Tratamento anti-inflamatório na depressão: uma revisão sistemática
DOI:
https://doi.org/10.25118/2763-9037.2024.v14.1156Palavras-chave:
depressão, inflamação, tratamento, anti-inflamatório, imunidade, psiquiatria, terapêuticaResumo
Introdução: A alta prevalência de depressão na população mundial, associada à elevada morbidade do transtorno, torna necessário o desenvolvimento de tratamentos eficazes. Estudos recentes comprovaram a correlação entre inflamação e desenvolvimento de quadros depressivos. Objetivos: Avaliar o uso de substâncias anti-inflamatórias no manejo de pacientes com depressão uni e bipolar. Metodologia: Este estudo é uma revisão sistemática com análise qualitativa baseada no protocolo Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A busca foi realizada na Biblioteca Virtual em Saúde e PubMed. Sete estudos foram selecionados. Resultados: O número de estudos que mostraram eficácia do celecoxibe e do infliximabe foi próximo daqueles que não o foram, os biomarcadores séricos foram relacionados à diminuição das escalas de depressão com ambos. Conclusões: Os resultados sobre a eficácia do tratamento anti-inflamatório na depressão ainda são inconclusivos devido à heterogeneidade das pesquisas e ao baixo número de estudos disponíveis.
Downloads
Métricas
Referências
World Health Organization. World mental health report: transforming mental health for all. Geneva: World Health Organization; 2022. https://www.who.int/publications/i/item/9789240049338
Zachariae R. Psychoneuroimmunology: a bio-psycho-social approach to health and disease. Scand J Psychol. 2009;50(6):645-51. https://doi.org/10.1111/j.1467-9450.2009.00779.x PMID:19930265 DOI: https://doi.org/10.1111/j.1467-9450.2009.00779.x
Patel A. Review: the role of inflammation in depression. Psychiatr Danub. 2013;25 Suppl 2:S216-23. PMID:23995180
Lynall ME, Turner L, Bhatti J, Cavanagh J, de Boer P, Mondelli V, Jones D, Drevets WC, Cowen P, Harrison NA, Pariante CM, Pointon L, Clatworthy MR, Bullmore E; Neuroimmunology of Mood Disorders and Alzheimer’s Disease (NIMA) Consortium. Peripheral blood cell-stratified subgroups of inflamed depression. Biol Psychiatry. 2020;88(2):185-96. https://doi.org/10.1016/j.biopsych.2019.11.017 - PMID:32000983 DOI: https://doi.org/10.1016/j.biopsych.2019.11.017
Jeon SW, Kim YK. Inflammation-induced depression: its pathophysiology and therapeutic implications. J Neuroimmunol. 2017;313:92-8. https://doi.org/10.1016/j.jneuroim.2017.10.016 PMID:29153615 DOI: https://doi.org/10.1016/j.jneuroim.2017.10.016
Kohler O, Benros ME, Nordentoft M, Farkouh ME, Iyengar RL, Mors O, Krogh J. Effect of anti-inflammatory treatment on depression, depressive symptoms, and adverse effects: a systematic review and meta-analysis of randomized clinical trials. JAMA Psychiatry. 2014;71(12):1381-91. https://doi.org/10.1001/jamapsychiatry.2014.1611 - PMID:25322082 DOI: https://doi.org/10.1001/jamapsychiatry.2014.1611
Husain MI, Strawbridge R, Stokes PR, Young AH. Anti-inflammatory treatments for mood disorders: systematic review and meta-analysis. J Psychopharmacol. 2017;31(9):1137-48. https://doi.org/10.1177/0269881117725711 - PMID:28858537 DOI: https://doi.org/10.1177/0269881117725711
Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, McKenzie JE. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ. 2021;372:n160. https://doi.org/10.1136/bmj.n160 PMID:33781993 - PMCID:PMC8005925 DOI: https://doi.org/10.1136/bmj.n160
Raison CL, Rutherford RE, Woolwine BJ, Shuo C, Schettler P, Drake DF, Haroon E, Miller AH. A randomized controlled trial of the tumor necrosis factor antagonist infliximab for treatment-resistant depression: the role of baseline inflammatory biomarkers. JAMA Psychiatry. 2013;70(1):31-41. https://doi.org/10.1001/2013.jamapsychiatry.4 - PMID:22945416 PMCID:PMC4015348 DOI: https://doi.org/10.1001/2013.jamapsychiatry.4
McIntyre RS, Subramaniapillai M, Lee Y, Pan Z, Carmona NE, Shekotikhina M, Rosenblat JD, Brietzke E, Soczynska JK, Cosgrove VE, Miller S, Fischer EG, Kramer NE, Dunlap K, Suppes T, Mansur RB. Efficacy of adjunctive infliximab vs placebo in the treatment of adults with bipolar I/II depression: a randomized clinical trial. JAMA Psychiatry. 2019;76(8):783-90. https://doi.org/10.1001/jamapsychiatry.2019.0779 PMID:31066887 - PMCID:PMC6506894 DOI: https://doi.org/10.1001/jamapsychiatry.2019.0779
Baune BT, Sampson E, Louise J, Hori H, Schubert KO, Clark SR, Mills NT, Fourrier C. No evidence for clinical efficacy of adjunctive celecoxib with vortioxetine in the treatment of depression: a 6-week double-blind placebo controlled randomized trial. Eur Neuropsychopharmacol. 2021;53:34-46. https://doi.org/10.1016/j.euroneuro.2021.07.092 PMID:34375789 DOI: https://doi.org/10.1016/j.euroneuro.2021.07.092
Halaris A, Cantos A, Johnson K, Hakimi M, Sinacore J. Modulation of the inflammatory response benefits treatment-resistant bipolar depression: a randomized clinical trial. J Affect Disord. 2020;261:145-52. https://doi.org/10.1016/j.jad.2019.10.021 PMID:31630035 DOI: https://doi.org/10.1016/j.jad.2019.10.021
Edberg D, Hoppensteadt D, Walborn A, Fareed J, Sinacore J, Halaris A. Plasma C-reactive protein levels in bipolar depression during cyclooxygenase-2 inhibitor combination treatment. J Psychiatr Res. 2018;102:1-7. https://doi.org/10.1016/j.jpsychires.2018.02.004 PMID:29554535 DOI: https://doi.org/10.1016/j.jpsychires.2018.02.004
Abbasi SH, Hosseini F, Modabbernia A, Ashrafi M, Akhondzadeh S. Effect of celecoxib add-on treatment on symptoms and serum IL-6 concentrations in patients with major depressive disorder: randomized double-blind placebo-controlled study. J Affect Disord. 2012;141(2-3):308-14. https://doi.org/10.1016/j.jad.2012.03.033 PMID:22516310 DOI: https://doi.org/10.1016/j.jad.2012.03.033
Mansur RB, Delgado-Peraza F, Subramaniapillai M, Lee Y, Iacobucci M, Rodrigues N, Rosenblat JD, Brietzke E, Cosgrove VE, Kramer NE, Suppes T, Raison CL, Chawla S, Nogueras-Ortiz C, McIntyre RS, Kapogiannis D. Extracellular vesicle biomarkers reveal inhibition of neuroinflammation by infliximab in association with antidepressant response in adults with bipolar depression. Cells. 2020;9(4):895. https://doi.org/10.3390/cells9040895 PMID:32268604 - PMCID:PMC7226726 DOI: https://doi.org/10.3390/cells9040895
Golan DE, Tashjian AH Jr, Armstrong EJ, Armstrong AW. Principles of pharmacology: the pathophysiologic basis of drug therapy. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2012.
