Depression and inflammation. Two disorders of the same cause
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Risk of depression and inflammation
An international study offers new insights into the biological mechanisms underlying major depressive disorder (MDD), and particularly the role of the immune system. The study specifically looked at “gene expression” – the process by which instructions stored in our genes take effect and influence body functions.
The study showedthat people with depression and elevated levels of inflammation had increased activity in genes associated with the immune system and metabolic activity. The conclusion was made based on observation of people with depression.
Specifically, 1 in 3 people with depression have high levels of inflammation. This is a sign of a highly active immune system, the body's defense against potentially harmful stimuli such as infections.
First correlations between inflammation and depression
During a stressful situation, our body activates inflammatory responses to effectively combat threats. As a result, the immune system during depression is constantly in a mode of increased activity, which is associated with a state of chronic stress.
The following pattern is also observed. People with depression and increased levels of inflammation have a reduced response to standard antidepressants. As a result, these patients may benefit from additional treatments that target the immune system. The same course of anti-inflammatory drugs.
Thus, understanding the biological mechanisms underlying this increased inflammation sheds light on how to help people with depression, especially those who do not respond to standard antidepressants. The same increased level of immune activity and autoimmune diseases correlates with risks of schizophrenia.
Genetic roots of depression and inflammatory diseases
With depression, as with almost any medical condition, there is no one-size-fits-all approach for all patients. The diversity of people with depression suggests a wide range of biological models of depression at work. As the field of precision medicine evolves, psychiatry is keeping up with the times.
Dr. Luca Sforzini, co-author of the study.
The researchers sequenced the mRNA to measure the activity of all genes expressed in the blood. The study found that people with depression and elevated levels of inflammation had increased activity in genes associated with the immune system and metabolic activity.
The study found that even with moderately elevated inflammation, there was significant activation of immune-related genes. In people with depression and high levels of inflammatory markers, genes involved in metabolic processes, that is, genes associated with how we produce, consume and store energy, are additionally activated. Which affects, for example, the functions of fats and sugar in the body.
Through gene expression, we can capture something different from what is observed clinically, something “intermediate” between what is encoded in our genes and what we ultimately observe. Therefore, such studies may help to fully understand the biology of depression.
Professor Annamaria Cattaneo, co-author of the study.
Typical profile for inflammation and depression
In the study, the researchers also identified a specific gene expression profile in individuals who responded effectively to antidepressants. In these same people, the biological mechanism of suppressing immune function changed, and there was also an increase in markers that help protect the brain. This suggests that these biological processes play a role in recovery from depression, and sheds a little more light on how antidepressants work.
Overall, the present study demonstrates the importance of gene expression in understanding the biology of depression and the effects of antidepressants.
Our genes and associated biology may explain differences between different types of depression, for example in those who do or do not respond to standard antidepressants, or in those who do or do not develop comorbidities such as diabetes and cardiovascular disease diseases.
Our study highlights the need to understand the biological basis of different types of depression, moving from the traditional approach to more targeted and personalized approaches.
Professor Carmine Pariante, co-author of the study.
As a result, scientists have found a foundation in which some drugs can be extremely effective in treating diseases that initially have nothing to do with drugs. And everything else is the work of the FDA's breakthrough therapy, which allows for the accelerated implementation and distribution of an effective solution.
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