Pathogenesis of depression and the mechanism research in TCM treatment of major depression

YAO Yuan; ZHOU Yi; ZHOU Tingting

doi:10.3969/j.issn.1006-0111.2018.03.001

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Article Navigation > Journal of Pharmaceutical Practice and Service > 2018 > 36(3): 193-197

YAO Yuan, ZHOU Yi, ZHOU Tingting. Pathogenesis of depression and the mechanism research in TCM treatment of major depression[J]. Journal of Pharmaceutical Practice and Service, 2018, 36(3): 193-197. doi: 10.3969/j.issn.1006-0111.2018.03.001

Citation:

YAO Yuan, ZHOU Yi, ZHOU Tingting. Pathogenesis of depression and the mechanism research in TCM treatment of major depression[J]. Journal of Pharmaceutical Practice and Service, 2018, 36(3): 193-197. doi: 10.3969/j.issn.1006-0111.2018.03.001

Pathogenesis of depression and the mechanism research in TCM treatment of major depression

doi: 10.3969/j.issn.1006-0111.2018.03.001

1.
School of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China;School of Pharmacy, Second Military Medical University, Shanghai 200433, China;Shanghai Key Laboratory for Pharmaceutical Metabolites Research, Shanghai 200433, China
2.
Medical Department of 94826 Military Hospital, Shanghai 200433, China
3.
School of Pharmacy, Second Military Medical University, Shanghai 200433, China;Shanghai Key Laboratory for Pharmaceutical Metabolites Research, Shanghai 200433, China

Received Date: 2017-12-19
Rev Recd Date: 2018-01-22

Abstract

Depression is a serious health hazard and the World Health Organization predicts that depression will be the second leading cause of abnormal death and disability by 2020. Currently, most antidepressants are tricyclic antidepressants (TCA), tetracyclic antidepressants and selective 5-HT reuptake inhibitors. Long term use of those medications will develop resistance and adverse reactions. In addition, drugs that block a single target are often hard to achieve therapeutic outcomes due to the biological abnormalities involving multiple systems in the body. Traditional Chinese Medicine (TCM) can simultaneously act on multiple targets to influence the disease network in many aspects at the same time. This approach has higher efficacy and lower side effects than a single chemical medication. Recently, there are increasing numbers of research papers on antidepressant mechanism of TMC, mainly focused on the release level of neurotransmitters, hippocampus brain derived neurotrophic factor (BDNF) expression and cytokines, etc. The latest researches also indicated that the gut microbiota has involved the development of emotional diseases and the diseases related to central nerves system. This paper reviews the mechanism studies of TMC as antidepressants and neuroprotection agents in order to shed new light on the study of depression pathogenesis and development of new antidepressant medications.
- Traditional Chinese Medicine,
- depression,
- mechanism,
- neurotrophic factor,
- inflammatory mediators,
- microbiota-gut-brain axis

