PDF herunterladen
Nervenheilkunde 2020; 39(09): 565-571
DOI: 10.1055/a-1202-2989
Übersichtsarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Aktueller Forschungsstand zum pflanzlichen Antidepressivum Johanniskrautextrakt

Review der WirkmechanismenCurrent scientific knowledge of the herbal antidepressant St. John’s Wort dry extractReview of the modes of action
Barbara Dillenburger∗
1   MedWiss. Institut, MWI GmbH, Köln
,
Christiane Kolb
2   Steigerwald Arzneimittelwerk GmbH, Phytomedicines Supply and Development Center, Bayer Consumer Health Division, Darmstadt
,
Hanns Häberlein∗
3   Institut für Biochemie und Molekularbiologie, Rheinische Friedrich-Wilhelms-University, Bonn
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
24. August 2020 (online)

    Lizenzen und Reprints

ZUSAMMENFASSUNG

Aus dem Zusammenspiel von neurobiologischen und psychosozialen Faktoren kennt man 3 für die Pathologie der Depression wesentliche Mechanismen. Neben der gut bekannten gestörten Neurotransmission resultiert die chronische Aktivierung der HPA-Achse in einer deregulierten Stressantwort, oxidativer Stress im Rahmen der Depression bedingt zusätzlich Inflammation und neurodegenerative Prozesse. In diesem Review wird der aktuelle Wissensstand zum Wirkspektrum des pflanzlichen Antidepressivums Johanniskrautextrakt dargelegt und mit synthetischen Antidepressiva verglichen. Auf der Basis aktueller Forschung lässt sich so ein Modell aus 3 wesentlichen Wirkmechanismen von Johanniskrautextrakt ableiten, über die – häufig analog zu klassischen chemisch-synthetischen Antidepressiva – in die Pathologie und Entwicklung der Depression eingegriffen werden kann.

ABSTRACT

In the interplay of neurobiological and psychosocial factors three essential mechanisms regarding the pathology of depression are well established. Apart from the well-known dysfunctional neurotransmission, the chronic activation of the HPA-axis results in a deregulated response to stress. Oxidative stress within context of depression further triggers inflammation and neurodegenerative processes. In this review, we summarize the current knowledge regarding the spectrum of activity of the herbal antidepressant St. John’s Wort extract also in comparison to synthetic antidepressants. Based on recent research, a model built on three major modes of action of St. John’s Wort extract can be deduced. Via these mechanisms the herbal antidepressant can, often analogous to classical, synthetic antidepressants, intervene in the pathology and development of depression.

Schlüsselwörter

Depression - Johanniskraut - Antidepressiva - pflanzlich - Pharmakologie - Wirkmechanismus

Key words

Depression - St. John’s wort - antidepressants - herbal - pharmacology - mode of action
 

