Effects of antidepressant drug therapy with or without physical exercise on inflammatory biomarkers in major depressive disorder: a systematic review and meta-analysis of randomized controlled trials
| Autor: | Beatriz Monteiro Fernandes, Márcio Gerhardt Soeiro-de-Souza, E. Scotti-Muzzi |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty media_common.quotation_subject Physical exercise law.invention Interferon-gamma Pharmacotherapy Randomized controlled trial law Internal medicine Medicine Humans Pharmacology (medical) Exercise media_common Randomized Controlled Trials as Topic Pharmacology Selection bias Depressive Disorder Major business.industry Tumor Necrosis Factor-alpha Interleukins General Medicine Middle Aged medicine.disease Antidepressive Agents C-Reactive Protein Strictly standardized mean difference Meta-analysis Quality of Life Antidepressant Major depressive disorder Female Inflammation Mediators business Biomarkers |
| Zdroj: | European journal of clinical pharmacology. 78(3) |
| ISSN: | 1432-1041 4202-0220 |
| Popis: | Objective To conduct a systematic review and meta-analysis of the effects of antidepressant drug therapy (with or without physical exercise) on peripheral inflammatory markers in patients with major depressive disorder (MDD). Methods MEDLINE, PyscINFO, Embase, and Google Scholar databases were searched until May 2020. Randomized trials that measured at least one inflammatory biomarker and included adult outpatients with MDD under antidepressant drug therapy (any drug) with or without physical exercise (any modality) were eligible. Results were summarized using the standardized mean difference (SMD) with 95% confidence intervals (95% CI) under a random-effects model. The Cochrane risk of bias tool (2010) was used to evaluate the risk of bias in the included trials. Results Sixty-three trials were identified, encompassing data from 3482 patients, and 20 investigated biomarkers. Trials had biases across multiple domains, rising concerns primarily to selection bias/performance bias/detection bias/attrition bias. SMDs between pre- and post-results indicated a significant reduction in the levels of IL-2 (SMD, - 0.25; 95% CI, - 0.41 to - 0.09, P = 0.002), IL-6 (SMD, - 0.19; 95% CI, - 0.35 to - 0.025, P = 0.024), IL-10 (SMD, - 0.32; 95% CI, - 0.57 to - 0.07, P = 0.011), and serum cortisol (SMD, - 0.35; 95% CI, - 0.58 to - 0.12, P = 0.002). Evidence supporting the influence of physical exercise combined with antidepressant drugs on peripheral inflammatory markers in MDD is sparse and heterogeneous. Conclusion There is some evidence that antidepressant drug therapy is associated with an overall positive reduction in inflammatory markers, but the evidence is heterogeneous. Further research linking how inflammatory biomarkers modulate physiology related to antidepressant response is required. Trial registration CRD42020220735. |
| Databáze: | OpenAIRE |
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