Zuzarte Pedro, Duong Angela, Figueira Maria L, Costa-Vitali Atilio, Scola Gustavo
Heart Failure Disease Management Program, Health Sciences North, Sudbury, Ontario, Canada.
University of Lisbon, Faculty of Medicine, Lisbon, Portugal.
Curr Drug Metab. 2018;19(8):674-687. doi: 10.2174/1389200219666180305143501.
Cardiovascular disease (CVD) and depression are extremely prevalent and debilitating conditions. Evidence suggest that there is a two-way relationship between depression and CVD. Inflammation is implicated in the pathophysiology of both conditions, thus representing a central candidate mediating the link between these disorders. Depression is consistently associated with increased inflammation and increased blood levels of inflammatory molecules. In recent years, studies have shown that depression significantly increases the risk of developing inflammatory-related diseases such as CVD, precipitated by the same inflammatory pathways involved in the pathophysiology of CVD.
The aim of this work is to discuss the role of inflammation in depression and CVD and review the evidence of the benefits and side effects of anti-inflammatory drugs in both the diseases.
Drugs with anti-inflammatory properties have shown benefit in alleviating signs and symptoms in CVD and in depression. This was shown to be particularly true for the following classes of drugs: non-steroidal antiinflammatory drugs (NSAIDS), polyunsaturated fatty acids (PUFAs) statins and cytokine inhibitors. Finally, antidepressant drugs initially used exclusively to treat depression also lead to improvement in CVD indicators, while lowering inflammation markers in patients at the same time. This evidence further strengthens the suggestion of the biological link between depression and CVD through inflammation.
Strategies that can mitigate this risk profile are highly needed in the clinical setting, and these particular groups of drugs have the possibility of becoming increasingly important in treatment strategies aiming to improve both the conditions.
心血管疾病（CVD）和抑郁症是极为常见且使人衰弱的病症。有证据表明抑郁症与心血管疾病之间存在双向关系。炎症与这两种病症的病理生理学均有关联，因此是介导这些疾病之间联系的核心候选因素。抑郁症始终与炎症增加及炎症分子血液水平升高相关。近年来，研究表明抑郁症会显著增加患炎症相关疾病如心血管疾病的风险，这是由心血管疾病病理生理学中涉及的相同炎症途径引发的。
这项工作的目的是探讨炎症在抑郁症和心血管疾病中的作用，并综述抗炎药物在这两种疾病中的益处和副作用的证据。
具有抗炎特性的药物已显示出对减轻心血管疾病和抑郁症的体征及症状有益。以下几类药物尤其如此：非甾体抗炎药（NSAIDs）、多不饱和脂肪酸（PUFAs）、他汀类药物和细胞因子抑制剂。最后，最初专门用于治疗抑郁症的抗抑郁药物也能改善心血管疾病指标，同时降低患者体内的炎症标志物。这一证据进一步强化了通过炎症在抑郁症和心血管疾病之间存在生物学联系的观点。
临床环境中迫切需要能够减轻这种风险状况的策略，并且这些特定类别的药物在旨在改善这两种病症的治疗策略中可能会变得越来越重要。
