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[脑-免疫相互作用及其在精神疾病中的意义]

[Brain-immune interactions and implications in psychiatric disorders].

作者信息

Marques Andrea H, Cizza Giovanni, Sternberg Esther

机构信息

Section on Neuroendocrine Immunology, National Institute of Mental Health, Integrative Neural Immune Program, Bethesda-Rockville, Maryland 20852, USA.

出版信息

Braz J Psychiatry. 2007 May;29 Suppl 1:S27-32. doi: 10.1590/s1516-44462007000500006.

Abstract

OBJECTIVE

This review will focus on the role of cytokines in the central nervous system and its implications to depressive disorder. We will then discuss the main findings of cytokine measurements in patients with major depressive disorder.

METHOD

We searched Pubmed for studies published from 1999-2007, using the keywords depression and cytokine; and depressive disorder and cytokine. We have focused on pro-inflammatory cytokine measurements in patients with depression syndrome using DSM-criteria.

RESULTS

Several lines of evidence suggest that cytokines have effects on depression, such as the induction of sickness behavior; clinical conditions related to cytokines that also overlap depressive symptoms; and immunotherapy that can lead to depressive symptoms attenuated by antidepressant treatment. Finally, patients with depression exhibit increased levels of pro-inflammatory cytokines, although conflicting results have been described.

CONCLUSION

Cytokines may play a role in the pathophysiology of some cases of depression, although a causal link has not been established yet. Further longitudinal studies are needed to determine patterns of cytokine in patients with major depressive disorder, taking into account confounding factors closely associated with the activation of pro-inflammatory cytokines. In addition, simultaneous measurements of multiple biomarkers could provide critical insights into mechanisms underlying major depressive disorder and a variety of common cytokine-related diseases.

摘要

目的

本综述将聚焦于细胞因子在中枢神经系统中的作用及其与抑郁症的关联。随后,我们将讨论重度抑郁症患者细胞因子测量的主要发现。

方法

我们在Pubmed上搜索了1999年至2007年发表的研究,使用关键词“抑郁症”和“细胞因子”;以及“抑郁障碍”和“细胞因子”。我们重点关注了依据DSM标准对抑郁症综合征患者进行的促炎细胞因子测量。

结果

多条证据表明细胞因子对抑郁症有影响,比如诱发疾病行为;与细胞因子相关的临床状况也与抑郁症状有重叠;以及免疫疗法会导致抑郁症状,而抗抑郁治疗可使其减轻。最后,抑郁症患者表现出促炎细胞因子水平升高,尽管也有相互矛盾的结果报道。

结论

细胞因子可能在某些抑郁症病例的病理生理学中起作用,尽管尚未确立因果联系。需要进一步的纵向研究来确定重度抑郁症患者的细胞因子模式,同时要考虑到与促炎细胞因子激活密切相关的混杂因素。此外,同时测量多种生物标志物可为重度抑郁症及多种常见细胞因子相关疾病的潜在机制提供关键见解。

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