MTHFR-C677T基因多态性-抑郁症治疗的新思路

MTHFR 677C/T polymorphism-new ideas about depressive disorder treatment

遗传因素在抑郁症的发病机制中起着重要的作用。亚甲基四氢叶酸还原酶(MTHFR)是叶酸和同型半胱氨酸(Hcy)代谢的关键酶之一,参与阿尔茨海默病、抑郁症等神经精神类疾病的发生。MTHFR-C677T基因突变引起酶耐热性和活性降低,导致叶酸水平降低,血浆同型半胱氨酸(Hcy)浓度升高,造成中枢神经元和微血管的损害,影响中枢神经递质的合成以及中枢神经系统中生物胺类和磷脂类的甲基化,诱发抑郁症等多种神经精神类疾病。该文从MTHFR基因突变及功能、叶酸缺乏、血浆Hcy水平升高、MTHFR-C677T基因多态性等方面,综述了近年来有关MTHFR-C677T基因多态性与抑郁症关系的研究进展,希望以此为抑郁症的治疗带来新的思考,供同行参考。

It has been confirmed that genetic factor plays an im-portant role in the pathogenesis of depression. MTHFR is one of the key enzymes in folate and homocysteine ( Hcy ) metabolism which participates in Alzheimer’ s disease, depression and other mental illnesses. MTHFR-677C/T polymorphism causes the de-crease of enzyme activity and heat resistance, which will lead to lower folate and elevated plasmal Hcy concentration. All of these results put together will cause the central neuronal damage and microvascular damage and affect the synthesis of central neuro-transmitter and methylation of biogenic amines and phospholipids in the central nervous system, which will eventually induce vari-ous mental illnesses like depression, etc. This article reviews the research advancement in the relationship between MTHFR-677C/T polymorphism and depression in recent years on the basis of MTHFR gene mutation and function, lack of folic acid, elevated plasma homocysteine levels and the MTHFR-C677T polymor-phism. Based on which we hope to bring new ideas about treat-ment of depression.