Pollmächer Thomas, Haack Monika, Schuld Andreas, Reichenberg Abraham, Yirmiya Raz
Max Planck Institute of Psychiatry, Kraepelinstrasse 10, D-80804 Munich, Germany.
Brain Behav Immun. 2002 Oct;16(5):525-32. doi: 10.1016/s0889-1591(02)00004-1.
Animal studies provide consistent evidence for the pivotal role of inflammatory cytokines in inducing sickness behavior during systemic infection and inflammation. Because depression in humans shows a considerable symptomatic overlap with sickness behavior, it has been hypothesized that cytokines are also involved in affective disorders. This view is supported by studies showing that therapeutic administration of inflammatory cytokines can induce typical major depression and by evidence that stimulated cytokine-release during experimental endotoxemia provokes transient deterioration in mood and memory. However, in these conditions, similar to the animal models of acute infections, huge amounts of cytokines produced in the periphery act on the brain. In contrast, during most clinical conditions where depression might involve cytokine actions, such as chronic infection and inflammation, only low amounts of cytokines are circulating. The present paper addresses the question whether and how low amounts of circulating cytokines act on the human brain. Evidence is presented that very low amounts of circulating cytokines are likely to influence brain functions, even under baseline conditions. It is also likely that low levels of cytokines affect the same brain function as high levels do. However, it is uncertain whether these effects go in the same direction. NonREM sleep, for example, is promoted by a slight increase in cytokine levels, but suppressed by prominent increases. Because no comparable data are available for mood and other brain functions, the answer to the question whether and how low circulating amounts of cytokines affect mood depends on further experimental studies.
动物研究提供了一致的证据,证明炎症细胞因子在全身感染和炎症期间诱发疾病行为中起关键作用。由于人类抑郁症与疾病行为在症状上有相当大的重叠,因此有人推测细胞因子也与情感障碍有关。这一观点得到了多项研究的支持,这些研究表明,炎症细胞因子的治疗性给药可诱发典型的重度抑郁症,也有证据表明,实验性内毒素血症期间细胞因子释放的刺激会引发情绪和记忆的短暂恶化。然而,在这些情况下,与急性感染的动物模型类似,外周产生的大量细胞因子作用于大脑。相比之下,在大多数抑郁症可能涉及细胞因子作用的临床情况下,如慢性感染和炎症,循环中的细胞因子含量很低。本文探讨了低水平循环细胞因子是否以及如何作用于人类大脑这一问题。有证据表明,即使在基线条件下,极低水平的循环细胞因子也可能影响脑功能。低水平的细胞因子也可能与高水平的细胞因子影响相同的脑功能。然而,这些影响是否朝着相同的方向尚不确定。例如,细胞因子水平略有升高会促进非快速眼动睡眠,但显著升高则会抑制非快速眼动睡眠。由于目前尚无关于情绪和其他脑功能的可比数据,低循环量细胞因子是否以及如何影响情绪这一问题的答案取决于进一步的实验研究。