Parallel Pathways, Divergent Outcomes: Adipose Tissue-Neural Crosstalk in Depression and Obesity.

Area of Science:

• Neuroscience
• Endocrinology
• Immunology

Background:

• Depression and obesity are significant global health issues with high morbidity and socioeconomic burden.
• These conditions are increasingly recognized as sharing common biological pathways, including HPA axis dysregulation, inflammation, gut dysbiosis, and mitochondrial dysfunction.

Purpose of the Study:

• To review the molecular crosstalk between adipose tissue and the brain.
• To summarize the role of adipokine dysregulation in connecting metabolic dysfunction with depressive neurobiology.
• To propose reconceptualizing depression as an immunometabolic disorder.

Main Methods:

• Narrative review integrating metabolic, immunological, and neuroendocrine perspectives.
• Analysis of scientific literature on adipokines and their impact on neuroimmune signaling and mood.

Main Results:

• Adipose tissue acts as an endocrine organ secreting molecules (adipokines) that significantly impact neuroimmune signaling and mood.
• Dysregulation of adipokines like leptin, adiponectin, and resistin is implicated in the development and persistence of depressive symptoms and increased adiposity.
• Convergent biological pathways link metabolic dysfunction to depressive neurobiology.

Conclusions:

• Depression should be viewed as an immunometabolic disorder.
• Understanding adipokine-mediated pathways can identify new biomarkers and therapeutic targets.
• Novel treatments, including recombinant adipokines, anti-inflammatory agents, and microbial modulation, show promise for selected patients.