5-羥色胺受體(5-hydroxy trptamine),一種吲哚衍生物。分子式C10H12N2O,普遍存在於動植物組織中。色氨酸經色氨酸羥化酶催化首先成5-羥色氨酸,再經5-羥色氨酸脫羥酶催化成5-羥色胺。
簡介
5-羥色胺最早是從血清中發現的,又名血清素,廣泛存在於哺乳動物組織中,特別在大腦皮層及神經突觸內含量很高,它也是一種抑制性神經遞質。在外周組織,5-羥色胺是一種強血管收縮劑和平滑肌收縮刺激劑。
在體內,5-羥色胺在腦組織中的濃度較高,它是調節神經活動的一種重要物質。有些肌體組織當受到某些藥物作用時,可以釋放出5-羥色胺。
作為活性物質,約90%合成和分布於腸嗜鉻細胞,通常與ATP等物質一起儲存於細胞顆粒內,並被血小板攝取和儲存,儲存量約占全身的8%。5-HT作為神經遞質,主要分布於松果體和下丘腦,可能參與痛覺、睡眠和體溫等生理功能的調節。中樞神經系統5-HT含量及功能異常可能與精神病與偏頭痛等多種疾病的發病有關。
5-HT必須通過相應受體的介導才能產生作用。5-HT受體分型複雜,已發現5-HT受體亞型。5-HT通過激活不同的5-HT受體亞型,可具有不同的藥理作用,但5-HT本身尚無臨床套用價值。
1.5-HT2A受體:5-HT2A受體基因定位於第13號染色體q14-21區,在嗅球、海馬、額葉皮質和梨狀內嗅皮質中密集分布。一些研究表明,精神分裂症患者腦額葉皮質5-HT2A受體的數目減少。非典型抗精神病藥如氯氮平、利培酮等對5-HT2A受體的阻滯作用強於對D2受體的阻滯。
對5-HT2A受體多態性與抗精神病藥反應的相關性的研究很多,但結果很不一致。Arranz等[16]報導5-HT2A受體編碼區 t102C多態性與精神分裂症有關,且與對氯氮平的反應有關。對氯氮平反應良好者的C102/C102純合子基因型的頻率低於無反應者,而T102/T102純合子頻率則高於無反應者。他們還發現,5-HT2A受體啟動子區域G-1438A和編碼區His452Tyr多態性也與對氯氮平的反應有關,對氯氮平治療無反應者的G-1438等位基因純合子頻率和Tyr452等位基因頻率均高於有反應者[17]。Malhotra等[18]的研究則未發現這些關係而Masellis等[19]的研究則發現T102C 和G-1438A多態性二者之間完全連鎖不平衡,但均與對氯氮平的反應無關,his452tyr多態性則與對氯氮平的反應有關。
2.5-HT2C受體:5-HT2C受體基因定位於X染色體q24區,分布於脈絡膜叢、前嗅核、梨狀區內嗅皮質、紋狀體及杏仁核中。5-HT2C受體可能含有非典型抗精神病藥如氯氮平的作用位點。
在5-HT2C受體基因編碼區第68位的鳥嘌呤被胞嘧啶替換,使受體蛋白23位半胱氨酸被絲氨酸替代,形成cys23ser多態性。Sodhi等[20]未發現此基因的多態性與精神分裂症有關聯,但報導90%的對氯氮平有反應的患者有1個或2個ser23等位基因,而在無此等位基因的患者中對氯氮平有反應者僅占59%,表明這個突變可預測對氯氮平的良好反應。Masellis等[19]則認為5-HT2C的cys23ser多態性與對氯氮平的反應無關。
3. 5-HT6受體:5-HT6受體基因定位於第1號染色體p35-36區,在人腦尾狀核中表達最多,在紋狀體中也大量表達。非典型抗精神病藥如氯氮平、利培酮等對5-HT6受體有很高的親和力,因此5-HT6介導的神經傳導可能在它們對精神分裂症的治療中發揮作用。
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