Graduate school, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China.
The Second Ward of Acupuncture and Moxibustion Department, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China.
Medicine (Baltimore). 2023 Nov 3;102(44):e35862. doi: 10.1097/MD.0000000000035862.
Depression, a prevalent psychiatric malady, afflicts a substantial global demographic, engendering considerable disease burden due to its elevated morbidity and mortality rates. Contemporary therapeutic approaches for depression encompass the administration of serotonin reuptake inhibitors, monoamine oxidase inhibitors, and tricyclic antidepressants, albeit these pharmaceuticals potentially induce adverse neurological and gastrointestinal effects. Traditional Chinese Medicine (TCM) natural products proffer the benefits of multi-target, multi-level, and multi-channel depression treatment modalities. In this investigation, we conducted a comprehensive literature review of the past 5 years in PubMed and other databases utilizing the search terms "Depression," "Natural medicines," "Traditional Chinese Medicine," and "hypothalamic-pituitary-adrenal axis." We delineated the 5 most recent and pertinent signaling pathways associated with depression and hypothalamic-pituitary-adrenal (HPA) axis dysregulation: nuclear factor kappa light-chain-enhancer of activated B cell, brain-derived neurotrophic factor, mitogen-activated protein kinase, cyclic AMP/protein kinase A, and phosphoinositide 3-kinase/protein kinase B. Additionally, we deliberated the antidepressant mechanisms of natural medicines comprising alkaloids, flavonoids, polyphenols, saponins, and quinones via diverse pathways. This research endeavor endeavored to encapsulate and synthesize the progression of TCMs in modulating HPA axis-associated signaling pathways to mitigate depression, thereby furnishing robust evidence for ensuing research in this domain.
抑郁症是一种常见的精神疾病，影响着相当大的全球人口，由于其高发病率和死亡率，给全球带来了巨大的疾病负担。目前治疗抑郁症的方法包括使用选择性 5-羟色胺再摄取抑制剂、单胺氧化酶抑制剂和三环类抗抑郁药，但这些药物可能会引起不良的神经和胃肠道反应。传统中药（TCM）天然产品提供了多靶点、多水平和多通道治疗抑郁症的优势。在这项研究中，我们在 PubMed 和其他数据库中使用“抑郁症”、“天然药物”、“传统中药”和“下丘脑-垂体-肾上腺轴”等关键词对过去 5 年的文献进行了全面回顾。我们描述了与抑郁症和下丘脑-垂体-肾上腺（HPA）轴失调相关的最近的 5 个最相关的信号通路：核因子 kappa 轻链增强子的激活 B 细胞、脑源性神经营养因子、丝裂原活化蛋白激酶、环 AMP/蛋白激酶 A 和磷酸肌醇 3-激酶/蛋白激酶 B。此外，我们还讨论了天然药物通过多种途径发挥抗抑郁作用的机制，包括生物碱、黄酮类、多酚、皂苷和醌类。这项研究努力旨在总结和综合 TCM 调节 HPA 轴相关信号通路以缓解抑郁症的进展，为该领域的进一步研究提供有力证据。
