Anisman H, Merali Z
Institute of Neuroscience, Carleton University, Ottowa, Ont, Canada K1S 5B6.
Brain Behav Immun. 2002 Oct;16(5):513-24. doi: 10.1016/s0889-1591(02)00009-0.
It has been suggested that immune activation, and particularly increased activity of several cytokines, notably interleukin-1, interleukin-2, interleukin-6, tumor necrosis factor-alpha as well as their soluble receptors is characteristic of depression. Normalization of cytokine activity does not necessarily occur following successful antidepressant, suggesting that cytokines may be trait markers of depression, or simply represent bystander effects of the illness. The relationship between cytokines and depression is complicated as a variety factors could directly or indirectly influence cytokine activity. While cytokine elevations are most pronounced in severe (melancholic) depression, their activity may also be related to chronicity of illness, neurovegetative features of depression (altered sleep patterns, food intake, weight changes, fatigue or general activity), or the high stress perception characteristic of depression. Although, studies assessing cytokines in depressive populations are basically correlational in nature, patients receiving cytokine immunotherapy frequently show depressive symptoms, which may be attenuated by antidepressant medication, supporting a causal role for cytokines in depressive disorders. The processes underlying such outcomes remain to be established, but the affective changes may stem from the neuroendocrine and central neurochemical changes elicited by cytokines, as these are reminiscent of those associated thought to subserve depression.
有人提出，免疫激活，特别是几种细胞因子活性的增加，尤其是白细胞介素 -1、白细胞介素 -2、白细胞介素 -6、肿瘤坏死因子 -α 及其可溶性受体，是抑郁症的特征。成功使用抗抑郁药后，细胞因子活性不一定会恢复正常，这表明细胞因子可能是抑郁症的特质标志物，或者仅仅代表该疾病的旁观者效应。细胞因子与抑郁症之间的关系很复杂，因为多种因素可能直接或间接影响细胞因子的活性。虽然细胞因子升高在重度（忧郁性）抑郁症中最为明显，但其活性也可能与疾病的慢性程度、抑郁症的神经植物性特征（睡眠模式改变、食物摄入、体重变化、疲劳或一般活动）或抑郁症特有的高压力感知有关。尽管评估抑郁症患者细胞因子的研究本质上基本是相关性的，但接受细胞因子免疫治疗的患者经常出现抑郁症状，抗抑郁药物可能会减轻这些症状，这支持了细胞因子在抑郁症中起因果作用的观点。导致这些结果的潜在过程仍有待确定，但情感变化可能源于细胞因子引发的神经内分泌和中枢神经化学变化，因为这些变化让人联想到那些与抑郁症相关的变化。
