Research Headquarters, Taisho Pharmaceutical Co., Ltd., Saitama, Saitama 331-9530, Japan; Chiba University Center for Forensic Mental Health, Chiba, Chiba 260-8670, Japan.
Pharmacol Biochem Behav. 2024 Sep;242:173818. doi: 10.1016/j.pbb.2024.173818. Epub 2024 Jul 4.
Anxiety disorders are chronic, disabling psychiatric disorders, and there is a growing medical need for the development of novel pharmacotherapeutic agents showing improved efficacy and an improved side effect profile as compared with the currently prescribed anxiolytic drugs. In the course of the search for next-generation anxiolytics, neuropeptide receptors have garnered interest as potential therapeutic targets, underscored by pivotal roles in modulating stress responses and findings from animal studies using pharmacological tools. Among these neuropeptide receptors, the type 1 receptor for melanin-concentrating hormone (MCH1), which has been demonstrated to be involved in an array of physiological processes, including the regulation of stress responses and affective states, has gained attraction as a therapeutic target for drugs used in the treatment of psychiatric disorders, including anxiety disorders. To date, a plethora of MCH1 antagonists have been synthesized, and studies using MCH1 antagonists and genetically manipulated mice lacking MCH1 have revealed that the blockade of MCH1 produces anxiolytic-like effects across diverse rodent paradigms. In addition, MCH1 antagonists have been demonstrated to show a rapid onset of antidepressant-like effects; therefore, they may be effective for conditions commonly encountered in patients with anxiety disorders, which is an advantage for anxiolytic drugs. Notably, MCH1 antagonists have not manifested the undesirable side effects observed with the currently prescribed anxiolytics. All these preclinical findings testify to the potential of MCH1 antagonists as novel anxiolytics. Although there are still issues that need to be resolved prior to the initiation of clinical trials, such as elucidating the precise neuronal mechanisms underlying their anxiolytic effects and exploring pertinent biomarkers that can be used in clinical trials, MCH1 blockade appears to be an attractive way to tackle anxiety disorders.
焦虑障碍是慢性、致残性精神疾病,目前临床上需要开发新型的药物治疗剂,这些药物需要比现有的抗焦虑药物具有更好的疗效和改善的副作用谱。在寻找下一代抗焦虑药物的过程中,神经肽受体已成为潜在的治疗靶点,这是因为它们在调节应激反应方面发挥着关键作用,并且在使用药理学工具的动物研究中也得到了证实。在这些神经肽受体中,黑色素浓缩激素 1 型受体(MCH1)已被证明参与了一系列生理过程,包括应激反应和情感状态的调节,作为治疗精神疾病(包括焦虑障碍)的药物的治疗靶点,已经引起了关注。迄今为止,已经合成了大量的 MCH1 拮抗剂,并且使用 MCH1 拮抗剂和缺乏 MCH1 的基因敲除小鼠进行的研究表明,阻断 MCH1 在多种啮齿动物模型中产生抗焦虑样作用。此外,MCH1 拮抗剂已被证明具有快速产生抗抑郁样作用的作用;因此,它们可能对焦虑障碍患者常见的病症有效,这是抗焦虑药物的一个优势。值得注意的是,MCH1 拮抗剂没有表现出与目前处方的抗焦虑药物相同的不良副作用。所有这些临床前研究结果都证明了 MCH1 拮抗剂作为新型抗焦虑药物的潜力。尽管在开始临床试验之前仍有一些问题需要解决,例如阐明其抗焦虑作用的精确神经元机制以及探索可用于临床试验的相关生物标志物,但 MCH1 阻断似乎是一种有吸引力的方法,可以用于治疗焦虑障碍。