The Impact of Immunological Factors on Depression Treatment – Relation Between Antidepressants and Immunomodulation Agents

  • Jovana Vojvodic Clinic for Psychiatric Disorders “Dr. Laza Lazarevic”, Belgrade, Serbia
  • Goran Mihajlovic Faculty of Medical Sciences, Department of Psychiatry, University of Kragujevac, Kragujevac, Serbia
  • Petar Vojvodic Clinic for Psychiatric Disorders “Dr. Laza Lazarevic”, Belgrade, Serbia
  • Dusan Radomirovic Faculty of Medicine, University of Nis, Serbia
  • Aleksandra Vojvodic Department of Dermatology and Venereology, Military Medical Academy, Belgrade, Serbia
  • Tatjana Vlaskovic-Jovicevic Clinic for Psychiatric Disorders “Dr. Laza Lazarevic”, Belgrade, Serbia
  • Zorica Peric-Hajzler Military Medical Academy, Belgrade, Serbia
  • Dusica Matovic Military Medical Academy, Belgrade, Serbia
  • Sanja Dimitrijevic Department of Gynecology, Military Medical Academy, Belgrade, Serbia
  • Goran Sijan Clinic for Plastic Surgery and Burns, Military Medical Academy, Belgrade, Serbia
  • Maria Grazia Roccia Department of Nuclear Physics, Sub-nuclear and Radiation, G. Marconi University, Rome, Italy
  • Massimo Fioranelli Department of Nuclear Physics, sub-nuclear and radiation, G. Marconi University, Rome, Italy
  • Torello Lotti University of Rome G. Marconi, Rome, Italia
Keywords: depression, inflammation, antidepressants, cytokines

Abstract

It is determined that 30% of patients with depression are resistant to antidepressant medication. The increased concentration of inflammation factors, such as C-reactive protein, and pro-inflammatory cytokines, have been detected in serum in these patients. It is necessary to establish new therapeutic possibilities and protocols that are created to overcome the difficulties caused by increased concentration of inflammatory biomarkers in depressive patients. The Selective Serotonin Reuptake Inhibitors (SSRIs) are considered to be the most powerful antidepressants, increasing the level of serotonin in endogenous depression, as well as in that caused by immunological mechanisms. It is believed that agents that influence cytokines, immunological signal pathways and cytokine syntheses, like the inhibitors of cyclooxygenase enzyme and other non-steroidal anti-inflammatory drugs (NSAIDs), are very important in the potential treatment of residual symptoms of depression. Treatment with cytokine antagonists is one of the potential adjuvant therapies, along with antidepressants. Signal pathways blockers, such as the inhibitors of cyclooxygenase and other NSAIDs, are in the phase of research, in terms of their antidepressant effects. Also, it has been shown that the inhibition of indolamin-2,3 deoxygenase (IDO) and kynurenine (KYN) signal pathways in the synthesis of neurotransmitters, by application of IDO antagonists, are leading to suppression of pro-inflammatory cytokine effects. Antidepressants may have anti-inflammatory effects, depending on dose and type, and they achieve this effect through the decrease of pro-inflammatory cytokine production and increase of anti-inflammatory cytokines. Also, antidepressants modulate the humoral and cellular immune system. This work aims to summarise certain neurobiological and neuroimmunological specificities that have been observed in patients with depression, antidepressants and immunomodulation agents. The understanding of complex and heterogenic pathophysiology of depression through the prism of the altered immune system, is of major importance, in terms of better optimisation of pharmacotherapy, and options for a personalised approach in depressive disorder treatment.

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Author Biography

Torello Lotti, University of Rome G. Marconi, Rome, Italia

Prof. Lotti is Full Professor of the Dermatology and Venereology at University of Studies Guglielmo Marconi, Rome, Italy. He is Honorary Professor of Dermatology - China Medical University Shenyang (2011), Lecturer at the New York Academy of Sciences "Howard Fox Memorial Lecture" (14 March 2012 - New York, NY – USA), and Chair, Executive Scientific Committee Vitiligo Research Foundation, New York , NY , USA. He is President of the World Health Academy, Dermatology since 2013. He has been Full Professor of the Dermatology and Venereology Division at University of Florence School of Medicine, Florence, Italy, from 2006 to 2010. He is Visiting Professor in six International Universities worldwide, and Key Note Lecturer in several international dermatology Societies. His activities in serving Dermatology have been numerous: President of the Italian Society of Dermatology and Venereology (SIDeMaST , 2009-2010) and President of the International Society of Dermatology ( ISD, 2009-2010), President of the European Society for Cosmetic and Aesthetic Dermatology (2003-2004), Editor in Chief of the Journal of the European Academy of Dermatology and Venereology (1992-2002) , Editor "Therapeutic Hotline"- Dermatologic Therapy (2007-)and served as Editor in Chief of the Giornale Italiano di Dermatologia in the period of presidency of the Societa' Italiana di Dermatologia (2009-2010). He has been President of numerous international congresses and is currently Editor in Chief of the Giornale Italiano di Dermatologia e Venereologia ( 2010-2020 ). He is Ordinary Member of the main Scientific Societies worldwide (EADV, SIDEV , ESDR , ISD, AAD, SID) and Honorary Member of several Scientific Societies of the Dermatology field. Moreover, he is a Scientific reviewer of ten sectorial journals, among which are the British Journal of Dermatology, Journal of Investigative Dermatology, Journal of the American Academy of Dermatology , Dermatologic Therapy. He has authored 1054 scientific publications (393 peer reviewed articles, 288 books chapters e 365 abstracts). For more information, see www.torellolotti.it

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Published
2019-09-12
How to Cite
1.
Vojvodic J, Mihajlovic G, Vojvodic P, Radomirovic D, Vojvodic A, Vlaskovic-Jovicevic T, Peric-Hajzler Z, Matovic D, Dimitrijevic S, Sijan G, Roccia MG, Fioranelli M, Lotti T. The Impact of Immunological Factors on Depression Treatment – Relation Between Antidepressants and Immunomodulation Agents. Open Access Maced J Med Sci [Internet]. 2019Sep.12 [cited 2020Oct.23];7(18):3064-9. Available from: https://www.id-press.eu/mjms/article/view/oamjms.2019.779

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