気分障害における免疫系機能障害とその文脈の理解:精神神経免疫内分泌学と臨床的介入

  • role: Corresponding author, Contribute equally, First author通信作者, 同等贡献者, 第一作者
  • Affiliation:

    Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain

    Ramón y Cajal Institute of Sanitary Research IRYCIS, 28034 Madrid, Spain

  • Email:miguel.angel.ortega92@gmail.com
  • Introduction:* Miguel A. Ortega miguel.angel.ortega92@gmail.com
Miguel A. Ortega12*,  
  • role: Contribute equally同等贡献者
  • Affiliation:

    Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain

    Ramón y Cajal Institute of Sanitary Research IRYCIS, 28034 Madrid, Spain

Oscar Fraile-Martinez12,  
  • role: Corresponding author通信作者
  • Affiliation:

    Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain

    Ramón y Cajal Institute of Sanitary Research IRYCIS, 28034 Madrid, Spain

  • Email:cielo.gmontero@gmail.com
  • Introduction:Cielo García-Montero cielo.gmontero@gmail.com
Cielo García-Montero12*,  
  • Affiliation:

    Ramón y Cajal Institute of Sanitary Research IRYCIS, 28034 Madrid, Spain

    Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain

Raul Diaz-Pedrero23,  
  • Affiliation:

    Ramón y Cajal Institute of Sanitary Research IRYCIS, 28034 Madrid, Spain

    Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain

Laura Lopez-Gonzalez23,  
  • Affiliation:

    Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain

    Ramón y Cajal Institute of Sanitary Research IRYCIS, 28034 Madrid, Spain

Jorge Monserrat12,  
  • Affiliation:

    Ramón y Cajal Institute of Sanitary Research IRYCIS, 28034 Madrid, Spain

    Department of Nursing and Physiotherapy, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain

Silvestra Barrena-Blázquez24,  
  • Affiliation:

    Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain

    Ramón y Cajal Institute of Sanitary Research IRYCIS, 28034 Madrid, Spain

    Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor,28031 Madrid, Spain

Miguel Angel Alvarez-Mon125,  
  • Affiliation:

    Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain

    Ramón y Cajal Institute of Sanitary Research IRYCIS, 28034 Madrid, Spain

    Psychiatry Service, Center for Biomedical Research in the Mental Health Network, University Hospital Príncipe de Asturias, 28806 Alcalá de Henares, Spain

Guillermo Lahera126,  
  • Affiliation:

    Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain

    Ramón y Cajal Institute of Sanitary Research IRYCIS, 28034 Madrid, Spain

    Immune System Diseases-Rheumatology and Internal Medicine Service, University Hospital Príncipe de Asturias, CIBEREHD, 28806 Alcalá de Henares, Spain

Melchor Alvarez-Mon127

サマリー

気分障害は、我々の社会で増加傾向にある一連の精神医学的症状を含み、主に大うつ病性障害(MDD)および双極性障害(BD)によって代表されます。気分障害の病因は非常に複雑であり、その出現と発展には、生物学的、心理学的、社会文化的な幅広い要因が関与しています。この意味で、免疫系の機能障害は気分障害の発症および病態生理の重要なメカニズムを表しており、主に中枢神経系(神経炎症)および身体の末梢(全身性炎症)を悪化させます。しかし、これらの変化は個別に理解されるのではなく、異なる要因やシステムが相互作用する複雑な全体像の一部として理解されなければなりません。精神神経免疫内分泌学(PNIE)は、これらの要素間の関係と心身統合の影響を研究する分野であり、免疫系を全体の一部として位置づけます。このように、免疫系の機能障害は精神の乱れ、神経系の損傷、内分泌および代謝系の変化、腸内細菌叢および腸内生態系の乱れ、さらに他の臓器への影響を促進するさまざまなメカニズムに影響を与え活性化することができ、これらのメカニズムは相互に免疫機能障害を誘導し増強します。同様に、これらの患者に対する臨床的アプローチは通常多職種で行われ、治療手段にはさまざまな薬物療法(例えば抗うつ薬、抗精神病薬、リチウム)および非薬物療法(すなわち心理療法、ライフスタイル、電気けいれん療法)が含まれます。これらの介入はまた、これらの患者の免疫系およびPNIEの他の要素を調節し、これらのアプローチの治療成功または失敗の理解に役立つ可能性があります。この点で、本レビューは免疫機能障害と気分障害との関係およびPNIEの複雑な文脈における統合を掘り下げることを目的としています。同様に、臨床的アプローチで利用可能なさまざまな戦略が免疫系に与える影響を探り、記述されたメカニズムとバイオマーカーとしての可能な利用法を特定しようと試みます。

キーワード

気分障害;免疫系;神経炎症;全身性炎症;精神神経免疫内分泌学(PNIE);薬理学的介入;ライフスタイル医学

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