Inflammation as a treatment target in mood disorders: review.
Depressive disorders
antidepressants
bipolar affective disorders
neuroimmunology
novel CNS drugs
Journal
BJPsych open
ISSN: 2056-4724
Titre abrégé: BJPsych Open
Pays: England
ID NLM: 101667931
Informations de publication
Date de publication:
05 Jun 2020
05 Jun 2020
Historique:
entrez:
6
6
2020
pubmed:
6
6
2020
medline:
6
6
2020
Statut:
epublish
Résumé
Mood disorders, i.e. major depressive disorder (MDD) and bipolar disorders, are leading sources of disability worldwide. Currently available treatments do not yield remission in approximately a third of patients with a mood disorder. This is in part because these treatments do not target a specific core pathology underlying these heterogeneous disorders. In recent years, abnormal inflammatory processes have been identified as putative pathophysiological mechanisms and treatment targets in mood disorders, particularly among individuals with treatment-resistant conditions. In this selective review, we aimed to summarise recent advances in the field of immunopsychiatry, including emerging pathophysiological models and findings from treatment ttrials of immunomodulatory agents for both MDD and bipolar disorders. We performed a literature review by searching Medline for clinical trials of immunomodulating agents as monotherapy or adjunctive treatments in MDD and bipolar disorders. Included studies are randomised controlled trials (RCTs), cluster RCTs or cross-over trials of immunomodulating agents that had an active comparator or a placebo-arm. Current evidence shows an association between inflammation and mood symptoms. However, there is conflicting evidence on whether this link is causal. Future studies should focus on identifying specific neurobiological underpinnings for the putative causal association between an activated inflammatory response and mood disorders. Results of these studies are needed before further treatment trials of immunomodulatory agents can be justified.
Sections du résumé
BACKGROUND
BACKGROUND
Mood disorders, i.e. major depressive disorder (MDD) and bipolar disorders, are leading sources of disability worldwide. Currently available treatments do not yield remission in approximately a third of patients with a mood disorder. This is in part because these treatments do not target a specific core pathology underlying these heterogeneous disorders. In recent years, abnormal inflammatory processes have been identified as putative pathophysiological mechanisms and treatment targets in mood disorders, particularly among individuals with treatment-resistant conditions.
AIMS
OBJECTIVE
In this selective review, we aimed to summarise recent advances in the field of immunopsychiatry, including emerging pathophysiological models and findings from treatment ttrials of immunomodulatory agents for both MDD and bipolar disorders.
METHOD
METHODS
We performed a literature review by searching Medline for clinical trials of immunomodulating agents as monotherapy or adjunctive treatments in MDD and bipolar disorders. Included studies are randomised controlled trials (RCTs), cluster RCTs or cross-over trials of immunomodulating agents that had an active comparator or a placebo-arm.
RESULTS
RESULTS
Current evidence shows an association between inflammation and mood symptoms. However, there is conflicting evidence on whether this link is causal.
CONCLUSIONS
CONCLUSIONS
Future studies should focus on identifying specific neurobiological underpinnings for the putative causal association between an activated inflammatory response and mood disorders. Results of these studies are needed before further treatment trials of immunomodulatory agents can be justified.
