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  • 1 Sapienza Tudományegyetem Szemészeti Klinika 00187 Roma Via Sardegna, 139
  • | 2 Semmelweis Egyetem, Általános Orvostudományi Kar Szemészeti Klinika Budapest
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Egyre több adat szól amellett, hogy a depresszió patomechanizmusában a gyulladásnak, más faktorokkal összhangban, meghatározó szerepe lehet. Klinikai megfigyelések alapján írták le a depresszió társulását egy sor nyilvánvalóan gyulladásos betegséggel, mint a gyomor-bél rendszer gyulladásai és az autoimmun betegségek. A depresszió ugyancsak társulhat cardiovascularis betegségekkel, diabetesszel, neurodegeneratív betegségekkel és daganatokkal, amelyeknek a kialakulásában szubklinikus gyulladás játszik szerepet. Mindez azt sugallja, hogy a depresszió egy krónikus gyulladásos szindróma neuropszichiátriai megnyilvánulása lehet. Számos megfigyelés utal arra, miszerint ezek a gyulladások a nyálkahártyáról, leggyakrabban a gyomor-bél rendszerből indulnak ki. A gyulladás oka a baktériumflóra és a nyálkahártya szimbiózisának felborulása rendszerint a nyálkahártyát károsító életmódfaktorok miatt. Ez a helyi gyulladás citokinek, neuropeptidek és eicosanoidok termelődése révén általános hatást fejthet ki, és ezáltal befolyásolja az egyes szervek, így az agy működését is. A gyulladás mind helyileg, mind általánosan a mitokondriális anyagcsere fokozódását, majd kimerülését okozhatja. Ez egy további új elem a depresszió patomechanizmusában. Végül, ugyancsak klinikai tapasztalatok szerint, a bélgyulladások helyi kezelése megfelelő probiotikumok és vitaminok, valamint az ómega-3 zsírsavak rendszeres bevitelével kikapcsolja azokat a gyulladásos ingereket is, amelyek az agy kóros aktivitását okozzák. A baktériumflóra és a bélnyálkahártya kölcsönhatásának helyreállítása, ezáltal a gyulladás megszüntetése egy új lehetőséget jelenthet a depresszió és a társuló betegségek kezelésében. Ez a kombináció gyorsíthatja, illetve fokozhatja a jelenleg alkalmazott antidepresszáns gyógyszerek és pszichoterápia hatásosságát. További vizsgálatok szükségesek mind a gyulladás patogenetikai szerepéről, mind a gyulladáscsökkentés terápiás hatásának igazolására. Orv. Hetil., 2011, 152, 1477–1485.

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