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神经营养因子、儿童创伤与精神障碍:一项基因、生化、认知与影像研究的系统综述,旨在寻找潜在的生物标志物。

Neurotrophic factors, childhood trauma and psychiatric disorders: A systematic review of genetic, biochemical, cognitive and imaging studies to identify potential biomarkers.

机构信息

Biological Psychiatry Unit, IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; Department of Pharmacological and Biomolecular Sciences, University of Milan, Italy.

Biological Psychiatry Unit, IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy.

出版信息

J Affect Disord. 2022 Jul 1;308:76-88. doi: 10.1016/j.jad.2022.03.071. Epub 2022 Apr 2.

Abstract

BACKGROUND

Exposure to traumatic experience represents one of the key environmental factors influencing the risk for several psychiatric disorders, in particular when suffered during childhood, a critical period for brain development, characterized by a high level of neuroplasticity. Abnormalities affecting neurotrophic factors might play a fundamental role in the link between childhood trauma (CT) and early life stress (ELS) and psychiatric disorders.

METHODS

A systematic review was conducted, considering genetic, biochemical and expression studies along with cognitive and brain structure imaging investigations, based on PubMed and Web of Science databases (available up until November 2021), to identify potential neuroplasticity related biomarkers associated both with CT/ELS and psychiatric disorders. The search was followed by data abstraction and study quality assessment (Newcastle-Ottawa Scale).

RESULTS

103 studies met our eligibility criteria. Among them, 65 were available for genetic, 30 for biochemical and 3 for mRNA data; 45 findings were linked to specific symptomatology/pathologies, 16 with various cognitive functions, 19 with different brain areas, 6 on methylation and 36 performed on control subjects for the Brain Derived Neurotrophic Factor (BDNF); whereas 4 expression/biochemical studies covered Neurotrophin 4 (NT-4), Vascular Endothelium Growth Factor (VEGF), Epidermal Growth Factor (EGF), Fibroblast Growth Factor (FGF), and Transforming Growth Factor β1 (TGF-β1).

LIMITATIONS

Heterogeneity of assessments (biological, psychological, of symptomatology, and CT/ELS), age range and ethnicity of samples for BDNF studies; limited studies for other neurotrophins.

CONCLUSIONS

Results support the key role of BDNF (in form of Met allele) as biomarker, both at genetic and biochemical level, in mediating the effect of CT/ELS in psychiatric disorders, passing through specific cognitive functions and specific brain region architecture.

摘要

背景

暴露于创伤性经历是影响多种精神疾病风险的关键环境因素之一,尤其是在儿童时期遭受创伤时,儿童期是大脑发育的关键时期,具有高水平的神经可塑性。影响神经营养因子的异常可能在儿童创伤 (CT) 和早期生活应激 (ELS) 与精神疾病之间的联系中发挥着重要作用。

方法

我们进行了一项系统评价,综合考虑了基于 PubMed 和 Web of Science 数据库(截至 2021 年 11 月可用)的遗传、生化和表达研究以及认知和大脑结构影像学研究,以确定与 CT/ELS 和精神疾病相关的潜在神经可塑性相关生物标志物。搜索后进行了数据提取和研究质量评估(纽卡斯尔-渥太华量表)。

结果

符合纳入标准的研究共有 103 项。其中,65 项研究可用于遗传数据,30 项用于生化数据,3 项用于 mRNA 数据;45 项研究结果与特定的症状学/病理学相关,16 项与各种认知功能相关,19 项与不同的大脑区域相关,6 项与甲基化相关,36 项与大脑源性神经营养因子 (BDNF) 的对照受试者相关;而 4 项表达/生化研究涵盖了神经营养因子 4 (NT-4)、血管内皮生长因子 (VEGF)、表皮生长因子 (EGF)、成纤维细胞生长因子 (FGF) 和转化生长因子 β1 (TGF-β1)。

局限性

BDNF 研究的评估(生物学、心理学、症状学和 CT/ELS)、样本的年龄范围和种族的异质性;其他神经营养因子的研究有限。

结论

结果支持 BDNF(以 Met 等位基因的形式)作为生物标志物的关键作用,无论是在遗传还是生化水平,都可以介导 CT/ELS 在精神疾病中的作用,通过特定的认知功能和特定的大脑区域结构。

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