5-HT1A receptor

5 - HT1A 受体
  • 文章类型: Journal Article
    血清素受体亚型1A(5-HT1AR),G蛋白偶联受体(GPCR)家族之一,与多种神经系统疾病有关。在分子水平上了解5-HT1AR的激活和失活机制对于发现许多疾病的新疗法至关重要。最近,人们越来越重视外部电场(EF)在影响生物分子结构和活性方面的作用。在这项研究中,我们使用分子动力学(MD)模拟来检查5-HT1AR活性状态的构象特征,并研究了0.02V/nm的外部静态EF对5-HT1AR活性状态的影响。我们的结果表明,5-HT1AR的活性状态保持了天然结构,虽然EF导致了5-HT1AR的结构修改,特别是诱导跨膜螺旋6(TM6)的向内运动。此外,它扰乱了CWxP中与激活相关的构象开关,干,PIF,和NPxxY图案,因此倾向于不活跃的构象。我们还发现,EF导致5-HT1AR的偶极矩整体增加,包括TM6和关键氨基酸。对TM6的构象性质的分析表明,在EF条件下发生了二级结构的改变和溶剂暴露的减少。在EF下,5-HT1AR与膜脂双层的相互作用也发生了变化。我们的发现揭示了由外部EF诱导的5-HT1AR构象转变的分子机制,这为GPCRs采用基于结构的EF应用的前景提供了潜在的新见解。
    The serotonin receptor subtype 1A (5-HT1AR), one of the G-protein-coupled receptor (GPCR) family, has been implicated in several neurological conditions. Understanding the activation and inactivation mechanism of 5-HT1AR at the molecular level is critical for discovering novel therapeutics in many diseases. Recently there has been a growing appreciation for the role of external electric fields (EFs) in influencing the structure and activity of biomolecules. In this study, we used molecular dynamics (MD) simulations to examine conformational features of active states of 5-HT1AR and investigate the effect of an external static EF with 0.02 V/nm applied on the active state of 5-HT1AR. Our results showed that the active state of 5-HT1AR maintained the native structure, while the EF led to structural modifications in 5-HT1AR, particularly inducing the inward movement of transmembrane helix 6 (TM6). Furthermore, it disturbed the conformational switches associated with activation in the CWxP, DRY, PIF, and NPxxY motifs, consequently predisposing an inclination towards the inactive-like conformation. We also found that the EF led to an overall increase in the dipole moment of 5-HT1AR, encompassing TM6 and pivotal amino acids. The analyses of conformational properties of TM6 showed that the changed secondary structure and decreased solvent exposure occurred upon the EF condition. The interaction of 5-HT1AR with the membrane lipid bilayer was also altered under the EF. Our findings reveal the molecular mechanism underlying the transition of 5-HT1AR conformation induced by external EFs, which offer potential novel insights into the prospect of employing structure-based EF applications for GPCRs.
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  • 文章类型: Journal Article
    淀粉样β肽(Aβ)的合成和沉积是阿尔茨海默病(AD)病理生理学的主要因素。Aβ寡聚体(Aβo)通过粘附在细胞膜上诱导氧化应激和损伤而发挥其神经毒性作用。尽管已经研究了几种抗抑郁药作为AD的神经保护剂,缺乏对Aβo诱导的神经毒性的神经保护作用的详细比较。这里,我们旨在阐明临床处方选择性5-羟色胺再摄取抑制剂的神经保护作用,5-羟色胺-去甲肾上腺素再摄取抑制剂,以及细胞水平的去甲肾上腺素能和特异性5-羟色胺能抗抑郁药,并建立了其潜在临床应用的潜在机制。因此,我们比较了三种抗抑郁药的神经保护作用,氟西汀(Flx),度洛西汀(Dlx),和米氮平(Mir),通过它们防止氧化应激诱导的细胞损伤的能力,使用SH-SY5Y细胞,通过评估细胞活力,活性氧(ROS)和线粒体ROS的产生,细胞膜磷脂的过氧化。这些抗抑郁药表现出有效的抗氧化活性(Dlx>Mir>Flx)和改善的细胞活力。此外,用5-羟色胺1A(5-HT1A)拮抗剂预处理抑制了它们的作用,提示5-HT1A受体参与抗抑郁药神经保护的抗氧化机制。这些发现表明通过预防Aβ诱导的氧化应激在AD中抗抑郁治疗的有益效果。
    Amyloid β-peptide (Aβ) synthesis and deposition are the primary factors underlying the pathophysiology of Alzheimer\'s disease (AD). Aβ oligomer (Aβo) exerts its neurotoxic effects by inducing oxidative stress and lesions by adhering to cellular membranes. Though several antidepressants have been investigated as neuroprotective agents in AD, a detailed comparison of their neuroprotection against Aβo-induced neurotoxicity is lacking. Here, we aimed to elucidate the neuroprotective effects of clinically prescribed selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and noradrenergic and specific serotonergic antidepressants at the cellular level and establish the underlying mechanisms for their potential clinical applications. Therefore, we compared the neuroprotective effects of three antidepressants, fluoxetine (Flx), duloxetine (Dlx), and mirtazapine (Mir), by their ability to prevent oxidative stress-induced cell damage, using SH-SY5Y cells, by evaluating cell viability, generation of reactive oxygen species (ROS) and mitochondrial ROS, and peroxidation of cell membrane phospholipids. These antidepressants exhibited potent antioxidant activity (Dlx > Mir > Flx) and improved cell viability. Furthermore, pretreatment with a 5-hydroxytryptamine 1A (5-HT1A) antagonist suppressed their effects, suggesting that the 5-HT1A receptor is involved in the antioxidant mechanism of the antidepressants\' neuroprotection. These findings suggest the beneficial effects of antidepressant treatment in AD through the prevention of Aβ-induced oxidative stress.
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  • 文章类型: Journal Article
    钙钙调蛋白依赖性蛋白激酶(CaMK)介导钙诱导的神经基因激活。CaMK还抑制非综合征性智力障碍基因,弗洛伊德-1/CC2D1A,人5-羟色胺-1A(5-HT1A)和多巴胺-D2受体基因的转录阻遏物。这些弗洛伊德-1调节基因的表达改变与精神疾病如抑郁症和精神分裂症有关。我们假设弗洛伊德-1被CaMK诱导的磷酸化阻断。纯化的弗洛伊德-1与CaMKIIα或CaMKIV的孵育增加了弗洛伊德-1磷酸化,这在弗洛伊德-1-Ser644Ala和弗洛伊德-1-Thr780AlaCaMK位点突变体中被部分阻止。在人类SK-N-SH神经母细胞瘤细胞中,活性CaMKIV诱导Freud-1的丝氨酸和苏氨酸磷酸化,并特异性增加转染的HEK-293细胞中的Freud-1-Thr780磷酸化。纯化的CaMKIIα或CaMKIV的激活降低了Freud-1与其在5-HT1A和多巴胺-D2受体基因上的DNA元件的结合。在SK-N-SH细胞中,活性CaMKIV而不是CaMKIIα阻断了弗洛伊德-1阻遏子活性,而弗洛伊德-1Ser644Ala,Thr780Ala或双重突变体对激活的CaMKIV或钙动员的抑制具有抗性。这些结果表明,Freud-1阻遏物活性被CaMKIV诱导的Thr780磷酸化阻断,导致靶基因的上调,如5-HT1A受体基因。CaMKIV介导的对Freud-1的抑制提供了一种新的去抑制机制来诱导5-HT1A受体表达以调节认知发育,行为和抗抑郁反应。
    Calcium calmodulin-dependent protein kinase (CaMK) mediates calcium-induced neural gene activation. CaMK also inhibits the non-syndromic intellectual disability gene, Freud-1/CC2D1A, a transcriptional repressor of human serotonin-1A (5-HT1A) and dopamine-D2 receptor genes. The altered expression of these Freud-1-regulated genes is implicated in mental illnesses such as major depression and schizophrenia. We hypothesized that Freud-1 is blocked by CaMK-induced phosphorylation. The incubation of purified Freud-1 with either CaMKIIα or CaMKIV increased Freud-1 phosphorylation that was partly prevented in Freud-1-Ser644Ala and Freud-1-Thr780Ala CaMK site mutants. In human SK-N-SH neuroblastoma cells, active CaMKIV induced the serine and threonine phosphorylation of Freud-1, and specifically increased Freud-1-Thr780 phosphorylation in transfected HEK-293 cells. The activation of purified CaMKIIα or CaMKIV reduced Freud-1 binding to its DNA element on the 5-HT1A and dopamine-D2 receptor genes. In SK-N-SH cells, active CaMKIV but not CaMKIIα blocked the Freud-1 repressor activity, while Freud-1 Ser644Ala, Thr780Ala or dual mutants were resistant to inhibition by activated CaMKIV or calcium mobilization. These results indicate that the Freud-1 repressor activity is blocked by CaMKIV-induced phosphorylation at Thr780, resulting in the up-regulation of the target genes, such as the 5-HT1A receptor gene. The CaMKIV-mediated inhibition of Freud-1 provides a novel de-repression mechanism to induce 5-HT1A receptor expression for the regulation of cognitive development, behavior and antidepressant response.
