Rossetti Andrea Carlo, Koch Philipp, Ladewig Julia
Author affiliations: Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; HITBR Hector Institute for Translational Brain Research gGmbH, Mannheim, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany. Address for correspondence: Philipp Koch:
Dialogues Clin Neurosci. 2019;21(2):203-224. doi: 10.31887/DCNS.2019.21.2/jladewig.
Psychiatric disorders are a heterogeneous group of mental illnesses associated with a high social and economic burden on patients and society. The complex symptomatology of these disorders, coupled with our limited understanding of the structural and functional abnormalities affecting the brains of neuropsychiatric patients, has made it difficult to develop effective medical treatment strategies. With the advent of reprogramming technologies and recent developments in induced pluripotent stem (iPS) cell-based protocols for differentiation into defined neuronal cultures and 3-dimensional cerebral organoids, a new era of preclinical disease modeling has begun which could revolutionize drug discovery in psychiatry. This review provides an overview of iPS cell-based disease models in psychiatry and how these models contribute to our understanding of pharmacological drug action. We also propose a refined iPSC-based drug discovery pipeline, ranging from cell-based stratification of patients through improved screening and validation steps to more precise psychopharmacology. .
精神疾病是一组异质性的精神障碍,给患者和社会带来了沉重的社会和经济负担。这些疾病复杂的症状表现,再加上我们对影响神经精神疾病患者大脑的结构和功能异常的有限理解,使得开发有效的医学治疗策略变得困难。随着重编程技术的出现以及基于诱导多能干细胞(iPS)的方案在分化为特定神经元培养物和三维类脑器官方面的最新进展,临床前疾病建模的新时代已经开始,这可能会彻底改变精神病学领域的药物发现。本综述概述了精神病学中基于iPS细胞的疾病模型,以及这些模型如何有助于我们理解药物的药理作用。我们还提出了一个完善的基于iPSC的药物发现流程,从基于细胞的患者分层,到改进的筛选和验证步骤,再到更精确的精神药理学。