Elevated immune-inflammatory signaling in mood disorders: a new therapeutic target?

Expert Rev Neurother. 2012 Sep;12(9):1143-61. doi: 10.1586/ern.12.98.

Abstract

Converging translational evidence has implicated elevated immune-inflammatory signaling activity in the pathoetiology of mood disorders, including major depressive disorder and bipolar disorder. This is supported in part by cross-sectional evidence for increased levels of proinflammatory eicosanoids, cytokines and acute-phase proteins during mood episodes, and prospective longitudinal evidence for the emergence of mood symptoms in response to chronic immune-inflammatory activation. In addition, mood-stabilizer and atypical antipsychotic medications downregulate initial components of the immune-inflammatory signaling pathway, and adjunctive treatment with anti-inflammatory agents augment the therapeutic efficacy of antidepressant, mood stabilizer and atypical antipsychotic medications. Potential pathogenic mechanisms linked with elevated immune-inflammatory signaling include perturbations in central serotonin neurotransmission and progressive white matter pathology. Both heritable genetic factors and environmental factors including dietary fatty-acid composition may act in concert to sustain elevated immune-inflammatory signaling. Collectively, these data suggest that elevated immune-inflammatory signaling is a mechanism that is relevant to the pathoetiology of mood disorders, and may therefore represent a new therapeutic target for the development of more effective treatments.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents, Non-Steroidal / pharmacology
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Antipsychotic Agents / pharmacology
  • Antipsychotic Agents / therapeutic use*
  • Cytokines / antagonists & inhibitors
  • Cytokines / blood
  • Drug Synergism
  • Evidence-Based Medicine
  • Humans
  • Immune System / drug effects
  • Immune System / immunology
  • Immune System / metabolism
  • Immunosuppressive Agents / pharmacology
  • Immunosuppressive Agents / therapeutic use*
  • Molecular Targeted Therapy*
  • Mood Disorders / blood
  • Mood Disorders / drug therapy*
  • Mood Disorders / immunology*
  • Mood Disorders / metabolism
  • Signal Transduction / drug effects*

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Antipsychotic Agents
  • Cytokines
  • Immunosuppressive Agents