A network medicine-based approach to explore the relationship between depression and inflammation
Authors: Hu Xiaonan , Pang Huaxin , Liu Jia , Wang Yu , Lou Yifang , Zhao Yufeng 
Published: July 2023

Background

Depression is widespread global problem that not only severely impacts individuals’ physical and mental health but also imposes a heavy disease burden on nations and societies. The role of inflammation in the pathogenesis and pathophysiology of depression has received much attention, but the precise relationship between the two remains unclear. This study aims to investigate the correlation between depression and inflammation using a network medicine approach.

Methods

We utilized a degree-preserving approach to identify the large connected component (LCC) of all depression-related proteins in the human interactome. The LCC was deemed as the disease module for depression. To measure the association between depression and other diseases, we calculated the overlap between these disease protein modules using the Sab algorithm. A smaller Sab value indicates a stronger association between diseases. Building on the results of this analysis, we further explored the correlation between inflammation and depression by conducting enrichment and pathway analyses of critical targets. Finally, we used a network proximity approach to calculate drug-disease proximity to predict the efficacy of drugs for the treatment of depression. We calculated and ranked the distances between depression disease modules and 6,100 drugs. The top-ranked drugs were selected to explore their potential for treating depression based on the hypothesis that their antidepressant effects are related to reducing inflammation.

Results

In the human interactome, all depression-related proteins are clustered into a large connected component (LCC) consisting of 202 proteins and multiple small subgraphs. This indicates that depression-related proteins tend to form clusters within the same network. We used the 202 LCC proteins as the key disease module for depression. Next, we investigated the potential relationships between depression and 299 other diseases. Our analysis identified over 18 diseases that exhibited significant overlap with the depression module. Where SAB = −0.075 for the vascular disease and depressive disorders module, SAB = −0.070 for the gastrointestinal disease and depressive disorders module, and SAB = −0.062 for the endocrine system disease and depressive disorders module. The distance between them SAB &lt; 0 implies that the pathogenesis of depression is likely to be related to the pathogenesis of its co-morbidities of depression and that potential therapeutic approaches may be derived from the disease treatment libraries of these co-morbidities. Further, considering that the inflammation is ubiquitous in some disease, we calculate the overlap between the collected inflammation module (236 proteins) and the depression module (202 proteins), finding that they are closely related (Sdi = −0.358) in the human protein interaction network. After enrichment and pathway analysis of key genes, we identified the HIF-1 signaling pathway, PI3K-Akt signaling pathway, Th17 cell differentiation, hepatitis B, and inflammatory bowel disease as key to the inflammatory response in depression. Finally, we calculated the Z-score to determine the proximity of 6,100 drugs to the depression disease module. Among the top three drugs identified by drug-disease proximity analysis were Perphenazine, Clomipramine, and Amitriptyline, all of which had a greater number of targets in the network associated with the depression disease module. Notably, these drugs have been shown to exert both anti-inflammatory and antidepressant effects, suggesting that they may modulate depression through an anti-inflammatory mechanism. These findings demonstrate a correlation between depression and inflammation at the network medicine level, which has important implications for future elucidation of the etiology of depression and improved treatment outcomes.

Conclusion

Neuroimmune signaling pathways play an important role in the pathogenesis of depression, and many classes of antidepressants exhibiting anti-inflammatory properties. The pathogenesis of depression is closely related to inflammation.