Identifiants
pubmed: 32498754
doi: 10.1192/bjo.2020.43
pii: S2056472420000435
pmc: PMC7345526
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e60Références
Med Hypotheses. 1991 Aug;35(4):298-306
pubmed: 1943879
Depress Anxiety. 2009;26(7):607-11
pubmed: 19496103
J Clin Psychiatry. 2003 Dec;64(12):1465-75
pubmed: 14728109
Nat Neurosci. 2002 May;5(5):405-14
pubmed: 11953750
J Affect Disord. 2018 Apr 1;230:56-64
pubmed: 29407539
Lancet. 1998 Dec 12;352(9144):1944
pubmed: 9863832
Brain Behav Immun. 2019 Feb;76:74-81
pubmed: 30414442
Inflamm Bowel Dis. 2015 Aug;21(8):1847-53
pubmed: 25993693
JAMA Psychiatry. 2013 Jan;70(1):31-41
pubmed: 22945416
J Clin Psychiatry. 2014 Jun;75(6):628-36
pubmed: 25004186
Psychol Med. 2019 Sep;49(12):1958-1970
pubmed: 31258105
Mol Psychiatry. 2010 Apr;15(4):393-403
pubmed: 19918244
J Affect Disord. 2018 Jan 1;225:665-670
pubmed: 28915505
Brain Behav Immun. 2018 Oct;73:85-114
pubmed: 29928963
Bipolar Disord. 2017 May;19(3):198-213
pubmed: 28599348
J Clin Psychiatry. 2018 Dec 4;80(1):
pubmed: 30549489
Brain Behav Immun. 2014 Aug;40:219-25
pubmed: 24703991
Biol Psychiatry. 2008 Sep 15;64(6):468-75
pubmed: 18534556
Am J Psychiatry. 2010 Jul;167(7):748-51
pubmed: 20595427
Mol Imaging. 2018 Jan-Dec;17:1536012118792317
pubmed: 30203712
Mol Neurobiol. 2018 May;55(5):4195-4206
pubmed: 28612257
Acta Psychiatr Scand. 2018 May;137(5):391-400
pubmed: 29457216
JAMA Psychiatry. 2019 Aug 1;76(8):783-790
pubmed: 31066887
Transl Psychiatry. 2018 Jan 24;8(1):27
pubmed: 29362444
Psychopharmacology (Berl). 2016 May;233(9):1679-88
pubmed: 25953327
Prog Neuropsychopharmacol Biol Psychiatry. 2011 Apr 29;35(3):702-21
pubmed: 21185346
J Affect Disord. 2012 Dec 10;141(2-3):308-14
pubmed: 22516310
J Affect Disord. 2019 Feb 15;245:1043-1051
pubmed: 30699846
Acta Psychiatr Scand. 2019 May;139(5):404-419
pubmed: 30834514
Pharmacol Biochem Behav. 2007 Jan;86(1):1-7
pubmed: 16806445
Br J Psychiatry. 2019 Jan;214(1):11-19
pubmed: 29764522
Aust N Z J Psychiatry. 2017 Aug;51(8):829-840
pubmed: 28578592
J Affect Disord. 2018 Feb;227:219-225
pubmed: 29102836
Psychol Med. 2018 Jul;48(9):1514-1522
pubmed: 29140226
Mol Psychiatry. 2020 Jan;25(1):94-113
pubmed: 31249382
Mol Psychiatry. 2020 Jun;25(6):1301-1311
pubmed: 29895893
Iran J Pharm Res. 2015 Summer;14(3):891-9
pubmed: 26330878
J Affect Disord. 2015 Mar 15;174:467-78
pubmed: 25553408
Hum Psychopharmacol. 2014 May;29(3):216-23
pubmed: 24911574
Neurosci Biobehav Rev. 2017 Mar;74(Pt B):277-286
pubmed: 27461915
J Psychopharmacol. 2017 Sep;31(9):1137-1148
pubmed: 28858537
World J Gastroenterol. 2018 Jul 7;24(25):2764-2775
pubmed: 29991880
Diabetes. 2004 Feb;53 Suppl 1:S110-8
pubmed: 14749275
Mol Psychiatry. 2006 Jul;11(7):680-4
pubmed: 16491133