References

[1]	Sayers J. The world health report 2001-Mental health:new understanding,new hope[J]. Bullet World Health Organ,2001,79(11):1085.
[2]	Zhang X, Tian JS, Liu H, et al. Progress of new antidepressant drugs development[J]. Chin J Chin Mater Medic, 2017, 42(1):29-33.
[3]	王旭东, 乔明琦, 张樟进,等. 中医药治疗抑郁症的研究进展[J]. 南京中医药大学学报, 2016, 32(1):93-96.
[4]	Adam Samuels B, Leonardo ED, Hen R. Hippocampal subfields and major depressive disorder[J]. Biol Psychiatry, 2015, 77(3):210-211.
[5]	Schoenfeld TJ, Mccausland HC, Morris HD, et al. Stress and loss of adult nurogenesis differentially reduce hippocampal volume[J]. Bioll Psychiatry, 2017,82(12):914-923.
[6]	Hill AS, Sahay A, Hen R. Increasing adult hippocampal neurogenesis is sufficient to reduce anxiety and depression-like behaviors[J]. Neuropsychopharmacology, 2015, 40(10):2368-2378.
[7]	Bremner JD, Narayan M, Anderson ER, et al. Hippocampal volume reduction in major depression[J]. Am J Psychiatry, 2000, 157(1):115-118.
[8]	Moraitis AG, Block T, Nguyen D, et al. The role of glucocorticoid receptors in metabolic syndrome and psychiatric illness[J]. J Steroid Biochem Mol Biol, 2017, 165:114-120.
[9]	张国双, 杨坤. 抗抑郁新靶点-糖皮质激素受体[J]. 国际精神病学杂志, 2015,42(1):84-86.
[10]	Kinlein SA, Wilson CD, Karatsoreos IN. Dysregulated hypothalamic-pituitary-adrenal axis function contributes to altered endocrine and neurobehavioral responses to acute stress[J]. Front Psychiatry, 2015, 6:31.
[11]	Ferrari F, Villa RF. The neurobiology of depression:an integrated overview from biological theories to clinical evidence[J]. Mol Neurobiol,2017,54(7):4847-4865.
[12]	乔卉, 安书成, 徐畅. BDNF与抑郁症的研究现状及进展[J]. 生理科学进展, 2011, 42(3):195-200.
[13]	Rantamaki T, Yalcin I. Antidepressant drug action-from rapid changes on network function to network rewiring[J]. Prog Neuropsychopharmacol Biol Psychiatry, 2016, 64:285-292.
[14]	Schmitt K, Holsboer-Trachsler E, Eckert A. BDNF in sleep, insomnia, and sleep deprivation[J]. Ann Med, 2016, 48(1-2):42-51.
[15]	Hauser SR, Getachew B, Taylor RE, et al. Alcohol induced depressive-like behavior is associated with a reduction in hippocampal BDNF[J]. Pharmacol Biochem Behav, 2011, 100(2):253-258.
[16]	Zhuang F, Zhou X, Gao X, et al. Cytokines and glucocorticoid receptors are associated with the antidepressant-like effect of alarin[J]. Peptides, 2016, 76:115-129.
[17]	Felger JC, Lotrich FE. Inflammatory cytokines in depression:neurobiological mechanisms and therapeutic implications[J]. Neuroscience, 2013, 246(5):199-229.
[18]	Su WJ, Cao ZY, Jiang CL. Inflammatory mechanism of depression and its new strategy for diagnosis and treatment[J].Sheng Li Xue Bao,2017,69(5):715-722.
[19]	汪崇泽, 盛国红. 免疫炎症途径与抑郁症的研究进展[J]. 精神医学杂志, 2015,28(5):397-400.
[20]	Zhu X, Han Y, Du J, et al. Microbiota-gut-brain axis and the central nervous system[J]. Oncotarget, 2017, 8(32):53829-53838.
[21]	于林, 胡号应, 丁国安,等. 肠道微生物在抑郁症发病中的作用及其研究进展[C].2016中华中医药学会神志病分会学术年会,2016.
[22]	Zheng P, Zeng B, Zhou C, et al. Gut microbiome remodeling induces depressive-like behaviors through a pathway mediated by the host's metabolism[J]. Mol Psychiatry, 2016, 21(6):786-796.
[23]	Zhang QX,Ma XL,Yang Y, et al. Jieyuanshen decoction exerts antidepressant effects on depressive rat model via regulating hpa axis and the level of amino acids neurotransmitter[J]. Afric J Tradit,Complement Altern Med,2017, 14(2):33-46.
[24]	刘婉婉, 许璐, 董宪喆,等. 开心散类方对慢性应激大鼠行为学及中枢单胺类神经递质的影响[J]. 中国中药杂志, 2015, 40(11):2180-2185.
[25]	Dong XZ, Li ZL, Zheng XL, et al. A representative prescription for emotional disease, Ding-Zhi-Xiao-Wan restores 5-HT system deficit through interfering the synthesis and transshipment in chronic mild stress-induced depressive rats[J]. J Ethnopharmacol, 2013, 150(3):1053-1061.
[26]	Gong MJ, Han B, Wang SM, et al. Icariin reverses corticosterone-induced depression-like behavior, decrease in hippocampal brain-derived neurotrophic factor (BDNF) and metabolic network disturbances revealed by NMR-based metabonomics in rats[J]. J Pharm Biomed Anal, 2016, 123:63-73.
[27]	Ye YL,Zhong K, Liu DD, et al. Huanglian-Jie-Du-Tang extract ameliorates depression-like behaviors through BDNF-TrkB-CREB pathway in rats with chronic unpredictable stress[J]. Evidence-Based Complement Altern Med,2017(4):1-13.
[28]	Chen CY, Yeh YW, Kuo SC, et al. Differences in immunomodulatory properties between venlafaxine and paroxetine in patients with major depressive disorder[J]. Psychoneuroendocrinology, 2017, 87:108-118.
[29]	An L, Li J,Yu ST, et al. Effects of the total flavonoid extract of Xiao bu xin-Tang on depression-like behavior induced by lipopolysaccharide and proinflammatory cytokine levels in mice[J]. J Ethnopharmacol, 2015, 163:83-87.
[30]	Qiu JJ, Liu Z, Zhao P, et al. Gut microbial diversity analysis using Illumina sequencing for functional dyspepsia with liver depression-spleen deficiency syndrome and the interventional Xiaoyaosan in a rat model[J]. World J Gastroenterol, 2017, 23(5):810-816.