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  • 文章类型: Journal Article
    背景:肥胖中过多的脂肪堆积,由于饮食不均衡,会导致代谢和神经系统疾病,并增加患焦虑和抑郁的风险。
    目的:评估饮食干预(DI)对5-羟色胺能系统的影响,肥胖小鼠脑源性神经营养因子(BDNF)表达与行为的关系.
    方法:雄性C57BL/6小鼠,5周大,接受高脂饮食(HFD)10周以诱导肥胖。在这段时间之后,八个星期,这些动物中有一半接受对照饮食(CD),组肥胖(OB)+对照饮食(OB+CD,n=10),还有一半人继续接受HFD,组肥胖+HFD(OB+HFD,n=10)。在第八周的干预结束时,进行了行为测试(蔗糖偏好测试,开放领域,新颖的物体识别,高架加上迷宫和尾部悬挂)。每周评估体重和食物摄入量。内脏肥胖,海马和下丘脑BDNF蛋白的表达,5-HT1A(5-HT1A血清素受体)和TPH2(血清素合成的关键酶),在安乐死后进行评估。
    结果:饮食干预涉及在8周内从HFD变为CD,有效减少体重增加,肥胖,和快感缺失的行为。在OB+HFD组中,我们在开阔的田野中看到了较低的蔗糖偏好和较短的行进距离,与OB+CD小鼠相比,下丘脑中的前BDNF表达增加。然而,TPH2和5-HT1A的水平保持不变。
    结论:HFD模型诱导肥胖和快感缺乏,但是饮食干预成功地改善了这些情况。
    BACKGROUND: The excessive fat accumulation in obesity, resulting from an unbalanced diet, can lead to metabolic and neurological disorders and increase the risk of developing anxiety and depression.
    OBJECTIVE: Assess the impact of dietary intervention (DI) on the serotonergic system, brain-derived neurotrophic factor (BDNF) expression and behaviors of obese mice.
    METHODS: Male C57BL/6 mice, 5 weeks old, received a high-fat diet (HFD) for 10 weeks for the induction of obesity. After this period, for 8 weeks, half of these animals received a control diet (CD), group obese (OB) + control diet (OB + CD, n = 10), and another half continued being fed HFD, group obese + HFD (OB + HFD, n = 10). At the end of the eighth week of intervention, behavioral tests were performed (sucrose preference test, open field, novel object recognition, elevated plus maze and tail suspension). Body weight and food intake were assessed weekly. Visceral adiposity, the hippocampal and hypothalamic protein expression of BDNF, 5-HT1A (5-HT1A serotonin receptor) and TPH2 (key enzyme in serotonin synthesis), were evaluated after euthanasia.
    RESULTS: The dietary intervention involved changing from a HFD to a CD over an 8-week period, effectively reduced body weight gain, adiposity, and anhedonia-like behavior. In the OB + HFD group, we saw a lower sucrose preference and shorter traveled distance in the open field, along with increased pro-BDNF expression in the hypothalamus compared to the OB + CD mice. However, the levels of TPH2 and 5-HT1A remained unchanged.
    CONCLUSIONS: The HFD model induced both obesity and anhedonia, but the dietary intervention successfully improved these conditions.
