Treatment of cytokine-induced depression
Treatment of cytokine-induced depression
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DOI：
10.1016/s0889-1591(02)00007-7
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发表时间：
2002-10-01
影响因子：
15.1
通讯作者：
Neveu, PJ
中科院分区：
文献类型：
--
作者：
Capuron, L;Hauser, P;Neveu, PJ
接受细胞因子免疫治疗的癌症和丙型肝炎患者中有很高比例会出现抑郁症状，这些症状与重度抑郁症中发现的症状难以区分。这些症状可通过抗抑郁治疗缓解。此外，用抗抑郁药，特别是选择性5-羟色胺再摄取抑制剂（SSRIs）进行预防性治疗可减弱IFN-α相关的抑郁、焦虑和神经毒性症状。这些影响的中间机制尚不清楚。研究表明，抑郁状态与各种细胞因子和可溶性细胞因子受体的血浆水平增加有关。此外，抗抑郁药已显示使细胞因子网络向减少促炎细胞因子的产生和增加抗炎细胞因子的产生转变。其他研究表明，抗抑郁药也可以通过作用于参与神经免疫调节的神经结构来改变免疫反应性。抗抑郁药可能有助于使在免疫治疗期间可能被破坏的胆碱能神经传递正常化，这是由于细胞因子对氨基酸前体色氨酸代谢的强效作用。需要进一步的工作来优化策略，以防止神经精神副作用的细胞因子免疫治疗，以澄清机制参与缓解作用的抗抑郁药对尼古丁诱导的抑郁症，以及评估可能的后果抗抑郁治疗的免疫治疗的疗效对疾病的过程。(C)2002 Elsevier Science（美国）。All rights reserved.
A high proportion of cancer and hepatitis C patients who receive cytokine immunotherapy develop symptoms of depression that are indistinguishable from those found in major depressive disorders. These symptoms are alleviated by anti-depressant treatment. Moreover, preventive treatment with anti-depressants, in particular selective serotonin reuptake inhibitors (SSRIs) attenuates IFN-alpha-associated symptoms of depression, anxiety, and neurotoxicity. The intermediate mechanisms of these effects are still unclear. Studies suggest that the state of depression is associated with an increase in plasma levels of various cytokines and soluble cytokine receptors. Furthermore, anti-depressants have been shown to shift the cytokine network towards a decreased production of pro-inflammatory cytokines and an increased production of anti-inflammatory cytokines. Other studies suggest that anti-depressants can also modify immune reactivity by acting on neural structures involved in neuroimmunomodulation. It is possible that anti-depressants could help to normalize the serotoninergic neurotransmission that is likely disrupted during immunotherapy due to the potent effects of cytokines on the metabolism of the amino acid precursor tryptophan. Further work is needed to optimize strategies for preventing neuropsychiatric side effects of cytokine immunotherapy, to clarify the mechanisms involved in the alleviating effects of anti-depressants on cytokine-induced depression, as well as to assess the possible consequences of anti-depressant therapy on the efficacy of immunotherapy on the disease process. (C) 2002 Elsevier Science (USA). All rights reserved.