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Cholecystokinin (CCK): a neuromodulator with therapeutic potential in Alzheimer’s and Parkinson’s disease 胆囊收缩素(CCK):一种对阿尔茨海默氏症和帕金森氏症具有治疗潜力的神经调节剂。
IF 7.4 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-02-10 DOI: 10.1016/j.yfrne.2024.101122
Niklas Reich , Christian Hölscher

Cholecystokinin (CCK) is a neuropeptide modulating digestion, glucose levels, neurotransmitters and memory. Recent studies suggest that CCK exhibits neuroprotective effects in Alzheimer’s disease (AD) and Parkinson’s disease (PD). Thus, we review the physiological function and therapeutic potential of CCK. The neuropeptide facilitates hippocampal glutamate release and gates GABAergic basket cell activity, which improves declarative memory acquisition, but inhibits consolidation. Cortical CCK alters recognition memory and enhances audio-visual processing. By stimulating CCK-1 receptors (CCK-1Rs), sulphated CCK-8 elicits dopamine release in the substantia nigra and striatum. In the mesolimbic pathway, CCK release is triggered by dopamine and terminates reward responses via CCK-2Rs. Importantly, activation of hippocampal and nigral CCK-2Rs is neuroprotective by evoking AMPK activation, expression of mitochondrial fusion modulators and autophagy. Other benefits include vagus nerve/CCK-1R-mediated expression of brain-derived neurotrophic factor, intestinal protection and suppression of inflammation. We also discuss caveats and the therapeutic combination of CCK with other peptide hormones.

胆囊收缩素(CCK)是一种调节消化、血糖水平、神经递质和记忆的神经肽。最近的研究表明,CCK 对阿尔茨海默病(AD)和帕金森病(PD)具有神经保护作用。因此,我们回顾了 CCK 的生理功能和治疗潜力。这种神经肽能促进海马谷氨酸的释放并控制GABA能篮状细胞的活动,从而改善陈述性记忆的获得,但会抑制记忆的巩固。皮层 CCK 可改变识别记忆并增强视听处理能力。通过刺激CCK-1受体(CCK-1Rs),硫酸化的CCK-8可引起黑质和纹状体释放多巴胺。在间叶通路中,CCK 的释放由多巴胺触发,并通过 CCK-2Rs 终止奖赏反应。重要的是,激活海马和黑质的 CCK-2Rs 可唤起 AMPK 激活、线粒体融合调节剂的表达和自噬,从而起到神经保护作用。其他益处包括迷走神经/CCK-1R介导的脑源性神经营养因子的表达、肠道保护和炎症抑制。我们还讨论了注意事项以及 CCK 与其他肽类激素的治疗组合。
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引用次数: 0
Neuroendocrine mechanisms in the links between early life stress, affect, and youth substance use: A conceptual model for the study of sex and gender differences 早期生活压力、情感和青少年药物使用之间联系的神经内分泌机制:研究性和性别差异的概念模型
IF 7.4 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-01-20 DOI: 10.1016/j.yfrne.2024.101121
Alexandra Donovan , Shervin Assari , Christine Grella , Magda Shaheen , Linda Richter , Theodore C. Friedman

Early life stress (ELS) is defined as an acute or chronic stressor that negatively impacts a child’s development. ELS is associated with substance use and mental health problems. This narrative literature review focuses on sex and gender differences in the effects of ELS on 1) adolescent neuroendocrine development; 2) pubertal brain maturation; and 3) development of internalizing symptoms and subsequent substance use. We posit that ELS may generate larger hormonal dysregulation in females than males during puberty, increasing internalizing symptoms and substance use. Future research should consider sex and gender differences in neuroendocrine developmental processes when studying the link between ELS and negative health outcomes.

