Understanding late-life depression: focus on inflammation.

IF 4.9 2区医学 Q1 PSYCHIATRY

Current Opinion in Psychiatry Pub Date : 2025-09-01 Epub Date: 2025-07-11 DOI:10.1097/YCO.0000000000001022

Antonio L Teixeira, Aline S de Miranda, Venugopal Reddy Venna, Jayandra J Himali, Moises E Bauer

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引用次数: 0

Abstract

Purpose of review: Late-life depression (LLD) is a prevalent condition and frequently complicated by higher rates of medical comorbidities and cognitive decline. We review the current evidence implicating inflammation in the pathophysiology of LLD and the potential of related molecules and pathways to be used as biomarkers or pharmacological targets.

Recent findings: A growing body of evidence implicates chronic low-grade inflammation in the pathophysiology and progression of LLD. Inflammatory cytokines, stress-related neuroendocrine pathways, oxidative stress, mitochondrial dysfunction, and blood-brain barrier permeability all synergize with aging to worsen depressive symptoms. Moreover, LLD presents marked biological heterogeneity, with inflammation-related subtypes exhibiting worse clinical outcomes. Several biomarkers and novel therapeutic targets, including cytokines, gut microbiota, and mitochondrial DNA, are identified.

Summary: Inflammation is a key modifiable contributor to LLD and may serve as both a biomarker and therapeutic target. Although current clinical trials of anti-inflammatory treatments show promise, findings remain inconsistent. Future research should focus on identifying inflammatory subtypes of LLD and validating personalized, mechanism-based interventions to improve treatment outcomes in aging populations.

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理解晚年抑郁：关注炎症。

综述目的：晚年抑郁症（LLD）是一种普遍的疾病，并且经常伴随较高的医学合并症和认知能力下降。我们回顾了目前的证据暗示炎症在LLD的病理生理和相关分子和途径的潜力，作为生物标志物或药理学靶点。最近发现：越来越多的证据表明慢性低度炎症参与LLD的病理生理和进展。炎症细胞因子、应激相关神经内分泌通路、氧化应激、线粒体功能障碍和血脑屏障通透性都与衰老协同作用，加重抑郁症状。此外，LLD具有明显的生物学异质性，炎症相关亚型表现出较差的临床结果。几个生物标志物和新的治疗靶点，包括细胞因子，肠道微生物群和线粒体DNA，被确定。摘要：炎症是LLD的关键可改变因素，可以作为生物标志物和治疗靶点。尽管目前抗炎治疗的临床试验显示出希望，但结果仍不一致。未来的研究应侧重于识别LLD的炎症亚型，并验证个性化的、基于机制的干预措施，以改善老年人群的治疗效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Psychiatry 医学-精神病学

CiteScore

12.20

自引率

1.40%

发文量

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Psychiatry is an easy-to-digest bimonthly journal covering the most interesting and important advances in the field of psychiatry. Eight sections on mental health disorders including schizophrenia, neurodevelopmental disorders and eating disorders, are presented alongside five area-specific sections, offering an expert evaluation on the most exciting developments in the field.