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  • 文章类型: Journal Article
    肿瘤治疗中存在长期放化疗引起的血小板减少。先前的研究表明,5-羟色胺(5-HT)及其受体可诱导巨核细胞(MK)和血小板的形成。然而,到目前为止,5-HT1A受体(5-HTR1A)与MK之间的关系尚不清楚。我们筛选并研究了维拉唑酮作为5-HTR1A部分激动剂促进MK分化的机制,并评估了其对血小板减少症的治疗作用。我们采用基于机器学习(ML)的药物筛选模型来筛选Vilazodone(VLZ)的巨核细胞生成活性。在HEL和Meg-01细胞中验证了VLZ对巨核细胞生成的影响。进行Tg(itga2b:eGFP)斑马鱼分析血小板生成的改变。此外,我们建立了血小板减少症小鼠模型,以研究VLZ给药如何加速血小板恢复和功能.我们开展了网络药理学,蛋白质印迹,和免疫荧光来证明VLZ的潜在靶标和途径。已预测VLZ具有潜在的生物学作用。同时,VLZ给药促进细胞和斑马鱼模型中的MK分化和血小板生成。渐进实验表明,VLZ对体内辐射诱导的血小板减少症具有潜在的治疗作用。网络药理学和相关机制研究表明,SRC和MAPK信号均参与了VLZ促进的巨核细胞生成过程。此外,5-HTR1A在巨核细胞分化过程中的表达与SRC和MAPK的激活密切相关。我们的发现表明,5-HTR1A在MK上的表达,VLZ可与5-HTR1A受体结合,进一步调节SRC/MAPK信号通路,促进巨核细胞分化和血小板生成,这为血小板减少症的替代治疗方案提供了新的见解。
    Thrombocytopenia caused by long-term radiotherapy and chemotherapy exists in cancer treatment. Previous research demonstrates that 5-Hydroxtrayptamine (5-HT) and its receptors induce the formation of megakaryocytes (MKs) and platelets. However, the relationships between 5-HT1A receptor (5-HTR1A) and MKs is unclear so far. We screened and investigated the mechanism of vilazodone as a 5-HTR1A partial agonist in promoting MK differentiation and evaluated its therapeutic effect in thrombocytopenia. We employed a drug screening model based on machine learning (ML) to screen the megakaryocytopoiesis activity of Vilazodone (VLZ). The effects of VLZ on megakaryocytopoiesis were verified in HEL and Meg-01 cells. Tg (itga2b: eGFP) zebrafish was performed to analyze the alterations in thrombopoiesis. Moreover, we established a thrombocytopenia mice model to investigate how VLZ administration accelerates platelet recovery and function. We carried out network pharmacology, Western blot, and immunofluorescence to demonstrate the potential targets and pathway of VLZ. VLZ has been predicted to have a potential biological action. Meanwhile, VLZ administration promotes MK differentiation and thrombopoiesis in cells and zebrafish models. Progressive experiments showed that VLZ has a potential therapeutic effect on radiation-induced thrombocytopenia in vivo. The network pharmacology and associated mechanism study indicated that SRC and MAPK signaling are both involved in the processes of megakaryopoiesis facilitated by VLZ. Furthermore, the expression of 5-HTR1A during megakaryocyte differentiation is closely related to the activation of SRC and MAPK. Our findings demonstrated that the expression of 5-HTR1A on MK, VLZ could bind to the 5-HTR1A receptor and further regulate the SRC/MAPK signaling pathway to facilitate megakaryocyte differentiation and platelet production, which provides new insights into the alternative therapeutic options for thrombocytopenia.