早期生活压力(ELS)是指对儿童成长产生负面影响的急性或慢性压力。ELS 与药物使用和心理健康问题有关。这篇叙述性文献综述的重点是 ELS 对以下方面影响的性别差异:1)青少年神经内分泌发育;2)青春期大脑成熟;3)内化症状的发展及随后的药物使用。我们认为,在青春期,ELS 可能会对女性产生比男性更大的荷尔蒙失调,从而增加内化症状和药物使用。在研究 ELS 与负面健康结果之间的联系时,未来的研究应考虑神经内分泌发育过程中的性别差异。
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引用次数: 0
The role of stress in perinatal depression and anxiety – A systematic review 压力在围产期抑郁和焦虑中的作用 - 系统综述
IF 7.4 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-01-01 DOI: 10.1016/j.yfrne.2023.101117
MA. Schalla , A. Stengel

Perinatal depression (PND) and anxiety affect around 20% of women, but available pharmacotherapy is not sufficiently effective in 20–60% of them, indicating a need for better understanding of these diseases. Since stress is a significant risk factor for PND, the aim was to examine the role of biological, environmental and psychological stress in PND and anxiety through a systematic literature search. Overall 210 studies were included, among which numerous rodent studies showed that perinatal stress induced depressive-like and anxious behavior, which was associated with HPA-axis alterations and morphological brain changes. Human studies indicated that the relationship between cortisol and perinatal depression/anxiety was not as clear and with many contradictions, although social and psychological stress were clearly positively associated with PND. Finally, oxytocin, synthetic neuroactive steroid and n-3 PUFA diet have been identified as potentially beneficial in the therapy of PND and anxiety, worth to be investigated in the future.

围产期抑郁症(PND)和焦虑症影响着约 20% 的妇女,但现有的药物疗法对其中 20%-60% 的妇女效果不佳,这表明我们需要更好地了解这些疾病。由于压力是 PND 的重要风险因素,因此本研究旨在通过系统性文献检索,研究生物、环境和心理压力在 PND 和焦虑症中的作用。共纳入 210 项研究,其中大量啮齿类动物研究表明,围产期压力会诱发抑郁样和焦虑行为,这与 HPA 轴改变和大脑形态学变化有关。人类研究表明,皮质醇与围产期抑郁/焦虑之间的关系并不明确,而且存在许多矛盾,尽管社会和心理压力显然与 PND 呈正相关。最后,催产素、合成神经活性类固醇和 n-3 PUFA 膳食被认为对治疗 PND 和焦虑症可能有益,值得在未来进行研究。
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引用次数: 0
Sex differences in cortisol levels in depression: A systematic review and meta-analysis 抑郁症患者皮质醇水平的性别差异:系统综述与荟萃分析
IF 7.4 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-01-01 DOI: 10.1016/j.yfrne.2023.101118
Rui Wang , Lydia Kogler , Birgit Derntl

Higher prevalence of depression in females might be associated with sex-specific cortisol levels. Evidence exists that cortisol levels differ between healthy females and males, however a sex-specific association in depression has not been systematically assessed. Thus, the current study quantifies the existing literature on different cortisol parameters, i.e., basal cortisol, hair cortisol, cortisol awakening response (CAR), and cortisol stress reactivity comparing depressed females and males as well as sex-specific comparisons with healthy controls. Following an extensive literature research, fifty original articles were included. Depressed females had significantly higher hair cortisol, higher CAR, and lower cortisol stress reactivity compared to depressed males. In comparison with sex-matched controls, female patients had significantly higher evening basal cortisol, higher CAR and lower cortisol stress reactivity, and male patients had significantly higher general, morning and evening basal cortisol. Overall, sex as a fundamental driver of cortisol levels in depression needs to be taken into account.

女性抑郁症发病率较高可能与皮质醇水平的性别特异性有关。有证据表明,健康女性和男性的皮质醇水平存在差异,但尚未对抑郁症的性别特异性关联进行系统评估。因此,本研究对现有文献中有关不同皮质醇参数(即基础皮质醇、毛发皮质醇、皮质醇唤醒反应(CAR)和皮质醇应激反应性)的研究进行了量化,并与抑郁症女性和男性以及健康对照组进行了性别特异性比较。经过广泛的文献研究,共收录了 50 篇原创文章。与抑郁男性相比,抑郁女性的毛发皮质醇含量明显更高,皮质醇应激反应率(CAR)更高,皮质醇应激反应性更低。与性别匹配的对照组相比,女性患者的晚间基础皮质醇、皮质醇应激反应性和皮质醇应激反应性均明显较高,而男性患者的一般、早晨和晚间基础皮质醇均明显较高。总之,需要考虑到性别是抑郁症皮质醇水平的基本驱动因素。
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引用次数: 0
Electroencephalography findings in menstrually-related mood disorders: A critical review 月经相关情绪障碍的脑电图检查结果:批判性评论
IF 7.4 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-01-01 DOI: 10.1016/j.yfrne.2023.101120
Elisavet Kaltsouni , Felix Schmidt , Rachel G. Zsido , Allison Eriksson , Julia Sacher , Inger Sundström-Poromaa , Rachael L. Sumner , Erika Comasco

