Deyama Satoshi
Laboratory of Molecular Pharmacology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University.
Nihon Yakurigaku Zasshi. 2020;155(6):381-385. doi: 10.1254/fpj.20044.
Conventional monoaminergic antidepressants have significant limitations, including delayed onset of therapeutic response and relatively low efficacy. Recent studies reveal that the NMDA receptor antagonist ketamine produces rapid and sustained antidepressant effects in treatment-resistant depressed patients. Despite the unique antidepressant efficacy, clinical use of ketamine as an antidepressant is limited due to its serious drawbacks, such as abuse potential and psychotomimetic/dissociative effects. The molecular and neuronal mechanisms underlying the antidepressant actions of ketamine have been intensively studied to pave the way for the development of novel, rapid and more efficacious antidepressants with fewer side effects than ketamine. Preclinical studies demonstrate that ketamine produces antidepressant effects through rapid release and/or expression of brain-derived neurotrophic factor (BDNF) and vascular endothelial growth factor (VEGF), and stimulation of mechanistic target of rapamycin complex 1 (mTORC1) signaling in the medial prefrontal cortex and hippocampus. We have recently found that resolvins (RvD1, RvD2, RvE1, RvE2 and RvE3), bioactive metabolites derived from docosahexaenoic acid and eicosapentaenoic acid, produce antidepressant effects, and that the antidepressant effects of RvD1, RvD2 and RvE1 require mTORC1 activation. These findings suggest that resolvins could be promising targets for the development of novel rapid antidepressants with fewer side effects than ketamine because they are endogenous lipid mediators that play an important role in homeostasis.
传统的单胺能抗抑郁药有显著局限性,包括治疗反应起效延迟和疗效相对较低。最近的研究表明,N-甲基-D-天冬氨酸(NMDA)受体拮抗剂氯胺酮对难治性抑郁症患者有快速且持续的抗抑郁作用。尽管氯胺酮有独特的抗抑郁疗效,但因其严重的缺点,如滥用潜力和拟精神病/解离作用,其作为抗抑郁药的临床应用受到限制。人们深入研究了氯胺酮抗抑郁作用的分子和神经元机制,为开发新型、快速且更有效的抗抑郁药铺平道路,这类抗抑郁药的副作用比氯胺酮少。临床前研究表明,氯胺酮通过快速释放和/或表达脑源性神经营养因子(BDNF)和血管内皮生长因子(VEGF),以及刺激内侧前额叶皮质和海马体中的雷帕霉素靶蛋白复合物1(mTORC1)信号传导来产生抗抑郁作用。我们最近发现,源自二十二碳六烯酸和二十碳五烯酸的生物活性代谢物消退素(RvD1、RvD2、RvE1、RvE2和RvE3)具有抗抑郁作用,且RvD1、RvD2和RvE1的抗抑郁作用需要mTORC1激活。这些发现表明,消退素有望成为开发新型快速抗抑郁药的靶点,这类抗抑郁药的副作用比氯胺酮少,因为它们是内源性脂质介质,在体内平衡中起重要作用。