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  • 文章类型: Journal Article
    大麻素在抗药性癫痫治疗中显示出潜力;然而,我们缺乏使用哪种大麻素的知识,给药,以及它们的药理靶点。这项研究调查了(i)单独使用大麻二酚(CBD)和(ii)与Delta-9四氢大麻酚(Δ9-THC)联合使用的抗惊厥作用,以及(iii)5-羟色胺(5-HT)1A受体在CBD作用机制中的作用。缉获活动,由4-氨基吡啶诱导,通过在小鼠脑切片的皮质层2/3中的细胞外场记录来测量。评估了10、30和100μMCBD单独和与Δ9-THC组合的抗惊厥作用。为了检查CBD的作用机制,在评估CBD的效果之前,用5-HT1A受体拮抗剂预处理切片。仅≥30µMCBD的量具有显着的抗惊厥作用,而10µMCBD则没有。然而,10µMCBD与低剂量Δ9-THC(20:3比例)的组合显示出比单独使用植物大麻素明显更大的抗惊厥作用。此外,在CBD应用前阻断5-HT1A受体显著消除了CBD的作用。因此,我们的结果表明低剂量CBD和Δ9-THC联合的疗效,并且CBD发挥其作用,至少在某种程度上,通过5-HT1A受体。这些结果可以解决耐药性问题,同时提供对CBD作用机制的洞察,为进一步测试大麻素作为抗惊厥药奠定基础。
    Cannabinoids have shown potential in drug-resistant epilepsy treatment; however, we lack knowledge on which cannabinoid(s) to use, dosing, and their pharmacological targets. This study investigated (i) the anticonvulsant effect of Cannabidiol (CBD) alone and (ii) in combination with Delta-9 Tetrahydrocannabinol (Δ9-THC), as well as (iii) the serotonin (5-HT)1A receptor\'s role in CBD\'s mechanism of action. Seizure activity, induced by 4-aminopyridine, was measured by extracellular field recordings in cortex layer 2/3 of mouse brain slices. The anticonvulsant effect of 10, 30, and 100 µM CBD alone and combined with Δ9-THC was evaluated. To examine CBD\'s mechanism of action, slices were pre-treated with a 5-HT1A receptor antagonist before CBD\'s effect was evaluated. An amount of ≥30 µM CBD alone exerted significant anticonvulsant effects while 10 µM CBD did not. However, 10 µM CBD combined with low-dose Δ9-THC (20:3 ratio) displayed significantly greater anticonvulsant effects than either phytocannabinoid alone. Furthermore, blocking 5-HT1A receptors before CBD application significantly abolished CBD\'s effects. Thus, our results demonstrate the efficacy of low-dose CBD and Δ9-THC combined and that CBD exerts its effects, at least in part, through 5-HT1A receptors. These results could address drug-resistance while providing insight into CBD\'s mechanism of action, laying the groundwork for further testing of cannabinoids as anticonvulsants.
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  • 文章类型: Journal Article
    行为和功能研究描述了焦虑中的半球不对称性和对压力的反应中的代谢行为。然而,尚未有研究报道在体内基底外侧杏仁核(BLA)中的5-羟色胺能受体(5-HT1A受体)对压力下的焦虑和代谢行为的作用。在本研究中,单侧和双侧抑制BLA中5-HT1A受体对焦虑的影响,并评估了对慢性束缚应激的代谢反应。雄性Wistar大鼠在插管进入BLA后7天连续14天接受慢性束缚应激。诱导压力前20分钟,将WAY-100-635(选择性5-HT1A拮抗剂)或无菌盐水(媒介物)单侧或双侧施用到BLA中。行为(高架加迷宫;EPM,和开放现场测试),并进行了代谢参数研究。结果表明,与对照组相比,压力导致体重增加显着增加。在非压力条件下,左边和两边,在压力条件下,左,和双方,在BLA中抑制5-HT1A可减少体重增加。在约束应力条件下,与对照组相比,仅抑制左侧BLA中的5-HT1A受体导致食物摄入减少.在压力条件下,抑制右侧的5-HT1A受体,左,与应激组相比,双侧BLA的饮水量增加。通过WAY-100-635抑制BLA左侧的5-HT1A受体在应激大鼠中诱导的焦虑样行为。同样,左侧BLA上的WAY-100-635在EPM和对照动物的野外测试中均有效地引起了焦虑样行为。总之,似乎左侧BLA中的5-HT1A受体更负责焦虑样行为和对压力的反应中的代谢变化。
    Behavioral and functional studies describe hemispheric asymmetry in anxiety and metabolic behaviors in responses to stress. However, no study has reported serotonergic receptor (the 5-HT1A receptor) lateralization in the basolateral amygdala (BLA) in vivo on anxiety and metabolic behaviors under stress. In the present study, the effect of unilateral and bilateral suppression of the 5-HT1A receptor in the BLA on anxiety, and metabolic responses to chronic restraint stress was assessed. Male Wistar rats 7 days after cannulation into the BLA received chronic restraint stress for 14 consecutive days. 20 minutes before induction of stress, WAY-100-635 (selective 5-HT1A antagonist) or sterile saline (vehicle) was administered either uni- or bi-laterally into the BLA. Behavioral (elevated plus maze; EPM, and open field test), and metabolic parameter studies were performed. Results showed that stress causes a significant increase in weight gain compared to control. In the non-stress condition, the left and bilaterally, and in the stress condition the right, left, and both sides, inhibition of 5-HT1A in the BLA reduced weight gain. In the restraint stress condition, only inhibition of the 5-HT1A receptor in the left BLA led to decreased food intake compared to the control group. In stress conditions, inhibition of the 5-HT1A receptor on the right, left, and bilateral BLA increased water intake compared to the stress group. Inhibition of the 5-HT1A receptor on the left side of the BLA by WAY-100-635 induced anxiety-like behaviors in stressed rats. Similarly, WAY-100-635 on the left BLA effectively caused anxiety-like behaviors in both EPM and open field tests in the control animals. In conclusion, it seems that 5-HT1A receptors in the left BLA are more responsible for anxiety-like behaviors and metabolic changes in responses to stress.