The female reproductive years are characterized by fluctuations in ovarian hormones across the menstrual cycle, which have the potential to modulate neurophysiological and behavioral dynamics. Menstrually-related mood disorders (MRMDs) comprise cognitive-affective or somatic symptoms that are thought to be triggered by the rapid fluctuations in ovarian hormones in the luteal phase of the menstrual cycle. MRMDs include premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), and premenstrual exacerbation (PME) of other psychiatric disorders. Electroencephalography (EEG) non-invasively records in vivo synchronous activity from populations of neurons with high temporal resolution. The present overview sought to systematically review the current state of task-related and resting-state EEG investigations on MRMDs. Preliminary evidence indicates lower alpha asymmetry at rest being associated with MRMDs, while one study points to the effect being luteal-phase specific. Moreover, higher luteal spontaneous frontal brain activity (slow/fast wave ratio as measured by the delta/beta power ratio) has been observed in persons with MRMDs, while sleep architecture results point to potential circadian rhythm disturbances. In this review, we discuss the quality of study designs as well as future perspectives and challenges of supplementing the diagnostic and scientific toolbox for MRMDs with EEG.

女性生育期的特点是整个月经周期中卵巢激素的波动,这种波动有可能调节神经生理和行为动态。月经相关情绪障碍(MRMDs)包括认知-情感或躯体症状,这些症状被认为是由月经周期黄体期卵巢激素的快速波动引发的。MRMD包括经前期综合征(PMS)、经前期情感障碍(PMDD)和其他精神疾病的经前期加重(PME)。脑电图(EEG)能以高时间分辨率无创记录神经元群的体内同步活动。本综述旨在系统回顾有关 MRMDs 的任务相关脑电图和静息态脑电图研究现状。初步证据表明,静息状态下较低的α不对称与 MRMDs 有关,而一项研究则指出这种效应具有黄体期特异性。此外,在 MRMD 患者中还观察到较高的黄体期自发额叶脑活动(以 delta/beta 功率比衡量的慢波/快波比率),而睡眠结构结果表明可能存在昼夜节律紊乱。在这篇综述中,我们将讨论研究设计的质量以及通过脑电图补充 MRMD 诊断和科学工具箱的未来前景和挑战。
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引用次数: 0
Modulatory role of neurosteroidogenesis in the spinal cord during peripheral nerve injury-induced chronic pain 周围神经损伤诱发慢性疼痛期间脊髓中神经类固醇生成的调节作用
IF 7.4 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-01-01 DOI: 10.1016/j.yfrne.2023.101116
Ayikoe-Guy Mensah-Nyagan, Laurence Meyer , Christine Patte-Mensah

The brain and spinal cord (SC) are both targeted by various hormones, including steroid hormones. However, investigations of the modulatory role of hormones on neurobiological functions usually focus only on the brain. The SC received little attention although this structure pivotally controls motor and sensory functions. Here, we critically reviewed key data showing that the process of neurosteroid biosynthesis or neurosteroidogenesis occurring in the SC plays a pivotal role in the modulation of peripheral nerve injury-induced chronic pain (PNICP) or neuropathic pain. Indeed, several active steroidogenic enzymes expressed in the SC produce endogenous neurosteroids that interact with receptors of neurotransmitters controlling pain. The spinal neurosteroidogenesis is differentially regulated during PNICP condition and its blockade modifies painful sensations. The paper suggests that future investigations aiming to develop effective strategies against PNICP or neuropathic pain must integrate in a gender or sex dependent manner the regulatory effects exerted by spinal neurosteroidogenesis.

