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创伤后应激障碍的新型药理学靶点

Novel Pharmacological Targets of Post-Traumatic Stress Disorders.

作者信息

Marazziti Donatella, Carmassi Claudia, Cappellato Gabriele, Chiarantini Ilaria, Massoni Leonardo, Mucci Federico, Arone Alessandro, Violi Miriam, Palermo Stefania, De Iorio Giovanni, Dell'Osso Liliana

机构信息

Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, 56100 Pisa, Italy.

Saint Camillus International University of Health and Medical Sciences, 00131 Rome, Italy.

出版信息

Life (Basel). 2023 Aug 11;13(8):1731. doi: 10.3390/life13081731.

Abstract

Post-traumatic stress disorder (PTSD) is a psychopathological condition with a heterogeneous clinical picture that is complex and challenging to treat. Its multifaceted pathophysiology still remains an unresolved question and certainly contributes to this issue. The pharmacological treatment of PTSD is mainly empirical and centered on the serotonergic system. Since the therapeutic response to prescribed drugs targeting single symptoms is generally inconsistent, there is an urgent need for novel pathogenetic hypotheses, including different mediators and pathways. This paper was conceived as a narrative review with the aim of debating the current pharmacological treatment of PTSD and further highlighting prospective targets for future drugs. The authors accessed some of the main databases of scientific literature available and selected all the papers that fulfilled the purpose of the present work. The results showed that most of the current pharmacological treatments for PTSD are symptom-based and show only partial benefits; this largely reflects the limited knowledge of its neurobiology. Growing, albeit limited, data suggests that the hypothalamic-pituitary-adrenal axis, opioids, glutamate, cannabinoids, oxytocin, neuropeptide Y, and microRNA may play a role in the development of PTSD and could be targeted for novel treatments. Indeed, recent research indicates that examining different pathways might result in the development of novel and more efficient drugs.

摘要

创伤后应激障碍(PTSD)是一种精神病理状态,其临床表现具有异质性,复杂且治疗具有挑战性。其多方面的病理生理学仍是一个未解决的问题,这无疑加剧了该问题的复杂性。PTSD的药物治疗主要基于经验,且以血清素能系统为核心。由于针对单一症状的处方药的治疗反应通常不一致,因此迫切需要新的发病机制假说,包括不同的介质和途径。本文旨在进行叙述性综述,以探讨PTSD目前的药物治疗方法,并进一步突出未来药物的潜在靶点。作者检索了一些主要的科学文献数据库,并挑选出所有符合本研究目的的论文。结果表明,目前大多数针对PTSD的药物治疗都是基于症状的,且仅显示出部分疗效;这在很大程度上反映了我们对其神经生物学的了解有限。尽管数据有限,但越来越多的数据表明,下丘脑 - 垂体 - 肾上腺轴、阿片类物质、谷氨酸、大麻素、催产素、神经肽Y和微小RNA可能在PTSD的发病过程中发挥作用,可作为新治疗方法的靶点。事实上,最近的研究表明,研究不同的途径可能会促成新型且更有效的药物的研发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0ee/10455314/2187f42f0334/life-13-01731-g001.jpg

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