Inflammation in cancer and depression: a starring role for the kynurenine pathway

• Published in: Psychopharmacology Vol. 236; no. 10; pp. 2997 - 3011
• Main Authors: Sforzini, Luca, Nettis, Maria Antonietta, Mondelli, Valeria, Pariante, Carmine Maria
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2019; Springer; Springer Nature B.V
• Subjects: Antidepressants; Antidepressive Agents - therapeutic use; Biomedical and Life Sciences; Biomedicine; Cancer; Chemotherapy; Comorbidity; Depression - drug therapy; Depression - immunology; Depression - metabolism; Depression, Mental; Enzymes; Humans; Immune system; Immunotherapy; Immunotherapy - methods; Immunotherapy - trends; Indoleamine-Pyrrole 2,3,-Dioxygenase - pharmacology; Indoleamine-Pyrrole 2,3,-Dioxygenase - therapeutic use; Inflammation; Inflammation - drug therapy; Inflammation - immunology; Inflammation - metabolism; Kynurenine - immunology; Kynurenine - metabolism; Mental depression; Neoplasms - drug therapy; Neoplasms - immunology; Neoplasms - metabolism; Neurosciences; Pharmacology/Toxicology; Psychiatry; Receptors, Enterotoxin - immunology; Receptors, Enterotoxin - metabolism; Review; Signal Transduction - drug effects; Signal Transduction - physiology; Systematic review; Tryptophan; United Kingdom; Chemotherapy; Immunotherapy; IDO inhibitors; Kynurenine; Depression; Inflammation; Indoleamine 2-3-dioxygenase; Cancer
• ISSN: 0033-3158; 1432-2072; 1432-2072
• DOI: 10.1007/s00213-019-05200-8

Depression is a common comorbidity in cancer cases, but this is not only due to the emotional distress of having a life-threatening disease. A common biological mechanism, involving a dysregulated immune system, seems to underpin this comorbidity. In particular, the activation of the kynurenine pathway of tryptophan degradation due to inflammation may play a key role in the development and persistence of both diseases. As a consequence, targeting enzymes involved in this pathway offers a unique opportunity to develop new strategies to treat cancer and depression at once. In this work, we provide a systematic review of the evidence up to date on the kynurenine pathway role in linking depression and cancer and on clinical implications of this evidence. In particular, complications due to chemotherapy are discussed, as well as the potential antidepressant efficacy of novel immunotherapies for cancer.