Aspesi Dario, Pinna Graziano
The Psychiatric Institute, Department of Psychiatry, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA.
Behav Pharmacol. 2019 Apr;30(2 and 3-Spec Issue):130-150. doi: 10.1097/FBP.0000000000000467.
Understanding the neurobiological basis of post-traumatic stress disorder (PTSD) is fundamental to accurately diagnose this neuropathology and offer appropriate treatment options to patients. The lack of pharmacological effects, too often observed with the most currently used drugs, the selective serotonin reuptake inhibitors (SSRIs), makes even more urgent the discovery of new pharmacological approaches. Reliable animal models of PTSD are difficult to establish because of the present limited understanding of the PTSD heterogeneity and of the influence of various environmental factors that trigger the disorder in humans. We summarize knowledge on the most frequently investigated animal models of PTSD, focusing on both their behavioral and neurobiological features. Most of them can reproduce not only behavioral endophenotypes, including anxiety-like behaviors or fear-related avoidance, but also neurobiological alterations, such as glucocorticoid receptor hypersensitivity or amygdala hyperactivity. Among the various models analyzed, we focus on the social isolation mouse model, which reproduces some deficits observed in humans with PTSD, such as abnormal neurosteroid biosynthesis, changes in GABAA receptor subunit expression and lack of pharmacological response to benzodiazepines. Neurosteroid biosynthesis and its interaction with the endocannabinoid system are altered in PTSD and are promising neuronal targets to discover novel PTSD agents. In this regard, we discuss pharmacological interventions and we highlight exciting new developments in the fields of research for novel reliable PTSD biomarkers that may enable precise diagnosis of the disorder and more successful pharmacological treatments for PTSD patients.
了解创伤后应激障碍(PTSD)的神经生物学基础对于准确诊断这种神经病理学并为患者提供合适的治疗方案至关重要。目前最常用的药物——选择性5-羟色胺再摄取抑制剂(SSRIs)常常缺乏药理作用,这使得发现新的药理学方法变得更加紧迫。由于目前对PTSD异质性以及引发人类该疾病的各种环境因素影响的理解有限,PTSD可靠的动物模型很难建立。我们总结了关于最常研究的PTSD动物模型的知识,重点关注它们的行为和神经生物学特征。其中大多数模型不仅可以重现行为内表型,包括焦虑样行为或恐惧相关的回避行为,还能重现神经生物学改变,如糖皮质激素受体超敏反应或杏仁核过度活跃。在分析的各种模型中,我们重点关注社会隔离小鼠模型,该模型重现了PTSD患者中观察到的一些缺陷,如神经甾体生物合成异常、GABAA受体亚基表达变化以及对苯二氮䓬类药物缺乏药理反应。神经甾体生物合成及其与内源性大麻素系统的相互作用在PTSD中发生改变,是发现新型PTSD药物的有前景的神经元靶点。在这方面,我们讨论了药理学干预措施,并强调了新型可靠PTSD生物标志物研究领域令人兴奋的新进展,这些进展可能有助于精确诊断该疾病,并为PTSD患者带来更成功的药物治疗。