Fehér János, Kovács Illés, Balacco Gabrieli Corrado
Sapienza Tudományegyetem Szemészeti Klinika 00187 Roma Via Sardegna, 139.
Orv Hetil. 2011 Sep 11;152(37):1477-85. doi: 10.1556/OH.2011.29166.
Recent studies have revealed that inflammation, among other factors, may be involved in the pathogenesis of depression. One line of studies has shown that depression is frequently associated with manifest gastrointestinal inflammations and autoimmune diseases as well as with cardiovascular diseases, neurodegenerative diseases, type 2-diabetes and also cancer, in which chronic low-grade inflammation is a significant contributing factor. Thus depression may be a neuropsychiatric manifestation of a chronic inflammatory syndrome. Another line of studies has shown that the primary cause of inflammation may be the dysfunction of the "gut-brain axis". Although, this is a bidirectional mechanism, life style factors may primarily affect the symbiosis between host mucous membrane and the microbiota. Local inflammation through the release of cytokines, neuropeptides and eicosanoids may also influence the function of the brain and of other organs. Role of metabolic burst due to inflammation represents a new aspect in both pathophysiology and treatment of the depression. Finally, an increasing number of clinical studies have shown that treating gastrointestinal inflammations with probiotics, vitamin B, D and omega 3 fatty acids, through attenuating proinflammatory stimuli to brain, may also improve depression symptoms and quality of life. All these findings justify an assumption that treating gastrointestinal inflammations may improve the efficacy of the currently used treatment modalities of depression and related diseases. However, further studies are certainly needed to confirm these findings.
最近的研究表明，炎症以及其他因素可能参与了抑郁症的发病机制。一系列研究表明，抑郁症常常与明显的胃肠道炎症、自身免疫性疾病以及心血管疾病、神经退行性疾病、2型糖尿病乃至癌症相关联，其中慢性低度炎症是一个重要的促成因素。因此，抑郁症可能是一种慢性炎症综合征的神经精神表现。另一系列研究表明，炎症的主要原因可能是“肠-脑轴”功能障碍。尽管这是一种双向机制，但生活方式因素可能主要影响宿主黏膜与微生物群之间的共生关系。通过释放细胞因子、神经肽和类花生酸引起的局部炎症也可能影响大脑和其他器官的功能。炎症引起的代谢爆发的作用在抑郁症的病理生理学和治疗方面代表了一个新的方面。最后，越来越多的临床研究表明，通过减弱对大脑的促炎刺激，用益生菌、维生素B、D和ω-3脂肪酸治疗胃肠道炎症，也可能改善抑郁症状和生活质量。所有这些发现证明了这样一种假设，即治疗胃肠道炎症可能提高目前用于治疗抑郁症及相关疾病的治疗方法的疗效。然而，肯定还需要进一步的研究来证实这些发现。