大脑和脊髓(SC)都是各种激素(包括类固醇激素)的靶标。然而,关于激素对神经生物学功能的调节作用的研究通常只关注大脑。虽然脊髓是控制运动和感觉功能的枢纽,但它却很少受到关注。在此,我们对一些关键数据进行了评述,这些数据表明,发生在SC中的神经类固醇生物合成或神经类固醇生成过程在周围神经损伤诱导的慢性疼痛(PNICP)或神经病理性疼痛的调节中起着关键作用。事实上,在脊髓囊肿中表达的几种活性类固醇生成酶会产生内源性神经类固醇,这些类固醇会与控制疼痛的神经递质受体相互作用。脊髓神经类固醇的生成在 PNICP 状态下受到不同程度的调节,阻断这种调节会改变疼痛感觉。本文认为,未来旨在开发有效的 PNICP 或神经病理性疼痛策略的研究必须以性别或性依赖的方式整合脊髓神经类固醇生成所产生的调节作用。
{"title":"Modulatory role of neurosteroidogenesis in the spinal cord during peripheral nerve injury-induced chronic pain","authors":"Ayikoe-Guy Mensah-Nyagan,&nbsp;Laurence Meyer ,&nbsp;Christine Patte-Mensah","doi":"10.1016/j.yfrne.2023.101116","DOIUrl":"10.1016/j.yfrne.2023.101116","url":null,"abstract":"<div><p>The brain and spinal cord (SC) are both targeted by various hormones, including steroid hormones. However, investigations of the modulatory role of hormones on neurobiological functions usually focus only on the brain. The SC received little attention although this structure pivotally controls motor and sensory functions. Here, we critically reviewed key data showing that the process of neurosteroid biosynthesis or neurosteroidogenesis occurring in the SC plays a pivotal role in the modulation of peripheral nerve injury-induced chronic pain (PNICP) or neuropathic pain. Indeed, several active steroidogenic enzymes expressed in the SC produce endogenous neurosteroids that interact with receptors of neurotransmitters controlling pain. The spinal neurosteroidogenesis is differentially regulated during PNICP condition and its blockade modifies painful sensations. The paper suggests that future investigations aiming to develop effective strategies against PNICP or neuropathic pain must integrate in a gender or sex dependent manner the regulatory effects exerted by spinal neurosteroidogenesis.</p></div>","PeriodicalId":12469,"journal":{"name":"Frontiers in Neuroendocrinology","volume":"72 ","pages":"Article 101116"},"PeriodicalIF":7.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139093971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Post-Finasteride Syndrome And Post-Ssri Sexual Dysfunction: Two Clinical Conditions Apparently Distant, But Very Close 非那雄胺后综合征和ssri后性功能障碍:两种临床症状,表面上相距遥远,但非常接近。
IF 7.4 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-11-21 DOI: 10.1016/j.yfrne.2023.101114
Silvia Giatti, Silvia Diviccaro, Lucia Cioffi, Roberto Cosimo Melcangi

Post-finasteride syndrome and post-SSRI sexual dysfunction, are two poorly explored clinical conditions in which men treated for androgenetic alopecia with finasteride or for depression with SSRI antidepressants show persistent side effects despite drug suspension (e.g., sexual dysfunction, psychological complaints, sleep disorders). Because of some similarities in the symptoms, common pathological mechanisms are proposed here. Indeed, as discussed, clinical studies and preclinical data obtained so far suggest an important role for brain modulators (i.e., neuroactive steroids), neurotransmitters (i.e., serotonin, and cathecolamines), and gut microbiota in the context of the gut-brain axis. In particular, the observed interconnections of these signals in these two clinical conditions may suggest similar etiopathogenetic mechanisms, such as the involvement of the enzyme converting norepinephrine into epinephrine (i.e., phenylethanolamine N-methyltransferase). However, despite the current efforts, more work is still needed to advance the understanding of these clinical conditions in terms of diagnostic markers and therapeutic strategies.