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通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

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Pathogenesis of depression and the mechanism research in TCM treatment of major depression

1. School of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China;School of Pharmacy, Second Military Medical University, Shanghai 200433, China;Shanghai Key Laboratory for Pharmaceutical Metabolites Research, Shanghai 200433, China

2. Medical Department of 94826 Military Hospital, Shanghai 200433, China

3. School of Pharmacy, Second Military Medical University, Shanghai 200433, China;Shanghai Key Laboratory for Pharmaceutical Metabolites Research, Shanghai 200433, China

Received Date: 2017-12-19

Rev Recd Date: 2018-01-22

Key words:

Abstract: Depression is a serious health hazard and the World Health Organization predicts that depression will be the second leading cause of abnormal death and disability by 2020. Currently, most antidepressants are tricyclic antidepressants (TCA), tetracyclic antidepressants and selective 5-HT reuptake inhibitors. Long term use of those medications will develop resistance and adverse reactions. In addition, drugs that block a single target are often hard to achieve therapeutic outcomes due to the biological abnormalities involving multiple systems in the body. Traditional Chinese Medicine (TCM) can simultaneously act on multiple targets to influence the disease network in many aspects at the same time. This approach has higher efficacy and lower side effects than a single chemical medication. Recently, there are increasing numbers of research papers on antidepressant mechanism of TMC, mainly focused on the release level of neurotransmitters, hippocampus brain derived neurotrophic factor (BDNF) expression and cytokines, etc. The latest researches also indicated that the gut microbiota has involved the development of emotional diseases and the diseases related to central nerves system. This paper reviews the mechanism studies of TMC as antidepressants and neuroprotection agents in order to shed new light on the study of depression pathogenesis and development of new antidepressant medications.

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Reference (30)

