Psychiatry Unit, Department of Biomedical and Clinical Sciences, ASST Fatebenefratelli-Sacco University Hospital, Università di Milano, Milan, Italy.
Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, King's College London, London, UK.
Psychopharmacology (Berl). 2019 Oct;236(10):2997-3011. doi: 10.1007/s00213-019-05200-8. Epub 2019 Feb 26.
Depression is a common comorbidity in cancer cases, but this is not only due to the emotional distress of having a life-threatening disease. A common biological mechanism, involving a dysregulated immune system, seems to underpin this comorbidity. In particular, the activation of the kynurenine pathway of tryptophan degradation due to inflammation may play a key role in the development and persistence of both diseases. As a consequence, targeting enzymes involved in this pathway offers a unique opportunity to develop new strategies to treat cancer and depression at once. In this work, we provide a systematic review of the evidence up to date on the kynurenine pathway role in linking depression and cancer and on clinical implications of this evidence. In particular, complications due to chemotherapy are discussed, as well as the potential antidepressant efficacy of novel immunotherapies for cancer.
抑郁症是癌症病例中的常见合并症，但这不仅是由于患有威胁生命的疾病所带来的情绪困扰。一种常见的生物学机制，涉及失调的免疫系统，似乎是这种合并症的基础。具体来说，由于炎症导致色氨酸降解的犬尿氨酸途径的激活可能在这两种疾病的发展和持续中起关键作用。因此，针对该途径中涉及的酶提供了一个独特的机会，可以同时开发治疗癌症和抑郁症的新策略。在这项工作中，我们对迄今为止有关犬尿氨酸途径在抑郁症和癌症之间联系中的作用的证据以及这一证据的临床意义进行了系统回顾。特别是，讨论了由于化疗引起的并发症，以及新型癌症免疫疗法的潜在抗抑郁作用。
