Background:
Modern medicine has gained considerable knowledge of the pathophysiology of mental disorders
at the body, systemic, organ and neurochemical levels of the biological organization of the body. Modern clinical
diagnostic of depression has some problem. That is why psychiatric Society to make diagnostics and taxonomy of
different types of depression by implemention modern molecular biomarkers in diagnostic procedures. But up to now
there were no reliable biomarkers of major depressive disorder (MDD) and other types of depression.
Objective:
The purpose of this review is to find fundamentals in pathological mechanisms of depression, which could be a
basis for development molecular and genetic biomarkers the most feasible for clinic.
Method:
This review summarizes the published data using PubMed, Science Direct, Google Scholar and Scopus.
Results:
In this review, we summarized and discussed findings in molecular biology, genetics, neuroplasticity,
neurotransmitters, neuroimaging that could increase our understanding of biological foundations of depression and show
new directions for development reliable biomarkers. We didn’t find no molecular and genetic biomarkers approved for
clinic. But Genome-Wide Association Study method promises some progress in development biomarkers based on SNP in
the future. Epigenetic factors also are a promising target for biomarkers. We have found some differences in etiology of
different type of atypical and melancholic depression. This knowledge could be the basis for development biomarkers for
clinical practice in diagnosis, prognosis and selection of treatment.
Conclusion:
Depression is not monoetiological disease. Many pathological mechanisms involved in depression, thus up to
now there is no approved and reliable biomarker for diagnosis, prognosis and correction of treatment of depression.
Structural and functional complexity of the brain, the lack of invasive technology, poor correlations between genetic and
clinical manifestation of depression, imperfect psychiatric classification and taxonomy of subtypes of disease are the main
causes of this situation . One of the possible way to come over this situation can be to pay attention to the trigger
mechanism of disease and its subtypes. Researchers and clinicians should focus their efforts on searching trigger mechanism of depression and different types of it . HPA axis can be a candidate for such trigger in depression caused by
stress, because it influences to the main branches of disease: neuroinflammation, activity of biogenic amines, oxidative
and nitrozative stress, epigenetic factors, metabolomics etc. But before we shall find any trigger mechanism, we need to
create complex biomarker reflecting genetic, epigenetic, metabolomics and other pathological changes in different types
of depression. Recently the most encouraging results have been obtained from genetics and neuroimaging. Continuing
research in these areas should be forced by using computational , statistical and systems biology approaches, which can
allow to get more knowledge about neurobiology of depression. In order to obtain clinically useful tests search for
biomarkers should use appropriate research methodologies with increasing samples and identifying more homogeneous
groups of depressed patients.