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罗氟司特:调节神经炎症并改善多发性硬化症的运动功能和抑郁症状。

Roflumilast: Modulating neuroinflammation and improving motor function and depressive symptoms in multiple sclerosis.

作者信息

Wang Zhaowei, Zhang Yanxin, Chai Jiaqing, Wu Yingying, Zhang Weiying, Zhang Zhijun

机构信息

Department of Neurology, Affiliated Zhongda Hospital, Research Institution of Neuropsychiatry, School of Medicine, Southeast University, Nanjing, Jiangsu 210009, China; Department of Neurology, Shaoxing People's Hospital, 568 Zhonxin Bei Road, Shaoxing City, Zhejiang Province 312000, China.

Department of Neurology, Shaoxing People's Hospital, 568 Zhonxin Bei Road, Shaoxing City, Zhejiang Province 312000, China.

出版信息

J Affect Disord. 2024 Apr 1;350:761-773. doi: 10.1016/j.jad.2023.12.074. Epub 2024 Jan 14.

Abstract

BACKGROUND

Multiple sclerosis (MS) is an autoimmune disease causing central nervous system demyelination, often associated with depression. Current treatments for MS do not effectively address both physical disability and depression. Roflumilast, a phosphodiesterase-4 inhibitor with anti-inflammatory properties, has shown promise for autoimmune diseases.

METHODS

We used an experimental autoimmune encephalomyelitis (EAE) rat model to study roflumilast's effects. Motor dysfunction and depression symptoms were assessed, and histopathological analysis evaluated its anti-inflammatory properties. Flow cytometry examined the drug's impact on brain microglia. TNF-α, IL-1β, and IL-6 levels in hippocampal tissue were assessed using ELISA kits.

RESULTS

Roflumilast improved motor dysfunction and depression symptoms in EAE rats. Histopathological analysis revealed reduced inflammation, demyelination, and axonal loss in the spinal cord. Roflumilast suppressed microglial cell activation and conversion to pro-inflammatory M1-type cells. Flow cytometry showed roflumilast inhibited inflammatory marker expression in microglia and their activation in the hippocampus. IL-6 was identified as a roflumilast target for suppressing hippocampal inflammation.

LIMITATIONS

This study used an animal model and did not assess long-term or potential side effects of roflumilast treatment.

CONCLUSIONS

Roflumilast holds promise as a treatment for depression and motor impairment in MS. Its anti-inflammatory properties, reducing inflammation and inhibiting microglial activation, suggest its potential for MS therapy. However, further research is needed to evaluate long-term effects and safety in MS patients.

摘要

背景

多发性硬化症(MS)是一种导致中枢神经系统脱髓鞘的自身免疫性疾病,常伴有抑郁症。目前用于治疗MS的方法并不能有效解决身体残疾和抑郁症这两个问题。罗氟司特是一种具有抗炎特性的磷酸二酯酶-4抑制剂,已显示出对自身免疫性疾病的治疗前景。

方法

我们使用实验性自身免疫性脑脊髓炎(EAE)大鼠模型来研究罗氟司特的作用。评估运动功能障碍和抑郁症状,并通过组织病理学分析评估其抗炎特性。流式细胞术检测该药物对脑小胶质细胞的影响。使用ELISA试剂盒评估海马组织中TNF-α、IL-1β和IL-6的水平。

结果

罗氟司特改善了EAE大鼠的运动功能障碍和抑郁症状。组织病理学分析显示脊髓中的炎症、脱髓鞘和轴突损失减少。罗氟司特抑制了小胶质细胞的激活以及向促炎性M1型细胞的转化。流式细胞术显示罗氟司特抑制了小胶质细胞中炎症标志物的表达及其在海马体中的激活。IL-6被确定为罗氟司特抑制海马体炎症的靶点。

局限性

本研究使用了动物模型,未评估罗氟司特治疗的长期或潜在副作用。

结论

罗氟司特有望成为治疗MS患者抑郁症和运动功能障碍的药物。其抗炎特性,即减轻炎症和抑制小胶质细胞激活,表明其在MS治疗中的潜力。然而,需要进一步研究来评估其对MS患者的长期影响和安全性。

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