Meijer O C, de Kloet E R
Leiden/Amsterdam Centre for Drug Research, Division of Medical Pharmacology, Sylvius Laboratories, The Netherlands.
Crit Rev Neurobiol. 1998;12(1-2):1-20.
The activity of the hippocampus is modulated by a serotonergic projection from the midbrain. Corticosteroids regulate the activity of this raphe-hippocampal system in various ways. These effects are differentially mediated via two types of central corticosteroid receptor types, the high-affinity mineralocorticoid receptor (MR), and the lower affinity glucocorticoid receptor (GR). Under physiological fluctuations of corticosteroid concentrations, predominantly MR-mediated effects suppress the activity of the raphe-hippocampal system, notably serotonin (5-HT)1A receptor-related activity: 5-HT1A receptors are down-regulated, and the cellular response to 5-HT1A receptor activation is attenuated. Transiently increased concentrations of corticosteroids, as induced by stress, result in combined occupation of both MR and GR, and allow increased activity of the raphe-hippocampal system. Stimulatory actions of corticosteroids involving GR occupation include increased responsiveness of hippocampal neurons to 5-HT1A receptor stimulation, attenuated autoinhibition of 5-HT, and a permissive effect on stress-induced increases in 5-HT release. Under (pathological) conditions of chronically elevated corticosteroid concentrations, however, serotonergic neurotransmission is impaired. Human depression is an important example of a condition of combined hypercorticism and an apparent hypoactivity of serotonergic transmission. Deficiency of brain GR function may be genetically determined or acquired by stress. It is proposed that the balance of MR/GR activation can be altered by chronic (stress-related) changes of corticosteroid concentrations, in combination with glucocorticoid feedback resistance. Such an imbalance would lead to a relative dominance of MR-mediated suppressive effects on the activity of the raphe-hippocampal system, which may be a biologically relevant aspect of depression.
海马体的活动受到来自中脑的血清素能投射的调节。皮质类固醇以多种方式调节这条中缝-海马体系统的活动。这些效应通过两种类型的中枢皮质类固醇受体差异介导,即高亲和力的盐皮质激素受体(MR)和低亲和力的糖皮质激素受体(GR)。在皮质类固醇浓度的生理波动下,主要由MR介导的效应会抑制中缝-海马体系统的活动,特别是与5-羟色胺(5-HT)1A受体相关的活动:5-HT1A受体下调,并且细胞对5-HT1A受体激活的反应减弱。由应激诱导的皮质类固醇浓度短暂升高,会导致MR和GR同时被占据,并使中缝-海马体系统的活动增加。涉及GR占据的皮质类固醇的刺激作用包括海马神经元对5-HT1A受体刺激的反应性增加、5-HT自身抑制作用减弱,以及对应激诱导的5-HT释放增加的允许作用。然而,在皮质类固醇浓度长期升高的(病理)情况下,血清素能神经传递会受损。人类抑郁症就是皮质醇增多症与血清素能传递明显低下相结合的一个重要例子。脑GR功能缺陷可能是由基因决定的,也可能是由应激导致的。有人提出,皮质类固醇浓度的慢性(与应激相关的)变化与糖皮质激素反馈抵抗相结合,可以改变MR/GR激活的平衡。这种失衡将导致MR介导的对中缝-海马体系统活动的抑制作用相对占主导,这可能是抑郁症生物学上的一个相关方面。