非那雄胺后综合征和SSRI后性功能障碍是两种很少被探索的临床症状,其中男性用非那雄胺治疗雄激素性脱发或用SSRI抗抑郁药治疗抑郁症,尽管停药,但仍有持续的副作用(如性功能障碍、心理不适、睡眠障碍)。由于症状有一些相似之处,本文提出了共同的病理机制。事实上,如前所述,临床研究和迄今为止获得的临床前数据表明,在肠-脑轴的背景下,脑调节剂(即神经活性类固醇)、神经递质(即血清素和儿茶酚胺)和肠道微生物群具有重要作用。特别是,在这两种临床情况下观察到的这些信号的相互联系可能表明类似的发病机制,例如将去甲肾上腺素转化为肾上腺素的酶(即苯乙醇胺n -甲基转移酶)的参与。然而,尽管目前的努力,在诊断标志物和治疗策略方面,仍需要做更多的工作来促进对这些临床状况的理解。
{"title":"Post-Finasteride Syndrome And Post-Ssri Sexual Dysfunction: Two Clinical Conditions Apparently Distant, But Very Close","authors":"Silvia Giatti,&nbsp;Silvia Diviccaro,&nbsp;Lucia Cioffi,&nbsp;Roberto Cosimo Melcangi","doi":"10.1016/j.yfrne.2023.101114","DOIUrl":"10.1016/j.yfrne.2023.101114","url":null,"abstract":"<div><p>Post-finasteride syndrome and post-SSRI sexual dysfunction, are two poorly explored clinical conditions in which men treated for androgenetic alopecia with finasteride or for depression with SSRI antidepressants show persistent side effects despite drug suspension (e.g., sexual dysfunction, psychological complaints, sleep disorders). Because of some similarities in the symptoms, common pathological mechanisms are proposed here. Indeed, as discussed, clinical studies and preclinical data obtained so far suggest an important role for brain modulators (i.e., neuroactive steroids), neurotransmitters (i.e., serotonin, and cathecolamines), and gut microbiota in the context of the gut-brain axis. In particular, the observed interconnections of these signals in these two clinical conditions may suggest similar etiopathogenetic mechanisms, such as the involvement of the enzyme converting norepinephrine into epinephrine (i.e., phenylethanolamine N-methyltransferase). However, despite the current efforts, more work is still needed to advance the understanding of these clinical conditions in terms of diagnostic markers and therapeutic strategies.</p></div>","PeriodicalId":12469,"journal":{"name":"Frontiers in Neuroendocrinology","volume":"72 ","pages":"Article 101114"},"PeriodicalIF":7.4,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0091302223000626/pdfft?md5=5141fc97c04f150685f7fd47f184422c&pid=1-s2.0-S0091302223000626-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138295045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sex differences in bipolar disorder: The dorsolateral prefrontal cortex as an etiopathogenic region 双相情感障碍的性别差异:背外侧前额皮质作为一个致病区域。
IF 7.4 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-11-21 DOI: 10.1016/j.yfrne.2023.101115
Lin Zhang, Dick F. Swaab

Bipolar disorder (BD) is worldwide a prevalent mental illness and a leading risk factor for suicide. Over the past three decades, it has been discovered that sex differences exist throughout the entire panorama of BD, but the etiologic regions and mechanisms that generate such differences remain poorly characterized. Available evidence indicates that the dorsolateral prefrontal cortex (DLPFC), a critical region that controls higher-order cognitive processing and mood, exhibits biological disparities between male and female patients with psychiatric disorders, which are highly correlated with the co-occurrence of psychotic symptoms. This review addresses the sex differences in BD concerning epidemiology, cognitive impairments, clinical manifestations, neuroimaging, and laboratory abnormalities. It also provides strong evidence linking DLPFC to the etiopathogenesis of these sex differences. We emphasize the importance of identifying gene signatures using human brain transcriptomics, which can depict sexually different variations, explain sex-biased symptomatic features, and provide novel targets for sex-specific therapeutics.

双相情感障碍(BD)是世界范围内普遍存在的精神疾病,也是自杀的主要危险因素。在过去的三十年中,人们发现性别差异存在于整个双相障碍的全景中,但产生这种差异的病因区域和机制仍然缺乏特征。现有证据表明,男性和女性精神障碍患者的背外侧前额叶皮层(DLPFC)是控制高阶认知加工和情绪的关键区域,其生物学差异与精神病症状的同时发生高度相关。本文综述了双相障碍在流行病学、认知障碍、临床表现、神经影像学和实验室异常方面的性别差异。它还提供了将DLPFC与这些性别差异的发病机制联系起来的有力证据。我们强调利用人脑转录组学鉴定基因特征的重要性,这可以描述性别差异,解释性别偏倚的症状特征,并为性别特异性治疗提供新的靶点。
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引用次数: 0
Advances in steroid research from the pioneering neurosteroid concept to metabolomics: New insights into pregnenolone function 从开创性的神经类固醇概念到代谢组学的类固醇研究进展:对孕烯醇酮功能的新见解。
IF 7.4 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-11-21 DOI: 10.1016/j.yfrne.2023.101113
Monique Vallée

