Int J Immunopathol Pharmacol. 2010 Apr-Jun;23(2):417-22. doi: 10.1177/039463201002300204.
Cytokines may influence brain activities especially during stressful conditions, and elevated levels of IL-6 and C-reactive protein have been pointed out in subjects with Major Depression. If pro-inflammatory cytokines play a causative role in major depressive disorders, one would expect that antidepressants may down-regulate these cytokines or interfere with their actions, leading to improvement of depressive symptoms. Accumulating evidence has been published that antidepressants modulate cytokine production and this is particularly true for Tricyclics and Selective serotonin reuptake inhibitors (SSRIs), but the influence of newer antidepressants acting on both serotonin (5-HT) and norepinephrine (NE) such as venlafaxine, duloxetine and mirtazapine on cytokine levels has not been extensively studied. However, both pre-clinical and clinical studies examined in this review have demonstrated that newer serotonin-noradrenalin antidepressants can inhibit the production and/or release of pro-inflammatory cytokines and stimulate the production of anti-inflammatory cytokines, suggesting that reductions in inflammation might contribute to treatment response. Moreover, the results of the present review support the notion that the serotonin-noradrenalin antidepressants venlafaxine and mirtazapine may influence cytokine secretion in patients affected by MD, restoring the equilibrium between their physiological and pathological levels and leading to recovery. To date, no studies have evaluated the effect of duloxetine, the newest serotonin-noradrenalin antidepressant, on cytokine levels and therefore this should be evaluated in future studies.
细胞因子可能会影响大脑活动，尤其是在应激条件下，而在重度抑郁症患者中，IL-6 和 C 反应蛋白的水平升高。如果促炎细胞因子在重度抑郁障碍中起因果作用，那么人们会期望抗抑郁药可能下调这些细胞因子或干扰其作用，从而改善抑郁症状。越来越多的证据表明抗抑郁药可以调节细胞因子的产生，这在三环类和选择性 5-羟色胺再摄取抑制剂（SSRIs）中尤为如此，但作用于 5-羟色胺（5-HT）和去甲肾上腺素（NE）的新型抗抑郁药，如文拉法辛、度洛西汀和米氮平对细胞因子水平的影响尚未得到广泛研究。然而，本综述中检查的临床前和临床研究都表明，新型 5-羟色胺-去甲肾上腺素抗抑郁药可以抑制促炎细胞因子的产生和/或释放，并刺激抗炎细胞因子的产生，这表明炎症的减少可能有助于治疗反应。此外，本综述的结果支持这样一种观点，即文拉法辛和米氮平这两种 5-羟色胺-去甲肾上腺素抗抑郁药可能会影响 MD 患者的细胞因子分泌，恢复其生理和病理水平之间的平衡，从而促使其康复。迄今为止，尚无研究评估新型 5-羟色胺-去甲肾上腺素抗抑郁药度洛西汀对细胞因子水平的影响，因此，这应该在未来的研究中进行评估。
