Inflammation and Depression - Hunter

Question 1

Depression may be caused by infammation due to the release of which three cytokines from the acute phase response?

Answer 1

TNF-a
IL-1b
IL6

Question 2

one third of people with depression have high levels of (CRP/SEDR)

Answer 2

CRP

Question 3

Compared to autoimmune and infectious dz, how do the increased levels of inflammatory markers in depression look?

Answer 3

not as high as autoimmune but comparable to CVD, stroke, and diabetes

Question 4

Which two inflammatory mediators serve as biomarkers and prognostic indicators of depression?

Answer 4

CRP and IL-1b

Question 5

T/F: t/f: inflammation is both necessary and sufficient to cause depression

Answer 5

false

Question 6

T/f: inflammation as a feature of depression is a feature only in a subset of patients

Answer 6

true

Question 7

There is evidence for what two to other factors that may cause depression/

Answer 7

genetic and environmental

Question 8

What other mental illnesses have shown a disruption in the immune and inflammatory response?

Answer 8

schizophrenia

Question 9

Depression occurs in 5-10x higher in people with what types of dz?

Answer 9

peripheral inflammatory diseases
psoriasis
rheumatoid arthritis
IBS

Question 10

MS has a lifetime prevalence of depression of (blank) %

Answer 10

50%, suicide 15%

Question 11

T/F: cancer, stroke, CAD, and epilepsy are risk factors for depression

Answer 11

true

Question 12

Patients treated with inflammatory cytokines have a high rate of (blank)

Answer 12

depression

Question 13

Which two cytokines that cause a cytokine storm are used for immunotherapy in hept C and cancer?

Answer 13

IFN-a

IL2

Question 14

the prevalence of pts treated with IFN-a was (blank)%

Answer 14

30%

Question 15

Pts with Crohn’s disease and depression had sig. remission from depression after treatment with (blank) an anti-TNF-a antibody

Answer 15

infliximab

Question 16

55% of pts with psoriasis and depression were treated with (blank), a soluble TNF-a receptor improved compared to antidepressants

Answer 16

etanercept

Question 17

T/f: anti-inflammatory tx have been associated with antidepressant effects

Answer 17

true

Question 18

Addition of celecoxib, a COX-2 inhibitor that inhibits the production of (blank), added to reboxetine a SNRI, showed increased improvement compared to reboxetine alone

Answer 18

PGE2

Question 19

t/F: Tx with antidepressants cuases a decrease in inflammatory mediators and depression

Answer 19

true

Question 20

T/f: IL1b, IL6, and TNF-a levels all decrease in response to antidepressants

Answer 20

FALSE, NOT TNFa

Question 21

Decrease in inflammatory markers was specific to Tx with (SSRI/SNRI)

Answer 21

SSRI

Question 22

T/F: antidepressants may block the action of inflammatory cytokines in the brain

Answer 22

true

Question 23

Inflammation plays a role in depression only in a subset of (blank) susceptible individuals

Answer 23

genetically

Question 24

Inflammation may act as a (blank) factor pushing someone into depression or a (blank) factor that is an obstacle for recovery

Answer 24

precipitating and perpetuating

Question 25

t/F: inflammatory mediators may aid in diagnosis and prognosis of depression

Answer 25

true

Question 26

Cytokines are produced by which three brain cell types?

Answer 26

neurons microglia astrocytes

Question 27

T/f: the cells that produce cytokines in the brain also have cytokine receptors

Answer 27

true

Question 28

Is the brain immunologicaly priveleged or can peripheral cytokines signal the brain?

Answer 28

peripheral cytokines can signal the brain

Question 29

What are the four pathways through which cyotkines may access the brain?

Answer 29

1. neural pathway 2. humoral pathway 3. cytokine transporters 4. Secondary messengers via the BBB

Question 30

Cytokines produced in the periphery trigger sensory afferents of which two cranial nerves? What pathway is this called?

Answer 30

vagal glossopharyngeal neural pathway (CNs then stimulate other neurons in the CNS to stim glial cells to release cytokines)

Question 31

volume diffusion of cyotkines from leaky circumventricular ogans that are outside the bbb is which pathway?

Answer 31

humoral

Question 32

T/F: direct cytokine transporters exist in the blood brain barrier

Answer 32

true

Question 33

Secretion of which two secondary messengers via the cells of the BBB allow peripheral cytokines to cause creation of cytokines within the brain?

Answer 33

PGE2 and NO

Question 34

Infection and tissue damage, aka PAMPs and DAMPs, are recognized by what receptor that stimulates the release of NF-kB

Answer 34

TLR-4

Question 35

Release of NF-kB causes the production and rlease of which three proinflammatory mediators

Answer 35

TNF-a IL1b IL6

Question 36

Cytokines that gain access to the brain or signal the brain to make cytokines act via which three hormone pathways?

Answer 36

1. Serotonergic and dopaminergic signaling 2. activation of CRH and engagement of HPA axis (cortisol production) 3. disruption of synaptic plasticity (BDNF)

Question 37

Activation of CRH causes the HPA axis to produce what stress hormone?

Answer 37

cortisol

Question 38

Cytokines cause the disruption of synaptic plasticity via the downregulation of which neurotrophic factor?

Answer 38

BDNF

Question 39

Environmental stressors activate (sympathetic/parasymp) neurons that synapse on mac's

Answer 39

sympathetic

Question 40

Which neurotransmitter is used in the synapses with macrophages?

Answer 40

norepi

Question 41

synapses on macrophages trigger the release of what transcription factor?

Answer 41

NF-kB

Question 42

Stressors cause an (inc/dec) on inhibitory motor vagal input which prevents the formation of NF-kB

Answer 42

decreases the inhibition therefore more NF-kB is produced therefore more inflamm

Question 43

ACh released from inhibitory motor vagal afferents bind to which receptor?

Answer 43

a7nAChR

Question 44

activation of the mitogen activated protein kinase pathway inhibits the function of which receptor?

Answer 44

glucocorticoid receptor

Question 45

Inhibition of the glucocorticoid receptors (inc./dec,) NF-kb release

Answer 45

increases NF-kB release from negative regulation

Question 46

With functioning receptors, glucocorticoids will (inc/dec.) inflammation

Answer 46

decrease, that's why we give you steroids when you have asthma

Question 47

The reason why the CHRONIC stimulation of CRH in the brain by peripheral cytokines doesn't lead to inflammatory down regulation via glucocoriticoid is....

Answer 47

GLUCOCORTICOID RESISTANCE, that's why chronic stress leads to diabetes and shit

Question 48

Which cell has the a7nAChR on it?

Answer 48

macrophages

Question 49

What cell type are the sympathetic, and motor vagal inputs synapsing on?

Answer 49

macrophages

Question 50

T/F: release of NF-kB causes an increase in adhesion moecules

Answer 50

true

Question 51

T/F: sympathetic input to macrophages only stimulates a1 adrenergic receptors

Answer 51

false; stimulates both a and b adrenergic