Advances in neuroendocrinology have led to major discoveries since the 19th century, identifying adaptive loops for maintaining homeostasis. One of the most remarkable discoveries was the concept of neurosteroids, according to which the brain is not only a target but also a source of steroid production. The identification of new membrane steroid targets now underpins the neuromodulatory effects of neurosteroids such as pregnenolone, which is involved in functions mediated by the GPCR CB1 receptor. Structural analysis of steroids is a key feature of their interactions with the phospholipid membrane, receptors and resulting activity. Therefore, mass spectrometry-based methods have been developed to elucidate the metabolic pathways of steroids, the ultimate approach being metabolomics, which allows the identification of a large number of metabolites in a single sample. This approach should enable us to make progress in understanding the role of neurosteroids in the functioning of physiological and pathological processes.

自19世纪以来,神经内分泌学的进步带来了重大发现,确定了维持体内平衡的适应回路。最引人注目的发现之一是神经类固醇的概念,根据该概念,大脑不仅是类固醇生产的目标,也是类固醇生产的来源。新的膜类固醇靶点的鉴定现在支持神经类固醇如孕烯醇酮的神经调节作用,孕烯醇酮参与GPCR CB1受体介导的功能。类固醇的结构分析是其与磷脂膜、受体及其活性相互作用的关键特征。因此,基于质谱的方法已经被开发出来阐明类固醇的代谢途径,最终的方法是代谢组学,它允许在单个样品中鉴定大量的代谢物。这种方法应该使我们能够在理解神经类固醇在生理和病理过程中的作用方面取得进展。
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引用次数: 0
Symptoms of mental disorders and oral contraception use: A systematic review and meta-analysis 精神障碍症状与口服避孕药的使用:一项系统回顾和荟萃分析。
IF 7.4 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-11-14 DOI: 10.1016/j.yfrne.2023.101111
Mathilda Z. Kraft , Philine Rojczyk , Thomas Weiss , Birgit Derntl , Zora Kikinis , Ilona Croy , Carina Heller

Worldwide, over 150 million adolescent and adult women use oral contraceptives (OC). An association between OC-use and the emergence of symptoms of mental disorders has been suggested. This systematic review and meta-analysis provide an overview of published research regarding symptoms of mental disorders in association with OC-use, factoring the influence of OC types, age of first-use, duration of OC-intake, and previous diagnoses of mental disorders. A systematic literature search was conducted between June-July 2022. 22 studies were included. While most found no significant OC-use effects on mental symptoms, some hinted at OCs as a potential risk. The existing evidence regarding the potential link between progestin-only OC-use and an elevated risk of mental symptoms in comparison to combined OC-use remains inconclusive. However, due to emerging indications suggesting that the formulation of OC might play a role in mental health outcomes, this topic warrants further investigation. Moreover, indications of an increased risk for depressive symptoms in adolescent OC-users should be noted. Hence, while general population effects seem unlikely, they cannot be completely disregarded. The decision on OC-use should depend on the patient's medical history and should be re-evaluated regularly.

全世界有超过1.5亿青少年和成年妇女使用口服避孕药(OC)。使用强迫症与精神障碍症状的出现之间存在关联。本系统综述和荟萃分析概述了已发表的与使用强迫症相关的精神障碍症状的研究,并考虑了强迫症类型、首次使用年龄、服用强迫症持续时间和既往精神障碍诊断的影响。在2022年6月至7月期间进行了系统的文献检索。纳入了22项研究。虽然大多数人没有发现使用强迫症对精神症状的显著影响,但有些人暗示强迫症是一种潜在的风险。与联合使用孕激素相比,仅使用孕激素与精神症状风险增加之间的潜在联系的现有证据仍然没有定论。然而,由于新出现的迹象表明OC的形成可能在心理健康结果中发挥作用,这一主题值得进一步研究。此外,应该注意青少年强迫症使用者抑郁症状风险增加的迹象。因此,尽管总体群体效应似乎不太可能,但也不能完全忽视它们。使用oc的决定应取决于患者的病史,并应定期重新评估。
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引用次数: 0
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