related to changes in sex steroids, but studies show that this relationship is governed by individual women's vulnerability to change rather than by differences in level. There is growing interest in the role of allopregnanolone (ALLO), a 3- reduced metabolite of progesterone and a strong allosteric modulator of the GABA receptor, in such symptoms, with enough evidence now across various times of reproductive transition to offer an overview of the role of this hormone in reproductive psychiatry. This review offers a brief overview, focusing on literature of the last 3 years, of the relationship between allopregnanolone and mood at menarche; in the menstrual cycle; in the peripartum; and in the menopausal transition. ALLO dysregulation is identified in all of these transitions and found to be associated with mood symptoms, although evidence of its exact role; its relationship to other systems; and directionality is not consistent.
摘要
与生殖过渡期同时出现的精神症状与性激素的变化有关，但研究表明，这种关系受个体女性对变化的易感性的支配，而不是由水平差异决定。人们对同种妊娠素酮（ALLO）的作用越来越感兴趣，ALLO 是孕激素的 3-还原代谢产物，是 GABA 受体的强变构调节剂，在这些症状中，现在有足够的证据在各种生殖过渡期提供这种激素在生殖精神病学中的作用概述。这篇综述提供了一个简要概述，重点介绍了过去 3 年中同种妊娠素酮与月经初潮时情绪、月经周期、围产期和绝经过渡期之间关系的文献。在所有这些过渡中都发现同种妊娠素酮失调，并与情绪症状相关，尽管其确切作用、与其他系统的关系以及方向性的证据并不一致。
相似文献
1
Allopregnanolone and reproductive psychiatry: an overview.孕烷醇酮与生殖精神病学：概述。
Int Rev Psychiatry. 2019 May;31(3):237-244. doi: 10.1080/09540261.2018.1553775. Epub 2019 Jan 31.
2
GABAA Receptor-Modulating Steroids in Relation to Women's Behavioral Health.GABAA 受体调节类固醇与女性行为健康的关系。
Curr Psychiatry Rep. 2015 Nov;17(11):92. doi: 10.1007/s11920-015-0627-4.
3
Effects of GABA active steroids in the female brain with a focus on the premenstrual dysphoric disorder.GABA 活性类固醇对女性大脑的影响，重点是经前烦躁障碍。
J Neuroendocrinol. 2018 Feb;30(2). doi: 10.1111/jne.12553.
4
Allopregnanolone and mood disorders.孕烷醇酮与心境障碍。
Prog Neurobiol. 2014 Feb;113:88-94. doi: 10.1016/j.pneurobio.2013.07.005. Epub 2013 Aug 23.
5
Women with premenstrual dysphoric disorder have altered sensitivity to allopregnanolone over the menstrual cycle compared to controls-a pilot study.与对照组相比，经前烦躁障碍女性在月经周期中对别孕烯醇酮的敏感性有所改变——一项初步研究。
Psychopharmacology (Berl). 2016 Jun;233(11):2109-2117. doi: 10.1007/s00213-016-4258-1. Epub 2016 Mar 10.
6
Sex steroid induced negative mood may be explained by the paradoxical effect mediated by GABAA modulators.性类固醇诱导的负面情绪可能由GABAA调节剂介导的矛盾效应来解释。
Psychoneuroendocrinology. 2009 Sep;34(8):1121-32. doi: 10.1016/j.psyneuen.2009.02.003. Epub 2009 Mar 9.
7
PTSD in women is associated with a block in conversion of progesterone to the GABAergic neurosteroids allopregnanolone and pregnanolone measured in plasma.女性创伤后应激障碍与血浆中孕激素向 GABA 能神经甾体别孕烯醇酮和孕烷醇酮转化受阻有关。
Psychoneuroendocrinology. 2018 Jul;93:133-141. doi: 10.1016/j.psyneuen.2018.04.024. Epub 2018 Apr 24.
