Aye Mu Myint

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Acta Clin Croat,  Vol. 49,  (Suppl) No. 2,  2010 69Myint Aye Mu Immune system related metabolic and genetic aspects in depressive disordersIMMUNE SYSTEM RELATED METABOLIC AND GENETIC ASPECTS IN DEPRESSIVE DISORDERSMyint Aye MuLaboratory section for Psychoneuroimmunology and Th erapeutic Drug Monitoring, Psychiatric Hospital,Ludwig-Maximillians University, Munich, GermanyBackground: Th e involvement of immune mecha-nism in psychiatric disorders was proposed in macro-phage theories of depression and schizophrenia. Later, the involvement of the infl ammatory related changes beyond the cytokines including the interaction be-tween infl ammatory response system and neuroactive tryptophan metabolites that brought imbalance in neuroprotective kynurenic acid arm and neurodegen-erative 3-hydroxykynurenine and quinolinic acid arm of the tryptophan catabolic pathway was proposed in neuro-degeneration hypothesis of depression. Method: A series of studies on human plasma and CSF changes and their associations to clinical symp-toms and response to treatment and certain SNPs of genes from the related enzymes were carried out. Results: It was observed that the neuroprotective, kynurenic acid was signifi cantly lower and one of the neurodegenerative metabolites 3-hydroxykynurenine was higher in the plasma of drug naïve depressed pa-tients. Th e plasma kynurenic acid concentration and neuroprotective ratio (kynurenic acid/kynurenine) gave clear discrimination between the patients and controls with reasonable sensitivity and the specifi city. Th e CSF fi ndings showed similar direction. Th e fi nd-ings were also supported by the fi ndings from SNPs polymorphism of kynurenine amonitransferase III en-zyme which indicated the signifi cant association with a haplotype and depressive symptoms in combination with anxiety in both unipolar and bipolar depression.Conclusion: Th e major depressive disorder is as-sociated with imbalanced immune-metabolic-neuro-chemical systems.

Immune System Related Metabolic and Genetic Aspects in Depressive Disorders

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