Alaa A A Aljabali, Almuthanna Alkaraki, Omar Gammoh, Esam Qnais, Abdelrahim Alqudah, Walhan Alshaer, Vijay Mishra, Yachana Mishra, Mohamed El-Tanani
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引用次数: 0
Abstract
Introduction: Treatment-Resistant Depression (TRD) is a complex clinical condition characterized by inadequate response to conventional antidepressant treatments. There is growing evidence that microRNAs (miRNAs) play a role in the underlying pathophysiology of TRD and may offer new avenues for diagnostics and therapy.
Methods: A structured literature review of peer-reviewed publications indexed in PubMed, Scopus, and Web of Science was conducted. The search strategy included combinations of keywords such as "treatment- resistant depression," "microRNAs," "biomarkers," and "miRNA-based interventions." Articles were selected based on relevance to miRNA expression patterns in TRD, therapeutic modulation, and their clinical potential.
Results: Dysregulation of several miRNAs-including miR-135a, miR-34a, and miR-155-was consistently observed in patients with TRD. These miRNAs were linked to impaired synaptic plasticity and persistent neuroinflammation. Therapeutic approaches using miRNA mimics or inhibitors showed potential in restoring neurobiological balance and enhancing response to traditional antidepressants. However, delivery system limitations and blood-brain barrier penetration remain significant challenges.
Discussion: miRNAs appear to play a dual role in TRD, serving both as biomarkers for diagnosis and as targets for novel therapies. Integrating miRNA profiling into clinical workflows could enhance diagnostic precision and guide individualized treatment strategies. Translational barriers, such as delivery specificity and standardization of detection protocols, must be addressed before the widespread clinical application of this technology.
Conclusion: This review highlights miRNAs as promising diagnostic and therapeutic tools in TRD. Continued advancements in delivery systems and validation of biomarker panels may pave the way for their clinical implementation in personalized psychiatry.
难治性抑郁症（TRD）是一种复杂的临床疾病，其特征是对常规抗抑郁药物治疗反应不足。越来越多的证据表明，microRNAs （miRNAs）在TRD的潜在病理生理中发挥作用，并可能为诊断和治疗提供新的途径。方法：对PubMed、Scopus和Web of Science检索的同行评议出版物进行结构化文献综述。搜索策略包括“治疗难治性抑郁症”、“microrna”、“生物标志物”和“基于mirna的干预”等关键词的组合。文章的选择基于miRNA在TRD中的表达模式、治疗调节及其临床潜力的相关性。结果：在TRD患者中一致观察到几种mirna（包括miR-135a、miR-34a和mir -155）的失调。这些mirna与突触可塑性受损和持续的神经炎症有关。使用miRNA模拟物或抑制剂的治疗方法显示出恢复神经生物学平衡和增强对传统抗抑郁药物反应的潜力。然而，递送系统的限制和血脑屏障的穿透仍然是重大的挑战。讨论：mirna似乎在TRD中发挥双重作用，既可以作为诊断的生物标志物，也可以作为新疗法的靶点。将miRNA分析整合到临床工作流程中可以提高诊断精度并指导个性化治疗策略。在该技术广泛的临床应用之前，必须解决翻译障碍，如递送特异性和检测方案的标准化。结论：本综述强调了mirna作为TRD诊断和治疗工具的前景。递送系统和生物标志物面板验证的持续进步可能为其在个性化精神病学中的临床应用铺平道路。
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