Adibfar A, Saleem M, Lanctot K L, Herrmann N
Neuropsychopharmacology Research Group, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Suite FG-08, M4N 3M5, Toronto, Canada.
Curr Mol Med. 2016;16(2):137-64. doi: 10.2174/1566524016666160126144143.
Depression, the most common mood disorder, is a leading contributor to the global burden of disease affecting more than 120 million individuals worldwide. Various pathophysiological processes underlie depression; this complexity renders it difficult to identify clinically useful diagnostic and prognostic markers, as well as treatment options. The current state of knowledge driving the management and treatment of depression remains incomplete, which underscores the need for further insight into pathways relevant to depression. Exploring co-morbid conditions, such as coronary artery disease, may be useful to further elucidate the etiopathology of depression. The present review therefore systematically identifies and critically evaluates relevant markers of depression as assessed in a high-risk population, namely patients with coronary artery disease. Biomarkers related to hypothalamicpituitary- adrenal axis dysregulation, inflammation, endothelial dysfunction, platelet activation and aggregation, serotonin activity, sympathetic nervous system activation, thyroid function, structural and morphological brain abnormalities, genetic variation, lipid metabolism, one-carbon metabolism, endocannabinoid signalling irregularities, and vitamin D deficiency are reviewed. Markers exhibiting the most consistent associations with depression include tumour necrosis factor-α, flow-mediated dilation, endothelin-1, endothelial progenitor cells, brain-derived neurotrophic factor, and docosahexaenoic acid. Further investigating the mechanisms underlying those markers and exploring novel pathways, such as oxidative stress, will extend the current state of knowledge and potentially lead to the identification of novel therapeutic targets.
抑郁症是最常见的情绪障碍，是全球疾病负担的主要促成因素，影响着全球超过1.2亿人。抑郁症有多种病理生理过程；这种复杂性使得难以确定临床上有用的诊断和预后标志物以及治疗选择。目前指导抑郁症管理和治疗的知识状态仍不完整，这突出了进一步深入了解与抑郁症相关途径的必要性。探索共病情况，如冠状动脉疾病，可能有助于进一步阐明抑郁症的病因病理。因此，本综述系统地识别并批判性地评估了在高危人群即冠状动脉疾病患者中评估的抑郁症相关标志物。综述了与下丘脑 - 垂体 - 肾上腺轴失调、炎症、内皮功能障碍、血小板活化和聚集、5-羟色胺活性、交感神经系统激活、甲状腺功能、脑结构和形态异常、基因变异、脂质代谢、一碳代谢、内源性大麻素信号异常以及维生素D缺乏相关的生物标志物。与抑郁症表现出最一致关联的标志物包括肿瘤坏死因子-α、血流介导的血管舒张、内皮素-1、内皮祖细胞、脑源性神经营养因子和二十二碳六烯酸。进一步研究这些标志物背后的机制并探索新的途径，如氧化应激，将扩展当前的知识状态，并可能导致识别新的治疗靶点。
