Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands.
Department of Public Health, College of Applied Medical Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia.
Int J Mol Sci. 2021 Oct 4;22(19):10743. doi: 10.3390/ijms221910743.
Exposure to trauma is one of the most important and prevalent risk factors for mental and physical ill-health. Excessive or prolonged stress exposure increases the risk of a wide variety of mental and physical symptoms. However, people differ strikingly in their susceptibility to develop signs and symptoms of mental illness after traumatic stress. Post-traumatic stress disorder (PTSD) is a debilitating disorder affecting approximately 8% of the world's population during their lifetime, and typically develops after exposure to a traumatic event. Despite that exposure to potentially traumatizing events occurs in a large proportion of the general population, about 80-90% of trauma-exposed individuals do not develop PTSD, suggesting an inter-individual difference in vulnerability to PTSD. While the biological mechanisms underlying this differential susceptibility are unknown, epigenetic changes have been proposed to underlie the relationship between exposure to traumatic stress and the susceptibility to develop PTSD. Epigenetic mechanisms refer to environmentally sensitive modifications to DNA and RNA molecules that regulate gene transcription without altering the genetic sequence itself. In this review, we provide an overview of various molecular biological, biochemical and physiological alterations in PTSD, focusing on changes at the genomic and epigenomic level. Finally, we will discuss how current knowledge may aid us in early detection and improved management of PTSD patients.
创伤暴露是精神和身体健康不良的最重要和最普遍的风险因素之一。过度或长期的压力暴露会增加各种精神和身体症状的风险。然而，人们在创伤后应激后出现精神疾病迹象和症状的易感性差异很大。创伤后应激障碍（PTSD）是一种使人衰弱的疾病，一生中大约有 8%的世界人口受到影响，通常在暴露于创伤性事件后发展。尽管在普通人群中有很大一部分人接触到潜在的创伤性事件，但大约 80-90%的创伤暴露个体不会发展出 PTSD，这表明对 PTSD 的易感性存在个体差异。虽然导致这种差异易感性的生物学机制尚不清楚，但已经提出表观遗传变化是创伤性应激暴露与易患 PTSD 之间关系的基础。表观遗传机制是指对 DNA 和 RNA 分子的环境敏感修饰，这些修饰可以调节基因转录，而不会改变遗传序列本身。在这篇综述中，我们提供了 PTSD 中各种分子生物学、生物化学和生理学改变的概述，重点介绍了基因组和表观基因组水平的变化。最后，我们将讨论当前的知识如何帮助我们早期发现和改善 PTSD 患者的管理。
