BEATRIZ MONTEIRO FERNANDES

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  • article 6 Citação(ões) na Scopus
    Effects of antidepressant drug therapy with or without physical exercise on inflammatory biomarkers in major depressive disorder: a systematic review and meta-analysis of randomized controlled trials
    (2022) FERNANDES, Beatriz Monteiro; SCOTTI-MUZZI, Estevao; SOEIRO-DE-SOUZA, Marcio Gerhardt
    Objective To conduct a systematic review and meta-analysis of the effects of antidepressant drug therapy (with or without physical exercise) on peripheral inflammatory markers in patients with major depressive disorder (MDD). Methods MEDLINE, PyscINFO, Embase, and Google Scholar databases were searched until May 2020. Randomized trials that measured at least one inflammatory biomarker and included adult outpatients with MDD under antidepressant drug therapy (any drug) with or without physical exercise (any modality) were eligible. Results were summarized using the standardized mean difference (SMD) with 95% confidence intervals (95% CI) under a random-effects model. The Cochrane risk of bias tool (2010) was used to evaluate the risk of bias in the included trials. Results Sixty-three trials were identified, encompassing data from 3482 patients, and 20 investigated biomarkers. Trials had biases across multiple domains, rising concerns primarily to selection bias/performance bias/detection bias/attrition bias. SMDs between pre- and post-results indicated a significant reduction in the levels of IL-2 (SMD, - 0.25; 95% CI, - 0.41 to - 0.09, P = 0.002), IL-6 (SMD, - 0.19; 95% CI, - 0.35 to - 0.025, P = 0.024), IL-10 (SMD, - 0.32; 95% CI, - 0.57 to - 0.07, P = 0.011), and serum cortisol (SMD, - 0.35; 95% CI, - 0.58 to - 0.12, P = 0.002). Evidence supporting the influence of physical exercise combined with antidepressant drugs on peripheral inflammatory markers in MDD is sparse and heterogeneous. Conclusion There is some evidence that antidepressant drug therapy is associated with an overall positive reduction in inflammatory markers, but the evidence is heterogeneous. Further research linking how inflammatory biomarkers modulate physiology related to antidepressant response is required.
  • article 2 Citação(ões) na Scopus
    Physical activity as an adjuvant therapy for depression and influence on peripheral inflammatory markers: A randomized clinical trial
    (2022) FERNANDES, Beatriz Monteiro; SIQUEIRA, Cristiana Carvalho; VIEIRA, Rodrigo Machado; MORENO, Ricardo Alberto; SOEIRO-DE-SOUZA, Marcio Gerhardt
    Introduction: Regular exercise is recommended for people with major depressive disorder (MDD) by major treatment guidelines (e.g. the NICE guideline, 2009). In addition, an effect of antidepressant (AD) treatment on pro-inflammatory markers has been reported. However, it remains unclear whether physical activity as an adjuvant to AD treatment increases clinical response rates and is associated with levels of inflammatory markers. Methods: A four-week single-blind clinical trial involving forty people with major MDD, divided into an AD group (sertraline) and AD + exercise (40 min/day, four times weekly for four weeks) group was conducted. Peripheral inflammatory markers (IL-12, IL-10, IL-8, IL-6, IL-1 beta, TNF-alpha) and cortisol were collected at baseline and at endpoint. Results: We observed a significant decrease in cortisol levels over time, but this change did not differ between the AD and AD + exercise groups. None of the other inflammatory markers showed a significant change in level during the trial. Also, most of the individuals who achieved remission were from the AD + exercise group. Conclusion: Although our study failed to find that the association of physical activity as an adjunct to antide-pressants promotes a change in cortisol or interleukins in people with MDD, we found that cortisol seems to be the most sensitive biomarker to antidepressant treatment. Further studies involving larger samples of, longer duration and with other classes of antidepressants and types of exercise should be conducted to better elucidate the link between inflammatory markers and depression.
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