一个安全的雌激素调节的框架在男性双相情感障碍:SERM启用辅助治疗的理论理由
1Montana State University, Bozeman, MT, United States.
Frontiers in psychiatry
|September 25, 2025
概括
这项研究建议使用雌激醇和选择性雌激素受体调节剂 (SERM) 通过向大脑雌激素受体来治疗男性耐治疗双相情感障碍 (TR-BD). 这种方法旨在改善情绪和认知,而不会引起女性化的效应.
科学领域:
- 神经内分泌学神经内分泌学
- 精神病学是一个精神病学.
- 神经药理学神经药理学
背景情况:
- 治疗耐药双极性障碍 (TR-BD) 在男性中是一个重大的临床挑战.
- 标准的单氨基疗法对于TR-BD通常是无效的.
- 需要针对特定神经生物学途径的新型治疗策略.
研究的目的:
- 提出一种新的,基于性别的假设来治疗男性的TR-BD.
- 为了研究辅助性雌激素的潜力,缓冲由SERMs,参与雌激素受体β (ER-β) 和G蛋白结合雌激素受体1 (GPER1) 在男性大脑.
- 探索该策略如何针对TR-BD的核心功能障碍.
主要方法:
- 整合来自神经内分泌,神经免疫和突触信号研究的证据.
- 假定中央雌激素受体激活可以恢复神经可塑性,抑制促炎级联,并重新校准应激反应.
- 审查ER-β和GPER1激活的临床前和转化研究.
主要成果:
- 激活ER-β和GPER1可能会增强来自大脑的神经营养因子 (BDNF) 的表达,并调节关键信号通路 (CREB,PI3K/Akt).
- 假设这种激活会减弱TR-BD中涉及的促炎细胞因子 (IL-6,TNF-α).
- 拟议的联合治疗旨在减少情绪不稳定,认知障碍和压力敏感性.
结论:
- 辅助性雌激醇和SERM可能通过选择性激活ER-β/GPER1.1,为男性TR-BD提供一种新的内分泌中性治疗策略.
- 这种方法可能会重塑性激素在男性精神病学中的作用,朝着精确的神经调节的方向前进.
- 用生物标志物丰富的患者分层进行进一步的翻译试验是有必要的,以验证这一假设.
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