n-3系多元不饱和脂肪酸对抑郁症的影响及其机制

The Effect of n-3 Polyunsaturated Fatty Acids on Depressive Disorder and Its Mechanism

越来越多的实验证据表明,n-3系多元不饱和脂肪酸(n-3PUFA)与抑郁症之间存在联系,二十二碳六烯酸(DHA)和二十碳五烯酸(EPA)可能具有预防和治疗抑郁症的作用。回顾国内外关于n-3PUFA与抑郁症之间存在的负性关系的研究并介绍其主要的研究结果和现状,解释n-3PUFA引起的抗抑郁效果可能涉及的神经机制,包括神经传递、葡萄糖的新陈代谢、促炎细胞因子的分泌、5-羟色胺(5-HT)以及脑源性神经营养因子(BDNF)的水平、还有神经元的凋亡等的变化。并且总结现有研究中存在的一些问题,例如使用的n-3PUFA种类和剂量问题,DHA或EPA是否对于不同种类的抑郁症均有效,单独作用还是共同作用才能引起抗抑郁效果等等,n-3PUFA对抑郁症病理机制的具体影响可能是未来的研究方向。

A growing body of evidence suggests that n-3 polyunsaturated fatty acid （n-3PUFA） is associated with depressive disorder, and supplementation of docosahexaenoic acid （DHA） and eicosapentaenoic acid （EPA）, which are the most common PUFA in the brain, may be of value in the prevention and treatment of depression. The purpose of this article is to review studies in this emerging area, identify and evaluate available evidence of a negative correction between n-3PUFA intake and depression, and propose mechanisms that could explain such relationship, n-3PUFA may play an etiological role in serotonergic transmission, glucose metabolism, and release of pro-inflammatory cytokines, brain-derived neurotrophic factor （BDNF） level, and neuronal apoptosis. Future studies are needed to examine the dosage response functions of n-3PUFA, the specific roles of DHA or EPA in different clusters of depressive symptoms, whether DHA or EPA is effective in antidepressant treatments independently or coefficiently, as well as the potential clinical value of n-3PUFA in major depression.