Inflammation, depression and cardiovascular disease in women: the role of the immune system across critical reproductive events

Abstract

Women are at increased risk for developing depression and cardiovascular disease (CVD) across the lifespan and their comorbidity is associated with adverse outcomes that contribute significantly to rates of morbidity and mortality in women worldwide. Immunesystem activity has been implicated in the etiology of both depression and CVD, but it is unclear how inflammation contributes to sex differences in this comorbidity. This narrative review provides an updated synthesis of research examining the association of inflammation with depression and CVD, and their comorbidity in women. Recent research provides evidence of pro-inflammatory states and sex differences associated with alterations in the hypothalamic-pituitary-adrenal axis, the renin-angiotensin-aldosterone system and the serotonin/kynurenine pathway, that likely contribute to the development of depression and CVD. Changes to inflammatory cytokines in relation to reproductive periods of hormonal fluctuation (i.e. the menstrual cycle, perinatal period and menopause) are highlighted and provide a greater understanding of the unique vulnerability women experience in developing both depressed mood and adverse cardiovascular events. Inflammatory biomarkers hold substantial promise when combined with a patient's reproductive and mental health history to aid in the prediction, identification and treatment of the women most at risk for CVD and depression. However, more research is needed to improve our understanding of the mechanisms underlying inflammation in relation to their comorbidity, and how these findings can be translated to improve women's health.

Increase of Oxidative Stress is Positively Associated with High-Sensitivity C-Reactive Protein in Women Using Combined Oral Contraceptives: An Observational Study

“…In ammation (58) and oxidative stress (34) have been implicated in the etiology of depression and disturbed sleep (59); in turn, OC use has been associated with depression (60). More longitudinal research is needed to improve the understanding of mechanisms induced by in ammation in OC-users possibly affecting the psyconeurological pathways (61).…”

Aerobic Exercise Inhibits CUMS-Depressed Mice Hippocampal Inflammatory Response via Activating Hippocampal miR-223/TLR4/MyD88-NF-κB Pathway

“…Recently, studies have shown that the pathogenesis of hippocampal lesions and neuronal cell death in patients with depression might be related to the explosive activation of inflammatory reactions [1]. The "cytokine theory" suggests that stress-stimulated or over-activated immune systems produce inflammatory cytokines and play an important role in the pathogenesis of depression [2], which have been confirmed by clinical trials [3][4][5] and animal experiments [6,7]. Therefore, anti-inflammatory treatment for reducing the hippocampal inflammatory response and improving hippocampal function have become a new target for the prevention and treatment of depression.…”

Gender‐biased kidney damage in mice following exposure to tobacco cigarette smoke: More protection in premenopausal females

“…Of note, the link between inflammation and kidney fibrosis has been well established and the pharmacological suppression of inflammation slows down renal dysfunction with a reduction in glomerulosclerosis and interstitial fibrosis (Beer, Mayer, & Kronbichler, ; Braun et al, ; Eardley et al, ). The disparity in inflammatory markers between genders is also established and mainly attributed to sex hormones and other gender‐biased factors such as body composition, physical/sexual maturation, and behavioral changes during adolescence (Mattina, Lieshout, & Steiner, ; Shanahan et al, ). The risk of chronic inflammation and the associated diseases is inversely proportional to aging during which sex hormones in both genders significantly decrease but to a different extent (Laaksonen et al, ; Mattina et al, ).…”

“…The disparity in inflammatory markers between genders is also established and mainly attributed to sex hormones and other gender‐biased factors such as body composition, physical/sexual maturation, and behavioral changes during adolescence (Mattina, Lieshout, & Steiner, ; Shanahan et al, ). The risk of chronic inflammation and the associated diseases is inversely proportional to aging during which sex hormones in both genders significantly decrease but to a different extent (Laaksonen et al, ; Mattina et al, ). Women smokers are now known to be at higher risk of developing dyslipidemia, cardiovascular diseases, and lung diseases (Hsu et al, ; Lee et al, ; Peters, Huxley, & Woodward, ; Yahagi, Davis, Arbustini, & Virmani, ).…”