Jump to content

User:Jolans2021/sandbox

From Wikipedia, the free encyclopedia

Immune Pathogenesis Theories on Depression

[edit]

The newer field of psychoneuroimmunology, the study between the immune system and the nervous system and emotional state, suggests that cytokines may impact depression.

Immune system abnormalities have been observed, including increased levels of cytokines -cells produced by immune cells that affect inflammation- involved in generating sickness behavior, creating a pro-inflammatory profile in MDD. Some people with depression have increased levels of pro-inflammatory cytokines and some have decreased levels of anti-inflammatory cytokines.[1] Research suggests that treatments can reduce pro-inflammatory cell production, like the experimental treatment of ketamine with treatment-resistant depression.[2] With this, in MDD, people will more likely have a Th-1 dominant immune profile, which is a pro-inflammatory profile. This suggests that there are components of the immune system affecting the pathology of MDD.[3]

Another way cytokines can affect depression is in the kynurenine pathway, and when this is overactivated, it can cause depression. This can be due to too much microglial activation and too little astrocytic activity. When microglia get activated, they release pro-inflammatory cytokines that cause an increase in the production of COX2. This, in turn, causes the production of PGE2, which is a prostaglandin, and this catalyzes the production of indolamine, IDO. IDO causes tryptophan to get converted into kynurenine and kynurenine becomes quinolinic acid.[4] Quinolinic acid is an agonist for NMDA receptors, so it activates the pathway. Studies have shown that the post-mortem brains of patients with MDD have higher levels of quinolinic acid than people who did not have MDD. With this, researchers have also seen that the concentration of quinolinic acid correlates to the severity of depressive symptoms.[5]

Edit - Add to pathophysiology section

[edit]

There is also a connection between the gut microbiome and the central nervous system, otherwise known as the Gut-Brain axis, which is a two-way communication system between the brain and the gut. Experiments have shown that microbiota in the gut can play an important role in depression as people with MDD often have gut-brain dysfunction. One analysis showed that those with MDD have different bacteria living in their guts. Bacteria Bacteroidetes and Firmicutes were most affected in people with MDD, and they are also impacted in people with Irritable Bowel Syndrome.[6] Another study showed that people with IBS have a higher chance of developing depression, which shows the two are connected.[7] There is even evidence suggesting that altering the microbes in the gut can have regulatory effects on developing depression. [6]

Edit - add to other medications and supplements

[edit]

Nonsteroidal anti-inflammatory drugs (NSAIDs) and cytokine inhibitors are effective in treating depression. For instance, Celecoxib, an NSAID, is a selective COX-2 inhibitor– which is an enzyme that helps in the production of pain and inflammation.[8] In recent clinical trials, this NSAID has been shown helpful with treatment-resistant depression as it helps inhibit proinflammatory signaling.[9]

Statins, which are anti-inflammatory medications prescribed to lower cholesterol levels, have also been shown to have antidepressant effects. When prescribed for patients already taking SSRIs, this add-on treatment was shown to improve anti-depressant effects of SSRIs when compared to the placebo group. With this, statins have been shown to be effective in preventing depression in some cases too.[10]

Create new section: Contemporary Shifts on Mental Health Awareness

[edit]

There are steps being taken in today's society aiming to reduce the stigma around depression and mental health, at least in Western cultures. Companies like BetterHelp aim to increase accessibility to therapy by providing affordable and online therapy options, allowing for people to seek help in an easy and anonymous manner. [11] Using famous sponsors, like Tom Brady, help reduce the stigma about asking for help in regard to mental health too. Likewise, Naomi Osaka has been candid as she talks her own mental health struggles with depression; she discussed her mental health woes when she explained how she doesn't do interviews to"protect her mental health".[12] Also, companies such as hers and hims, make it easy to get medications for anxiety and depression symptoms. These companies allow one to talk to an online physician and receive a personalized prescription without the hassle of going to a doctors office.[13][14] This accessibility to mental health, and openness about it, care shows a societal shift to encouraging seeking help and providing easy ways to get it, which in turn is helping to destigmatize depression and mental health issues in current society.[15]

Edit - add to end of "other" in management

[edit]

With this, fecal microbiota transplants (FMT) are being researched as add-on therapy treatments for people who do not respond to typical therapies. It has been shown that the patient's depressive symptoms improved, with minor gastrointestinal issues, after a FMT, with improvements in symptoms lasting at least 4 weeks after the transplant. [16]

