Immune-based strategies for mood disorders: facts and challenges

Expert Rev Neurother. 2018 Feb;18(2):139-152. doi: 10.1080/14737175.2018.1407242. Epub 2017 Nov 27.

Abstract

Inflammation seems to play a role in the pathophysiology of mood disorders, including major depressive disorder (MDD) and bipolar disorder (BD). In the last years several studies have shown increased levels of inflammatory and/or immune markers in patients with mood disorders. Accordingly, the immune system has become a target of interest for the development of biomarkers and therapeutics for mood disorders. Areas covered: Here, we review the evidence showing low-grade inflammation in mood disorders and the studies evaluating immune-based strategies for the treatment of these conditions. Expert commentary: Clinical trials with non-steroidal anti-inflammatory drugs, polyunsaturated acids, N-acetylcysteine, anti-cytokines, physical activity and probiotics have provided promising results in terms of antidepressant efficacy in patients with MDD and BD. Regarding stem cells, only studies with animal models have been performed so far with interesting pre-clinical results. Due to the preliminary nature of the results, most of the clinical studies need to be replicated and/or confirmed in larger clinical settings, embracing the highly heterogeneous pathophysiology of mood disorders.

Keywords: Mood disorders; anti-inflammatory drugs; bipolar disorder; cytokines; immunomodulation; inflammation; major depressive disorder; neuroinflammation.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Acetylcysteine / therapeutic use
  • Animals
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Antidepressive Agents / therapeutic use
  • Bipolar Disorder / drug therapy
  • Bipolar Disorder / immunology
  • Bipolar Disorder / therapy
  • Cytokines / antagonists & inhibitors
  • Cytokines / physiology
  • Depressive Disorder, Major / drug therapy
  • Depressive Disorder, Major / immunology
  • Depressive Disorder, Major / therapy
  • Exercise Therapy
  • Fatty Acids, Unsaturated / therapeutic use
  • Humans
  • Inflammation / drug therapy
  • Mesenchymal Stem Cell Transplantation
  • Mood Disorders / drug therapy
  • Mood Disorders / immunology*
  • Mood Disorders / therapy*
  • Neuroimmunomodulation
  • Probiotics / therapeutic use

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Antidepressive Agents
  • Cytokines
  • Fatty Acids, Unsaturated
  • Acetylcysteine