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强迫症中的炎症:文献综述及基于假设的经颅光生物调节的潜在作用。

Inflammation in obsessive-compulsive disorder: A literature review and hypothesis-based potential of transcranial photobiomodulation.

机构信息

Division of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital, Boston, Massachusetts, USA.

Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.

出版信息

J Neurosci Res. 2024 Mar;102(3):e25317. doi: 10.1002/jnr.25317.

Abstract

Obsessive-compulsive disorder (OCD) is a disabling neuropsychiatric disorder that affects about 2%-3% of the global population. Despite the availability of several treatments, many patients with OCD do not respond adequately, highlighting the need for new therapeutic approaches. Recent studies have associated various inflammatory processes with the pathogenesis of OCD, including alterations in peripheral immune cells, alterations in cytokine levels, and neuroinflammation. These findings suggest that inflammation could be a promising target for intervention. Transcranial photobiomodulation (t-PBM) with near-infrared light is a noninvasive neuromodulation technique that has shown potential for several neuropsychiatric disorders. However, its efficacy in OCD remains to be fully explored. This study aimed to review the literature on inflammation in OCD, detailing associations with T-cell populations, monocytes, NLRP3 inflammasome components, microglial activation, and elevated proinflammatory cytokines such as TNF-α, CRP, IL-1β, and IL-6. We also examined the hypothesis-based potential of t-PBM in targeting these inflammatory pathways of OCD, focusing on mechanisms such as modulation of oxidative stress, regulation of immune cell function, reduction of proinflammatory cytokine levels, deactivation of neurotoxic microglia, and upregulation of BDNF gene expression. Our review suggests that t-PBM could be a promising, noninvasive intervention for OCD, with the potential to modulate underlying inflammatory processes. Future research should focus on randomized clinical trials to assess t-PBM's efficacy and optimal treatment parameters in OCD. Biomarker analyses and neuroimaging studies will be important in understanding the relationship between inflammatory modulation and OCD symptom improvement following t-PBM sessions.

摘要

强迫症(OCD)是一种使人丧失能力的神经精神疾病,影响着全球约 2%-3%的人口。尽管有几种治疗方法可用,但许多 OCD 患者的反应并不充分,这凸显了需要新的治疗方法。最近的研究将各种炎症过程与 OCD 的发病机制联系起来,包括外周免疫细胞的改变、细胞因子水平的改变和神经炎症。这些发现表明炎症可能是一个有前途的干预靶点。近红外光的经颅光生物调节(t-PBM)是一种非侵入性的神经调节技术,已显示出对多种神经精神疾病的潜在疗效。然而,其在 OCD 中的疗效仍有待充分探索。本研究旨在综述 OCD 中炎症的文献,详细说明与 T 细胞群体、单核细胞、NLRP3 炎症小体成分、小胶质细胞激活以及升高的促炎细胞因子(如 TNF-α、CRP、IL-1β和 IL-6)的关联。我们还检查了 t-PBM 针对 OCD 这些炎症途径的假设基础潜力,重点关注调节氧化应激、调节免疫细胞功能、降低促炎细胞因子水平、失活神经毒性小胶质细胞以及上调 BDNF 基因表达等机制。我们的综述表明,t-PBM 可能是 OCD 的一种很有前途的非侵入性干预手段,具有调节潜在炎症过程的潜力。未来的研究应集中在随机临床试验上,以评估 t-PBM 在 OCD 中的疗效和最佳治疗参数。生物标志物分析和神经影像学研究对于理解炎症调节与 t-PBM 治疗后 OCD 症状改善之间的关系将非常重要。

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