Ravindran A V, Griffiths J, Merali Z, Anisman H
Department of Psychiatry, University of Ottawa, Institute of Mental Health Research at the Royal Ottawa Hospital, Ontario, Canada.
J Affect Disord. 1999 Jan-Mar;52(1-3):1-10. doi: 10.1016/s0165-0327(98)00072-x.
Obsessive compulsive disorder (OCD) shares several features with depressive illness (e.g., comorbidity, early escape from dexamethasone suppression, effectiveness of serotonergic pharmacotherapy). It was of interest to establish whether OCD, like major depression, was also associated with immune alterations, notably elevations of circulating natural killer (NK) cells.
Circulating lymphocytes were determined from morning blood samples taken from OCD and major depressive patients, as well as from age- and sex-matched controls. Stress perception and coping styles were evaluated in order to assess whether such variables accompanied the NK alterations. Finally, in a subset of patients, symptoms of the illness, stress/coping, and circulating lymphocytes, were also evaluated following 12 weeks of antidepressant medication (serotonergic reuptake inhibitor).
The major depressive and OCD patients reported increased perception of day-to-day stresses, coupled with reliance on emotion focused coping styles. Moreover, circulating NK cells were elevated among male OCD and major depressive patients, whereas only a modest increase of NK cells was seen in female major depressives. Twelve weeks of medication alleviated depressive and OCD symptoms, and resulted in normalization of NK cells in the major depressives. However, in OCD patients the reduction of symptoms was not accompanied by significant variations of circulating NK cells.
Although major depression and OCD are both accompanied by elevated circulating NK cells, at least in males, normalization of NK cells following treatment was only evident in depression. The persistent elevations of NK cells among male OCD patients may reflect either a trait characteristic of the illness, or symptom reduction and not true remission.
Although elevations of lymphocyte subsets in major depressive and OCD patients were observed, conclusions concerning immune status in OCD ought to be held in abeyance pending assessment of other indices of immune and cytokine functioning.
强迫症（OCD）与抑郁症有若干共同特征（例如，共病、地塞米松抑制试验早期脱抑制、血清素能药物治疗的有效性）。探究强迫症是否如重度抑郁症一样也与免疫改变有关，尤其是循环自然杀伤（NK）细胞升高，这一点很有意义。
从强迫症患者、重度抑郁症患者以及年龄和性别匹配的对照组的晨间血样中测定循环淋巴细胞。评估压力感知和应对方式，以评估这些变量是否伴随NK细胞改变。最后，在一部分患者中，还在接受12周抗抑郁药物（血清素再摄取抑制剂）治疗后评估疾病症状、压力/应对方式和循环淋巴细胞情况。
重度抑郁症患者和强迫症患者报告称日常压力感知增加，同时依赖以情绪为中心的应对方式。此外，男性强迫症患者和重度抑郁症患者的循环NK细胞升高，而女性重度抑郁症患者中仅观察到NK细胞有适度增加。12周的药物治疗缓解了抑郁和强迫症症状，并使重度抑郁症患者的NK细胞恢复正常。然而，在强迫症患者中，症状减轻并未伴随循环NK细胞的显著变化。
虽然重度抑郁症和强迫症都伴有循环NK细胞升高，至少在男性中如此，但治疗后NK细胞恢复正常仅在抑郁症中明显。男性强迫症患者中NK细胞持续升高可能反映了该疾病的一种特质特征，或者是症状减轻而非真正缓解。
尽管观察到重度抑郁症患者和强迫症患者淋巴细胞亚群升高，但在评估免疫和细胞因子功能的其他指标之前，关于强迫症免疫状态的结论应暂缓得出。
