Jeon Sang Won, Kim Yong-Ku
Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Psychiatry, College of Medicine, Korea University, Ansan Hospital, Ansan, Republic of Korea.
J Neuroimmunol. 2017 Dec 15;313:92-98. doi: 10.1016/j.jneuroim.2017.10.016. Epub 2017 Oct 28.
Inflammation is not the only cause of depression and cannot explain its entire pathophysiology, but it is an important pathogenic factor that explains one possible mechanism of depression, with the kynurenine (KYN) pathway of tryptophan at its center. In particular, greater impairment seems to exist in the KYN pathway in inflammation-induced depression related to immunotherapy, autoimmune disease, and infection. In patients with these conditions, immunopharmacology is likely to be an important therapy. To develop this therapy, clear evidence of the immune-KYN pathway must be established via multiple types of experiments. This paper reviews the body of evidence, not only for the action of tryptophan (TRY) and consequent serotonin depletion, but also for the detrimental effects of TRY catabolites and the key enzymes in the KYN pathway that play important roles in the pathophysiology of inflammation-induced depression. In addition, this paper explores a potential treatment strategy for inflammation-induced depression using KYN metabolism.
炎症并非抑郁症的唯一病因,也无法解释其整个病理生理学过程,但它是一个重要的致病因素,可解释抑郁症的一种可能机制,其核心是色氨酸的犬尿氨酸(KYN)途径。特别是,在与免疫治疗、自身免疫性疾病和感染相关的炎症诱导型抑郁症中,KYN途径似乎存在更大的损伤。对于患有这些病症的患者,免疫药理学可能是一种重要的治疗方法。为了开发这种疗法,必须通过多种类型的实验来确立免疫-KYN途径的明确证据。本文回顾了相关证据,这些证据不仅涉及色氨酸(TRY)的作用以及随之而来的血清素耗竭,还涉及TRY分解代谢产物以及KYN途径中的关键酶在炎症诱导型抑郁症病理生理学中所起的有害作用。此外,本文还探讨了利用KYN代谢治疗炎症诱导型抑郁症的潜在策略。