Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30306, United States.
Neuroscience. 2013 Aug 29;246:199-229. doi: 10.1016/j.neuroscience.2013.04.060. Epub 2013 May 3.
Mounting evidence indicates that inflammatory cytokines contribute to the development of depression in both medically ill and medically healthy individuals. Cytokines are important for development and normal brain function, and have the ability to influence neurocircuitry and neurotransmitter systems to produce behavioral alterations. Acutely, inflammatory cytokine administration or activation of the innate immune system produces adaptive behavioral responses that promote conservation of energy to combat infection or recovery from injury. However, chronic exposure to elevated inflammatory cytokines and persistent alterations in neurotransmitter systems can lead to neuropsychiatric disorders and depression. Mechanisms of cytokine behavioral effects involve activation of inflammatory signaling pathways in the brain that results in changes in monoamine, glutamate, and neuropeptide systems, and decreases in growth factors, such as brain-derived neurotrophic factor. Furthermore, inflammatory cytokines may serve as mediators of both environmental (e.g. childhood trauma, obesity, stress, and poor sleep) and genetic (functional gene polymorphisms) factors that contribute to depression's development. This review explores the idea that specific gene polymorphisms and neurotransmitter systems can confer protection from or vulnerability to specific symptom dimensions of cytokine-related depression. Additionally, potential therapeutic strategies that target inflammatory cytokine signaling or the consequences of cytokines on neurotransmitter systems in the brain to prevent or reverse cytokine effects on behavior are discussed.
越来越多的证据表明,炎症细胞因子与医学上患病和健康个体的抑郁症的发展有关。细胞因子对于发育和正常的大脑功能很重要,并且有能力影响神经回路和神经递质系统,从而产生行为改变。在急性炎症细胞因子给药或先天免疫系统激活的情况下,会产生适应性的行为反应,以促进能量的保存,从而抵抗感染或从损伤中恢复。然而,慢性暴露于升高的炎症细胞因子和持续的神经递质系统改变会导致神经精神疾病和抑郁症。细胞因子行为效应的机制涉及大脑中炎症信号通路的激活,导致单胺、谷氨酸和神经肽系统的变化,以及生长因子(如脑源性神经营养因子)的减少。此外,炎症细胞因子可能作为环境(例如儿童创伤、肥胖、压力和睡眠不佳)和遗传(功能基因多态性)因素的介质,这些因素导致抑郁症的发展。本综述探讨了特定基因多态性和神经递质系统是否可以预防或易患与细胞因子相关的抑郁症的特定症状维度的观点。此外,还讨论了靶向炎症细胞因子信号或细胞因子对大脑中神经递质系统的影响的潜在治疗策略,以预防或逆转细胞因子对行为的影响。
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