[1]	Sayers J. The world health report 2001-Mental health:new understanding,new hope[J]. Bullet World Health Organ,2001,79(11):1085.
[2]	Zhang X, Tian JS, Liu H, et al. Progress of new antidepressant drugs development[J]. Chin J Chin Mater Medic, 2017, 42(1):29-33.
[3]	王旭东, 乔明琦, 张樟进,等. 中医药治疗抑郁症的研究进展[J]. 南京中医药大学学报, 2016, 32(1):93-96.
[4]	Adam Samuels B, Leonardo ED, Hen R. Hippocampal subfields and major depressive disorder[J]. Biol Psychiatry, 2015, 77(3):210-211.
[5]	Schoenfeld TJ, Mccausland HC, Morris HD, et al. Stress and loss of adult nurogenesis differentially reduce hippocampal volume[J]. Bioll Psychiatry, 2017,82(12):914-923.
[6]	Hill AS, Sahay A, Hen R. Increasing adult hippocampal neurogenesis is sufficient to reduce anxiety and depression-like behaviors[J]. Neuropsychopharmacology, 2015, 40(10):2368-2378.
[7]	Bremner JD, Narayan M, Anderson ER, et al. Hippocampal volume reduction in major depression[J]. Am J Psychiatry, 2000, 157(1):115-118.
[8]	Moraitis AG, Block T, Nguyen D, et al. The role of glucocorticoid receptors in metabolic syndrome and psychiatric illness[J]. J Steroid Biochem Mol Biol, 2017, 165:114-120.
[9]	张国双, 杨坤. 抗抑郁新靶点-糖皮质激素受体[J]. 国际精神病学杂志, 2015,42(1):84-86.
[10]	Kinlein SA, Wilson CD, Karatsoreos IN. Dysregulated hypothalamic-pituitary-adrenal axis function contributes to altered endocrine and neurobehavioral responses to acute stress[J]. Front Psychiatry, 2015, 6:31.
[11]	Ferrari F, Villa RF. The neurobiology of depression:an integrated overview from biological theories to clinical evidence[J]. Mol Neurobiol,2017,54(7):4847-4865.
[12]	乔卉, 安书成, 徐畅. BDNF与抑郁症的研究现状及进展[J]. 生理科学进展, 2011, 42(3):195-200.
[13]	Rantamaki T, Yalcin I. Antidepressant drug action-from rapid changes on network function to network rewiring[J]. Prog Neuropsychopharmacol Biol Psychiatry, 2016, 64:285-292.
[14]	Schmitt K, Holsboer-Trachsler E, Eckert A. BDNF in sleep, insomnia, and sleep deprivation[J]. Ann Med, 2016, 48(1-2):42-51.
[15]	Hauser SR, Getachew B, Taylor RE, et al. Alcohol induced depressive-like behavior is associated with a reduction in hippocampal BDNF[J]. Pharmacol Biochem Behav, 2011, 100(2):253-258.
[16]	Zhuang F, Zhou X, Gao X, et al. Cytokines and glucocorticoid receptors are associated with the antidepressant-like effect of alarin[J]. Peptides, 2016, 76:115-129.
[17]	Felger JC, Lotrich FE. Inflammatory cytokines in depression:neurobiological mechanisms and therapeutic implications[J]. Neuroscience, 2013, 246(5):199-229.
[18]	Su WJ, Cao ZY, Jiang CL. Inflammatory mechanism of depression and its new strategy for diagnosis and treatment[J].Sheng Li Xue Bao,2017,69(5):715-722.
[19]	汪崇泽, 盛国红. 免疫炎症途径与抑郁症的研究进展[J]. 精神医学杂志, 2015,28(5):397-400.
[20]	Zhu X, Han Y, Du J, et al. Microbiota-gut-brain axis and the central nervous system[J]. Oncotarget, 2017, 8(32):53829-53838.
[21]	于林, 胡号应, 丁国安,等. 肠道微生物在抑郁症发病中的作用及其研究进展[C].2016中华中医药学会神志病分会学术年会,2016.
[22]	Zheng P, Zeng B, Zhou C, et al. Gut microbiome remodeling induces depressive-like behaviors through a pathway mediated by the host's metabolism[J]. Mol Psychiatry, 2016, 21(6):786-796.
[23]	Zhang QX,Ma XL,Yang Y, et al. Jieyuanshen decoction exerts antidepressant effects on depressive rat model via regulating hpa axis and the level of amino acids neurotransmitter[J]. Afric J Tradit,Complement Altern Med,2017, 14(2):33-46.
[24]	刘婉婉, 许璐, 董宪喆,等. 开心散类方对慢性应激大鼠行为学及中枢单胺类神经递质的影响[J]. 中国中药杂志, 2015, 40(11):2180-2185.
[25]	Dong XZ, Li ZL, Zheng XL, et al. A representative prescription for emotional disease, Ding-Zhi-Xiao-Wan restores 5-HT system deficit through interfering the synthesis and transshipment in chronic mild stress-induced depressive rats[J]. J Ethnopharmacol, 2013, 150(3):1053-1061.
[26]	Gong MJ, Han B, Wang SM, et al. Icariin reverses corticosterone-induced depression-like behavior, decrease in hippocampal brain-derived neurotrophic factor (BDNF) and metabolic network disturbances revealed by NMR-based metabonomics in rats[J]. J Pharm Biomed Anal, 2016, 123:63-73.
[27]	Ye YL,Zhong K, Liu DD, et al. Huanglian-Jie-Du-Tang extract ameliorates depression-like behaviors through BDNF-TrkB-CREB pathway in rats with chronic unpredictable stress[J]. Evidence-Based Complement Altern Med,2017(4):1-13.
[28]	Chen CY, Yeh YW, Kuo SC, et al. Differences in immunomodulatory properties between venlafaxine and paroxetine in patients with major depressive disorder[J]. Psychoneuroendocrinology, 2017, 87:108-118.
[29]	An L, Li J,Yu ST, et al. Effects of the total flavonoid extract of Xiao bu xin-Tang on depression-like behavior induced by lipopolysaccharide and proinflammatory cytokine levels in mice[J]. J Ethnopharmacol, 2015, 163:83-87.
[30]	Qiu JJ, Liu Z, Zhao P, et al. Gut microbial diversity analysis using Illumina sequencing for functional dyspepsia with liver depression-spleen deficiency syndrome and the interventional Xiaoyaosan in a rat model[J]. World J Gastroenterol, 2017, 23(5):810-816.

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Pathogenesis of depression and the mechanism research in TCM treatment of major depression

doi: 10.3969/j.issn.1006-0111.2018.03.001

Abstract

References

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通讯作者: 陈斌, bchen63@163.com

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