Is ‘Antidepressants Treating COVID-19’ Science?

  On October 27, 2021, a randomized controlled trial published in the authoritative medical journal “The Lancet” showed that the antidepressant fluvoxamine reduced hospitalization rates, mortality rates and time needed for care in patients with new coronary pneumonia. It has played a significant effect. If there is more experimental data to support it, fluvoxamine is likely to become a new “anti-coronavirus magic drug”.
  Antidepressants can treat new coronary pneumonia, is there really scientific basis for this? Indeed, there are still different opinions on how antidepressants treat new coronary pneumonia, but some researchers said: “It is not a fantasy to treat new coronary pneumonia with antipsychotics, and phenothiazine antipsychotics have been used to treat RNA viruses in the past. Research on related diseases.”
  There is a theory that fluvoxamine can inhibit the S1R protein of the new coronavirus, thereby achieving anti-inflammatory effects. In fact, researchers have long found that antidepressants can affect people’s mental and psychological conditions, and this has a certain relationship with the body’s immune system. In the treatment of new coronary pneumonia, the body’s immune system plays an important role, so there is a scientific basis for antidepressants to help patients with new coronary pneumonia recover.
What is Psychoneuroimmunology

  What is the relationship between the nervous system, endocrine system and immune system? This is the problem to be studied in psychoneuroimmunology. Psychoneuroimmunology, named by American psychologist Dr. Robert Eide in 1981, mainly studies how the immune system interacts with the brain and nervous system to affect health.
  Ed proposed that psychoneuroimmunology is a discipline formed by the combination of behavioral, neurological, endocrine and immunological disciplines. Other researchers believe that psychoneuroimmunology studies the relationship between stress, mental disorders and physical health.
  Keith Kelly, a professor of neuroimmunology in the United States, proposed that human beings have entered the era of psychoneuroimmunity, and the mission of psychoneuroimmunology is to describe the relationship between the mind and body, try to understand the relationship between the mind and body at the molecular level, and use this knowledge to prevent, Curing disease.
Diseases of body and mind

  For a long time, people believed that the immune system, nervous system and endocrine system of the body are independent systems that perform their functions autonomously. Until now, the hospital’s departments are still divided into neurology, endocrinology, rheumatology and immunology and psychiatry.
  However, human beings have noticed the important influence of psychological factors on physical diseases since ancient times. The Emperor’s Internal Classic, which was compiled in the Spring and Autumn Period and the Warring States Period, pointed out that joy hurts the heart, anger hurts the liver, thinking hurts the spleen, sadness hurts the lungs, and fear hurts the kidneys. In the clinical work of modern medicine, the therapeutic concept of mind-body integration has also repeatedly shown miraculous effects.
  At an academic conference in 2017, Dr. Luo Yanli from the Department of Psychological Medicine, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, described the experience of a patient with hyperthyroidism. The patient’s mother had Alzheimer’s disease, and when her mother moved into her home, her symptoms of hyperthyroidism significantly worsened due to the conflicting mother-daughter relationship. After the patient’s mother was admitted to a nursing home, her thyroid function also became relatively normal. The psychologist and endocrinologist provided parallel treatment for this patient, using drugs to improve anxiety and sleep, and using psychotherapy to help her recognize the impact of her personality characteristics, growth experience, and work and life stress on hyperthyroidism. This comprehensive treatment has received significant results.
  Dr. Fan Qing from the Rehabilitation Department of the Shanghai Mental Health Center also talked about a patient with depression who also suffered from diabetes. He had been treated with insulin before, but it had not been very effective. Later, he was hospitalized for depression. After treatment by a psychiatrist, his depressive symptoms were significantly improved. At this time, the patient’s blood sugar was also controlled. In fact, there are many diseases obviously related to psychosocial factors, such as essential hypertension, coronary heart disease, peptic ulcer, neurodermatitis, bronchial asthma, chronic pain, tumor, neurological vomiting, etc.
  Cancer is a disease that threatens human life. The occurrence of cancer is a complex biological phenomenon that can be finally generated after multiple factors, multiple genes, and multiple stages. Modern medicine believes that the occurrence of cancer is related to individual biological characteristics and psychosocial factors. Epidemiological surveys have shown that cancer patients have long-term emotional abnormalities, and modern psychoneuroimmunology believes that psychological behavioral factors are related to people’s nervous, endocrine, and immune systems.
  Defective cellular immune function caused by emotional factors and the resulting neuroendocrine changes are important mechanisms of cancer occurrence. Abnormal emotions can cause decreased immune function, thereby affecting the occurrence, development, metastasis and treatment of cancer.
  At present, there is solid evidence that the immune system, nervous system and endocrine system are closely related, and the three systems influence each other to form the neuroendocrine immune network. With the rapid development of neuroscience and immunology in recent years, scientists have tried to elucidate their associations at the molecular level.