8
Allopregnanolone in premenstrual dysphoric disorder (PMDD): Evidence for dysregulated sensitivity to GABA-A receptor modulating neuroactive steroids across the menstrual cycle.经前烦躁障碍（PMDD）中的别孕烯醇酮：整个月经周期对γ-氨基丁酸A（GABA-A）受体调节神经活性甾体的敏感性失调的证据。
Neurobiol Stress. 2020 Feb 4;12:100213. doi: 10.1016/j.ynstr.2020.100213. eCollection 2020 May.
9
Tolerance to allopregnanolone with focus on the GABA-A receptor.对孕烷二醇耐受的研究进展——聚焦于 GABA-A 受体。
Br J Pharmacol. 2011 Jan;162(2):311-27. doi: 10.1111/j.1476-5381.2010.01059.x.
10
Allopregnanolone as a mediator of affective switching in reproductive mood disorders.别孕烯醇酮作为生殖性情绪障碍中情感转换的介质。
Psychopharmacology (Berl). 2014 Sep;231(17):3557-67. doi: 10.1007/s00213-014-3599-x. Epub 2014 May 21.
引用本文的文献
1
Neurosteroid Levels in Pregnancy and Its Implications for Mental Health: A Literature Review.孕期神经甾体水平及其对心理健康的影响：文献综述
Ann Neurosci. 2025 Jul 19:09727531251351075. doi: 10.1177/09727531251351075.
2
Autism, menstruation and mental health- a scoping review and a call to action.自闭症、月经与心理健康——一项范围综述及行动呼吁
Front Glob Womens Health. 2025 Jun 25;6:1531934. doi: 10.3389/fgwh.2025.1531934. eCollection 2025.
3
Biomarkers of reproductive psychiatric disorders.生殖精神障碍的生物标志物。
Br J Psychiatry. 2025 Jun;226(6):352-368. doi: 10.1192/bjp.2025.134. Epub 2025 Jun 20.
4
The cross-cultural adaptation and psychometric properties of the menstrual health instrument (MHI) among Iranian adolescent females.月经健康量表（MHI）在伊朗青春期女性中的跨文化适应性及心理测量特性
BMC Public Health. 2025 Mar 13;25(1):991. doi: 10.1186/s12889-025-22174-9.
5
Impact of premenstrual syndrome and premenstrual dysphoric disorder on maternal antenatal depression.经前期综合征和经前期烦躁障碍对孕妇产前抑郁的影响。
PLoS One. 2024 Dec 19;19(12):e0315628. doi: 10.1371/journal.pone.0315628. eCollection 2024.
6
Early Life Trauma, Emotion Dysregulation and Hormonal Sensitivity Across Female Reproductive Life Events.早期生活创伤、情绪调节障碍与女性生殖生命事件中的激素敏感性。
Curr Psychiatry Rep. 2024 Oct;26(10):530-542. doi: 10.1007/s11920-024-01527-y. Epub 2024 Aug 27.
7
Association of menopausal symptoms and menopausal quality of life with premenstrual syndrome.绝经症状和生活质量与经前期综合征的关系。
Malawi Med J. 2023 Jun;35(2):95-100. doi: 10.4314/mmj.v35i2.4.
8
Profiling GABA(A) Receptor Subunit Expression in the Hippocampus of PMDD Rat Models Based on TCM Theories.基于中医理论探讨 PMDD 大鼠模型海马 GABA(A)受体亚单位表达谱。
Mol Neurobiol. 2023 Aug;60(8):4418-4428. doi: 10.1007/s12035-023-03354-3. Epub 2023 Apr 27.
9
Role of allopregnanolone-mediated γ-aminobutyric acid A receptor sensitivity in the pathogenesis of premenstrual dysphoric disorder: Toward precise targets for translational medicine and drug development.别孕烯醇酮介导的γ-氨基丁酸A受体敏感性在经前烦躁障碍发病机制中的作用：迈向转化医学和药物开发的精确靶点
Front Psychiatry. 2023 Mar 2;14:1140796. doi: 10.3389/fpsyt.2023.1140796. eCollection 2023.
