What causes the disease
We have internal motivators within us that can make us happy. These are hormones responsible for feelings of pleasure and emotional balance. There are several of them, but the main active “players” are the hormones dopamine and serotonin. When they are produced normally, we are cheerful, active, able to control our feelings, actions, and look forward with pleasure to eating delicacies, meeting loved ones and other joys of life. But it happens that our biomolecular sources of joy dry up (sometimes genetic inheritance leads to this). Then the system must be treated. In a conversation with the director of the Institute of Translational Biomedicine and the scientific director of the Clinic of High Medical Technologies named after. N.I. Pirogov of St. Petersburg State University, laureate of the National Prize in the field of future technologies “Challenge” Raul Gainetdinov, we learned that:
– Every hundredth person on Earth is sick with schizophrenia, but not everyone is known to doctors;
– Without added sugar, an antidepressant diet is useless;
– Scientists have found “cousins” of dopamine and serotonin.
Photo courtesy of the press service of the Challenge Foundation
– Today we know that approximately every hundredth person in the world is a patient with schizophrenia. This is a very common disease in any country in the world. It mainly has a genetic basis, but there are also environmental conditions, for example, stressful situations, harmful chemicals.
– It is clear that this is an imbalance of chemical neurotransmitters in the brain. This is basically a breakdown of the dopamine, glutamate and serotonin transmission system. These are substances through which neurons communicate with each other. In particular, it is known for sure that in the case of schizophrenia, the work of genes associated with the production of dopamine is disrupted to a greater extent. That is, a very large amount of the “pleasure hormone” leads to schizophrenia. By analogy with such a breakdown, narcotic substances act, sharply increasing the amount of dopamine – they lead to psychomotor agitation, pleasure, euphoria and, if there is a lot of them, cause psychotic reactions. This is how schizophrenia is modeled in animals – we give them amphetamine, and then try to calm them down with the help of potential antipsychotics – drugs that then treat schizophrenia.
– No. They were always and always in approximately the same quantities as I indicated earlier. Doctors then did not know how to treat them. After all, it was only in the 1950s that the first drug was discovered that blocks the dopamine system. That is, those receptor molecules that “catch” dopamine and transmit the signal inside the cell. Even if there is a lot of dopamine, the body no longer reacts to it.
– It is definitely difficult to answer this question. The fact is that men and women have different periods of manifestation of the peaks of this disease. For men, these are young years, from 18 to 25 years old, and for women, they are closer to 50 and over 50. That is, when the most serious hormonal changes in the body occur. There is even a hypothesis that estrogen (a female hormone) has antipsychotic properties. When it drops, then menopause occurs and some begin to experience psychotic symptoms. But in general, men suffer a little more.
– This also happens. More precisely, its manifestations may become significantly less.
– The insidiousness of this disease is that people with it are not always in an unhealthy state – at some periods they are absolutely normal. Let's start with those that you may never figure out, even if you communicate with them every day. These are those people in whom the disease is not clearly expressed and, under “heavenly”, calm living conditions without stressful situations, may never manifest itself. There are patients who regularly take antipsychotics, and they also cannot be recognized by external signs.
Photo courtesy of the press service of the Challenge Foundation
Now let's move on to more pronounced forms of the disease. The most serious, requiring immediate action, is associated with hallucinations. Everything is more or less clear here. But there is another form, which is associated with loss of interest in life, withdrawal into loneliness, loss of will. It can be confused with depression. And the third form, which can be mistaken for dementia, is associated with cognitive impairment, when a person begins to have memory problems, when he has difficulty remembering new things.
– Unfortunately, there is no biochemical marker for schizophrenia yet. Psychiatrists, alas, still have to rely only on their professional experience and accumulated knowledge when making a diagnosis. But there is also bipolar disorder, when a person is either depressed or euphoric. The most difficult thing for a psychiatrist is to distinguish schizophrenia from bipolar disorder.
– The trigger can be extreme stress, pharmacological drugs.
– Of course they can. Especially computer games, which lead to greater social isolation. Such isolation aggravates the course of many diseases in psychiatry.
– As for food, there is only one component contained in some of them that can directly affect brain function, improving mood, and that is tryptophan, a precursor to serotonin. There is a lot of it in hard cheeses, cottage cheese, milk, yogurt, fish, meat, mushrooms, oats, dates, peanuts, sesame seeds, pine nuts and soybeans, says Raul Gainetdinov. – But tryptophan does not affect the production of dopamine, only serotonin, which is seriously involved in the development of depression.
– If in schizophrenia it is simply produced by the brain in excess, then in depression it is not a matter of its small quantity, but most likely in poorly functioning cell receptors that should recognize it.
