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

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 path...

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Published inPsychopharmacology Vol. 236; no. 10; pp. 2997 - 3011
Main Authors Sforzini, Luca, Nettis, Maria Antonietta, Mondelli, Valeria, Pariante, Carmine Maria
Format Journal Article
LanguageEnglish
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
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Abstract 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.
AbstractList 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.
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.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.
Audience Academic
Author Mondelli, Valeria
Nettis, Maria Antonietta
Pariante, Carmine Maria
Sforzini, Luca
Author_xml – sequence: 1
  givenname: Luca
  surname: Sforzini
  fullname: Sforzini, Luca
  organization: Psychiatry Unit, Department of Biomedical and Clinical Sciences, ASST Fatebenefratelli-Sacco University Hospital, Università di Milano, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, King’s College London
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  givenname: Maria Antonietta
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  surname: Nettis
  fullname: Nettis, Maria Antonietta
  email: maria.nettis@kcl.ac.uk
  organization: Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, King’s College London, National Institute for Health and Research Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London
– sequence: 3
  givenname: Valeria
  surname: Mondelli
  fullname: Mondelli, Valeria
  organization: Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, King’s College London, National Institute for Health and Research Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London
– sequence: 4
  givenname: Carmine Maria
  surname: Pariante
  fullname: Pariante, Carmine Maria
  organization: Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, King’s College London, National Institute for Health and Research Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London
BackLink https://www.ncbi.nlm.nih.gov/pubmed/30806743$$D View this record in MEDLINE/PubMed
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Thu Jul 10 21:06:05 EDT 2025
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Wed Mar 19 00:54:20 EDT 2025
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Tue Jul 01 04:16:54 EDT 2025
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IsDoiOpenAccess true
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Issue 10
Keywords Chemotherapy
Immunotherapy
IDO inhibitors
Kynurenine
Depression
Inflammation
Indoleamine 2-3-dioxygenase
Cancer
Language English
License OpenAccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
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  doi: 10.1097/MPA.0000000000001016
– volume: 196
  start-page: 4487
  year: 2016
  ident: 5200_CR66
  publication-title: J Immunol
  doi: 10.4049/jimmunol.1600141
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Snippet 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...
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SubjectTerms 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
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Title Inflammation in cancer and depression: a starring role for the kynurenine pathway
URI https://link.springer.com/article/10.1007/s00213-019-05200-8
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