10
Prevention of Pregnancy Loss: Combining Progestogen Treatment and Psychological Support.预防流产：孕激素治疗与心理支持相结合。
J Clin Med. 2023 Feb 24;12(5):1827. doi: 10.3390/jcm12051827.
本文引用的文献
1
Brexanolone injection in post-partum depression: two multicentre, double-blind, randomised, placebo-controlled, phase 3 trials.产后抑郁症中注射布雷沙诺酮：两项多中心、双盲、随机、安慰剂对照、3 期临床试验。
Lancet. 2018 Sep 22;392(10152):1058-1070. doi: 10.1016/S0140-6736(18)31551-4. Epub 2018 Aug 31.
2
Neuroactive Steroids and Perinatal Depression: a Review of Recent Literature.神经活性甾体和围产期抑郁：近期文献综述。
Curr Psychiatry Rep. 2018 Aug 9;20(9):78. doi: 10.1007/s11920-018-0937-4.
3
GABA dysregulation as an explanatory model for late-onset postpartum depression associated with weaning and resumption of menstruation.GABA 失调作为解释晚发性产后抑郁症与断奶和恢复月经相关的模型。
Arch Womens Ment Health. 2019 Feb;22(1):55-63. doi: 10.1007/s00737-018-0871-9. Epub 2018 Jul 3.
4
Effects of GABA active steroids in the female brain with a focus on the premenstrual dysphoric disorder.GABA 活性类固醇对女性大脑的影响，重点是经前烦躁障碍。
J Neuroendocrinol. 2018 Feb;30(2). doi: 10.1111/jne.12553.
5
Adverse life events, psychiatric history, and biological predictors of postpartum depression in an ethnically diverse sample of postpartum women.在一个种族多样化的产后女性样本中，生活中的不幸事件、精神病史和生物预测因素与产后抑郁症的关系。
Psychol Med. 2018 May;48(7):1190-1200. doi: 10.1017/S0033291717002641. Epub 2017 Sep 27.
6
Correlation between allopregnanolone levels and depressive symptoms during late menopausal transition and early postmenopause.绝经后期过渡和绝经后早期阶段孕烷醇酮水平与抑郁症状之间的相关性。
Gynecol Endocrinol. 2018 Feb;34(2):144-147. doi: 10.1080/09513590.2017.1371129. Epub 2017 Aug 31.
7
The steroid metabolome in women with premenstrual dysphoric disorder during GnRH agonist-induced ovarian suppression: effects of estradiol and progesterone addback.促性腺激素释放激素激动剂诱导卵巢抑制期间经前烦躁障碍女性的类固醇代谢组：雌二醇和孕酮补充的影响
Transl Psychiatry. 2017 Aug 8;7(8):e1193. doi: 10.1038/tp.2017.146.
8
Allopregnanolone levels and depressive symptoms during pregnancy in relation to single nucleotide polymorphisms in the allopregnanolone synthesis pathway.孕期别孕烯醇酮水平及抑郁症状与别孕烯醇酮合成途径中单核甘酸多态性的关系
Horm Behav. 2017 Aug;94:106-113. doi: 10.1016/j.yhbeh.2017.06.008. Epub 2017 Jul 20.
9
Brexanolone (SAGE-547 injection) in post-partum depression: a randomised controlled trial.产后抑郁的 Brexanolone（SAGE-547 注射液）：一项随机对照试验。
Lancet. 2017 Jul 29;390(10093):480-489. doi: 10.1016/S0140-6736(17)31264-3. Epub 2017 Jun 12.
10
Influence of endogenous estradiol, progesterone, allopregnanolone, and dehydroepiandrosterone sulfate on brain resting state functional connectivity across the menstrual cycle.内源性雌二醇、孕酮、别孕烯醇酮和硫酸脱氢表雄酮对月经周期中大脑静息状态功能连接的影响。
Fertil Steril. 2017 May;107(5):1246-1255.e4. doi: 10.1016/j.fertnstert.2017.03.021.
Zotero 插件