期刊
JOURNAL OF NEUROENDOCRINOLOGY
卷 25, 期 11, 页码 1196-1208出版社
WILEY
DOI: 10.1111/jne.12066
关键词
steroids; neuroactive steroids; androgens; dopamine
资金
- National Institute of Health (NIH) [R21 HD070611]
- Tourette Syndrome Association
- Sardinia Regional Research Grant
- 'Master and Back' fellowships
- National Institute of General Medical Sciences of NIH [P20 GM103638]
- NIH [UL1 TR000001, UL1RR033179]
- EU COST Action [CM1103]
Tourette's syndrome (TS) is a neurodevelopmental disorder characterised by recurring motor and phonic tics. The pathogenesis of TS is considered to reflect dysregulations in the signalling of dopamine (DA) and other neurotransmitters, which lead to excitation/inhibition imbalances in cortico-striato-thalamocortical circuits. The causes of these deficits may reflect complex genexenvironmentxsex (GxExS) interactions; indeed, the disorder is markedly predominant in males, with a male-to-female prevalence ratio of approximately 4:1. Converging lines of evidence point to neuroactive steroids as being likely molecular candidates to account for GxExS interactions in TS. Building on these premises, our group has begun examining the possibility that alterations in the steroid biosynthetic process may be directly implicated in TS pathophysiology; in particular, our research has focused on 5-reductase (5R), the enzyme catalysing the key rate-limiting step in the synthesis of pregnane and androstane neurosteroids. In clinical and preclinical studies, we found that 5R inhibitors exerted marked anti-DAergic and tic-suppressing properties, suggesting a central role for this enzyme in TS pathogenesis. Based on these data, we hypothesise that enhancements in 5R activity in early developmental stages may lead to an inappropriate activation of the backdoor' pathway for androgen synthesis from adrenarche until the end of puberty. We predict that the ensuing imbalances in steroid homeostasis may impair the signalling of DA and other neurotransmitters, ultimately resulting in the facilitation of tics and other behavioural abnormalities in TS.
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