抑郁症中的免疫代谢调控异常与药物干预研究进展

Update on immune and metabolic dysregulation in major depressive disorder and the implications for drug intervention

针对单胺类神经递质失衡的经典抗抑郁治疗方案有着较大的局限性。近年来,临床和动物实验不断揭示炎症免疫机制与抑郁症的发生、发展密切相关。随着神经-免疫-代谢互动研究的深入,免疫代谢异常驱动的神经炎症反应和病变已成为抑郁病理机制和药物干预研究的重要方向。本文在阐述抑郁症病理网络中免疫代谢失调环节的基础上,总结抗抑郁活性化合物免疫代谢调控的新作用,并探讨以上研究进展对于抗抑郁症药物研发策略和临床治疗的启示。

Traditional anti-depressant therapy based on the regulation of monoamine neurotransmitters has shown certain limitations. Recently, accumulating clinical and preclinical studies have reported the tantalizing link between immune dysregulation, inflammatory process and the initiation and exacerbation of major depressive disorder （MDD）. With a deepening understanding of neural-immune-metabolic interactions, an immunome- tabolism driven disease network has attracted huge interests in understanding neuronal inflammation and dysfunction underlying MDD pathogenesis and intervention. This review describes recent data uncovering immunometabolic dysregulation as a key factor in MDD network, with a focus on the recent appreciation of immune-metabolic actions of several anti-depressant compounds. The implications for the discovery of novel antidepressant drugs and clinical management of MDD are discussed.