Effect of immune activation on the kynurenine pathway and depression symptoms - A systematic review and meta-analysis

NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS

卷:118

Review

Hunt, Charlotte¹  Macedo e Cordeiro, Thiago²  Suchting, Robert²  de Dios, Constanza²  Leal, Valeria A. Cuellar²  Soares, Jair C.²  Dantzer, Robert³  Teixeira, Antonio L.²  Selvaraj, Sudhakar^2,4 

[1] Univ Texas Hlth Sci Ctr Houston, McGovern Med Sch, 6431 Fannin St, Houston, TX 77030 USA

[2] Univ Texas Hlth Sci Ctr Houston UTHlth, McGovern Med Sch, Louis A Faillace MD Dept Psychiat & Behav Sci, 1941 East Rd, Houston, TX 77054 USA

[3] Univ Texas MD Anderson Canc Ctr, Dept Symptom Res, 1515 Holcombe Blvd, Houston, TX 77030 USA

[4] Inst Acad Med, Houston Methodist Res Inst, 6670 Bertner St, Houston, TX 77030 USA

关键词: Depression;    Kynurenine;    Kynurenic acid;    Tryptophan;    Interferon;    Inflammation;    Mood disorder;   

DOI  :  10.1016/j.neubiorev.2020.08.010

来源: Elsevier

【 摘 要 】

Dysregulated kynurenine (KYN) pathway has been implicated in the pathophysiology of depression. In this systematic review, we examined the relationship between kynurenine pathway metabolites (KYN, kynurenic acid KYNA, tryptophan TRP, quinolinic acid QUIN, KYN/TRP ratio) and depression symptoms in the context of proinflammatory activation and immune response. Out of 5,082 articles, fifteen studies were suitable; ten studies (N = 315 medically ill patients treated with interferon-alpha IFN-alpha) reported baseline and post-intervention plasma KYN, TRP and KYN/TRP ratios which were included in quantitative meta-analysis. Data from five studies were summarized (IFN-alpha, interferon-beta IFN-beta, and lipopolysaccharide LPS). We found that IFN-alpha treatment in patients with chronic illnesses was associated with decreased TRP, increased levels of KYN and KYN/TRP ratio and depression scores from baseline to follow-up at both 4 and 24 weeks. Our findings suggest that increased risk of depression observed after immune-activating agents in patients with chronic medical illnesses is likely mediated by the kynurenine pathway. Further prospective studies are required to investigate the exact pathophysiology of the KYN pathway in depression.

【 授权许可】

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