– Of course not. To cope with depression, you need the help of a psychiatrist and drug therapy. This is important to understand. Cheese and chicken breast by themselves definitely won’t do the job here. But some foods actually contain the amino acid tryptophan, which plays an important role in the synthesis of the hormone serotonin, which affects emotional state and mood. But in order for tryptophan from these products to get into the brain, you need to add a little sweet to them. Banana, for example, is an ideal product – it contains both tryptophan and natural sugar. In addition, a common theory says that the development of depression, in addition to the lack of the right foods, is influenced by the lack of sun and fresh air saturated with oxygen. By the way, air, sun and communication also have a beneficial effect in that form of schizophrenia, which in a person is associated with withdrawal and isolation. Relatives of patients told me about this.
– No. Those antipsychotics that are now prescribed to patients (by the way, something like haloperidol is now used all over the world) have a number of side effects. After all, a decrease in dopamine is not only a decrease in psychosis, such drugs also reduce the enjoyment of life or, with long-term use, lead to the development of Parkinson's disease (as is known, it is associated with a very small amount of dopamine). Therefore, at some point you have to stop – it is impossible to constantly “keep” people on these drugs.
– We once proposed using so-called trace amines – these are cousins of the amine hormones – dopamine and serotonin. They remained unstudied for a long time, and now we are trying to develop a drug that can influence both dopamine and serotonin through them. Not directly, but indirectly. In this way, we hope to get a milder effect on the brain than with traditional drugs, and less side effects.
– We expect that the last clinical trials will end soon in the USA and Japan… Yes, I carried out my work on the synthesis of new drugs overseas, where I lived for 20 years before returning to Russia. Now I brought this idea here and we are launching our drugs here.
– The main cause of the disease in elderly people, over 70 years of age, is the death of dopamine neurons. No one knows for sure why they die; there are many hypotheses. There are heated debates among experts, and many are inclined to believe that in most cases the cause of receptor death may be pesticides, fertilizers or stress. There is also a strong version that people simply began to live to see this disease more often. The projections are really crazy: every year there is an increase in the number of cases by 10 percent! Moreover, genetics occurs among patients with parkinsonism only in 10 percent of cases.
– There are young parkinsonians, but mostly these are those whose disease is genetically determined. And don’t forget that there are crazy people who use drugs, and some of them lead to breakdowns in the neurotransmitter system, and then senile tremors can occur even in very young people.
– The point is not in a specific substance, but in the fact that it is synthesized in unknown kitchens using large quantities of impurities harmful to the brain.
– They are mainly based on levodopa, a precursor to dopamine. They work quite well for patients for about five years, and then, unfortunately, side effects begin.
– Unfortunately, the first signs of the disease appear when a person has already lost 70 percent of the neurons that produce dopamine. Even if, after diagnosis, he begins to lead a healthy lifestyle, avoids toxic substances such as varnishes and paints, pesticides (according to the latest scientific data, they accelerate the development of the disease), adheres to a special diet, this will only give a minor correction, and the development of the disease still cannot be avoided.
– Previously, it was believed that nerve cells do not recover. Now it has been proven that they are recovering, but not as quickly as we would like. The idea is to help strengthen this process. So that, starting from the 70% lack of cells, return the situation to at least 60%.
– It’s easier here – there is one symptom that you need to pay attention to. This is forgetfulness, which concerns things that a person has never forgotten before, for example, house keys. This symptom can occur after 60 years.
– I believe that they are not the only ones, there are forms of the disease without plaques. There is a hypothesis that I really like: we are constantly in the process of dying cells, but at the same time new ones appear – 2-3 percent, and when the rate of neuronal death begins to exceed the rate of recovery, a neurodegenerative disease begins to develop.
– According to the hypothesis, yes.
– If such a medicine appears, it will be possible to neutralize the undesirable side effects of taking levodopa in Parkinson’s disease. This, for example, is the psychosis that develops in those who have been taking dopamine precursor for years. There is a lot of hormone, and people begin to experience psychosis, visions, and they begin to run away from home. Then levodopa is discontinued and antipsychotics begin to be used, after which parkinsonism takes effect again… I want a remedy to appear that would not lead patients with parkinsonism to psychosis, so that the medicine would act effectively, but gently.
– Theoretically, there is logic in this. There is another work – its author is the Danish Maiken Nedergaard – which showed that in our brain there is a process of natural cleaning of the intercellular space, for which the glymphatic system is responsible. Its action is similar to the body’s lymphatic system, which cleanses it of dead cells, protein breakdown products and other biological debris. It turned out that it is during sleep that the rate of brainwashing increases by 2-3 times compared to the period of wakefulness. The researcher advised that in order not to accumulate damaged cells and toxic forms of proteins in the brain, simply sleep more. I'm sure she will receive a Nobel Prize for this discovery.
– Just get more positive emotions… Everyone has their own ways. Enjoy life more!
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