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抗抑郁治疗对重度抑郁症(MDD)患者神经营养因子(脑源性神经营养因子和胰岛素样生长因子-1)的影响

Effects of Antidepressant Treatment on Neurotrophic Factors (BDNF and IGF-1) in Patients with Major Depressive Disorder (MDD).

作者信息

Mosiołek Anna, Mosiołek Jadwiga, Jakima Sławomir, Pięta Aleksandra, Szulc Agata

机构信息

Department of Psychiatry, Faculty of Health Sciences, Medical University of Warsaw, Żwirki i Wigury 61 Street, 02-091 Warszawa, Poland.

Mazovia Specialist Health Center in Pruszków, Partyzantów 2/4 Street, 05-802 Pruszków, Poland.

出版信息

J Clin Med. 2021 Jul 30;10(15):3377. doi: 10.3390/jcm10153377.

Abstract

Major depressive disorder (MDD) remains the subject of ongoing research as a multifactorial disease and a serious public health problem. There is a growing body of literature focusing on the role of neurotrophic factors in pathophysiology of MDD. A neurotrophic hypothesis of depression proposes that abnormalities of neurotrophins serum levels lead to neuronal atrophy and decreased neurogenesis, resulting in mood disorders. Consequently, in accordance with recent findings, antidepressant treatment modifies the serum levels of neurotrophins and thus leads to a clinical improvement of MDD. The purpose of this review is to summarize the available data on the effects of various antidepressants on serum levels of neurotrophins such as brain-derived neurotrophic factor (BDNF) and insulin-like growth factor (IGF-1). In addition, the authors discuss their role as prognostic factors for treatment response in MDD. A literature search was performed using the PubMed database. Following the inclusion and exclusion criteria, nine original articles and three meta-analyses were selected. The vast majority of studies have confirmed the effect of antidepressants on BDNF levels. Research on IGF-1 is limited and insufficient to describe the correlation between different antidepressant drugs and factor serum levels; however, four studies indicated a decrease in IGF-1 after treatment. Preliminary data suggest BDNF as a promising predictor of treatment response in MDD patients. The role of IGF-1 needs further investigation.

摘要

重度抑郁症(MDD)作为一种多因素疾病和严重的公共卫生问题,仍然是正在进行研究的主题。越来越多的文献关注神经营养因子在MDD病理生理学中的作用。一种抑郁症的神经营养假说提出,神经营养因子血清水平异常会导致神经元萎缩和神经发生减少,从而导致情绪障碍。因此,根据最近的研究结果,抗抑郁治疗会改变神经营养因子的血清水平,从而导致MDD的临床改善。本综述的目的是总结关于各种抗抑郁药对脑源性神经营养因子(BDNF)和胰岛素样生长因子(IGF-1)等神经营养因子血清水平影响的现有数据。此外,作者还讨论了它们作为MDD治疗反应预后因素的作用。使用PubMed数据库进行了文献检索。根据纳入和排除标准,选择了9篇原创文章和3篇荟萃分析。绝大多数研究证实了抗抑郁药对BDNF水平的影响。关于IGF-1的研究有限,不足以描述不同抗抑郁药与因子血清水平之间的相关性;然而,有4项研究表明治疗后IGF-1水平下降。初步数据表明BDNF是MDD患者治疗反应的一个有前景的预测指标。IGF-1的作用需要进一步研究。

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