Cited by 554Stress Responses and CortisolTryptophan and brain disordersTreatment of Major Depression

The DOI matches its Crossref record; 112 of the 124 references it cites were found in a registry or an index; none of the 100 sources its claims cite is checked for support yet.

Glucocorticoids, cytokines and brain abnormalities in depression

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Zunszain, Patricia A., Anacker, Christoph, Cattaneo, Annamaria, Carvalho, Livia A., Pariante, Carmine M.·2011·Progress in Neuro-Psychopharmacology and Biological Psychiatry

Abstract

Major depression (MD) is a common psychiatric disorder with a complex and multifactor aetiology. Potential mechanisms associated with the pathogenesis of this disorder include monoamine deficits, hypothalamic-pituitary-adrenal (HPA) axis dysfunctions, inflammatory and/or neurodegenerative alterations. An increased secretion and reactivity of cortisol together with an altered feedback inhibition are the most widely observed HPA abnormalities in MD patients. Glucocorticoids, such as cortisol, are vital hormones that are released in response to stress, and regulate metabolism and immunity but also neuronal survival and neurogenesis. Interestingly depression is highly prevalent in infectious, autoimmune and neurodegenerative diseases and at the same time, depressed patients show higher levels of pro-inflammatory cytokines. Since communication occurs between the endocrine, immune and central nervous system, an activation of the inflammatory responses can affect neuroendocrine processes, and vice versa. Therefore, HPA axis hyperactivity and inflammation might be part of the same pathophysiological process: HPA axis hyperactivity is a marker of glucocorticoid resistance, implying ineffective action of glucocorticoid hormones on target tissues, which could lead to immune activation; and, equally, inflammation could stimulate HPA axis activity via both a direct action of cytokines on the brain and by inducing glucocorticoid resistance. In addition, increased levels of pro-inflammatory cytokines also induce the production of neurotoxic end products of the tryptophan–kynurenine pathway. Although the evidence for neurodegeneration in MD is controversial, depression is comorbid with many other conditions where neurodegeneration is present. Since several systems seem to be involved interacting with each other, we cannot unequivocally accept the simple model that glucocorticoids induce neurodegeneration, but rather that elevated cytokines, in the context of glucocorticoid resistance, are probably the offenders. Chronic inflammatory changes in the presence of glucocorticoid resistance may represent a common feature that could be responsible for the enhanced vulnerability of depressed patients to develop neurodegenerative changes later in life. However, further studies are needed to clarify the relative contribution of glucocorticoids and inflammatory signals to MD and other disorders.

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Crossref · 10.1016/j.pnpbp.2010.04.011

Cites

112 of 112 references verified0 citation errors · 0 not checkable

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  • It may state two separate claims as one. 58
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  • The paper relies on this without support.

    Communication occurs between the endocrine, immune, and central nervous systems, so activation of inflammatory responses can affect neuroendocrine processes and vice versa.

    “Since communication occurs between the endocrine, immune and central nervous system, an activation of the inflammatory responses can affect neuroendocrine processes, and vice versa.”
  • The paper relies on this without support.

    Activation of the inflammatory immune system provokes neuroendocrine and neurotransmitter changes similar to those provoked by physical or psychological stressors.

    “activation of the inflammatory immune system provokes numerous neuroendocrine and neurotransmitter changes, many of which are similar to those provoked by physical or psychological stressors”
  • The paper relies on this without support.

    Stress can promote inflammatory responses through effects on sympathetic and parasympathetic nervous system pathways.

    “stress can promote inflammatory responses through effects on sympathetic and parasympathetic nervous system pathways”
  • The paper relies on this without support.

    Depression is comorbid with many other conditions in which neurodegeneration is present.

    “depression is comorbid with many other conditions where neurodegeneration is present”
  • The paper relies on this without support.

    Animal models of chronic stress and inflammation-induced depressive-like behavior are valid models for human depression.

    “preclinical studies in which animals are exposed to chronic stress (a paradigm used to mimic what happens in depressed patients where stressful life events represent a precipitating factor for the pathogenesis of depression) have been used to understand the hippocampal shrinkage in depressed patients.”
  • The paper relies on this without support.

    Findings from post-mortem tissue reflect antemortem brain states in depression.

    “All these analyses were conducted on post-mortem tissues, where results are indicative of conditions at one time point only”
  • The paper relies on this without support.

    Chronic inflammatory changes are a common feature of depression.

    “If chronic inflammatory changes represent a common feature of depression, this could predispose depressed patients to neurodegenerative changes later in life.”
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Metadata

Authors
Zunszain, P. A., Anacker, C., Cattaneo, A., Carvalho, L. A., & Pariante, C. M.
Affiliations
King's College London (GB)
Corresponding author
Zunszain, Patricia A.
Venue
Progress in Neuro-Psychopharmacology and Biological Psychiatry
Publisher
Elsevier BV
Published
2011-04
Volume
35
Issue
3
Pages
722-729
ISSN
0278-5846 (ISSN-L)
OpenAlex
W2025129891
Cited by
554
References
124
Citations by year
2026: 18 · 2025: 31 · 2024: 30 · 2023: 30 · 2022: 33 · 2021: 52 · 2020: 39 · 2019: 34 · 2018: 44 · 2017: 31 · 2016: 38 · 2015: 42 · 2014: 40 · 2013: 40 · 2012: 31
FWCI
2.57
Type
journal article
Language
en
Open access
Locations
  • Progress in Neuro-Psychopharmacology and Biological Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • Research Portal (King's College London) (submittedVersion)
Funders
  • National Institute for Health and Care Research
  • NIHR Sheffield Biomedical Research Centre
Topics
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
  • Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
  • Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Keywords
major depressive disorder, glucocorticoids, cortisol, inflammatory cytokines, hypothalamic-pituitary-adrenal axis, glucocorticoid resistance, neuroinflammation, neurodegeneration, kynurenine pathway, neuroendocrine-immune interaction, depression pathophysiology
MeSH terms
Animals, Brain, Depression, Female, Glucocorticoids, Humans, Inflammation, Male, Nerve Degeneration, Cytokines, Neurodegenerative Diseases

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