Ceren ŞAHİN, Feyza ARICIOĞLU

4713

Depresyon ve sitokin hipotezinde yeni bir boyut: ‘NLRP3 inflamazomu’

Günümüzde majör depresyon hastalarının yaklaşık 1/3’ünün monoaminerjik aşırımı kuvvetlendirerek etkilerini gösteren mevcut farmakolojik tedavilere yanıt vermemesi depresyon patogenezinin aydınlatılmasında tek başına monoamin hipotezinin yeterli olmadığını göstermektedir. Klinik ve deneysel çok sayıda çalışma ile depresyon tablosuna artmış serum IL-1ß, IL-6, TNF-? gibi proinflamatuvar sitokin seviyelerinin eşlik ettiği, serotonerjik sistem üzerinden etkisini gösteren antidepresan ilaçlar ile depresyon hastalarında söz konusu sitokin seviyelerinin azaldığı ve sitokin aracılı immün yanıtları baskılayan ajanlarla antidepresan benzeri etkiler elde edildiği gösterilmiştir. Diğer taraftan depresyon hastalarında arttığı gösterilen Hipotalamus-hipofiz-adrenal (HPA) eksenin aktivasyonuna paralel olarak plazma kortizol düzeyleri yükseliklerine inflamatuvar sitokinlerin aracılık ettiği düşünülmektedir. Depresyonda sitokin hipotezinin ortaya konulması ile son yıllarda sitokinler aracılı inflamatuvar süreçleri başlatan mekanizmaların önemi gündeme gelmiştir. NLRP3 inflamazomu; depresyon ile ilişkisi araştırılan proinflamatuvar sitokinlerin başında gelen IL-1ß ve beraberinde IL-18 aracılı inflamatuvar yanıtların başlamasından sorumlu olduğu keşfedilen multiprotein yapıda bir kompleks olup; makrofaj, mikroglia gibi immün sistem hücrelerinin sitozolünde yerleşim gösteren Nod benzeri reseptör proteini 3’ün (NLRP3) aktivasyonu ile meydana gelmektedir. NLRP3 inflamazomu ile ilişkili yolakların aydınlatılması; depresyonda sitokin hipotezine ve antidepresan tedavi yaklaşımlarına yeni bir boyut kazandırabilmesi bakımından ilgi çekici bir konu niteliğini taşımaktadır.
Anahtar Kelimeler:

Depresyon, sitokin, proinflamatuvar, IL-1β, NLRP3, inflamazom

A novel aspect for depression and cytokine hypothesis: ‘NLRP3 inflammasome’

At present, 1/3 of patients diagnosed with major depression do not respond to the current pharmacological treatments acting on monoaminergic neurotransmission has shown that the monoaminergic hypothesis alone, remains inconclusive for highlighting the pathogenesis of depression. It has been shown by several clinical and experimental studies that high serum plasma levels of proinflammatory cytokines such as IL-1ß, IL-6, TNF-? are related with depressive status. Besides, with the antidepressant treatment acting on serotonergic system, there is a decrease in cytokine levels of depressive patients and antidepressant-like effects are observed with the use of immune suppressant drugs acting on cytokines mediated mechanisms. On the other hand, inflammatory cytokines have been proposed to contribute the increase in activation of hypothalamus-pituitary-adrenal (HPA) axis, in parallel with elevated plasma cortisol levels in depressed patients. With the establishment of cytokine hypothesis in depression, the initiating mechanisms of inflammatory processes have become important issues. NLRP3 inflammasome is a multiprotein complex, known to be responsible for initiating the inflammatory mechanisms mediated with IL-1ß, one of the major proinflammatory cytokine investigated in depression, and also IL-18. It results from the activation of Nod like receptor protein 3 (NLRP3) which is a cytosolic receptor protein especially located in macrophage and microglia. Investigating NLRP3 inflammasome and related pathways in depression could be accepted as an intriguing subject for possibly bringing a new aspect to cytokine hypothesis and further approach for antidepressant therapies.
Keywords:

Depression, cytokine, proinflammatory, IL-1β, NLRP3, inflammasome,

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Clinical and Experimental Health Sciences-Cover
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2011
  • Yayıncı: Marmara Üniversitesi
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