Wang Z, Wu Q, Wang Q. Effect of celecoxib on improving depression: a systematic review and meta-analysis. World J Clin Cases. 2022;10(22):7872-82. https://doi.org/10.12998/wjcc.v10.i22.7872 PMID:36158469 - PMCID:PMC9372844 DOI: https://doi.org/10.12998/wjcc.v10.i22.7872
Halaris A, Hain D, Law R, Brown L, Lewis D, Filip M. Single nucleotide polymorphisms in C-reactive protein (CRP) predict response to adjunctive celecoxib treatment of resistant bipolar depression. Brain Behav Immun Health. 2023;30:100625. https://doi.org/10.1016/j.bbih.2023.100625 PMID:37181328 - PMCID:PMC10172701 DOI: https://doi.org/10.1016/j.bbih.2023.100625
Howren MB, Lamkin DM, Suls J. Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosom Med. 2009;71(2):171-86. https://doi.org/10.1097/psy.0b013e3181907c1b PMID:19188531 DOI: https://doi.org/10.1097/PSY.0b013e3181907c1b
Bavaresco DV, Uggioni MLR, Ferraz SD, Marques RMM, Simon CS, Dagostin VS, Grande AJ, da Rosa MI. Efficacy of infliximab in treatment-resistant depression: a systematic review and meta-analysis. Pharmacol Biochem Behav. 2020;188:172838. https://doi.org/10.1016/j.pbb.2019.172838 PMID:31837338 DOI: https://doi.org/10.1016/j.pbb.2019.172838
Rizzo FR, Musella A, De Vito F, Fresegna D, Bullitta S, Vanni V, Guadalupi L, Stampanoni Bassi M, Buttari F, Mandolesi G, Centonze D, Gentile A. Tumor necrosis factor and interleukin-1β modulate synaptic plasticity during neuroinflammation. Neural Plast. 2018;2018:8430123. https://doi.org/10.1155/2018/8430123 PMID:29861718 - PMCID:PMC5976900 DOI: https://doi.org/10.1155/2018/8430123
Brietzke E, Kapczinski F. TNF-alpha as a molecular target in bipolar disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2008;32(6):1355-61. https://doi.org/10.1016/j.pnpbp.2008.01.006 PMID:18316149 DOI: https://doi.org/10.1016/j.pnpbp.2008.01.006
Liguz-Lecznar M, Zakrzewska R, Kossut M. Inhibition of Tnf-α R1 signaling can rescue functional cortical plasticity impaired in early post-stroke period. Neurobiol Aging. 2015;36(10):2877-84. https://doi.org/10.1016/j.neurobiolaging.2015.06.015 PMID:26189092 DOI: https://doi.org/10.1016/j.neurobiolaging.2015.06.015
Yao R, Man Y, Lu Y, Su Y, Zhou M, Wang S, Gu X, Wang R, Wu Y, Wang L. Infliximab alleviates memory impairment in rats with chronic pain by suppressing neuroinflammation and restoring hippocampal neurogenesis. Neuropharmacology. 2024;245:109813. https://doi.org/10.1016/j.neuropharm.2023.109813 PMID:38110173 DOI: https://doi.org/10.1016/j.neuropharm.2023.109813
Zovetti N, Rossetti MG, Perlini C, Brambilla P, Bellani M. Brain ageing and neurodegeneration in bipolar disorder. J Affect Disord. 2023;323:171-5. https://doi.org/10.1016/j.jad.2022.11.066 PMID:36435402 DOI: https://doi.org/10.1016/j.jad.2022.11.066
Dinan TG. Inflammatory markers in depression. Curr Opin Psychiatry. 2009;22(1):32-6. https://doi.org/10.1097/yco.0b013e328315a561 - PMID:19122532 DOI: https://doi.org/10.1097/YCO.0b013e328315a561
Haapakoski R, Mathieu J, Ebmeier KP, Alenius H, Kivimaki M. Cumulative meta-analysis of interleukins 6 and 1β, tumour necrosis factor α and C-reactive protein in patients with major depressive disorder. Brain Behav Immun. 2015;49:206-15. https://doi.org/10.1016/j.bbi.2015.06.001 - PMID:26065825 - PMCID:PMC4566946 DOI: https://doi.org/10.1016/j.bbi.2015.06.001
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2024 Barbara Dicarlo Braga, Bruna Teixeira da Costa, Katiene Rodrigues Menezes de Azevedo
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial 4.0 International License.
Debates em Psiquiatria permite que o (s) autor (es) mantenha(m) seus direitos autorais sem restrições. Atribuição-NãoComercial 4.0 Internacional (CC BY-NC 4.0) - Debates em Psiquiatria é regida pela licença CC-BY-NC
