Inflammation and Immune Regulation as Potential Drug Targets in Antidepressant Treatment

Author(s): Frank M. Schmidt, Kenneth C. Kirkby, Nicole Lichtblau.

Journal Name: Current Neuropharmacology

Volume 14 , Issue 7 , 2016

Graphical Abstract:


Abstract:

Growing evidence supports a mutual relationship between inflammation and major depression. A variety of mechanisms are outlined, indicating how inflammation may be involved in the pathogenesis, course and treatment of major depression. In particular, this review addresses 1) inflammatory cytokines as markers of depression and potential predictors of treatment response, 2) findings that cytokines interact with antidepressants and non-pharmacological antidepressive therapies, such as electroconvulsive therapy, deep brain stimulation and physical activity, 3) the influence of cytokines on the cytochrome (CYP) p450-system and drug efflux transporters, and 4) how cascades of inflammation might serve as antidepressant drug targets. A number of clinical trials have focused on agents with immunmodulatory properties in the treatment of depression, of which this review covers nonsteroidal anti-inflammatory drugs (NSAIDs), cytokine inhibitors, ketamine, polyunsaturated fatty acids, statins and curcumin. A perspective is also provided on possible future immune targets for antidepressant therapy, such as toll-like receptor-inhibitors, glycogen synthase kinase-3 inhibitors, oleanolic acid analogs and minocycline. Concluding from the available data, markers of inflammation may become relevant factors for more personalised planning and prediction of response of antidepressant treatment strategies. Agents with anti-inflammatory properties have the potential to serve as clinically relevant antidepressants. Further studies are required to better define and identify subgroups of patients responsive to inflammatory agents as well as to define optimal time points for treatment onset and duration.

Keywords: Biomarker, cytokines, curcumin, depression, infliximab, ketamine, treatment prediction.

Rights & PermissionsPrintExport Cite as

Article Details

VOLUME: 14
ISSUE: 7
Year: 2016
Page: [674 - 687]
Pages: 14
DOI: 10.2174/1570159X14666160115130414
Price: $58

Article Metrics

PDF: 46
HTML: 2
EPUB: 1
PRC: 1