Depression disorder is a common psychological condition characterized by high incidence, high relapse rates, and disability, and has become a major global public health issue. The prevalence of depression has increased by 27.6% after the COVID-19 pandemic. Depression disorder not only exacerbates healthcare resource consumption and reduces social productivity but may also trigger extreme behaviors such as suicide, posing a severe threat to the life and health of humans. However, the pathological mechanisms underlying depression disorder remain unclear. The phosphoinositide 3-kinase/protein kinase B signaling pathway, one of the key pathways, participates in disease progression by mediating the inflammatory response, oxidative stress, and apoptosis. In traditional Chinese medicine (TCM) theory, depression disorder is classified under categories such as "depression syndrome," "hysteria," or "lily disease," with deficiency, heat, phlegm, and blood stasis as its primary pathological factors and "stagnation-deficiency-obstruction" as the core phthogenesis. The theory of form, qi, and spirit, rooted in the holistic view of TCM, conceptualizes depression disorder as a dynamic process of "spirit dysfunction → qi depletion → physical damage." Notably, the biological processes mediated by the PI3K/Akt signaling pathway exhibit significant similarities with the pathological chain of the spirit-qi-form. This paper systematically explores the association between the PI3K/Akt signaling pathway and the pathogenesis of depression disorder from the perspective of the form-qi-spirit theory. Spirit dysfunction affects pathway activity through neuroendocrine pathways. Qi depletion is closely associated with mitochondrial dysfunction, which is regulated by the pathway. Physical damage involves pathological processes such as inflammation and apoptosis. By elucidating the intrinsic relationships between these three aspects, this study provides a theoretical foundation and research direction for the integration of traditional Chinese and western medicine treatments, as well as drug development for depression disorder.
- Article type
- Year
Open Access
Issue
Open Access
Issue
To explore the effect of "Xingshen-Jieyu" (inducing resuscitation and dispel ling melancholy) electroacupuncture (EA) on serum metabolites in patients with depression and its underlying mechanisms through serum non-targeted metabolomics.
Fifteen depression patients were subjected into the EA group, and 15 healthy volunteers were matched into the healthy group. EA (2 Hz/15 Hz, a tolerable strength) was applied to Baihui (GV20), Shenting (GV24), Toulinqi (GB15), Benshen (GB13), Touwei (ST8), Xuanli (GB6) and Qubin (GB7) for 30 min, 3 times a week for 6 weeks. The severity of depression was assessed using Hamilton Depression Scale-17(HAMD-17) and Hamilton Anxiety Scale (HAMA), the degree of fatigue was evaluated using Fatigue Scale-14(FS-14). The subjects sleep quality was assessed using Pittsburgh sleep quality index (PSQI). Blood samples were collected before and after the treatment for processing serum to perform non-targeted metabolomics profile detection using ultra-high-performance liquid chromatography coupled with mass spectrometry (UPLC-MS), and Partial Least Squares Discriminant Analysis (PLS-DA, a statistical approach). Differential metabolites were screened and pathway enrichment analysis was performed.
After the treatment, the scores of HAMD-17, HAMA, PSQI and FS-14 of depression patients were significantly lowered in the EA group (P < 0.05). Compared with the healthy subjects, 46 differential metabolites (21 up-regulated, 25 down-regulated) were screened in patients with depression. Compared with pre-treatment in the EA group, 19 differential (17 up-regulated, and 2 down-regulated) metabolites were screened. Four down-regulated metabolites of the 46 differential metabolites in depression patients were recovered after EA treatment. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis of differential metabolites before and after EA showed that 19 metabolic pathways were enriched, mainly involving glutaminergic synapses, GABAergic synapses and several amino acid metabolism related pathways.
"Xingshen-Jieyu" EA mainly regulates the metabolism of amino acids, and activities of neurotransmitter glutamate and GABA, and restores the excitatory/inhibitory balance, thus playing a role in improving depression.
京公网安备11010802044758号