Department of Neurochemistry, Institute of Psychiatry and Neurology, 9 Sobieskiego Street, 02-957 Warsaw, Poland.
Centre for Preclinical Research and Technology (CEPT), Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 1B Banacha Street, 02-097 Warsaw, Poland.
Int J Environ Res Public Health. 2021 Dec 28;19(1):314. doi: 10.3390/ijerph19010314.
Post-traumatic stress disorder (PTSD) is characterized by re-experiencing a traumatic event, avoidance, negative alterations in cognitions and mood, hyperarousal, and severe functional impairment. Women have a two times higher risk of developing PTSD than men. The neurobiological basis for the sex-specific predisposition to PTSD might be related to differences in the functions of stress-responsive systems due to the interaction between gonadal hormones and stress peptides such as corticotropin-releasing factor (CRF), orexin, oxytocin, and neuropeptide Y. Additionally, in phases where estrogens levels are low, the risk of developing or exacerbating PTSD is higher. Most studies have revealed several essential sex differences in CRF function. They include genetic factors, e.g., the CRF promoter contains estrogen response elements. Importantly, sex-related differences are responsible for different predispositions to PTSD and diverse treatment responses. Fear extinction (the process responsible for the effectiveness of behavioral therapy for PTSD) in women during periods of high endogenous estradiol levels (the primary form of estrogens) is reportedly more effective than in periods of low endogenous estradiol. In this review, we present the roles of selected neuropeptides in the sex-related predisposition to PTSD development.
创伤后应激障碍（PTSD）的特征是重新体验创伤事件、回避、认知和情绪的负面改变、过度警觉和严重的功能障碍。女性患 PTSD 的风险是男性的两倍。导致 PTSD 易感性存在性别差异的神经生物学基础可能与应激反应系统的功能差异有关，这些差异是由于性腺激素与促肾上腺皮质释放因子（CRF）、食欲素、催产素和神经肽 Y 等应激肽之间的相互作用所致。此外，在雌激素水平较低的阶段，患 PTSD 或使其恶化的风险更高。大多数研究揭示了 CRF 功能的几个重要性别差异。它们包括遗传因素，例如，CRF 启动子包含雌激素反应元件。重要的是，性别相关差异导致了 PTSD 的不同易感性和不同的治疗反应。据报道，在高内源性雌二醇水平（雌激素的主要形式）期间，女性的恐惧消退（负责 PTSD 行为治疗效果的过程）比在低内源性雌二醇水平期间更有效。在这篇综述中，我们介绍了选定神经肽在 PTSD 发展的性别易感性中的作用。
