铁死亡：抑郁症治疗的新靶点

doi:10.12114/j.issn.1007-9572.2023.0228

中国全科医学 ›› 2024, Vol. 27 ›› Issue (12): 1417-1423.DOI: 10.12114/j.issn.1007-9572.2023.0228

铁死亡：抑郁症治疗的新靶点

杜书琴¹^,²^,³, 钱立锋⁴^,⁵, 熊烈¹^,², 史汉强¹^,², 石彦波¹^,²^,^*()

1．314000　浙江省嘉兴市，浙江中医药大学附属医院嘉兴市中医医院分子医学中心中心实验室
2．314000　浙江省嘉兴市糖尿病血管病变研究重点实验室
3．310002　浙江省杭州市，浙江工业大学药学院
4．314000　浙江省嘉兴市，浙江中医药大学附属医院嘉兴市中医医院康复科
5．314000　浙江省嘉兴市脑血管病中西医结合康复研究重点实验室

收稿日期:2023-03-23 修回日期:2023-05-29 出版日期:2024-04-20 发布日期:2024-01-23
通讯作者: 石彦波
作者贡献：杜书琴负责文章的构思与设计、研究资料的收集与整理、论文撰写；钱立锋负责论文修订和质量控制；熊烈、史汉强负责图片的编辑、整理；石彦波负责论文修订、文章的质量控制及审校,对文章整体负责，监督管理。
基金资助:
浙江省中医药卫生科技计划项目(2021ZB283); 浙江省卫生科技计划项目(2020PY029，2023KY1227); 嘉兴市科技局民生科技创新专项(2020AY30003); 浙江中医药大学附属医院科研专项重点项目(2022FSYYZZ22)

Ferroptosis: a New Target for the Treatment of Depressive Disorder

DU Shuqin¹^,²^,³, QIAN Lifeng⁴^,⁵, XIONG Lie¹^,², SHI Hanqiang¹^,², SHI Yanbo¹^,²^,^*()

1. Central Laboratory of Molecular Medicine Research Center, Zhejiang Chinese Medical University Affiliated Jiaxing TCM Hospital, Jiaxing 314000, China
2. Jiaxing Key Laboratory of Diabetic Angiopathy Research, Jiaxing 314000, China
3. School of Pharmacy, Zhejiang University of Technology, Hangzhou 310002, China
4. Department of Rehabilitation, Zhejiang Chinese Medical University Affiliated Jiaxing TCM Hospital, Jiaxing 314000, China
5. Jiaxing Key Laboratory of Cerebrovascular Disease Rehabilitation Research of Integrated Chinese and Western Medicine, Jiaxing 314000, China

Received:2023-03-23 Revised:2023-05-29 Published:2024-04-20 Online:2024-01-23
Contact: SHI Yanbo

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摘要/Abstract

摘要： 抑郁症是常见的情感类精神障碍疾病，是目前世界范围内第二大健康负担，但其发病机制仍有待明晰。临床抗抑郁症治疗以西药为主，但目前所用药物差强人意的效果、显著的治疗时滞和难以耐受的不良反应，反映出临床对有效和快速起效抗抑郁症药物的巨大需求。铁死亡是近年来发现的新型细胞死亡方式，其参与了包括抑郁症在内的多种神经系统疾病发病进程。目前已有部分研究将目光转向靶向抑制铁死亡的抗抑郁症治疗，并显现出了积极的疗效。本文以抑郁症与铁死亡机制为基础，结合临床与临床前研究，总结了铁死亡参与抑郁症发病机制及其治疗抑郁症的可能性。

关键词: 抑郁症, 铁死亡, 铁沉积, 线粒体, 脂质过氧化作用, 综述

Abstract:

As a common affective mental disorder, depressive disorder has currently become the second health burden worldwide, however, its pathogenesis remains to be further elucidated. The clinical treatment of depressive disorder primarily relies on western medicine. However, there is great clinical need for effective and rapid-onset antidepressants for the unsatisfactory effect, obvious treatment time-lag, and intolerable adverse reactions of current drug treatment. Ferroptosis is a novel form of cell death discovered in recent years, which has been found to be involved in the pathogenesis of numerous neurological disorders, including depressive disorder. Currently, some studies have shifted the focus of antidepressant treatment towards targeted inhibition of ferroptosis, and achieved positive outcomes. The present paper provides a comprehensive review of the involvement of ferroptosis in depressive disorder pathogenesis and its potential therapeutic implications, drawing on clinical and preclinical evidence that elucidates the underlying mechanisms linking depressive disorder with ferroptotic processes.

Key words: Depressive disorder, Ferroptosis, Iron overload, Mitochondria, Lipid peroxidation, Review

杜书琴,钱立锋,熊烈,等. 铁死亡：抑郁症治疗的新靶点[J]. 中国全科医学, 2024, 27(12): 1417-1423. DOI: 10.12114/j.issn.1007-9572.2023.0228.
DU Shuqin,QIAN Lifeng,XIONG Lie, et al. Ferroptosis: a New Target for the Treatment of Depressive Disorder[J]. Chinese General Practice, 2024, 27(12): 1417-1423. DOI: 10.12114/j.issn.1007-9572.2023.0228.

图/表 2

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抑郁症假说	具体调控机制
神经递质^[4,5]	单胺类神经递质5-HT、DA、NE合成减少；氨基酸类神经递质Glu、GABA、Gln表达改变，神经元兴奋性下降/亢奋，诱发抑郁症
BDNF^[6,7]	BDNF水平下降，神经元内在细胞死亡途径被激活；增加前脑结构内神经细胞的脆弱性，引发海马神经元受损，影响认知功能
炎症因子^[8,9,10]	促炎生物标志物TNF-α、IL-1、IL-10、CRP等增加，在促进毒性自由基释放和细胞死亡的同时，抑制神经递质的水平
线粒体功能障碍^[11,12,13]	氧化还原平衡紊乱，提高促炎因子表达，致使机体出现免疫炎症；破坏DNA、蛋白质合成以及线粒体能量生成，进一步影响神经递质的生成、摄取与释放
HPA轴^[14,15]	GC、ACTH、CRH、CORT释放异常以及GR介导的负反馈受损，GC无法有效地发挥抗炎作用，导致免疫炎症，神经元受损；大脑中单胺类神经递质的异常释放

抑郁症假说	具体调控机制
神经递质^[4,5]	单胺类神经递质5-HT、DA、NE合成减少；氨基酸类神经递质Glu、GABA、Gln表达改变，神经元兴奋性下降/亢奋，诱发抑郁症
BDNF^[6,7]	BDNF水平下降，神经元内在细胞死亡途径被激活；增加前脑结构内神经细胞的脆弱性，引发海马神经元受损，影响认知功能
炎症因子^[8,9,10]	促炎生物标志物TNF-α、IL-1、IL-10、CRP等增加，在促进毒性自由基释放和细胞死亡的同时，抑制神经递质的水平
线粒体功能障碍^[11,12,13]	氧化还原平衡紊乱，提高促炎因子表达，致使机体出现免疫炎症；破坏DNA、蛋白质合成以及线粒体能量生成，进一步影响神经递质的生成、摄取与释放
HPA轴^[14,15]	GC、ACTH、CRH、CORT释放异常以及GR介导的负反馈受损，GC无法有效地发挥抗炎作用，导致免疫炎症，神经元受损；大脑中单胺类神经递质的异常释放

铁死亡：抑郁症治疗的新靶点

Ferroptosis: a New Target for the Treatment of Depressive Disorder

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