Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China.
Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China.
Signal Transduct Target Ther. 2024 Feb 9;9(1):30. doi: 10.1038/s41392-024-01738-y.
Worldwide, the incidence of major depressive disorder (MDD) is increasing annually, resulting in greater economic and social burdens. Moreover, the pathological mechanisms of MDD and the mechanisms underlying the effects of pharmacological treatments for MDD are complex and unclear, and additional diagnostic and therapeutic strategies for MDD still are needed. The currently widely accepted theories of MDD pathogenesis include the neurotransmitter and receptor hypothesis, hypothalamic-pituitary-adrenal (HPA) axis hypothesis, cytokine hypothesis, neuroplasticity hypothesis and systemic influence hypothesis, but these hypothesis cannot completely explain the pathological mechanism of MDD. Even it is still hard to adopt only one hypothesis to completely reveal the pathogenesis of MDD, thus in recent years, great progress has been made in elucidating the roles of multiple organ interactions in the pathogenesis MDD and identifying novel therapeutic approaches and multitarget modulatory strategies, further revealing the disease features of MDD. Furthermore, some newly discovered potential pharmacological targets and newly studied antidepressants have attracted widespread attention, some reagents have even been approved for clinical treatment and some novel therapeutic methods such as phototherapy and acupuncture have been discovered to have effective improvement for the depressive symptoms. In this work, we comprehensively summarize the latest research on the pathogenesis and diagnosis of MDD, preventive approaches and therapeutic medicines, as well as the related clinical trials.
全球范围内，重度抑郁症（MDD）的发病率每年都在增加，这导致了更大的经济和社会负担。此外，MDD 的病理机制以及 MDD 药物治疗效果的机制非常复杂且不明确，因此仍然需要额外的 MDD 诊断和治疗策略。目前被广泛接受的 MDD 发病机制理论包括神经递质和受体假说、下丘脑-垂体-肾上腺（HPA）轴假说、细胞因子假说、神经可塑性假说和系统影响假说，但这些假说并不能完全解释 MDD 的病理机制。即使采用单一假说也难以完全揭示 MDD 的发病机制，因此近年来，在阐明多个器官相互作用在 MDD 发病机制中的作用以及确定新的治疗方法和多靶点调节策略方面取得了重大进展，进一步揭示了 MDD 的疾病特征。此外，一些新发现的潜在药理学靶点和新研究的抗抑郁药引起了广泛关注，一些试剂甚至已被批准用于临床治疗，一些新的治疗方法，如光疗和针灸，也被发现对抑郁症状有有效的改善作用。在这项工作中，我们全面总结了 MDD 的发病机制和诊断、预防方法和治疗药物以及相关临床试验的最新研究进展。