  • Literatur

  • 1 Binder EB, Nemeroff CB. The CRF system, stress, depression and anxietyinsights from human genetic studies.. Mol Psychiatry 2010; 15: 574-588
    CrossrefPubMedGoogle Scholar
  • 2 Zannas AS, Wiechmann T, Gassen NC. et al Gene-Stress-Epigenetic Regulation of FKBP5: Clinical and Translational Implications.. Neuropsychopharmacology 2016; 41: 261-274
    CrossrefPubMedGoogle Scholar
  • 3 Miller BR, Hen R. The current state of the neurogenic theory of depression and anxiety.. Curr Opin Neurobiol 2015; 30: 51-58
    CrossrefPubMedGoogle Scholar
  • 4 Liu W, Ge T, Leng Y. et al The Role of Neural Plasticity in Depression: From Hippocampus to Prefrontal Cortex.. Neural Plast 2017; 2017: 1-11
    CrossrefPubMedGoogle Scholar
  • 5 Bürgi S, Baltensperger K, Honegger UE. Antidepressant-induced Switch of β 1 -Adrenoceptor Trafficking as a Mechanism for Drug Action.. J Biol Chem 2003; 278: 1044-1052
    CrossrefPubMedGoogle Scholar
  • 6 Fakhoury M. Revisiting the Serotonin Hypothesis: Implications for Major Depressive Disorders.. Mol Neurobiol 2016; 53: 2778-2786
    CrossrefPubMedGoogle Scholar
  • 7 EMEA. Community Herbal Monograph on Hypericum Perforatum L., Herba. HMPC 2009: 0-8
    Google Scholar
  • 8 Schulz H-U, Schürer M, Bässler D. et al Investigation of Pharmacokinetic Data of Hypericin, Pseudohypericin, Hyperforin and the Flavonoids Quercetin and Isorhamnetin Revealed from Single and Multiple Oral Dose Studies with a Hypericum Extract Containing Tablet in Healthy Male Volunteers.. Arzneimittelforschung 2012; 55: 561-568
    Google Scholar
  • 9 Paulke A, Schubert-Zsilavecz M, Wurglics M. Determination of St. John’s wort flavonoid-metabolites in rat brain through high performance liquid chromatography coupled with fluorescence detection.. J Chromatogr B 2006; 832: 109-113
    CrossrefPubMedGoogle Scholar
  • 10 Butterweck V. Mechanism of Action of St John’s Wort in Depression.. CNS Drugs 2003; 17: 539-562
    CrossrefPubMedGoogle Scholar
  • 11 Grundmann O, Lv Y, Kelber O. et al Mechanism of St. John’s wort extract (STW3-VI) during chronic restraint stress is mediated by the interrelationship of the immune, oxidative defense, and neuroendocrine system.. Neuropharmacology 2010; 58: 767-773
    CrossrefPubMedGoogle Scholar
  • 12 Ising M, Maccarrone G, Brückl T. et al FKBP5 Gene Expression Predicts Antidepressant Treatment Outcome in Depression.. Int J Mol Sci 2019; 20: 485
    CrossrefPubMedGoogle Scholar
  • 13 Verjee S, Weston A, Kolb C. et al Hyperforin and Miquelianin from St Johns Wort Attenuate Gene Expression in Neuronal Cells after Dexamethasone-Induced Stress.. Planta Med 2018; 84: 696-703
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 14 Fankhauser S, Hochstrasser B, Kolb C. et al Effects of St. John’s wort, miquelianin and hyperforin on CRH induced HPA axis activation in pituitary-derived AtT-20 cells.. Berlin: DGPPN; 2018
    Google Scholar
  • 15 Grammatopoulos DK. Regulation of G-protein coupled receptor signalling underpinning neurobiology of mood disorders and depression.. Mol Cell Endocrinol 2017; 449: 82-89
    CrossrefPubMedGoogle Scholar
  • 16 Pascual-Brazo J, Baekelandt V, Encinas J. Neurogenesis as a New Target for the Development of Antidepressant Drugs.. Curr Pharm Des 2014; 20: 3763-3775
    CrossrefPubMedGoogle Scholar
  • 17 Bonaterra GA, Schwendler A, Hüther J. et al Neurotrophic, Cytoprotective, and Anti-inflammatory Effects of St. John’s Wort Extract on Differentiated Mouse Hippocampal HT-22 Neurons.. Front Pharmacol 2018: 8
    PubMedGoogle Scholar
  • 18 Mierau O, Hofmann J, Schwendler A. et al STW 3-VI (St. John’s wort) increases plasticity of hippocampal neurons as well as the migration of microglia cells and inhibits oxLDL-induced ROS-production.. Berlin: DGPPN; 2018: P-30-002
    Google Scholar
  • 19 Ou Q, Zheng Z, Zhao Y. et al Impact of quercetin on systemic levels of inflammation: a meta-analysis of randomised controlled human trials.. Int J Food Sci Nutr 2019: 1-12
    PubMedGoogle Scholar
  • 20 Schmidt M, Butterweck V. The mechanisms of action of St. John’s wort: an updateDie Wirkmechanismen von Johanniskraut – Ein Update.. Wiener Medizinische Wochenschrift 2015; 165: 229-235
    CrossrefPubMedGoogle Scholar
  • 21 Prenner L, Sieben A, Zeller K. et al Reduction of High-Affinity β 2 -Adrenergic Receptor Binding by Hyperforin and Hyperoside on Rat C6 Glioblastoma Cells Measured by Fluorescence Correlation Spectroscopy.. Biochemistry 2007; 46: 5106-5113
    CrossrefPubMedGoogle Scholar
  • 22 Jakobs D, Hage-Hülsmann A, Prenner L. et al Downregulation of β1-adrenergic receptors in rat C6 glioblastoma cells by hyperforin and hyperoside from St John’s wort.. J Pharm Pharmacol 2013; 65: 907-915
    CrossrefPubMedGoogle Scholar
  • 23 Keksel N, Bussmann H, Unger M. et al St John’s wort extract influences membrane fluidity and composition of phosphatidylcholine and phosphatidylethanolamine in rat C6 glioblastoma cells.. Phytomedicine 2019; 54: 66-76
    CrossrefPubMedGoogle Scholar
  • 24 Dunigan CD, Hoang Q, Curran PK. et al Complexity of agonist- and cyclic AMP-mediated downregulation of the human beta 1-adrenergic receptor: role of internalization, degradation, and mRNA destabilization.. Biochemistry 2002; 41: 8019-8030
    CrossrefPubMedGoogle Scholar
  • 25 Aatz S, Kolb C, Häberlein H. Influence of St. John’s wort extract STW 3-VI, hyperoside, and hyperforin on the binding behavior and lateral mobility of 5-HT2A-receptors.. Berlin: DGPPN; 2018: ep-02-009
    Google Scholar
  • 26 Linde K, Berner MM, Kriston L. St John’s wort for major depression.. Cochrane database Syst Rev 2008: CD000448
    PubMedGoogle Scholar
  • 27 Ng QX, Venkatanarayanan N, Ho CYX. Clinical use of Hypericum perforatum (St John’s wort) in depression: A meta-analysis.. J Affect Disord 2017; 210: 211-221
    CrossrefPubMedGoogle Scholar
  • 28 Schüle C, Baghai T, Ferrera A. et al Neuroendocrine Effects of Hypericum Extract WS 5570 in 12 Healthy Male Volunteers.. Pharmacopsychiatry 2001; 34: 127-133
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 29 Concerto C, Boo H, Hu C. et al Hypericum perforatum extract modulates cortical plasticity in humans.. Psychopharmacology (Berl) 2018; 235: 145-153
    CrossrefPubMedGoogle Scholar