Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519;
Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT 06519.
Proc Natl Acad Sci U S A. 2017 Aug 1;114(31):8390-8395. doi: 10.1073/pnas.1701749114. Epub 2017 Jul 17.
Posttraumatic stress disorder (PTSD) is a prevalent and highly disabling disorder, but there is currently no targeted pharmacological treatment for it. Dysfunction of the glutamate system has been implicated in trauma and stress psychopathology, resulting in a growing interest in modulation of the glutamate system for the treatment of PTSD. Specifically, the metabotropic glutamate receptor 5 (mGluR5) represents a promising treatment target. We used [F]FPEB, a radioligand that binds to the mGluR5, and positron emission tomography (PET) to quantify in vivo mGluR5 availability in human PTSD vs. healthy control (HCs) subjects. In an independent sample of human postmortem tissue, we investigated expression of proteins that have a functional relationship with mGluR5 and glucocorticoids in PTSD. We observed significantly higher cortical mGluR5 availability in PTSD in vivo and positive correlations between mGluR5 availability and avoidance symptoms. In the postmortem sample, we observed up-regulation of SHANK1, a protein that anchors mGluR5 to the cell surface, as well as decreased expression of FKBP5, implicating aberrant glucocorticoid functioning in PTSD. Results of this study provide insight into molecular mechanisms underlying PTSD and suggest that mGluR5 may be a promising target for mechanism-based treatments aimed at mitigating this disorder.
创伤后应激障碍(PTSD)是一种普遍且高度致残的疾病,但目前尚无针对其的靶向药物治疗方法。谷氨酸系统功能障碍与创伤和应激精神病理学有关,这导致人们对调节谷氨酸系统治疗 PTSD 的兴趣日益增加。具体来说,代谢型谷氨酸受体 5(mGluR5)是一个很有前途的治疗靶点。我们使用 [F]FPEB,一种与 mGluR5 结合的放射性配体,以及正电子发射断层扫描(PET)来定量比较 PTSD 患者和健康对照组(HCs)体内的 mGluR5 可用性。在另一组人类死后组织样本中,我们研究了与 mGluR5 和糖皮质激素具有功能关系的蛋白质在 PTSD 中的表达情况。我们观察到 PTSD 患者体内皮质层 mGluR5 的可用性明显更高,且 mGluR5 的可用性与回避症状之间存在正相关。在尸检样本中,我们观察到 SHANK1 的上调,SHANK1 是一种将 mGluR5 锚定在细胞表面的蛋白质,同时还观察到 FKBP5 的表达减少,这表明 PTSD 中存在糖皮质激素功能异常。这项研究的结果为 PTSD 的分子机制提供了深入的了解,并表明 mGluR5 可能是一种有前途的治疗靶点,可用于针对这种疾病的基于机制的治疗。