Lancet. 2018 Apr 7;391(10128):1357-1366
pubmed: 29477251
Depress Anxiety. 2017 Mar;34(3):281-290
pubmed: 28135023
Circulation. 2015 Sep 8;132(10):965-86
pubmed: 26260736
J Affect Disord. 2016 Apr;194:120-7
pubmed: 26820761
Curr Neuropharmacol. 2015;13(5):636-55
pubmed: 26467412
Brain Behav Immun. 2020 Jan;83:7-21
pubmed: 31550500
Brain Behav Immun. 2018 May;70:61-75
pubmed: 29499302
BMC Med. 2019 Jan 25;17(1):18
pubmed: 30678686
Neuropsychiatr Dis Treat. 2017 May 10;13:1245-1262
pubmed: 28546750
Nat Rev Immunol. 2016 Jan;16(1):22-34
pubmed: 26711676
Mol Psychiatry. 2020 Jul;25(7):1457-1468
pubmed: 29899546
Biol Psychiatry. 2020 Jul 15;88(2):185-196
pubmed: 32000983
J Psychopharmacol. 2017 Sep;31(9):1166-1175
pubmed: 28857658
Chem Res Toxicol. 2007 Oct;20(10):1536-42
pubmed: 17887726
J Neurol Neurosurg Psychiatry. 2020 Jan;91(1):21-32
pubmed: 31658959
Behav Brain Res. 2012 Dec 1;235(2):302-17
pubmed: 22963995
Can J Psychiatry. 2014 Jul;59(7):349-57
pubmed: 25007419
Psychiatry Res. 2018 May;263:268-274
pubmed: 29605103
Mol Psychiatry. 2020 Feb;25(2):339-350
pubmed: 31427752
Neurosci Biobehav Rev. 2011 Jan;35(3):804-17
pubmed: 20934453
Acta Psychiatr Scand. 2019 Mar;139(3):227-236
pubmed: 30383306
Neuropsychopharmacology. 2020 May;45(6):925-931
pubmed: 31683271
J Psychiatr Res. 2017 Sep;92:160-182
pubmed: 28458141
Neurochem Int. 2002 Jun;40(7):621-7
pubmed: 11900857
J Affect Disord. 2017 Mar 15;211:99-106
pubmed: 28107669
Pharmacol Ther. 2011 May;130(2):226-38
pubmed: 21334376
Br J Gen Pract. 2013 Dec;63(617):e852-8
pubmed: 24351501
Front Psychiatry. 2019 Jul 09;10:458
pubmed: 31354538
Neuropsychopharmacology. 2017 Jan;42(1):334-359
pubmed: 27555382
Neurosci Biobehav Rev. 1988 Summer;12(2):123-37
pubmed: 3050629
J Neurosci Res. 2007 Aug 1;85(10):2059-70
pubmed: 17497670
Int Clin Psychopharmacol. 2016 Jan;31(1):20-6
pubmed: 26465919
Lancet. 2015 Jul 18;386(9990):258-65
pubmed: 25975452
Brain Behav Immun. 2019 Oct;81:24-40
pubmed: 31195092
Brain Sci. 2017 Oct 30;7(11):
pubmed: 29084144
Neuropsychiatr Dis Treat. 2016 Dec 19;13:1-8
pubmed: 28031712
J Clin Psychiatry. 2015 Feb;76(2):163-9
pubmed: 25742203
Acta Psychiatr Scand. 2015 Sep;132(3):180-91
pubmed: 25772638
Mol Psychiatry. 2018 Feb;23(2):335-343
pubmed: 27752078
Br J Psychiatry. 2019 Jan;214(1):42-51
pubmed: 30457075
Dig Dis Sci. 2004 Mar;49(3):492-7
pubmed: 15139504
Bipolar Disord. 2016 Mar;18(2):89-101
pubmed: 26990051
JAMA Psychiatry. 2014 Dec 1;71(12):1381-91
pubmed: 25322082
Acta Psychiatr Scand. 2017 May;135(5):373-387
pubmed: 28122130
Acta Psychiatr Scand. 2014 Mar;129(3):163-79
pubmed: 24215721
Prog Neuropsychopharmacol Biol Psychiatry. 2012 Jun 1;37(2):222-6
pubmed: 22349578
Neuropsychopharmacology. 2010 Dec;35(13):2510-20
pubmed: 20827273