Portal Benjamin, Guiard Bruno P
Centre de Recherches sur la Cognition Animale, Centre de Biologie Intégrative, Université de Toulouse, CNRS, 31000 Toulouse, France.
Biol Aujourdhui. 2020;214(3-4):71-83. doi: 10.1051/jbio/2020008. Epub 2020 Dec 24.
Major depression is a psychiatric disorder relying on different neurobiological mechanisms. In particular, a hypersensitivity of the hypothalamic-pituitary-adrenal axis leading to an excess of cortisol in blood and a deficit in monoaminergic neurotransmission have been associated with mood disorders. In keeping with these mechanisms, currently available antidepressant drugs act by increasing the extracellular levels of monoamines in the synaptic cleft. Since the discovery of the rapid and long-lasting antidepressant effects of ketamine, an NMDA receptor antagonist, a growing attention in psychiatry is paid to the pharmacological tools able to attenuate glutamatergic neurotransmission. Astrocytes play an important role in the excitatory/inhibitory balance of the central nervous system through the regulation of glutamate reuptake and secretion. Interestingly, the release of this excitatory amino acid is controlled, at least in part, by plasma membrane proteins (i.e. connexins) that cluster together to form gap junctions or hemichannels. Preclinical evidence suggests that these functional entities play a critical role in emotional behaviour. After a brief overview of the literature on mood disorders and related treatments, this review describes the role of astrocytes and connexins in glutamatergic neurotransmission and major depression. Moreover, we highlight the arguments supporting the therapeutic potential of connexins blockers but also the practical difficulties to target the hemichannels while maintaining gap junctions intact.
重度抑郁症是一种依赖于不同神经生物学机制的精神障碍。特别是,下丘脑-垂体-肾上腺轴的超敏反应导致血液中皮质醇过多以及单胺能神经传递不足,这些都与情绪障碍有关。与这些机制一致,目前可用的抗抑郁药物通过增加突触间隙中单胺的细胞外水平来发挥作用。自从发现NMDA受体拮抗剂氯胺酮具有快速且持久的抗抑郁作用以来,精神病学领域越来越关注能够减弱谷氨酸能神经传递的药理学工具。星形胶质细胞通过调节谷氨酸的再摄取和分泌,在中枢神经系统的兴奋/抑制平衡中发挥重要作用。有趣的是,这种兴奋性氨基酸的释放至少部分受聚在一起形成缝隙连接或半通道的质膜蛋白(即连接蛋白)控制。临床前证据表明,这些功能实体在情绪行为中起关键作用。在简要概述了关于情绪障碍及相关治疗的文献后,本综述描述了星形胶质细胞和连接蛋白在谷氨酸能神经传递及重度抑郁症中的作用。此外,我们强调了支持连接蛋白阻滞剂治疗潜力的论据,同时也指出了在保持缝隙连接完整的情况下靶向半通道所面临的实际困难。