摘要
背景:在过去的几十年中,选择性5-羟色胺(5-HT)再摄取抑制剂(SSRIs)的有效性以及随后OCD的5-HT假说的发展显着促进了强迫症(OCD)的药理学治疗。然而,由于绝大多数患者(40%至60%)对基于5-HT系统调节的SSRI或策略没有反应,因此现在必须寻找其他可能的治疗靶点。 目的:本文的目的是通过PubMed和Google Scholar检索目前的文献,寻找治疗强迫症的新假设和相关化合物,特别关注谷氨酸和免疫系统。 讨论:文献表明谷氨酸是主要的兴奋性神经递质,可能在强迫症的病理生理过程中发挥重要作用。此外,一系列临床研究也支持调节谷氨酸系统的药物的潜在功效。需要更深入地阐明儿童和成人免疫系统改变OCD的作用。在儿童中,已经广泛描述了由O组链球菌β-血红素驱动的感染引起的OCD亚型,并且属于所谓的“与链球菌相关的小儿自身免疫性神经精神病症”(PANDAS)。在成年人中,虽然有趣,但现有的研究结果微薄且有争议。 结论:谷氨酸和免疫系统代表了两个有趣的研究课题,这些研究有助于开发OCD开放式新型治疗策略。
关键词: 强迫症,抵抗,耐火,谷氨酸,免疫系统,新型治疗。
Current Medicinal Chemistry
Title:The Glutamate and the Immune Systems: New Targets for the Pharmacological Treatment of OCD
Volume: 25 Issue: 41
关键词: 强迫症,抵抗,耐火,谷氨酸,免疫系统,新型治疗。
摘要: Background: In the last decades the pharmacological treatment of obsessivecompulsive disorder (OCD) has been significantly promoted by the effectiveness of selective serotonin (5-HT) reuptake inhibitors (SSRIs) and the subsequent development of the 5-HT hypothesis of OCD. However, since a large majority of patients (between 40% and 60 %) do not respond to SSRIs or strategies based on the modulation of the 5-HT system, it is now essential to search for other possible therapeutic targets.
Aims: The aim of this paper was to review current literature through a PubMed and Google Scholar search of novel hypotheses and related compounds for the treatment of OCD, with a special focus on the glutammate and the immune systems.
Discussion: The literature indicates that glutamate, the main excitatory neurotransmitter, might play an important role in the pathophysiology of OCD. In addition, a series of clinical studies also supports the potential efficacy of drugs modulating the glutamate system.
The role of the immune system alterations in OCD in both children and adults needs to be more deeply elucidated. In children, a subtype of OCD has been widely described resulting from infections driven by group A streptococcus β-hemolitic and belonging to the so-called "pediatric autoimmune neuropsychiatric disorders associated with streptococcus" (PANDAS). In adults, available findings are meager and controversial, although interesting.
Conclusion: The glutamate and the immune systems represent two intriguing topics of research that hold promise for the development of open novel treatment strategies in OCD.
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Cite this article as:
The Glutamate and the Immune Systems: New Targets for the Pharmacological Treatment of OCD, Current Medicinal Chemistry 2018; 25 (41) . https://dx.doi.org/10.2174/0929867324666171108152035
DOI https://dx.doi.org/10.2174/0929867324666171108152035 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
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