Department of Biotechnology, School of Biosciences and Technology, Vellore Institute of Technology, Vellore, Tamil Nadu, India.
Department of Biosciences, School of Biosciences and Technology, Vellore Institute of Technology, Vellore, Tamil Nadu, India.
Biochem Med (Zagreb). 2024 Feb 15;34(1):010503. doi: 10.11613/BM.2024.010503. Epub 2023 Dec 15.
Obsessive compulsive disorder (OCD) is a prevalent behavioral disorder with a complex etiology. However, the underlying pathogenic molecular pathways and the associated risk factors are largely obscure. This has hindered both the identification of relevant prognostic biomarkers and the development of effective treatment strategies. Because of the diverse range of clinical manifestations, not all patients benefit from therapies currently practiced in the clinical setting. Nevertheless, several lines of evidence indicate that neurotrophic, neurotransmitter, and oxidative signaling are involved in the pathophysiology of OCD. Based upon evidences from clinical (and pre-clinical studies), the present review paper sets out to decipher the utilities of three parameters ( brain-derived neurotrophic factor; BDNF, noradrenalin-synthesizing enzyme dopamine beta-hydroxylase; DBH; and oxidative damage marker malondialdehyde; MDA) as diagnostic peripheral biomarkers as well as bio-targets for therapeutic strategies. While the data indicates promising results, there is necessitation for future studies to further confirm and establish these. Further, based again on the available clinical data, we investigated the possibilities of exploiting the etiological links between disruptions in the sleep-wake cycle and insulin signaling, and OCD for the identification of potential anti-OCD ameliorative agents with the ability to elicit multimodal effects, including attenuation of the alterations in BDNF, noradrenergic and redox pathways. In this respect, agomelatine and metformin may represent particularly interesting candidates; however, further clinical studies are warranted to establish these as singular or complementary medications in OCD subjects.
强迫症（OCD）是一种常见的行为障碍，其病因复杂。然而，潜在的致病分子途径和相关的风险因素在很大程度上仍是未知的。这既阻碍了相关预后生物标志物的识别，也阻碍了有效治疗策略的发展。由于临床表现多种多样，并非所有患者都能从目前临床实践中所采用的治疗中获益。然而，有几条证据表明神经营养、神经递质和氧化信号在 OCD 的病理生理学中起作用。基于临床（和临床前研究）的证据，本综述论文旨在解读三种参数（脑源性神经营养因子；BDNF、去甲肾上腺素合成酶多巴胺-β-羟化酶；DBH 和氧化损伤标志物丙二醛；MDA）作为诊断外周生物标志物以及治疗策略的生物靶点的效用。虽然这些数据表明了有希望的结果，但需要进一步的未来研究来进一步证实和确定这些结果。此外，我们再次根据现有的临床数据，研究了睡眠-觉醒周期和胰岛素信号紊乱与 OCD 之间的病因联系的可能性，以确定潜在的抗 OCD 改善剂，这些药物具有引发多模式效应的能力，包括减轻 BDNF、去甲肾上腺素能和氧化还原途径的改变。在这方面，阿戈美拉汀和二甲双胍可能是特别有趣的候选药物；然而，还需要进一步的临床研究来确定它们是否可以作为 OCD 患者的单一或联合药物。
