Malemud Charles J, Miller Andrew H
Case Western Reserve University School of Medicine and University Hospitals Case Medical Center, Department of Medicine, Division of Rheumatic Diseases, 2061 Cornell Road, Cleveland, Ohio 44106-5076, USA.
Expert Opin Ther Targets. 2008 Feb;12(2):171-83. doi: 10.1517/14728222.12.2.171.
Adult rheumatoid arthritis (RA) patients are frequently clinically depressed. Peripheral inflammation in RA may influence neurotransmitter metabolism, neuroendocrine function, synaptic plasticity, as well as growth factor production, which can modify neural circuitry and contribute to depression.
A convergence between pro-inflammatory cytokine-induced synovial joint inflammation in RA and the effects of pro-inflammatory cytokines on the brain may occur through activation of the stress-activated/mitogen-activated protein kinases (SAPK/MAPK) and/or Janus kinase/signal transducers and activators of transcription (JAK/STAT) pathways.
The PubMed and Medlines databases were critically evaluated for evidence of SAPK/MAPK and/or JAK/STAT pathway activation in RA and depression.
RESULTS/CONCLUSION: Some novel anti-depression drugs that were employed in animal models of 'sickness behavior' and in human depression clinical trials suppressed clinical markers of inflammation, as well as SAPK/MAPK and/or JAK/STAT signaling in vitro. Modifying pro-inflammatory cytokine signaling pathways in the brain with antidepressants may also be useful in ameliorating peripheral inflammation in RA.
成年类风湿关节炎(RA)患者常伴有临床抑郁。RA中的外周炎症可能影响神经递质代谢、神经内分泌功能、突触可塑性以及生长因子生成,这些均可改变神经回路并导致抑郁。
RA中促炎细胞因子诱导的滑膜关节炎症与促炎细胞因子对大脑的影响之间可能通过应激激活/丝裂原激活蛋白激酶(SAPK/MAPK)和/或Janus激酶/信号转导子及转录激活子(JAK/STAT)途径的激活而产生关联。
对PubMed和Medlines数据库进行严格评估,以寻找RA和抑郁中SAPK/MAPK和/或JAK/STAT途径激活的证据。
结果/结论:一些用于“疾病行为”动物模型和人类抑郁临床试验的新型抗抑郁药物在体外可抑制炎症临床指标以及SAPK/MAPK和/或JAK/STAT信号传导。用抗抑郁药调节大脑中的促炎细胞因子信号通路可能也有助于改善RA中的外周炎症。