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  • 文章类型: Journal Article
    目的:肌痛性脑脊髓炎/慢性疲劳综合征(ME/CFS)是一个重大的医学挑战,迄今为止,尚无无可争议的病理生理机制。
    方法:根据临床线索,我们假设5-羟色胺(5-HT)过度激活与ME/CFS的致病原因和相关症状有关.我们在一系列小鼠模型中实验评估了这一假设。
    结果:高剂量选择性5-羟色胺再摄取抑制剂(SSRI)治疗可诱导小鼠背中缝核内和细胞外5-羟色胺溢出。这种情况导致严重疲劳(rota-rota,疲劳旋转轮和家笼活动测试)和ME/CFS相关症状(筑巢,足底和露地试验),伴随下丘脑-垂体-肾上腺(HPA)轴对运动挑战的反应功能障碍。使用5-HT合成抑制剂和Htr1a(5-HT1A受体)基因敲低的病毒载体,进一步验证了由过量5-羟色胺诱导的这些ME/CFS样特征。
    结论:我们的发现支持5-强能过度活动参与ME/CFS的病理生理学。这种模拟ME/CFS的动物模型将有助于理解ME/CFS生物学及其治疗方法。
    Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a significant medical challenge, with no indisputable pathophysiological mechanism identified to date.
    Based on clinical clues, we hypothesized that 5-hydroxytryptamine (5-HT) hyperactivation is implicated in the pathogenic causes of ME/CFS and the associated symptoms. We experimentally evaluated this hypothesis in a series of mouse models.
    High-dose selective serotonin reuptake inhibitor (SSRI) treatment induced intra- and extracellular serotonin spillover in the dorsal raphe nuclei of mice. This condition resulted in severe fatigue (rota-rod, fatigue rotating wheel and home-cage activity tests) and ME/CFS-associated symptoms (nest building, plantar and open field test), along with dysfunction in the hypothalamic-pituitary-adrenal (HPA) axis response to exercise challenge. These ME/CFS-like features induced by excess serotonin were additionally verified using both a 5-HT synthesis inhibitor and viral vector for Htr1a (5-HT1A receptor) gene knockdown.
    Our findings support the involvement of 5-HTergic hyperactivity in the pathophysiology of ME/CFS. This ME/CFS-mimicking animal model would be useful for understanding ME/CFS biology and its therapeutic approaches.