  1. ^ Osimo, Emanuele F.; Pillinger, Toby; Rodriguez, Irene Mateos; Khandaker, Golam M.; Pariante, Carmine M.; Howes, Oliver D. (2020-07). "Inflammatory markers in depression: A meta-analysis of mean differences and variability in 5,166 patients and 5,083 controls". Brain, Behavior, and Immunity. 87: 901–909. doi:10.1016/j.bbi.2020.02.010. PMC 7327519. PMID 32113908. {{cite journal}}: Check date values in: |date= (help)CS1 maint: PMC format (link)
  2. ^ Sukhram, Shiryn D.; Yilmaz, Grozdena; Gu, Jianying (2022-09-16). Sase, Ajinkya (ed.). "Antidepressant Effect of Ketamine on Inflammation-Mediated Cytokine Dysregulation in Adults with Treatment-Resistant Depression: Rapid Systematic Review". Oxidative Medicine and Cellular Longevity. 2022: 1–13. doi:10.1155/2022/1061274. ISSN 1942-0994. PMC 9507757. PMID 36160713.{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link)
  3. ^ Rachayon, Muanpetch; Jirakran, Ketsupar; Sodsai, Pimpayao; Sughondhabirom, Atapol; Maes, Michael (2024-05-16). "T cell activation and deficits in T regulatory cells are associated with major depressive disorder and severity of depression". Scientific Reports. 14 (1): 11177. doi:10.1038/s41598-024-61865-y. ISSN 2045-2322.
  4. ^ McNally, Leah; Bhagwagar, Zubin; Hannestad, Jonas (2008-06). "Inflammation, Glutamate, and Glia in Depression: A Literature Review". CNS Spectrums. 13 (6): 501–510. doi:10.1017/S1092852900016734. ISSN 1092-8529. {{cite journal}}: Check date values in: |date= (help)
  5. ^ Hestad, Knut; Alexander, Jan; Rootwelt, Helge; Aaseth, Jan O. (2022-07-18). "The Role of Tryptophan Dysmetabolism and Quinolinic Acid in Depressive and Neurodegenerative Diseases". Biomolecules. 12 (7): 998. doi:10.3390/biom12070998. ISSN 2218-273X. PMC 9313172. PMID 35883554.{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link)
  6. ^ a b Zhu, Fangyuan; Tu, Huaijun; Chen, Tingtao (2022-05-16). "The Microbiota–Gut–Brain Axis in Depression: The Potential Pathophysiological Mechanisms and Microbiota Combined Antidepression Effect". Nutrients. 14 (10): 2081. doi:10.3390/nu14102081. ISSN 2072-6643. PMC 9144102. PMID 35631224.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  7. ^ Fond, Guillaume; Loundou, Anderson; Hamdani, Nora; Boukouaci, Wahid; Dargel, Aroldo; Oliveira, José; Roger, Matthieu; Tamouza, Ryad; Leboyer, Marion; Boyer, Laurent (2014-12). "Anxiety and depression comorbidities in irritable bowel syndrome (IBS): a systematic review and meta-analysis". European Archives of Psychiatry and Clinical Neuroscience. 264 (8): 651–660. doi:10.1007/s00406-014-0502-z. ISSN 1433-8491. PMID 24705634. {{cite journal}}: Check date values in: |date= (help)
  8. ^ "COX-2 Inhibitors: What They Are, Uses & Side Effects". Cleveland Clinic. Retrieved 2024-05-28.
  9. ^ Beckett, Charles W.; Niklison-Chirou, Maria Victoria (2022-08-17). "The role of immunomodulators in treatment-resistant depression: case studies". Cell Death Discovery. 8 (1): 1–6. doi:10.1038/s41420-022-01147-6. ISSN 2058-7716.
  10. ^ Gutlapalli, Sai Dheeraj; Farhat, Hadi; Irfan, Huma; Muthiah, Kanmani; Pallipamu, Namratha; Taheri, Sogand; Thiagaraj, Suvedha S; Shukla, Twisha S; Giva, Sheiniz; Penumetcha, Sai Sri (2022-12-08). "The Anti-Depressant Effects of Statins in Patients With Major Depression Post-Myocardial Infarction: An Updated Review 2022". Cureus. doi:10.7759/cureus.32323. ISSN 2168-8184. PMC 9825119. PMID 36628002.{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link)
  11. ^ "About Us - The Largest Online Therapy Provider | BetterHelp". www.betterhelp.com. Retrieved 2024-05-30.
  12. ^ "Naomi Osaka withdraws from French Open & reveals 'bouts of depression'". BBC Sport. 2021-05-31. Retrieved 2024-06-23.
  13. ^ "About Us". hers. Retrieved 2024-05-30.
  14. ^ "About Us". hims. Retrieved 2024-05-30.
  15. ^ "Destigmatizing Mental Health: The Impact of Public Figures | WFU Online". WFU Online Counseling. 2022-11-30. Retrieved 2024-06-23.
  16. ^ Doll, Jessica P. K.; Vázquez-Castellanos, Jorge F.; Schaub, Anna-Chiara; Schweinfurth, Nina; Kettelhack, Cedric; Schneider, Else; Yamanbaeva, Gulnara; Mählmann, Laura; Brand, Serge; Beglinger, Christoph; Borgwardt, Stefan; Raes, Jeroen; Schmidt, André; Lang, Undine E. (2022-02-17). "Fecal Microbiota Transplantation (FMT) as an Adjunctive Therapy for Depression—Case Report". Frontiers in Psychiatry. 13: 815422. doi:10.3389/fpsyt.2022.815422. ISSN 1664-0640. PMC 8891755. PMID 35250668.{{cite journal}}: CS1 maint: unflagged free DOI (link)
Retrieved from "https://en.wikipedia.org/w/index.php?title=User:Jolans2021/sandbox&oldid=1230609726"