The current pharmacological strategies for the management of anxiety disorders and
depression, serious conditions which are gaining greater prevalence worldwide, depend on only two
therapeutic classes of mood-stabilizing drugs: Serotonin Reuptake Inhibitors (SSRIs) and
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs). Although first line agents with proven
efficacy, their clinical success in the management of anxiety disorders and depression is still
considered highly complex due to the multifaceted nature of such conditions. Several studies have
shown a possible therapeutic target could be found in the form of the Angiotensin-Converting
Enzyme [ACE] type 2 (ACE2), Angiotensin [Ang]-(1-7) and Mas receptor pathway of the Renin-
Angiotensin System (RAS), which as will be discussed, has been described to exhibit promising
therapeutic properties for the management of anxiety disorders and depression. In this article, the
literature to describe recent findings related to the role of the RAS in anxiety and depression
disorders was briefly revised. The literature used covers a time range from 1988 to 2019 and were
acquired from the National Center for Biotechnology Information’s (NCBI) PubMed search engine.
The results demonstrated in this review are promising and encourage the development of new
research for the treatment of anxiety and depression disorders focusing on the RAS. In conclusion,
the ACE2/Ang-(1-7)/Mas pathway may exhibit anxiolytic and anti-depressive effects through many
possible biochemical mechanisms both centrally and peripherally, and result in highly promising
mental health benefits which justifies further investigation into this system as a possible new
therapeutic target in the management of neuropsychiatric disorders, including any as of yet
undescribed risk-benefit analysis compared to currently-implemented pharmacological strategies.
Background
The oral lichen planus is a chronic inflammatory disease. Although its aetiology is not well understood, the role of T lymphocytes in its inflammatory events is recognised. Identifying the epigenetic mechanisms involved in the pathogenesis of this immune‐mediated condition is fundamental for understanding the inflammatory reaction that occurs in the disease. The purpose of this work was to evaluate the methylation pattern of 21 immune response‐related genes in the different clinical forms of oral lichen planus.
Methods
A cross‐sectional study was performed to analyse the DNA methylation patterns in three distinct groups of oral lichen planus: (i) reticular/plaque lesions; (ii) erosive lesions; (iii) normal oral mucosa (control group). After DNA extraction from biopsies, the samples were submitted to digestions by methylation‐sensitive and methylation‐dependent enzymes and double digestion. The relative percentage of methylated DNA for each gene was provided using real‐time polymerase chain reaction arrays.
Results
Hypermethylation of the STAT5A gene was observed only in the control group (59.0%). A higher hypermethylation of the ELANE gene was found in reticular/plaque lesions (72.1%) compared to the erosive lesions (50.0%).
Conclusion
Our results show variations in the methylation profile of immune response‐related genes, according to the clinical type of oral lichen planus after comparing with the normal oral mucosa. Further studies are necessary to validate these findings using gene expression analysis.
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