Discipline of Psychiatry, School of Medicine, University of Adelaide: North Terrace, Adelaide, SA 5005, Australia.
J Neural Transm (Vienna). 2012 Oct;119(10):1147-66. doi: 10.1007/s00702-012-0819-6. Epub 2012 Jun 1.
The rising burden of unipolar depression along with its often related sleep disturbances, as well as increasing rates of sleep restriction in modern society, make the search for an extended understanding of the aetiology and pathophysiology of depression necessary. Accumulating evidence suggests an important role for the immune system in mediating disrupted neurobiological and chronobiological processes in depression. This review aims to provide an overview of the neuroimmunomodulatory processes involved with depression and antidepressant treatments with a special focus on chronobiology, chronotherapeutics and the emerging field of immune-circadian bi-directional crosstalk. Increasing evidence suggests that chronobiological disruption can mediate immune changes in depression, and likewise, immune processes can mediate chronobiological disruption. This may suggest a bi-directional relationship in immune-circadian crosstalk. Furthermore, given the immunomodulatory effects of antidepressants and chronotherapeutics, as well as their associated beneficial effects on circadian disturbance, we--and others--suggest that these therapeutic agents may exert their chronobiotic effects partially via the neuroimmune system. Further research is required to better elucidate the mechanisms of immune involvement in the chronobiology of depression.
随着单相抑郁症负担的增加，以及其常伴随的睡眠障碍，以及现代社会中睡眠限制的增加，有必要对抑郁症的病因和病理生理学进行更深入的理解。越来越多的证据表明，免疫系统在调节抑郁症中的神经生物学和生理节律紊乱过程中起着重要作用。这篇综述旨在概述与抑郁症和抗抑郁治疗相关的神经免疫调节过程，特别关注生理节律、时间治疗学和免疫-生理节律双向相互作用的新兴领域。越来越多的证据表明，生理节律紊乱可以介导抑郁症中的免疫变化，反之亦然，免疫过程也可以介导生理节律紊乱。这可能表明免疫-生理节律双向相互作用存在关系。此外，鉴于抗抑郁药和时间治疗学的免疫调节作用，以及它们对生理节律紊乱的有益作用，我们和其他人认为，这些治疗药物可能部分通过神经免疫系统发挥其生理节律作用。需要进一步研究以更好地阐明免疫在抑郁症生理节律中的作用机制。
