R-氯胺酮抗抑郁作用及其机制研究进展
Research progress on antidepressant effects of R-ketamine and its mechanisms
张森兵 1阎文军 2安池冰 3李乐文 4张文霞4
作者信息
- 1. 甘肃中医药大学第一临床医学院,甘肃兰州 730000;咸宁市中心医院/湖北科技学院附属第一医院,湖北咸宁 437100
- 2. 甘肃中医药大学第一临床医学院,甘肃兰州 730000;甘肃省人民医院,甘肃兰州 730000
- 3. 咸宁市中心医院/湖北科技学院附属第一医院,湖北咸宁 437100
- 4. 甘肃中医药大学第一临床医学院,甘肃兰州 730000
- 折叠
摘要
尽管氯胺酮和艾司氯胺酮已被证实治疗难治性抑郁症有效,但临床应用中发现均存在一定的拟精神病样作用和滥用倾向.最新研究证实,R-氯胺酮具有更高效、持久的抗抑郁作用且不良反应发生率和滥用倾向更低.目前研究发现,脑源性神经营养因子(BDNF)、α-氨基-3-羟基-5-甲基-4-异噁唑丙酸受体(AMPAR)激活以及脑-脾轴、微生物群-肠-脑轴等可能与R-氯胺酮的抗抑郁作用密切相关,但确切机制尚不清楚.探讨R-氯胺酮及其代谢物的抗抑郁作用以及可能作用机制与靶点,对研发速效、持久、安全的抗抑郁新药具有重要意义.
Abstract
Although ketamine and esketamine have been shown to be effective in the treatment of refractory-depression,they have been found to have some psychomimetic effects and a tendency to abuse in clinical use.Recent studies have demonstrated that R-ketamine has a more potent and long-lasting antidepressant effect with a lower incidence of adverse effects and a lower propensity for abuse.Currently,brain-derived neurotrophic factor(BDNF),α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid receptor(AMPAR)activation,brain-spleen axis,microbiota-gut-brain axis,and so on may be closely related to the antidepressant effects of R-ketamine,but the exact mechanism is not clear.Exploring the antidepressant effects of R-ketamine and its metabolites and their possible mechanisms of action and targets is of great significance for the development of new antidepressant drugs that are fast-acting,long-lasting and safe.
关键词
氯胺酮/R-氯胺酮/抑郁症/药理作用分子作用机制/抗抑郁药/脑源性神经营养因子Key words
ketamine/R-ketamine/depressive disorder/molecular mechanisms of pharmacological action/antidepressive agents/brain-derived neurotrophic factor引用本文复制引用
基金项目
国家自然科学基金(81860233)
甘肃省麻醉与脑功能临床医学研究中心项目(21JR7RA675)
咸宁市中心医院湖北科技学院附属第一医院院级项目(2022XYB032)
出版年
2024
NETL
NSTL
万方数据