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  • 文章类型: Journal Article
    在临床抑郁症的治疗中,选择性5-羟色胺再摄取抑制剂(SSRIs)作为一线药物治疗的广泛采用改变了这种疾病的药物治疗前景。SSRIs比它们替代的三环抗抑郁药(TCA)更安全,耐受性更好。然而,他们的局限性可能使一线药物治疗的期望达到上限.SSRIs的显著问题包括在治疗开始时诱导焦虑,延迟发作的显着治疗效果,性功能障碍,睡眠障碍,总体疗效适中。后者与SSRIs无法有效治疗快感缺失和认知障碍综合征有关。联合5-羟色胺和去甲肾上腺素再摄取抑制剂(SNRIs),比如文拉法辛,在功效上比SSRIs产生了一些有限的改善,以更大的副作用负担为代价。尝试通过对5-羟色胺受体亚型的作用来补充5-羟色胺的再摄取活性尚未产生实质性的益处;然而,沃替西汀可能在认知障碍的治疗中提供更多的效用.未来的进步可能来自SNRI的发展,更紧密地模拟有效的TCA的作用。组合SSRIs与5-HT4受体激动剂和5-HT7受体拮抗剂也可能有益处。
    The widespread adoption of selective serotonin reuptake inhibitors (SSRIs) as first-line pharmacological treatments in the management of clinical depression transformed the landscape of drug therapy for this condition. SSRIs are safer and better tolerated than the tricyclic antidepressants (TCAs) that they replaced. However, they have limitations that may have placed a ceiling on the expectations of first-line pharmacological treatment. Notable problems with SSRIs include induction of anxiety on treatment initiation, delayed onset of significant therapeutic effect, sexual dysfunction, sleep disturbance and overall modest efficacy. The latter is linked with an inability of SSRIs to effectively treat syndromes of anhedonia and cognitive impairment. Combined serotonin and noradrenaline reuptake inhibitors (SNRIs), such as venlafaxine, have produced some limited improvements over SSRIs in efficacy, at the cost of a greater side-effect burden. Attempts to supplement serotonin reuptake activity with actions at serotonin receptor sub-types have not yet yielded substantial benefits; however, vortioxetine may provide more utility in the management of cognitive impairment. Future advances might come from the development of SNRIs, which more closely mimic the actions of effective TCAs. There may also be possible benefits to be derived from combining SSRIs with 5-HT4 receptor agonists and 5-HT7 receptor antagonists.
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  • 文章类型: Journal Article
    大麻二酚是第一种被批准用于治疗Lennox-Gastaut综合征的大麻衍生药物,德拉韦综合征,和结节性硬化症。在目前的研究中,我们对从VigiBase®数据库中提取的CBD引起的潜在不良事件进行了描述性分析,然后进行了不成比例的分析.此外,我们分析并讨论了CBD与5-羟色胺5-HT1A受体之间关联作为不良事件可能原因的生物学合理性.使用VigiLyze®信号检测和信号处理工具从VigiBase®数据库中提取数据。使用MedDRA对VigiBase®报告中的不良事件进行编码,首选术语(PT)的第19版。将数据上传到SPSS软件中,并通过不成比例分析进行分析。CBD的统计学显着不成比例的信号被发现为“体重减轻”(5.19(95%CI:4.54-5.70)),“吞咽不足”(3.68(95%CI:3.22-5.27)),和“失眠”(1.6(95%CI:1.40-1.83))。发现“体重减轻”(2.2)的IC025值为阳性,“吞咽不足”(1.3),和“失眠”(0.5),表明报告的病例过剩。CBD与5-HT1A5-羟色胺受体的相互作用可能为患者失眠的发生提供潜在的生物学解释。值得注意的是,监管机构在处方CBD作为抗癫痫药的信息中提到的风险状况显示出与不良事件“失眠”特别相关的差异。
    Cannabidiol is the first cannabis-derived drug approved for the treatment of Lennox-Gastaut syndrome, Dravet syndrome, and Tuberous Sclerosis Complex. In the current study, we performed a descriptive analysis followed by a disproportionality analysis of potential adverse events caused by CBD extracted from the VigiBase® database. Furthermore, the biological plausibility of the association between CBD and the serotonin 5-HT1A receptor as a possible cause of adverse events was analyzed and discussed. Data were extracted from the VigiBase® database using the VigiLyze® signal detection and signal management tool. Adverse events in VigiBase® reports were coded using MedDRA, version 19 of Preferred Terms (PTs). Data were uploaded into SPSS software and analyzed via a disproportionality analysis. Statistically significant disproportionality signals for CBD were found for \"weight decreased\" (5.19 (95% CI: 4.54-5.70)), \"hypophagia\" (3.68 (95% CI: 3.22-5.27)), and \"insomnia\" (1.6 (95% CI: 1.40-1.83)). Positive IC025 values were found for \"weight decreased\" (2.2), \"hypophagia\" (1.3), and \"insomnia\" (0.5), indicating a surplus of reported cases. CBD\'s interactions with 5-HT1A serotonin receptors may offer a potential biological explanation for the occurrence of insomnia in patients. It is noteworthy that the risk profiles mentioned in the information for prescribing CBD as an antiepileptic agent by regulatory agencies showed disparities specifically related to the adverse event \"insomnia\".
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