Understanding immune system dysfunction and its context in mood disorders: psychoneuroimmunoendocrinology and clinical interventions.

IF 16.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Military Medical Research Pub Date : 2024-12-17 DOI:10.1186/s40779-024-00577-w
Miguel A Ortega, Oscar Fraile-Martinez, Cielo García-Montero, Raul Diaz-Pedrero, Laura Lopez-Gonzalez, Jorge Monserrat, Silvestra Barrena-Blázquez, Miguel Angel Alvarez-Mon, Guillermo Lahera, Melchor Alvarez-Mon
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Abstract

Mood disorders include a set of psychiatric manifestations of increasing prevalence in our society, being mainly represented by major depressive disorder (MDD) and bipolar disorder (BD). The etiopathogenesis of mood disorders is extremely complex, with a wide spectrum of biological, psychological, and sociocultural factors being responsible for their appearance and development. In this sense, immune system dysfunction represents a key mechanism in the onset and pathophysiology of mood disorders, worsening mainly the central nervous system (neuroinflammation) and the periphery of the body (systemic inflammation). However, these alterations cannot be understood separately, but as part of a complex picture in which different factors and systems interact with each other. Psychoneuroimmunoendocrinology (PNIE) is the area responsible for studying the relationship between these elements and the impact of mind-body integration, placing the immune system as part of a whole. Thus, the dysfunction of the immune system is capable of influencing and activating different mechanisms that promote disruption of the psyche, damage to the nervous system, alterations to the endocrine and metabolic systems, and disruption of the microbiota and intestinal ecosystem, as well as of other organs and, in turn, all these mechanisms are responsible for inducing and enhancing the immune dysfunction. Similarly, the clinical approach to these patients is usually multidisciplinary, and the therapeutic arsenal includes different pharmacological (for example, antidepressants, antipsychotics, and lithium) and non-pharmacological (i.e., psychotherapy, lifestyle, and electroconvulsive therapy) treatments. These interventions also modulate the immune system and other elements of the PNIE in these patients, which may be interesting to understand the therapeutic success or failure of these approaches. In this sense, this review aims to delve into the relationship between immune dysfunction and mood disorders and their integration in the complex context of PNIE. Likewise, an attempt will be made to explore the effects on the immune system of different strategies available in the clinical approach to these patients, in order to identify the mechanisms described and their possible uses as biomarkers.

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了解免疫系统功能障碍及其与情绪障碍的关系:心理神经免疫内分泌学与临床干预。
情绪障碍包括一系列精神病表现,在我们的社会中越来越普遍,主要表现为重度抑郁障碍(MDD)和双相情感障碍(BD)。情绪失调症的病因极为复杂,其出现和发展与多种生物、心理和社会文化因素有关。从这个意义上说,免疫系统功能障碍是情绪障碍性疾病发病和病理生理学的一个关键机制,主要恶化中枢神经系统(神经炎症)和身体外周(全身炎症)。然而,这些变化不能单独理解,而是不同因素和系统相互作用的复杂图景的一部分。心理神经免疫内分泌学(PNIE)负责研究这些因素之间的关系以及身心整合的影响,将免疫系统作为一个整体的一部分。因此,免疫系统功能失调能够影响和激活不同的机制,这些机制会导致精神紊乱、神经系统受损、内分泌和新陈代谢系统改变、微生物群和肠道生态系统以及其他器官紊乱,反过来,所有这些机制又会诱发和加强免疫功能失调。同样,针对这些患者的临床方法通常是多学科的,治疗手段包括不同的药物(如抗抑郁药、抗精神病药和锂)和非药物(即心理疗法、生活方式和电休克疗法)治疗。这些干预措施也会调节这些患者的免疫系统和 PNIE 的其他要素,这可能有助于了解这些方法的治疗成败。从这个意义上说,本综述旨在深入探讨免疫功能障碍与情绪障碍之间的关系,以及它们在 PNIE 复杂背景下的整合。同样,本综述还将尝试探讨针对这些患者的临床方法中的不同策略对免疫系统的影响,以确定所述机制及其作为生物标志物的可能用途。
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来源期刊
Military Medical Research
Military Medical Research Medicine-General Medicine
CiteScore
38.40
自引率
2.80%
发文量
485
审稿时长
8 weeks
期刊介绍: Military Medical Research is an open-access, peer-reviewed journal that aims to share the most up-to-date evidence and innovative discoveries in a wide range of fields, including basic and clinical sciences, translational research, precision medicine, emerging interdisciplinary subjects, and advanced technologies. Our primary focus is on modern military medicine; however, we also encourage submissions from other related areas. This includes, but is not limited to, basic medical research with the potential for translation into practice, as well as clinical research that could impact medical care both in times of warfare and during peacetime military operations.
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