Merkouris Ermis, Brasinika Alexandra, Patsiavoura Meropi, Siniosoglou Chrysanthi, Tsiptsios Dimitrios, Triantafyllis Andreas S, Mueller Christoph, Mpikou Ioulia, Samara Myrto T, Christodoulou Nikolaos, Tsamakis Konstantinos
Neurology Department, Democritus University of Thrace, 68100 Alexandroupoli, Greece.
3rd Neurology Department, Aristotle University, 54124 Thessaloniki, Greece.
Int J Mol Sci. 2025 Jun 5;26(11):5417. doi: 10.3390/ijms26115417.
Anxiety disorders are among the most common psychiatric conditions that significantly impair one's quality of life and place a significant burden on healthcare systems. Conventional treatments have certain restraints, such as potential side effects and limited efficacy. Τhe underlying pathophysiological mechanisms of anxiety are not fully understood. A comprehensive literature search was performed in MEDLINE and Scopus databases for original English-language articles published between January 2014 and December 2024. Study selection, data extraction, and screening were independently carried out by multiple investigators using predefined criteria. Our review aimed to help better comprehend the molecular basis of anxiety, focusing on the hypothalamic-pituitary-adrenal (HPA) axis, serotonergic signaling, and gamma-aminobutyric acid (GABA) neurotransmission. In addition, we addressed the role of epigenetics and pharmacogenomics in personalized treatment. Although novel anxiety treatments are promising, they are predominantly preclinical and highly heterogeneous, which poses a challenge to achieving reliable therapeutic efficacy. Our findings could potentially contribute to the development of new therapeutic interventions. Further research is warranted, especially in human subjects, with an aim to combine genetic and epigenetic profiles to refine treatment approaches and develop innovative therapeutics.
焦虑症是最常见的精神疾病之一，严重损害个人生活质量，并给医疗系统带来沉重负担。传统治疗方法存在一定限制，如潜在的副作用和疗效有限。焦虑症的潜在病理生理机制尚未完全明确。我们在MEDLINE和Scopus数据库中进行了全面的文献检索，以查找2014年1月至2024年12月期间发表的英文原创文章。研究选择、数据提取和筛选由多名研究人员根据预先设定的标准独立进行。我们的综述旨在帮助更好地理解焦虑症的分子基础，重点关注下丘脑-垂体-肾上腺（HPA）轴、血清素能信号传导和γ-氨基丁酸（GABA）神经传递。此外，我们还探讨了表观遗传学和药物基因组学在个性化治疗中的作用。尽管新型焦虑症治疗方法前景广阔，但它们主要处于临床前阶段，且高度异质性，这对实现可靠的治疗效果构成了挑战。我们的研究结果可能有助于开发新的治疗干预措施。有必要进行进一步研究，尤其是在人类受试者中，旨在结合遗传和表观遗传特征来优化治疗方法并开发创新疗法。
