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氧化应激如何导致抑郁症?

How Oxidative Stress Induces Depression?

机构信息

The School of Public Health, Faculty of Basic Medical Sciences, Guangxi Key Laboratory of Brain and Cognitive Neuroscience, Guilin Medical University, Guilin Guangxi, China.

The School of Public Health, Faculty of Basic Medical Sciences, Guilin Medical University, Guilin Guangxi, China.

出版信息

ASN Neuro. 2023 Jan-Dec;15:17590914231181037. doi: 10.1177/17590914231181037.

Abstract

Depression increasingly affects a wide range and a large number of people worldwide, both physically and psychologically, which makes it a social problem requiring prompt attention and management. Accumulating clinical and animal studies have provided us with substantial insights of disease pathogenesis, especially central monoamine deficiency, which considerably promotes antidepressant research and clinical treatment. The first-line antidepressants mainly target the monoamine system, whose drawbacks mainly include slow action and treatment resistant. The novel antidepressant esketamine, targeting on central glutamatergic system, rapidly and robustly alleviates depression (including treatment-resistant depression), whose efficiency is shadowed by potential addictive and psychotomimetic side effects. Thus, exploring novel depression pathogenesis is necessary, for seeking more safe and effective therapeutic methods. Emerging evidence has revealed vital involvement of oxidative stress (OS) in depression, which inspires us to pursue antioxidant pathway for depression prevention and treatment. Fully uncovering the underlying mechanisms of OS-induced depression is the first step towards the avenue, thus we summarize and expound possible downstream pathways of OS, including mitochondrial impairment and related ATP deficiency, neuroinflammation, central glutamate excitotoxicity, brain-derived neurotrophic factor/tyrosine receptor kinase B dysfunction and serotonin deficiency, the microbiota-gut-brain axis disturbance and hypothalamic-pituitary-adrenocortical axis dysregulation. We also elaborate on the intricate interactions between the multiple aspects, and molecular mechanisms mediating the interplay. Through reviewing the related research progress in the field, we hope to depict an integral overview of how OS induces depression, in order to provide fresh ideas and novel targets for the final goal of efficient treatment of the disease.

摘要

抑郁症在全球范围内越来越多地影响着大量的人群,无论在身体上还是心理上,这使其成为一个需要及时关注和管理的社会问题。越来越多的临床和动物研究为我们提供了疾病发病机制的大量见解,特别是中枢单胺缺乏症,这极大地促进了抗抑郁药物的研究和临床治疗。一线抗抑郁药主要针对单胺系统,其缺点主要包括作用缓慢和治疗抵抗。新型抗抑郁药艾司氯胺酮,靶向中枢谷氨酸能系统,迅速而有力地缓解抑郁(包括治疗抵抗性抑郁),但其潜在的成瘾性和精神病样副作用使其疗效黯然失色。因此,探索新的抑郁症发病机制是必要的,以寻求更安全有效的治疗方法。新出现的证据表明氧化应激(OS)在抑郁症中起着重要作用,这启发我们探索抗氧化途径来预防和治疗抑郁症。充分揭示 OS 诱导的抑郁症的潜在机制是实现这一途径的第一步,因此我们总结并阐述了 OS 可能的下游途径,包括线粒体损伤和相关的 ATP 缺乏、神经炎症、中枢谷氨酸兴奋性毒性、脑源性神经营养因子/酪氨酸受体激酶 B 功能障碍和 5-羟色胺缺乏、肠道微生物群-肠道-大脑轴的紊乱和下丘脑-垂体-肾上腺轴的失调。我们还详细阐述了多个方面之间的复杂相互作用以及介导相互作用的分子机制。通过回顾该领域的相关研究进展,我们希望描绘出 OS 如何诱导抑郁症的整体概况,为高效治疗该病的最终目标提供新的思路和新的靶点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6cd/10280786/8a01bcf86edb/10.1177_17590914231181037-fig1.jpg

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