基于cAMP/PKA/CREB/BDNF通路的中药治疗抑郁症的药理机制研究进展  

Research progress in the treatment of depression with traditional Chinese medicine based on cAMP/PKA/CREB/BDNF pathway

作　　者：雷晶晶 何乾超[2] 高玉广[3] 廖煜雄 谷晶 黄德祥 LEI Jingjing;HE Qianchao;GAO Yuguang;LIAO Yuxiong;GU Jing;HUANG Dexiang(Graduate School of Guangxi University of Traditional Chinese Medicine,Nanning 530023,China)

机构地区：[1]广西中医药大学研究生院,南宁530023 [2]广西中医药大学第一附属医院脑病科 [3]广西中医药大学第一附属医院急诊科

出　　处：《环球中医药》2025年第2期339-347,共9页Global Traditional Chinese Medicine

基　　金：广西自然科学基金(2020GXNFAA297161);广西中医脑病临床研究中心(桂科AD20238028);国家中医药管理局高水平重点学科-中医内科学(ZYYZDXK-2023166);广西中医药大学“歧黄工程”高层次人才团队(202410);广西中医药重点学科建设项目(GZXK-Z-20-13)。

摘　　要：抑郁症是一种常见的精神疾病,环磷腺苷(adenosine cyclophosphate, cAMP)/蛋白激酶A(protein kinase A,PKA)/环磷腺苷效应元件结合蛋白(cAMP-response element binding protein, CREB)/脑源性神经营养因子(brain-derived neurotrophic factor, BDNF)信号通路是与抑郁症关系密切的信号转导通路之一,可以通过影响突触的形态、炎症反应、神经发生、微小RNA、BDNF的生成与降解参与抑郁症的发生发展。近年来研究表明,中药可以影响cAMP/PKA/CREB/BDNF通路改善抑郁情况。本文将从中药影响长时程增强和长时程抑制、相关受体以及蛋白调控突触可塑性,影响相关神经递质以及受体改善神经递质含量,影响炎症因子、激活犬尿酸氨途径调控炎症反应,促进细胞增殖、修复受损神经元促进神经发生,影响相关微小RNA促进细胞增殖、改善突触形态、调节缝隙连接蛋白43改善间隙连接功能,调节BDNF的降解改善抑郁情况等几个方面对近五年的文献进行综述,阐释中药的有效成分干预抑郁症的药理机制,为临床提供一定的参考。Depression is a prevalent psychiatric disorder characterized by dysregulation of the adenosine cyclophosphate(cAMP)/protein kinase A(PKA)signaling pathway,which in turn affects cAMP-response element binding protein(CREB)and brain-derived neurotrophic factor(BDNF)levels,both of which are closely associated with depressive symptoms.It can contribute to the onset and progression of depression through its regulation of synaptic morphology,inflammatory response,neuronal morphology and density,microRNA and BDNF production and degradation.Recent research has indicated that traditional Chinese medicine has the potential to modulate the cAMP/PKA/CREB/BDNF pathway in order to ameliorate symptoms of depression.This paper reviewed the impact of traditional Chinese medicine on long-term potentiation(LTP)and long-term depression(LTD),the regulation of synaptic plasticity through related receptors and proteins,modulation of neurotransmitter levels,and enhancement of neurotransmitter content.Additionally,it examined the influence of traditional Chinese medicine on inflammatory factors,activation of the kynurenate ammonia pathway to regulate inflammatory responses,stimulation of cell proliferation,repair of damaged neurons,and promotion of neurogenesis,the influence of specific microRNAs on cell proliferation,synaptic morphology improvement,regulation of connexin 43(Cx43),protein for enhanced gap junction function,and modulation of BDNF degradation to alleviate depression.Additionally,recent literature within the past five years was reviewed to elucidate the pharmacological mechanisms of active components in Chinese medicine for depression intervention,offering reasonable insights for clinical applications.

关 键 词：抑郁症 信号通路 中药 综述 药理机制 环磷腺苷 环磷腺苷效应元件结合蛋白 脑源性营养因子 

分 类 号：R285[医药卫生—中药学]