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抗抑郁治疗对重度抑郁症(MDD)患者外周生物标志物的影响。

Effects of Antidepressant Treatment on Peripheral Biomarkers in Patients with Major Depressive Disorder (MDD).

作者信息

Mosiołek Anna, Pięta Aleksandra, Jakima Sławomir, Zborowska Natalia, Mosiołek Jadwiga, Szulc Agata

机构信息

Department of Psychiatry, Faculty of Health Sciences, Medical University of Warsaw, Żwirki i Wigury 61 Street, 02-091 Warszawa, Poland.

Mazovia Specialist Health Center in Pruszków, Partyzantów 2/4 Street, 05-802 Pruszków, Poland.

出版信息

J Clin Med. 2021 Apr 15;10(8):1706. doi: 10.3390/jcm10081706.

Abstract

Major depressive disorder (MDD) is one of the most prevalent mental illness and a leading cause of disability worldwide. Despite a range of effective treatments, more than 30% of patients do not achieve remission as a result of conventional therapy. In these circumstances the identification of novel drug targets and pathogenic factors becomes essential for selecting more efficacious and personalized treatment. Increasing evidence has implicated the role of inflammation in the pathophysiology of depression, revealing potential new pathways and treatment options. Moreover, convergent evidence indicates that MDD is related to disturbed neurogenesis and suggests a possible role of neurotrophic factors in recovery of function in patients. Although the influence of antidepressants on inflammatory cytokines balance was widely reported in various studies, the exact correlation between drugs used and specific cytokines and neurotrophins serum levels often remains inconsistent. Available data suggest anti-inflammatory properties of selective serotonin reuptake inhibitors (SSRIs), selective serotonin and noradrenaline inhibitors (SNRIs), and tricyclic antidepressants (TCAs) as a possible additional mechanism of reduction of depressive symptoms. In this review, we outline emerging data regarding the influence of different antidepressant drugs on a wide array of peripheral biomarkers such as interleukin (IL)-1ß, IL-2, IL-5, IL-6, IL-8, IL-10, C-reactive protein (CRP), or interferon (IFN)-γ. Presented results indicate anti-inflammatory effect for selected drugs or lack of such effect. Research in this field is insufficient to define the role of inflammatory markers as a predictor of treatment response in MDD.

摘要

重度抑郁症(MDD)是全球最常见的精神疾病之一,也是导致残疾的主要原因。尽管有一系列有效的治疗方法,但超过30%的患者因传统治疗无法实现缓解。在这种情况下,识别新的药物靶点和致病因素对于选择更有效和个性化的治疗至关重要。越来越多的证据表明炎症在抑郁症的病理生理学中起作用,揭示了潜在的新途径和治疗选择。此外,越来越多的证据表明MDD与神经发生紊乱有关,并提示神经营养因子在患者功能恢复中可能发挥作用。尽管在各种研究中广泛报道了抗抑郁药对炎症细胞因子平衡的影响,但所用药物与特定细胞因子和神经营养因子血清水平之间的确切相关性往往仍不一致。现有数据表明选择性5-羟色胺再摄取抑制剂(SSRIs)、选择性5-羟色胺和去甲肾上腺素抑制剂(SNRIs)以及三环类抗抑郁药(TCAs)的抗炎特性可能是减轻抑郁症状的另一种机制。在本综述中,我们概述了有关不同抗抑郁药物对多种外周生物标志物如白细胞介素(IL)-1ß、IL-2、IL-5、IL-6、IL-8、IL-10、C反应蛋白(CRP)或干扰素(IFN)-γ影响的新数据。呈现的结果表明某些药物具有抗炎作用或缺乏这种作用。该领域的研究不足以确定炎症标志物作为MDD治疗反应预测指标的作用。

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