S- 腺苷蛋氨酸在肝病患者中抗抑郁作用的研究进展

S-腺苷蛋氨酸(S-adenosyl-L-methionine,SAMe)是一种天然分子存在于人体所有细胞中,在肝脏、肾上腺以及松果体中具有较高浓度,在大脑中亦均匀分布。S-腺苷蛋氨酸通过抗氧化自由基及促进肝细胞再生等机制对肝细胞具有多重保护作用长久以来被广泛应用于肝病所致的肝内胆汁淤积、抗肝纤维化等治疗。近年来,研究亦发现S-腺苷蛋氨酸可增加患者脑中神经元膜的流动性及促进兴奋性神经递质的产生等对改善肝病患者情绪、治疗肝病患者抑郁症等方面具有重要的双重作用。通过静脉或口服用药,均可提高患者脑脊液中SAMe浓度,对于轻、中度抑郁患者的辅助治疗,更具安全性、有效性,这为人类的"生理-心理"疾病的治疗带来更广阔的应用前景。现将其对肝病患者抗抑郁的作用机制及临床应用综述如下。

Research on Antidepressant Effects of S-adenosylmethionine in Patients with Liver Diseases

S-adenosylmethionine (S-adenosyl-L-methionine, SAMe) is a natural molecule exsisting in all human cells, expressing a higher concentration in the liver, adrenal gland as well as in the pineal gland, and also uniformly distributed in the brain. S-adenosylmethionine has long been widely used in most of intrahepatic cholestasis and liver fibrosis diseases because of its mutiple protection mechanisms of liver cells by anti-oxidant free radicals and promoting the regeneration of liver cells. Moreover, in recent years, literature illustrates that it has a vital dual role in improving the mood and treating depression of patients with liver diseases by increasing the neurons membrane fluidity in patients'' brains and promoting the generation of excitatory neurotransmitter. The cerebrospinal concentration of SAMe can be improved by either intravenous or oral intake. SAMe safely and efficiently serves as an adjuvant medication for patients with mild to moderate depression, which will bring broad application prospects for the treatment of human physiological - psychological diseases. Therefore, its antidepressant mechanisms and clinical applications in patients with liver diseases are summarized below