How the three systems interact with each other

  The immune system is regulated by the nervous system and the endocrine system. Numerous studies have demonstrated that hormones produced by the endocrine system can lead to a weakened or enhanced immune response. Most hormones play an immunosuppressive role, such as adrenocorticotropic hormone, somatostatin, androgens, prostaglandins, etc., all belong to the immunosuppressive endocrine hormones, which are specifically manifested as inhibiting phagocytosis, reducing the proliferation ability of lymphocytes and reducing antibodies generate etc.
  The nervous system also affects the immune and endocrine systems. For example, damage to the central nervous system (mainly including the hypothalamus, limbic forebrain structures, cerebral cortex, and brainstem) affects immune function. Neurotransmitters regulate the signal opening and closing of calcium ion channels and second messengers through synaptic connections, and then play an effect on immune cells. They can also directly act on the corresponding receptors on immune cells to regulate immune effects. This explains why the patients with hyperthyroidism and diabetes mentioned above also improved their immune and endocrine system disorders after receiving psychological and emotional treatments. Obviously, these studies are of great significance to clinical medicine and drug research.
  In 1969, British scientists published a study on the lifespan of widowers. They found that the death rate of widowers was alarmingly high – often within 6 months of the woman’s death. They believed that it was psychological stress that damaged people’s immunity. caused by the system. Australian scientists conducted a simple blood experiment on 26 male and female widows. After 6 weeks of widowhood, the reactivity of the subjects’ immune cells decreased, indicating that severe psychological stress can make the abnormality of immune function reach a significant level. .

  The regulatory pathways of the immune system to the nervous system include: immune regulators, neuroactive substances and hormones produced by immune cells, which can not only regulate the function of the immune system through paracrine and autocrine, but also regulate the functions of the nervous system and endocrine system. Function; there are receptors for immune regulators on nerve cells, such as IL-2 receptors distributed in the hippocampus, cerebellum, hypothalamus and cerebral cortex; lymphocytes (the main executors of immune system function) pass through the blood-brain barrier, in the central It plays a role in immune surveillance in the nervous system.
  On the other hand, the endocrine system also affects the nervous system and mood. In some patients with depression, anxiety, and other mental distress, doctors often find abnormal levels of thyroid hormones. Too much thyroid hormone can speed up the body’s metabolism, leading to symptoms such as sweating, heart palpitations, weight loss, and anxiety; too little thyroid hormone can cause physical fatigue, weight gain, slow movement, depression, inability to concentrate, and memory problems Wait. By treating thyroid disease, doctors have found that patients’ mood, memory, and cognition have improved.
Improve immunity with “heart”

  In a new study published December 21, 2021 in the Proceedings of the National Academy of Sciences, a team of researchers from Harvard Medical School and the University of Oregon, among others, demonstrates that meditation practice boosts immunity without activating inflammatory signals. Features.
  For the study, researchers recruited 104 volunteers with an average age of 40 and asked them to participate in an advanced meditation retreat at a scientific institute in Tennessee. Three months after the eight-day meditation retreat, the researchers found changes in the participants’ oxidative stress response, detoxification and cell cycle regulation pathways. The relative proportion of neutrophils increased after meditation, accompanied by increased interferon (IFN) pathway activity. The researchers found that up-regulated and down-regulated genes were significantly associated with meditation through gene co-expression network analysis.
  More notably, 220 genes directly related to immune response, including 68 genes related to interferon signaling, were upregulated. Interferon signaling plays a key role in the process of anti-disease by triggering the immune response regulatory system to defend against pathogen invasion.
  This study provides a molecular basis for understanding the healing functions of meditation and shows that meditation as a non-pharmacological means of behavioral intervention can effectively improve immune responses to treat a variety of disorders related to immune system disorders.
  A systems view of psychoneuroimmunology has important implications for clinicians in diagnosis and treatment. For example, when an experienced psychiatrist diagnoses depression, it often begins with knowing whether a patient has a thyroid disorder. In addition, the treatment of many physical diseases has also begun to comprehensively consider the impact of emotions. For example, in the treatment of chronic pain, irritable bowel syndrome, foreign body sensation in the throat and other diseases, many doctors will know whether there is depression and anxiety in patients.
  In addition to disease treatment, the systems view described in this article is also of great significance for improving physical and mental health. Under the current reality of high study pressure and high work pressure, we need to pay more attention to our mental health and actively use effective emotional adjustment methods to strengthen self-care before our physical health is damaged, and improve our ability to resist psychosomatic diseases. ability.