Ketamine's effect on inflammation and kynurenine pathway in depression: A systematic review.
J Psychopharmacol
; 35(8): 934-945, 2021 Aug.
Article
en En
| MEDLINE
| ID: mdl-34180293
ABSTRACT
BACKGROUND:
Ketamine is a novel rapid-acting antidepressant with high efficacy in treatment-resistant patients. Its exact therapeutic mechanisms of action are unclear; however, in recent years its anti-inflammatory properties and subsequent downstream effects on tryptophan (TRP) metabolism have sparked research interest.AIM:
This systematic review examined the effect of ketamine on inflammatory markers and TRP-kynurenine (KYN) pathway metabolites in patients with unipolar and bipolar depression and in animal models of depression.METHODS:
MEDLINE, Embase, and PsycINFO databases were searched on October 2020 (1806 to 2020).RESULTS:
Out of 807 initial results, nine human studies and 22 animal studies on rodents met the inclusion criteria. Rodent studies provided strong support for ketamine-induced decreases in pro-inflammatory cytokines, namely in interleukin (IL)-1ß, IL-6, and tumor necrosis factor (TNF)-α and indicated anti-inflammatory effects on TRP metabolism, including decreases in the enzyme indoleamine 2,3-dioxygenase (IDO). Clinical evidence was less robust with high heterogeneity between sample characteristics, but most experiments demonstrated decreases in peripheral inflammation including in IL-1ß, IL-6, and TNF-α. Preliminary support was also found for reduced activation of the neurotoxic arm of the KYN pathway.CONCLUSION:
Ketamine appears to induce anti-inflammatory effects in at least a proportion of depressed patients. Suggestions for future research include investigation of markers in the central nervous system and examination of clinical relevance of inflammatory changes.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Trastorno Depresivo Mayor
/
Inflamación
/
Ketamina
Tipo de estudio:
Prognostic_studies
/
Systematic_reviews
Límite:
Animals
/
Humans
Idioma:
En
Revista:
J Psychopharmacol
Asunto de la revista:
PSICOFARMACOLOGIA
Año:
2021
Tipo del documento:
Article
País de afiliación:
Reino Unido