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更年期与抑郁症的交集:使用动物模型的研究综述

The intersection between menopause and depression: overview of research using animal models.

作者信息

Herrera-Pérez José Jaime, Hernández-Hernández Olivia Tania, Flores-Ramos Mónica, Cueto-Escobedo Jonathan, Rodríguez-Landa Juan Francisco, Martínez-Mota Lucía

机构信息

Laboratorio de Farmacología Conductual, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico.

Consejo Nacional de Humanidades, Ciencias y Tecnologías Research Fellow. Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico.

出版信息

Front Psychiatry. 2024 Jul 15;15:1408878. doi: 10.3389/fpsyt.2024.1408878. eCollection 2024.

Abstract

Menopausal women may experience symptoms of depression, sometimes even progressing clinical depression requiring treatment to improve quality of life. While varying levels of estrogen in perimenopause may contribute to an increased biological vulnerability to mood disturbances, the effectiveness of estrogen replacement therapy (ERT) in the relief of depressive symptoms remains controversial. Menopausal depression has a complex, multifactorial etiology, that has limited the identification of optimal treatment strategies for the management of this psychiatric complaint. Nevertheless, clinical evidence increasingly supports the notion that estrogen exerts neuroprotective effects on brain structures related to mood regulation. Indeed, research using preclinical animal models continues to improve our understanding of menopause and the effectiveness of ERT and other substances at treating depression-like behaviors. However, questions regarding the efficacy of ERT in perimenopause have been raised. These questions may be answered by further investigation using specific animal models of reduced ovarian function. This review compares and discusses the advantages and pitfalls of different models emulating the menopausal stages and their relationship with the onset of depressive-like signs, as well as the efficacy and mechanisms of conventional and novel ERTs in treating depressive-like behavior. Ovariectomized young rats, middle-to-old aged intact rats, and females treated with reprotoxics have all been used as models of menopause, with stages ranging from surgical menopause to perimenopause. Additionally, this manuscript discusses the impact of organistic and therapeutic variables that may improve or reduce the antidepressant response of females to ERT. Findings from these models have revealed the complexity of the dynamic changes occurring in brain function during menopausal transition, reinforcing the idea that the best approach is timely intervention considering the opportunity window, in addition to the careful selection of treatment according to the presence or absence of reproductive tissue. Additionally, data from animal models has yielded evidence to support new promising estrogens that could be considered as ERTs with antidepressant properties and actions in endocrine situations in which traditional ERTs are not effective.

摘要

更年期女性可能会出现抑郁症状,有时甚至会发展为需要治疗以提高生活质量的临床抑郁症。虽然围绝经期雌激素水平的变化可能会增加情绪障碍的生物学易感性,但雌激素替代疗法(ERT)缓解抑郁症状的有效性仍存在争议。更年期抑郁症病因复杂,涉及多种因素,这限制了针对这种精神疾病的最佳治疗策略的确定。然而,临床证据越来越支持雌激素对与情绪调节相关的脑结构具有神经保护作用这一观点。事实上,使用临床前动物模型的研究不断增进我们对更年期以及ERT和其他物质治疗抑郁样行为有效性的理解。然而,关于围绝经期ERT疗效的问题也随之而来。这些问题可能通过使用特定的卵巢功能减退动物模型进行进一步研究来解答。本综述比较并讨论了模拟更年期阶段的不同模型的优缺点及其与抑郁样症状发作的关系,以及传统和新型ERT治疗抑郁样行为的疗效和机制。卵巢切除的年轻大鼠、中老年完整大鼠以及接受生殖毒性药物治疗的雌性大鼠都被用作更年期模型,涵盖从手术绝经到围绝经期的各个阶段。此外,本文还讨论了可能改善或降低雌性对ERT抗抑郁反应的机体和治疗变量的影响。这些模型的研究结果揭示了更年期过渡期间脑功能动态变化的复杂性,强化了这样一种观点,即除了根据生殖组织的有无仔细选择治疗方法外,最佳方法是考虑时机窗口进行及时干预。此外,动物模型的数据为支持新的有前景的雌激素提供了证据,这些雌激素可被视为在传统ERT无效的内分泌情况下具有抗抑郁特性和作用的ERT。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d0d/11287658/c84111ae0a6a/fpsyt-15-1408878-g001.jpg

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