MGH Center for Translational Pain Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
J Clin Invest. 2012 Aug;122(8):2940-54. doi: 10.1172/JCI61884. Epub 2012 Jul 2.
Pain and depression are frequently comorbid disorders, but the mechanism underlying this association is unknown. Here, we report that brain indoleamine 2,3-dioxygenase 1 (IDO1), a rate-limiting enzyme in tryptophan metabolism, plays a key role in this comorbidity. We found that chronic pain in rats induced depressive behavior and IDO1 upregulation in the bilateral hippocampus. Upregulation of IDO1 resulted in the increased kynurenine/tryptophan ratio and decreased serotonin/tryptophan ratio in the bilateral hippocampus. We observed elevated plasma IDO activity in patients with both pain and depression, as well as in rats with anhedonia induced by chronic social stress. Intra-hippocampal administration of IL-6 in rats, in addition to in vitro experiments, demonstrated that IL-6 induces IDO1 expression through the JAK/STAT pathway. Further, either Ido1 gene knockout or pharmacological inhibition of hippocampal IDO1 activity attenuated both nociceptive and depressive behavior. These results reveal an IDO1-mediated regulatory mechanism underlying the comorbidity of pain and depression and suggest a new strategy for the concurrent treatment of both conditions via modulation of brain IDO1 activity.
疼痛和抑郁经常并发,但这种关联的机制尚不清楚。在这里,我们报告脑吲哚胺 2,3-双加氧酶 1(IDO1)在色氨酸代谢中起限速酶的作用,在这种共病中起着关键作用。我们发现,大鼠慢性疼痛诱导抑郁行为和双侧海马 IDO1 上调。IDO1 的上调导致双侧海马中犬尿氨酸/色氨酸比值升高和 5-羟色氨酸/色氨酸比值降低。我们观察到疼痛和抑郁并存的患者以及慢性社交应激引起快感缺失的大鼠的血浆 IDO 活性升高。在大鼠中,除了体外实验外,海马内注射白细胞介素 6(IL-6)表明,IL-6 通过 JAK/STAT 途径诱导 IDO1 表达。此外,Ido1 基因敲除或海马 IDO1 活性的药理学抑制均减轻了伤害感受和抑郁行为。这些结果揭示了疼痛和抑郁共病的 IDO1 介导的调节机制,并提示通过调节脑 IDO1 活性来同时治疗这两种疾病的新策略。