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Interferon, tryptophan and depression

Published online by Cambridge University Press:  24 June 2014

D. Fekkes*
Affiliation:
Department of Psychiatry, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
A. R. Van Gool
Affiliation:
Department of Psychiatry, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
*
Durk Fekkes PhD, Erasmus Medical Center Rotterdam, Laboratory of Psychiatry, Room Ee 1438, PO Box 1738, 3000 DR Rotterdam, the Netherlands. Tel: + 31 10 4087529; Fax: + 31 10 4089495, E-mail: [email protected]

Abstract

Depression is a frequent comorbid disorder of many inflammatory diseases and it is suggested that brain inflammatory processes have a pathogenic role in mood dysregulation. Several immunocompromised patients have been treated with cytokines and long-term treatments have resulted in a variety of neuropsychiatric side-effects. The objective of the study was to present evidence for an association between the induction of neuropsychiatric side-effects during treatment with interferon-α (IFN-α) and changes in serotonergic and immunological parameters. Moreover, the use of IFN-α-induced depression as a paradigm for research into the pathophysiology of depressive disorders in general will be discussed. This literature review focused on the relationships between tryptophan, serotonin, cytokines and depression associated with interferon treatment. Immunotherapy with IFN-α influences several immunological and serotonergic parameters, and induces in most patients neurovegetative, somatic and depressive symptoms. Literature findings indicate that the development of depressive symptoms in patients undergoing cytokine therapy are secondary to cytokine induction and could be mediated by a reduced availability of tryptophan to the brain, resulting ultimately in decreased serotonergic activity. Changes in the metabolism of tryptophan and consequently of serotonin may play a role in the pathophysiology of interferon-induced depression. Studies on interferon-induced neuropsychiatric side-effects may be a promising research paradigm and shed light on the role of immunological and serotonergic factors in the pathogenesis of depressive disorders in general. However, first the appropriate symptomatology of the interferon-induced depressive states has to be documented.

Type
Review Article
Copyright
Copyright © 2003 Blackwell Munksgaard

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