Immune and neuroendocrine mechanisms of stress vulnerability and resilience
Open accessAbstract
Diagnostic criteria for mood disorders including major depressive disorder (MDD) largely ignore biological factors in favor of behavioral symptoms. Compounding this paucity of psychiatric biomarkers is a need for therapeutics to adequately treat the 30-50% of MDD patients who are unresponsive to traditional antidepressant medications. Interestingly, MDD is highly prevalent in patients suffering from chronic inflammatory conditions, and MDD patients exhibit higher levels of circulating pro-inflammatory cytokines. Together, these clinical findings suggest a role for the immune system in vulnerability to stress-related psychiatric illness. A growing body of literature also implicates the immune system in stress resilience and coping. In this review, we discuss the mechanisms by which peripheral and central immune cells act on the brain to affect stress-related neurobiological and neuroendocrine responses. We specifically focus on the roles of pro-inflammatory cytokine signaling, peripheral monocyte infiltration, microglial activation, and hypothalamic-pituitary-adrenal axis hyperactivity in stress vulnerability. We also highlight recent evidence suggesting that adaptive immune responses and treatment with immune modulators (exogenous glucocorticoids, humanized antibodies against cytokines) may decrease depressive symptoms and thus represent an attractive alternative to the current antidepressant treatments.
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Growing evidence implicates the immune system in stress resilience and coping through peripheral and central immune mechanisms of action, affecting the brain and all stress-related neurobiological and neuroendocrine responses.
“Growing evidence, accordingly, implicates the immune system in stress resilience and coping through peripheral and central immune mechanisms of action, affecting the brain and all stress-related neurobiological and neuroendocrine responses (160).”
From Developmental Trajectories of Early Life Stress and Trauma: A Narrative Review on Neurobiological Aspects Beyond Stress System Dysregulation (2019) · cites this paper as [160]
The Introduction (page unavailable) identifies a role for the immune system in stress vulnerability and resilience, and the section on chronic psychological stress describes relevant peripheral and central inflammation. The section on neuroendocrine mechanisms says immune, autonomic, and HPA-axis processes interact, but it does not support the claim that immune mechanisms affect *all* stress-related neurobiological and neuroendocrine responses. (LLM, conf=0.86)
Experimental — accuracy not yet measuredWhen exposed to stressful events, only a subgroup of individuals develops major depression.
“When exposed to stressful events, only a subgroup of individuals develops major depression.192–195”
From Epigenetic regulation in major depression and other stress-related disorders: molecular mechanisms, clinical relevance and therapeutic potential (2023) · cites this paper as [194]
Clinical studies report higher levels of circulating pro-inflammatory cytokines in MDD patients, a pattern replicated in preclinical animal models of depression.
“clinical studies report higher levels of circulating pro-inflammatory cytokines in MDD patients, a pattern that has been replicated in preclinical animal models of depression1, 7–10.”
From Social stress induces neurovascular pathology promoting depression (2017) · cites this paper as [1]
Heightened peripheral inflammation contributes to the pathogenesis of major depressive disorder.
“Studies suggest that heightened peripheral inflammation contributes to the pathogenesis of major depressive disorder.”
From Social stress induces neurovascular pathology promoting depression (2017) · cites this paper as [1]
Hippocampal IL4 levels vary inversely with stress vulnerability.
“Our results, together with evidence from the literature (26, 27), suggest that levels of hippocampal IL4 vary inversely with stress vulnerability.”
From IL4-driven microglia modulate stress resilience through BDNF-dependent neurogenesis (2021) · cites this paper as [26]
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- Authors
- Ménard, C., Pfau, M. L., Hodes, G. E., & Russo, S. J.
- Affiliations
- Icahn School of Medicine at Mount Sinai (US)
- Corresponding author
- Russo, Scott J
- Venue
- Neuropsychopharmacology
- Published
- 2016-06-13
- Volume
- 42
- Issue
- 1
- Pages
- 62-80
- ISSN
- 0893-133X (ISSN-L)
- 1740-634X
- PMC
- PMC5143517
- OpenAlex
- W2443768325
- Cited by
- 374
- References
- 249
- Citations by year
- 2026: 27 · 2025: 30 · 2024: 50 · 2023: 32 · 2022: 55 · 2021: 60 · 2020: 41 · 2019: 35 · 2018: 28 · 2017: 13 · 2016: 3
- FWCI
- 1.63
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Neuropsychopharmacology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Office of Dietary Supplements (AT008661-01, P50 AT008661-01)
- National Institutes of Health (P50-AT008661-01)
- National Institute of Mental Health (R01MH090264, P50MH096890, T32MH096678, R01MH104559, T32MH087004)
- National Center for Complementary and Integrative Health (P50AT008661, AT008661-01, AT008661)
- Topics
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Keywords
- major depressive disorder, stress vulnerability, stress resilience, neuroinflammation, inflammatory cytokines, microglial activation, monocyte infiltration, hypothalamic-pituitary-adrenal axis, glucocorticoids, anti-cytokine antibodies, immunomodulators, antidepressant resistance, psychiatric biomarkers, chronic inflammation
- MeSH terms
- Humans, Hypothalamo-Hypophyseal System, Inflammation, Monocytes, Pituitary-Adrenal System, Stress, Psychological, Cytokines, Microglia, Mood Disorders
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