抑郁症与HPA轴关系及中药干预的研究进展-柴丽

20101213006200957-11*[e-mail]13595040770HPA550002。CNKI39。、、、/------。、、HPA。--R284A1005-9903201112-0268-04RelationshipbetweenDepressionandHPAAxisandInterventionbyTraditionalChineseMedicineCHAILiZHAOBoSchoolofBasicMedicineGuiyangUniversityofTraditonalChineseMedicineGuiyang550002ChinaAbstractItisveryimportantthathyperactivityofhypothalamic-pituitary-adrenocorticalHPAaxisisoneofthepathophysiologicalmechanismofdepression．Previousstudieshavefestimatedthatplasmalevelofcorticotropin-releasinghormoneCRHadrenocorticotropichormoneACTHglucocorticoidGChaveincreasedsignificantlymeanwhilethesustainedincreasinglevelofGChasreducedthenumberofthehippocampusintheglucocorticoidreceptorGRandmineralocorticoidreceptorMR/GRratiobecameimbalancethereforedestroyingthehippocampalneurons．ThehippocampusitselfcouldmediatetheactivitiesofHPAaxisthedestructionofhippocampalneuronshasbecomesoweakertomediatetheHPAaxiswhiletheincreasinglevelofGCsothatthenumberandfunctionofGRhavereducedGCnegativefeedbackinhibitiontoHPAaxishasdecreasedtomakeitfunctionmorehyperactivity．Keywordsdepressionhypothalamic-pituitary-adrenocorticalHPAglucocorticoidreceptorGRmineralocorticoidreceptorMR。、。WHO20202121“”215%3。200/10。26004-550%～70%。60%3%～5%。·862·171220116ChineseJournalofExperimentalTraditionalMedicalFormulaeVol．17No．12Jun．2011622。11.1HPA--hypothalamic-pituitary-adrenocorticalHPA。6①corticotropin-releasinghormoneCRH②CRHadrenocorticotropichormoneACTH③ACTHglucocorticoidGCcortisolCORTcorticosteroneCORT④GCGCglucocorticoidreceptorGRACTH⑤GCGCACTH。GC。GC10。1.2HPA7-13--。GCGR。HPA。、HPA。GRGCHPA。HPA、CORT1415HPAdexamethasonesuppressiontestDST16。ACTHCRH。CRHHPA17。Dahl1824hCRHCORT。CRHcentralnervoussystemCNS。Hauser19CRHmRNACRHHPA。HPA。HPA。GCGRmineralocorticoidreceptorMRGR、、、MR。MR/GR、。MR/GRmRNA20。GRHPAMRGCGC。GRGCGCGC。GRGCHPA。GRGCPHAGCHPAHPA21。GRDST22。2HPAHPAHPA。2.1Butterweck23SD610imipramine、hypericin、hyperoside、isoquercitrin、-3-miquelianin25ACTHCORT8ACTH、、-3-HPA。24-26CRHACTHCORTCRHmRNACRHACTHCORTHPA。27HPLC-ECD、·962·HPA。HPA。28YZ-50、CRHACTHCORTHPA。29、、CORTCRHACTH。HPA。30SDCORTACTHRT-PCRCRHCORTACTHCRHmRNAHPA。2.2“”。HPA2。2.2.131CRHACTHCORT、、、CRHCORTACTHHPA。32ACTHCORT、、、、、、、、、、、12、CORTACTH。HPA。33CRHACTHCORT5-5-HT、NE、DA、、、5-HTNECRHACTH、CORT。5-HT5-HTHPA。34ACTH、CRH、CORTCRHmRNAACTHmRNA、、、ACTH、CRH、CORTCRHmRNAACTHmRNA。HPA。35CRHACTH。、、、、、、CRHACTHHPA。36ACTHCORT、、、、、、、、ACTHCORTcAMP、、、、HPA。2.2.237-ACTHCORT、、、、、ACTHCORT。38、、、、CRH、ACTHCORTHPA。39CORT。、CORT。HPACORT。3HPACRHACTHCORTHPAGR、HPAHPA、。1．J．2010233228.2．J．2010295227.3IrwinMRMillerAH．Depressivedisordersand·072·171220116ChineseJournalofExperimentalTraditionalMedicalFormulaeVol．17No．12Jun．2011immunity20yearsofprogressanddiscoveryJ．BrainBehavImmun200721374.4．J．20072310877.5．J．2008235696.6．M．5．2009663.7．J．2008204243.14Ulrich-laiYMFigueiredoHFOstranderMMetal．ChronicstressinducesadrenalHyperplasiaandhypertrophyinasubregion-specificmannerJ．AmJPhysiolEndocrinolMetab200629151965.15．J．2008176441.16LemusCZAsnisGMHslbreichlletal．Clinicalvariablesandhypothalamic-pituitary-adrenalfunctionindepressionTheimportanceofmoodreactivityJ．AffectDisorder1987123219.17MathewSJManjiHKChameyDS．NoveldrugsandthempeutictargetsforseveremooddisordersJ．Neuropsychopharmacology20083392080.18DahlRERyanNDPuig-AntichJetal．24-hourcortisolmeasuresinadolescentswithmajordepressionacontrolledstudyJ．BiolPsychiatry19913012526.19HauserJLeszczynskaASamochowiecJetal．Associationanalysisoftheinsertion/deletionpolymorphisminserotonintransportergeneinpatientswithaffectivedisorderJ．EurPsychiatry2003183129.20ParianteCM．TheglueocorticoidreceptorpartofthesolutionorpartoftheproblemJ．Psyehopharmacol20062079.21BardenN．Implicationofthehypothalamic-pituitary-adrenalaxisinthephysiopathologyofdepressionJ．PsychiatryNeurosci200429185.22ParianteCM．GlucocorticoidreceptorfunctioninvitroinpatientswithmajordepressionJ．Stress200474209.23ButterweckVHeggerMWinterhoffH．FlavonoidsofSt．John’swortreduceHPAaxisfunctionintheratJ．PlandMed2004701008.24．CRHACTHJ．200424412.25．CORTACTHJ．2004122185.26．CRHmRNAJ．2005303219.27．J．2005286492.28．YZ-50CRHACTHCORJ．200824295.29．--J．200977667.30．HPAJ．2010265699.31．--J．2009142163.32．--J．200510111231.33．J．2009328557.34．--J．200943956.35．J．20097111073.36．ACTHCORcAMPJ．201034l58.37．-ACTHCORJ．2005165341.38．--J．200926445.39．J．201032122．·172·HPA