Research and Development Service, Behavioral Health and Clinical Neurosciences Division, Portland VA Medical Center, 3710 SW US Veterans Hospital Rd., Portland, OR 97239, USA.
Neurobiol Dis. 2010 Mar;37(3):519-33. doi: 10.1016/j.nbd.2009.11.015. Epub 2009 Nov 26.
The relationships between immune and neural function are an increasingly important area of study for neuropsychiatric disorders, in particular depression. This is exemplified by the growing number of publications on cytokines and depression during the last 10 years, as compared to earlier decades. This review summarizes the current theories and novel treatment strategies for depression, with a focus on cytokine-induced depression. Neuroimmune mechanisms are now viewed as central to the development of depressive symptoms and emerging evidence is beginning to identify the neural circuits involved in cytokine-induced depression. The current diagnostic categories for depression, as defined by the Diagnostic and Statistical Manual of Mental Disorders, however, are not etiologically or biologically derived, and it has been proposed that "depression", likely reflects multiple pathogeneses leading to varying symptom constellations. As we move toward a better biological understanding of depression-related symptom constellations or syndromes, the term "depression" may prove inadequately broad, and an integration of interdisciplinary literatures will increase in importance. Future research should aim to characterize these depression-related symptom constellations or syndromes better with the goal of optimizing treatment strategies.
免疫和神经功能之间的关系是神经精神疾病(尤其是抑郁症)研究中日益重要的领域。这体现在过去 10 年中关于细胞因子和抑郁症的出版物数量不断增加,而在早些年则相对较少。本综述总结了目前抑郁症的理论和新的治疗策略,重点关注细胞因子诱导的抑郁症。神经免疫机制现在被认为是抑郁症状发展的核心,新的证据开始确定细胞因子诱导的抑郁症所涉及的神经回路。然而,目前由《精神障碍诊断与统计手册》定义的抑郁症的诊断类别既不是病因学的也不是生物学的,有人提出“抑郁症”可能反映了导致不同症状组合的多种发病机制。随着我们对与抑郁症相关的症状组合或综合征有了更好的生物学理解,“抑郁症”这个术语可能证明不够广泛,跨学科文献的整合将变得更加重要。未来的研究应该旨在更好地描述这些与抑郁症相关的症状组合或综合征,以优化治疗策略为目标。