Interaction Mechanisms Between Major Depressive Disorder and Non-alcoholic Fatty Liver Disease

Abstract

Major depressive disorder (MDD), which is highly associated with non-alcoholic fatty liver disease (NAFLD), has complex pathogenic mechanisms. However, a limited number of studies have evaluated the mutual pathomechanisms involved in MDD and NAFLD development. Chronic stress-mediated elevations in glucocorticoid (GC) levels play an important role in the development of MDD-related NAFLD. Elevated GC levels can induce the release of inflammatory factors and changes in gut permeability. Elevated levels of inflammatory factors activate the hypothalamic–pituitary–adrenal (HPA) axis, which further increases the release of GC. At the same time, changes in gut permeability promote the release of inflammatory factors, which results in a vicious circle among the three, causing disease outbreaks. Even though the specific role of the thyroid hormone (TH) in this pathogenesis has not been fully established, it is highly correlated with MDD and NAFLD. Therefore, changing lifestyles and reducing psychological stress levels are necessary measures for preventing MDD-related NAFLD. Among them, GC inhibitors and receptor antagonists may be key in the alleviation of early and mid-term disease progression. However, combination medications may be important in late-stage diseases, but they are associated with various side effects. Traditional Chinese medicines have been shown to be potential therapeutic alternatives for such complex diseases.

Monoamine Neurotransmitters Control Basic Emotions and Affect Major Depressive Disorders

“…Bile acids are steroid acids which are synthesized in the liver and further processed in the gut by digestive enzymes. Bile acids participate in a range of important host functions such as monoamine neurotransmitters, short-chain fatty acids, and indoles [ 75 ]. Non-alcoholic fatty liver disease has complex pathogenic mechanisms for MDD [ 76 ].…”

“…The interactions between glutamatergic and GABAergic systems can be affected by negative life events at early childhood, such as a mother–infant relationship and adolescent social stress, and results in emotional behavior [ 75 ]. GABAergic activates depending on ionotropic GABA A and metabotropic GABA B receptors.…”

Network Embedding Across Multiple Tissues and Data Modalities Elucidates the Context of Host Factors Important for COVID-19 Infection

“…Another was cytochrome P450 family 2 subfamily E member 1 (CYP2E1), which is an important protein in the microsomal oxidation system. Shao et al (2021 ) evaluated the mutual pathomechanisms in both MDD and nonalcoholic fatty liver disease as they mediate and promote the progression of each other.…”

The Role of the Stress Response in Metabolic Dysfunction-Associated Fatty Liver Disease: A Psychoneuroendocrineimmunology-Based Perspective

“…Particularly, long-term psychological stress is highly correlated with the onset of major depressive disorder (MDD), possibly via the central actions of up-regulated inflammatory cytokines [ 88 ]. It appears that a bidirectional association exists between MDD and NAFLD, since MDD mediates NAFLD occurrence and development, while NAFLD aggravates depressive states [ 87 , 89 ]. The same happens in children, since pediatric NAFLD is frequently accompanied by psychological distress, whilst children with psychiatric disorders are at greater risk of hepatic steatosis [ 90 ].…”

“…We agree with and emphasize these views by bringing to attention that stress management interventions would simultaneously affect eating behaviors and diet adherence, as previously explained by the effects of stress on appetite, food choice, and metabolism [ 48 , 122 , 123 , 124 , 125 , 126 , 127 ]. Moreover, psychological support to MAFLD patients with a high risk of psychological distress could prevent worsening into full-blown psychiatric disorders such as MDD, which shows a bidirectional relationship with MAFLD as described above [ 89 ].…”