Abstract:
Major mood disorder (i.e. major depressive disorder [MDD] and bipolar disorders [BPDs]) are among the most prevalent and disabling mental illnesses. Several, frequently intertwining theories (such as the monoamine, neuroinflammatory and neurotrophic theories) exist to explain the etiopathogenic background of mood disorders. A lesser-known hypothesis addresses the role of oxidative stress (OS; i.e. the overproduction and accumulation of free radicals) in the pathogenesis of these mental disorders. Free radicals are capable of damaging phospholipids, polyunsaturated fatty acids, proteins and nucleic acids. In the brain, OS impairs inter alia synaptic signalling and neuroplasticity. In the current paper, in addition to a brief description of the aforementioned pathophysiological processes involved in mood disorders (with a special focus on OS), we discuss in detail the results of studies on changes in non-enzymatic antioxidant uric acid (UA) levels in major mood disorders. Findings to date indicate that UA - a routinely measured laboratory parameter - may be a candidate biomarker to distinguish between MDD and BPD. Since the diagnostic criteria are identical for major depressive episodes regardless of whether the episode occurs in the context of MDD or BPD and also bearing in mind that the treatment for those two disorders is different, we may conclude that the identification of biomarkers to enable MDD to be distinguished from BPD would be of great clinical relevance.
摘要:
严重情绪障碍(即严重抑郁障碍[MDD]和双相情感障碍[BPDs])是最普遍和致残的精神疾病之一。几个,经常相互交织的理论(如单胺,神经炎症和神经营养理论)的存在可以解释情绪障碍的病因背景。鲜为人知的假设解决了氧化应激(OS;即自由基的过度产生和积累)在这些精神障碍的发病机理中的作用。自由基能够破坏磷脂,多不饱和脂肪酸,蛋白质和核酸。在大脑中,OS尤其损害突触信号传导和神经可塑性。在当前的论文中,除了简要描述上述涉及情绪障碍的病理生理过程(特别关注OS),我们详细讨论了主要情绪障碍中非酶抗氧化剂尿酸(UA)水平变化的研究结果。迄今为止的研究结果表明,UA-常规测量的实验室参数-可能是区分MDD和BPD的候选生物标志物。由于严重抑郁发作的诊断标准是相同的,无论该发作是在MDD还是BPD的背景下发生,并且考虑到这两种疾病的治疗是不同的,我们可以得出结论,鉴定能够将MDD与BPD区分开的生物标志物将具有极大的临床意义.(神经精神药理学红2024;26(2):105-124)关键词:抑郁症,双相情感障碍,大脑,氧化应激,尿酸。