Nervenheilkunde 2018; 37(12): 873-879
DOI: 10.1055/s-0038-1677359
Universitätsklinikum Ulm
Georg Thieme Verlag KG Stuttgart · New York

Depression als Stoffwechselstörung

Welche Rolle spielen die Mitochondrien?Depression as a metabolic disorder
A. Karabatsiakis
1   Institut für Psychologie und Pädagogik, Klinische & Biologische Psychologie, Universität Ulm
,
C. Schönfeldt-Lecuona
2   Klinik für Psychiatrie und Psychotherapie III, Universitätsklinik Ulm
› Author Affiliations
Further Information

Publication History

eingegangen am: 30 September 2018

angenommen am: 12 October 2018

Publication Date:
04 January 2019 (online)

Zusammenfassung

Die Majore Depression (MD) hat sich zu einer Volkskrankheit entwickelt und stellt eine immense soziale sowie volkswirtschaftliche Herausforderung dar. Trotz intensiver Forschung konnten die pathophysiologischen Prozesse der Erkrankung nicht vollständig aufgeklärt werden. Diese sind von besonderer Bedeutung, da entsprechende Therapieansätze für eine effizientere und anhaltende Verbesserung der depressionsassoziierten Symptomatik zwingend erforderlich sind. Bislang galt die MD, wie viele andere psychische Störungen auch, als eine Erkrankungen, die hauptsächlich das zentrale Nervensystem betrifft. In den letzten Jahren konnten jedoch immer mehr Befunde gesammelt werden, die belegen, dass in Zusammenhang mit der MD körperliche Veränderungen auftreten, die den gesamten Organismus in seiner Funktionalität und Integrität beeinträchtigen. Somit scheint ein Paradigmenwechsel hin zu einer gesamtorganischen Betrachtung der MD notwendig, die die zum Einsatz kommenden Behandlungskonzepte mit einschließt. Ein innovativer Ansatz zeigt die Bedeutung des mitochondrialen Energiemetabolismus für das pathophysiologische Verständnis der MD auf. Mitochondrien, intrazelluläre Organellen aller eukaryotischen Zellen, nutzen die in der Nahrung enthaltenen chemischen Verbindungen aus Kohlenwasserstoffen zur biochemischen Bereitstellung von Adenosintriphosphat (ATP). ATP stellt die elementare Energiewährung für enzymatische Aktivität in allen Zellen, Geweben und Organen dar. In den letzten Jahren konnte gezeigt werden, dass klinischrelevante Symptome der MD wie Antriebslosigkeit, Müdigkeit und Konzentrationsschwäche mit Veränderungen der mitochondrialen Energieproduktion und der Anzahl von Mitochondrien pro Zelle (mitochondriales Netzwerk) assoziiert sind.

Summary

Major depressive disorders (MDD) has become a serious widespread disease and immense social as well as economic challenge. Although intense research has been performed, the precise underlying pathophysiological processes in MDD have not been completely resolved. This is of special clinical interest because therapeutic approaches for an efficient and persistent improvement of depression-associated symptoms is of very high need. Like other mental disorders, MDD has been hypothesized to mainly affect the central nervous system. Over the last years, more research findings indicate mental disorders to change somatic functioning, which affects the functionality and the integrity of the whole organism. As a consequence, a paradigm shift seems reasonable towards a systemic view of how depression affects the body. Same holds true for clinical treatment approaches, which so far focus on the central nervous system. One innovative approach highlights the importance of the bioenergetics activity and network dynamics of mitochondria for the pathophysiological understanding of MDD. Mitochondria, intra-cellular organelles of mostly all eukaryotic cells, use carbohydrate compounds from food to provide biochemical energy in form of adenosine triphosphate (ATP). ATP is the essential bioenergetics currency and the main driver for enzymatic activity in all cells, tissues and organs. In the last years clinically-relevant symptoms in MDD including lack of motivation, fatique and difficulties concentrating were reported associated with impaired mitochondrial production of energy and changes in the mitochondrial network within cells.

 
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