Immunomodulation Mechanism of Antidepressants: Interactions between Serotonin/Norepinephrine Balance and Th1/Th2 Balance.
Immunomodulation Mechanism of Antidepressants: Interactions between Serotonin/Norepinephrine Balance and Th1/Th2 Balance.
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DOI：
10.2174/157015912800604542
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发表时间：
2012-06
影响因子：
5.3
通讯作者：
Fornaro M
中科院分区：
文献类型：
--
作者：
Martino M;Rocchi G;Escelsior A;Fornaro M
神经递质和激素调节主要的免疫功能，包括选择T辅助细胞（Th）1或Th 2细胞因子反应，分别与细胞介导的和体液免疫。Th 1/Th 2系统的不平衡和动态转换的作用已被提出，与Th 1/Th 2和神经激素平衡波动之间的复杂相互作用有关的免疫储备的相对位移，在各种慢性人类疾病的发病机制中，可能也包括精神疾病。应激系统的成分如去甲肾上腺素（NE）和糖皮质激素似乎介导Th 2移位，而5-羟色胺（5-HT）和褪黑激素可能介导Th 1移位。一些抗抑郁药会影响这些系统，作用于神经递质平衡（特别是5-HT/NE平衡）和受体亚型的表达水平，进而影响细胞因子的产生和相对Th 1/Th 2平衡。因此，可以假设抗抑郁药相关的NE张力增加增强了Th 2应答，而NE张力降低或5-HT张力增加增强了Th 1应答。然而，神经递质和Th 1/Th 2平衡调节可能是相对的，旨在恢复生理水平的受体敏感性和细胞因子产生的先前的不平衡。对神经免疫调节的考虑可以代表精神疾病的病理生理学研究和在特定的症状群中选择特定的抗抑郁药的额外帮助，特别是在与内部病理的合并症中。此外，有限的数据，在这里审查，已经显示了一些抗抑郁药作为纯免疫调节剂的有效性。然而，这些考虑是暂时的，需要实验证实或反驳未来的研究。
Neurotransmitters and hormones regulate major immune functions, including the selection of T helper (Th)1 or Th2 cytokine responses, related to cell-mediated and humoral immunity, respectively. A role of imbalance and dynamic switching of Th1/Th2 system has been proposed, with relative displacement of the immune reserve in relation to complex interaction between Th1/Th2 and neuro-hormonal balance fluctuations, in the pathogenesis of various chronic human diseases, probably also including psychiatric disorders. Components of the stress system such as norepinephrine (NE) and glucocorticoids appear to mediate a Th2 shift, while serotonin (5-HT) and melatonin might mediate a Th1 shift. Some antidepressants would occur affecting these systems, acting on neurotransmitter balance (especially the 5-HT/NE balance) and expression levels of receptor subtypes, which in turn affect cytokine production and relative Th1/Th2 balance. It could be therefore hypothesized that the antidepressant-related increase in NE tone enhances the Th2 response, while the decrease in NE tone or the increase in 5-HT tone enhances the Th1 response. However, the neurotransmitter and Th1/Th2 balance modulation could be relative, aiming to restore physiological levels a previous imbalance in receptor sensitivity and cytokine production. The considerations on neuro-immunomodulation could represent an additional aid in the study of pathophysiology of psychiatric disorders and in the choice of specific antidepressants in specific clusters of symptoms, especially in comorbidity with internal pathologies. Furthermore limited data, reviewed here, have shown the effectiveness of some antidepressants as pure immunomodulators. However, these considerations are tentative and require experimental confirmation or refutation by future studies.
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影响因子：
4.2
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