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2011, Número 6

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Salud Mental 2011; 34 (6)


Los fármacos antidepresivos como reguladores de la neurogénesis hipocámpica de roedores y humanos adultos

Ramírez-Rodríguez G, Laguna-Chimal J, Vega-Rivera NM, Ortiz-López L, Méndez-Cuesta L, Estrada-Camarena EM, Babu H

Idioma: Español
Referencias bibliográficas: 110
Paginas: 497-506
Archivo PDF: 706.34 Kb.


RESUMEN

El hallazgo de la formación de nuevas neuronas en el giro dentado (GD) del hipocampo amplió el conocimiento acerca de la plasticidad del encéfalo. En este sentido, la neurogénesis es un proceso que involucra diferentes eventos celulares tales como: la división de las células madre, la proliferación de los neuroblastos, la migración y la sobrevivencia celular, así como la maduración dendrítica, la elongación axonal y la integración de las neuronas nuevas a los circuitos neuronales existentes. En conjunto, todas estas etapas causan cambios estructurales y funcionales en el cerebro. Por lo tanto, la formación de neuronas es un proceso regulado de manera fina por diferentes factores entre los que se incluyen: el nicho; algunos neurotransmisores como la serotonina, la dopamina, el glutamato y el GABA; factores de crecimiento como el factor de crecimiento de fibroblastos, el factor de crecimiento epidermal y el factor de crecimiento vascular endotelial (FGF, EGF y VEGF, por sus siglas en inglés); neurotrofinas como el factor neurotrópico derivado del cerebro y por la neurotrofina 3 (BDNF y NT3, por sus siglas en inglés).
Aunado a la existencia de factores que favorecen la neurogénesis hipocámpica, también hay factores que influyen de manera negativa en la formación de neuronas. Entre éstos se encuentra el estrés, el cual se relaciona con algunas enfermedades neuropsiquiátricas como la depresión y la ansiedad. A este respecto, estudios preclínicos han revelado que la aplicación de diferentes tipos de estresores puede afectar la plasticidad neuronal al inducir alteraciones morfológicas y funcionales en el hipocampo, así como afectar el proceso neurogénico. Las alteraciones causadas por el estrés se han relacionado con un aumento considerable y sostenido de los niveles de glucocorticoides. Esto último afecta el proceso neurogénico debido a que el hipocampo es una estructura cerebral que expresa niveles altos de receptores para estas hormonas. Al ser activados de forma persistente, los receptores a glucocorticoides causan una alteración en la neuroplasticidad hipocámpica. De tal modo y considerando lo anterior, teorías recientes han asociado un fallo en la formación de neuronas en el hipocampo con algunos trastornos psiquiátricos como la demencia, la esquizofrenia y la depresión.
No esta del todo elucidado el mecanismo a través del cual el estrés altera el proceso neurogénico. Sin embargo, trabajos recientes han revelado que la exposición a estrés causa un aumento en los niveles de ciertas citocinas proinflamatorias, tales como la interleucina-1β (IL-1β). El aumento en los niveles de esta citocina provoca un efecto tipo depresivo y una disminución en los niveles del BDNF, así como una alteración en la formación de nuevas neuronas. Estos hallazgos apoyan la idea de que la IL-1β es un mediador crítico del efecto antineurogénico causado por el estrés crónico y agudo. Sin embargo, la IL-1β no es la única citocina asociada con las alteraciones en el proceso neurogénico, ya que recientemente se reportó que la disminución en la proliferación celular causada por el estrés ocurre de manera paralela con el aumento en la expresión de los mensajeros de la IL-6 y del TNF-α.
Una manera de contrarrestar los efectos del estrés sobre la plasticidad neuronal es a través de la administración de fármacos antidepresivos. Diversos trabajos han mostrado que el tratamiento crónico con este tipo de fármacos revierte las alteraciones en la neurogénesis hipocámpica y en la plasticidad neuronal causadas por el estrés.
Finalmente, aun cuando existen evidencias del papel que desempeña la neurogénesis en modelos animales de algunas enfermedades neuropsiquiátricas y de la forma en que los fármacos antidepresivos favorecen la formación de neuronas, es importante contar con más estudios en humanos que permitan corroborar los hallazgos que se han obtenido en los estudios preclínicos. De algún modo todos los reportes apuntan a que los fármacos antidepresivos pueden actuar por mecanismos independientes o dependientes de la neurogénesis hipocámpica.


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