Interferons, serotonin and neurotoxicity

作     者：Menkes, DB MacDonald, JA 

作者机构：Dunedin Publ Hosp Dunedin New Zealand Univ Otago Dunedin Sch Med Dunedin New Zealand 

出 版 物：《PSYCHOLOGICAL MEDICINE》 (心理医学)

年 卷 期：2000年第30卷第2期

页      面：259-268页

核心收录：

学科分类：0402[教育学-心理学(可授教育学、理学学位）] 1002[医学-临床医学] 10[医学] 

主　　题：抗肿瘤药/副作用 抗肿瘤药/治疗应用 抗病毒药/副作用 抗病毒药/治疗应用 脑/药物作用 脑/病理生理学 抑郁症/化学诱导 抑郁症/病理生理学 干扰素类/副作用 干扰素类/治疗应用 产品监测 售后 危险因素 血清素/生理学 人类 

摘      要：Background. Interferons are a class of cytokines profoundly affecting immune function. Several interferons are now synthesized and used clinically, notably for viral diseases and cancer. In addition to their desired immune effects, interferons cause a number of toxicities, including prominent effects on the nervous system. Methods. This literature review focused on the incidence of depression associated with interferon treatment. Possible neurochemical mechanisms and remedial strategies were also considered. Results. Interferon treatment, particularly with the alpha subtype, is unquestionably linked with depression, but the strength of association is uncertain because of erratic ascertainment and pretreatment co-morbidity. A likely pathogenic mechanism has been described, involving interferon suppression of serotonin synthesis. Controlled treatment trials of interferon-induced depression are not yet available. Conclusions. Neurotoxicity substantially limits the use of interferons. At least some of the risk of depression appears to derive from their anti-serotonergic effects, consistent with the large body of evidence pointing to a general link between serotonin and affective illness. Vigilant detection and aggressive treatment of depression is necessary to optimize interferon treatment of many patients.