Key Lab of Cardiovascular and Cerebrovascular Medicine, Drug Target and Drug Discovery Center, School of Pharmacy, Nanjing Medical University, Nanjing, China.
Department of Clinical Pharmacology, School of Pharmacy, Nanjing Medical University, Nanjing, China; Sir Run Run Hospital, Nanjing Medical University, Nanjing, China.
Biomed Pharmacother. 2021 May;137:111322. doi: 10.1016/j.biopha.2021.111322. Epub 2021 Feb 16.
Autism spectrum disorder (ASD) is a sort of mental disorder marked by deficits in cognitive and communication abilities. To date no effective cure for this pernicious disease has been available. Valproic acid (VPA) is a broad-spectrum, antiepileptic drug, and it is also a potent teratogen. Epidemiological studies have shown that children exposed to VPA are at higher risk for ASD during the first trimester of their gestational development. Several animal and human studies have demonstrated important behavioral impairments and morphological changes in the brain following VPA treatment. However, the mechanism of VPA exposure-induced ASD remains unclear. Several factors are involved in the pathological phase of ASD, including aberrant excitation/inhibition of synaptic transmission, neuroinflammation, diminished neurogenesis, oxidative stress, etc. In this review, we aim to outline the current knowledge of the critical pathophysiological mechanisms underlying VPA exposure-induced ASD. This review will give insight toward understanding the complex nature of VPA-induced neuronal toxicity and exploring a new path toward the development of novel pharmacological treatment against ASD.
自闭症谱系障碍(ASD)是一种以认知和沟通能力缺陷为特征的精神障碍。迄今为止,这种恶性疾病还没有有效的治疗方法。丙戊酸(VPA)是一种广谱抗癫痫药物,也是一种有效的致畸剂。流行病学研究表明,在妊娠发育的头三个月,接触 VPA 的儿童患 ASD 的风险更高。几项动物和人类研究表明,VPA 治疗后大脑会出现重要的行为损伤和形态变化。然而,VPA 暴露导致 ASD 的机制尚不清楚。许多因素参与 ASD 的病理阶段,包括突触传递的异常兴奋/抑制、神经炎症、神经发生减少、氧化应激等。在这篇综述中,我们旨在概述 VPA 暴露引起 ASD 的关键病理生理机制的最新知识。这篇综述将深入了解 VPA 诱导的神经元毒性的复杂性,并为开发针对 ASD 的新型药理学治疗方法开辟新的途径。