Pharmacological Treatment for Neuroinflammation in Stress-Related Disorder

Biomedicines. 2022 Oct 9;10(10):2518. doi: 10.3390/biomedicines10102518.

Abstract

Stress is an organism's response to a biological or psychological stressor, a method of responding to threats. The autonomic nervous system and hypothalamic-pituitary-adrenal axis (HPA axis) regulate adaptation to acute stress and secrete hormones and excitatory amino acids. This process can induce excessive inflammatory reactions to the central nervous system (CNS) by HPA axis, glutamate, renin-angiotensin system (RAS) etc., under persistent stress conditions, resulting in neuroinflammation. Therefore, in order to treat stress-related neuroinflammation, the improvement effects of several mechanisms of receptor antagonist and pharmacological anti-inflammation treatment were studied. The N-methyl-D-aspartate (NMDA) receptor antagonist, peroxisome proliferator-activated receptor agonist, angiotensin-converting enzyme inhibitor etc., effectively improved neuroinflammation. The interesting fact is that not only can direct anti-inflammation treatment improve neuroinflammation, but so can stress reduction or pharmacological antidepressants. The antidepressant treatments, including selective serotonin reuptake inhibitors (SSRI), also helped improve stress-related neuroinflammation. It presents the direction of future development of stress-related neuroinflammation drugs. Therefore, in this review, the mechanism of stress-related neuroinflammation and pharmacological treatment candidates for it were reviewed. In addition, treatment candidates that have not yet been verified but indicate possibilities were also reviewed.

Keywords: angiotensin II; angiotensin-converting enzyme; cyclooxygenase-2; glutamate; hypothalamic-pituitary-adrenal axis; inducible nitric oxide synthase; microbiome; neuroinflammation; peroxisome proliferator-activated receptor; reactive oxygen species; stress.

Publication types

  • Review