Psychosocial Oncology and Palliative Care, University Health Network/Princess Margaret Hospital and University of Toronto, Toronto, ON M5G 2M9, Canada.
Curr Psychiatry Rep. 2011 Oct;13(5):316-20. doi: 10.1007/s11920-011-0210-6.
Currently available antidepressants are effective in less than two thirds of depressed patients, with even lower remission rates in the context of co-morbid medical illness. A rapidly expanding evidence base suggests that maladaptive inflammatory immune responses may be a common pathophysiology underlying depression, particularly in the presence of a general medical condition. The inflammatory hypothesis of depression marks a significant shift away from monoamine-based approaches and is a major step towards developing novel treatments that directly target causal factors of depression. Many antidepressants exert anti-inflammatory effects and there is an emerging literature documenting the efficacy of anti-inflammatory agents as adjunctive treatments for depression. Identification of inflammatory biomarkers in depression will require a re-conceptualization of both the diagnostic phenomenology and the experimental approaches to studying multi-determined psychiatric disorders. In addition to their application in diagnosis, predicting prognosis, and monitoring severity and response to treatment, inflammatory biomarkers may serve as novel therapeutic targets in the treatment of depression.
目前可用的抗抑郁药在不到三分之二的抑郁症患者中有效，而在合并有医学疾病的情况下，缓解率甚至更低。不断扩大的证据基础表明，适应性免疫炎症反应可能是抑郁症的一种常见病理生理学基础，特别是在存在一般医学病症的情况下。抑郁症的炎症假说标志着从单胺为基础的方法的重大转变，也是朝着开发直接针对抑郁症病因的新治疗方法迈出的重要一步。许多抗抑郁药具有抗炎作用，越来越多的文献记录了抗炎药物作为抑郁症辅助治疗的疗效。在抑郁症中识别炎症生物标志物将需要重新概念化诊断现象学和研究多因素精神障碍的实验方法。除了在诊断、预测预后以及监测严重程度和对治疗的反应中的应用外，炎症生物标志物也可能成为治疗抑郁症的新治疗靶点。
