8/12/2019 Asthma Major Depression And
1/2
Kasturba Medical College
POB 53, KMC, Lighthouse Hill Road
Mangalore 575001
Karnataka, India
Tel.: +91 94484 37749 (C.J. Kumar)
E-mail address:[email protected] (C.J. Kumar)
doi:10.1016/j.mehy.2005.03.008
Asthma, major depression and
brain-derived neurotrophic factor
I have read with great interest the recent article,
Therapeutic value of antidepressants in asthma
by Karamitsos et al. [1]. The authors suggested that
antidepressants may have a therapeutic role in
asthma by suppressing production of proimfamma-
tory cytokines and inducing production of anti-
inflammatory ones [1]. However, one should be
cautious that antidepressant treatment may in-
crease brain-derived neurotrophic factor (BDNF)
which may deteriorate, rather then improve,
asthma.
BDNF, a member of the neurotrophic factor fam-
ily, plays an important role in the growth, develop-
ment, maintenance, and function of several
neuronal systems. It has been proposed that BDNF
plays an important role in the pathogenesis of ma-
jor depressive disorder (MDD) and, therefore, in
the mechanisms underlying antidepressant action
[2]. This proposal was further supported by thefinding of
increased hippocampal BDNF immunore-
activity in subjects treated with antidepressant
medication [3], and the findings that serum BDNF
was significantly lower in the antidepressant-naive
MDD group than in the treated or in the control
group [4].
While BDNF is highly concentrated in the brain,
it is also abundantly present in the lung [5]. Utilis-
ing a mouse model of asthma, Braun et al. [6] have
identified BDNF as a candidate molecule for medi-
ating functional neuronal changes in allergic bron-
chial asthma. In a later report, the same study
group further reported that enhanced platelet
BDNF is associated with airflow limitation and air-
way hyper-responsiveness in asthma patients [7].
From the above findings, it is probable that anti-
depressant treatment in asthma patients may fur-
ther worsen asthma condition due to the increase
of peripheral BDNF levels. From Medline search,
there is still no study of the antidepressant effects
on the pulmonary BDNF levels. It should be noted
that, in animal studies, the alteration of the cen-
tral BDNF levels by antidepressants depended on
the type of antidepressants, the treatment dura-
tion, the drug dosage and the brain regions studied
[8,9]. Considering the higher rate of depression in
asthma, and the potential value of antidepressants
in asthma by modulating immune reacting [1], it is
suggested that the dose, the duration and the type
of antidepressants for such intervention need to be
tested in animal model asthma. Furthermore,
whether BDNF may play a role in the biological link-
age between asthma and major depression may be
of interest for further exploration.
References
[1] Krommydas G, Gourgoulianis KI, Karamitsos K, Krapis K,
Kotrotsiou E, Molyvdas PA. Therapeutic value of antidepres-
sants in asthma. Med Hypotheses 2005;64:93840.
[2] Duman RS, Heninger GR, Nestler EJ. A molecular and
cellular
theory of depression. Arch Gen Psychiatry 1997;54:597606.
[3] Chen B, Dowlatshahi D, MacQueen GM, Wang JF, Young LT.
Increased hippocampal BDNF immunoreactivity in subjects
treated with antidepressant medication. Biol Psychiatry
2001;50:2605.
[4] Shimizu E, Hashimoto K, Okamura N, Koike K, Komatsu N,
KumakiriC, et al. Alterations of serum levels of
brain-derived
neurotrophic factor (BDNF) in depressed patients with or
without antidepressants. Biol Psychiatry 2003;54:705.
[5] Lommatzsch M, Braun A, Mannsfeldt A, Botchkarev VA,
Botchkareva NV, Paus R, et al. Abundant production of
brain-derived neurotrophic factor by adult visceral epithe-
lia. Implications for paracrine and target-derived Neurotro-
phic functions. Am J Pathol 1999;155:118393.[6] BraunA,
Lommatzsch M, Mannsfeldt A, Neuhaus-Steinmetz U,
Fischer A, Schnoy N, et al. Cellular sources of enhanced
brain-derived neurotrophic factor production in a mouse
model of allergic inflammation. Am J Respir Cell Mol Biol
1999;21:53746.
[7] Lommatzsch M, Schloetcke K, Klotz J, Schuhbaeck K,
Zingler D, Zingler C, et al. Brain-derived neurotrophic
factor in platelets and airflow limitation in asthma. Am J
Respir Crit Care Med 2005;171:11520.
[8] Xu H, Steven Richardson J, Li XM. Dose-related effects
of
chronic antidepressants on neuroprotective proteins BDNF,
Bcl-2 and Cu/Zn-SOD in rat hippocampus. Neuropsychophar-
macology 2003;28:5362.
Correspondence 417
