Depresión inflamatoria: revisión sobre los avances en fisiopatología, implicaciones clínicas y tratamiento
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Palabras clave
Trastorno Depresivo Mayor, Inflamación, Antiinflamatorios, Medicina de Precisión, Endotipo
Resumen
El trastorno depresivo mayor (TDM) es un trastorno altamente prevalente y, aunque los tratamientos convencionales enfocados en los neurotransmisores han sido útiles, muchos pacientes no responden adecuadamente. En los últimos años, diversas investigaciones han señalado a la inflamación sistémica como un componente central en la fisiopatología del TDM. La activación del sistema inmune puede influir de forma negativa en la neurotransmisión, la neuroplasticidad y el eje hipotálamo-hipófisis-adrenal (HHA), además de inducir la activación de células gliales, todo lo cual puede contribuir a la resistencia terapéutica. Este fenómeno ha llevado a proponer el concepto de “depresión inflamatoria” como un subtipo específico dentro del espectro depresivo. Reconocer este endotipo inflamatorio resulta fundamental para avanzar hacia una medicina de precisión y optimizar la toma de decisiones clínicas. Se postula que estos pacientes podrían beneficiarse de intervenciones antiinflamatorias, incluyendo fármacos, nutracéuticos, ejercicio físico regular y estrategias dietéticas con impacto inmunomodulador. A pesar de su potencial terapéutico, aún se requieren estudios clínicos más robustos que permitan establecer protocolos estandarizados y mejorar la selección de pacientes con base en su perfil inflamatorio, asegurando así intervenciones más eficaces y personalizadas.
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