Rahul DESHMUKH, Aanchal SHARMA, Anju SHARMA, Rajender GULERİA, Vivek SHARMA

Depresyon: Bir İmmünoİnflamatuvar Döngü

Klinik depresyon, unipolar depresyon veya depresyon olarakta bilinen major depresif bozukluk morbidite, mortalite, yüksek intihar eğilimi ve ölümle önemli ölçüde ili?kilidir. Preklinik ve klinik çalı?malar, major depresif bozuklukgibi psikiyatrik hastalıkların inflamasyon süreci ile ili?kili olduğunu ifade etmektedir. Major depresif bozukluğun temelde bir inflamasyon hastalığı olması muhtemel olmamasına rağmen, inflamasyonun major depresif bozukluğun patofizyolojisinde az da olsa rol oynadığını ileri süren kanıtlar bulunmaktadır. Depresyon kaskatı dahilinde geli?en inflamasyon, immünitenin a?ırı aktivitesinden orijinlendiğine i?aret eder ve böylelikle immün sistem aracılı inflamasyonun rolünü açıklayan yeni bir teori kabul öngörülmü? olup ara?tırılmı?tır. Bu teori depresyonun, deği?tirilmi? immün fonksiyon ve inflamasyon cevap sistemi ile birlikte görüldüğünü belirtir. Bu teori temelde nörotransmitterleri hedefleyen mevcut terapotik seçeneklerin birçok hastada etkili olmadığı gerçeği ile güçlenmi?tir ve bu hastalarda inflamasyon mediatörlerinin artan seviyeleri ile sitokinlerin spesifik olarak ili?kili olduğu bulunmu?tur. Son zamanlarda psikososyal stres, psikolojik tramva, uyku bozukluğu ve ağrı gibi depresyonun diğer risk faktörlerinin de inflamasyon sürecini artırdığı bulunmu?tur. Bu bağlamda inflamatuar sitokinlerden orijinlenen immün sistemdeki müdahalelerin depresyon ara?tırmaları alanında terapötik olarak uygulanabilecek bir seçenek olarak görülmektedir.

Depression: An Immuno-Inflammatory Cascade

Major depressive disorder also known as clinical depression, unipolar depression or depression is associated with significant morbidity, mortality, high suicidal tendencies and deaths. Preclinical and clinical studies suggest that psychiatric illnesses like major depression are associated with inflammatory processes. While it is unlikely that major depression is a primary inflammatorydisorder, there is now evidence to suggest that inflammation play a subtle role in the pathophysiology of major depression. The inflammation in depression cascade pin points to the origin from immune hyperactivity and thus a new theory that explains role of immune system mediated inflammation has been accepted and researched upon. widely. This theory states that depression is accompanied by altered immune function and activation of the inflammatory response system. This theory is strengthened form the fact that the current therapeutic options which mainly target neurotransmitters, are not effective in many patients and these patients has been found to be associated with elevated levels of inflammatory mediators specifically cytokines. It is reported more recently that other risk factors for depression, including psychosocial stress, psychological trauma, sleep disturbance and pain, also increases inflammatory processes. Thus the intervention in the immune system originated from inflammatory cytokines seems a therapeutically viable option in the field of depression research.

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