Rothermundt M, Arolt V, Peters M, Gutbrodt H, Fenker J, Kersting A, Kirchner H
Department of Psychiatry and Psychotherapy, Westfaelische Wilhelms-University, Albert-Schweitzer-Strasse 11, D-48129 Muenster, Germany.
J Affect Disord. 2001 Mar;63(1-3):93-102. doi: 10.1016/s0165-0327(00)00157-9.
There is evidence that patients with major depression (MD) also suffer an inflammatory immune reaction. However, the results remain ambiguous. This could be due to the psychiatrically heterogeneous patient samples investigated in many published studies. Since melancholic depression is psychopathologically and possibly etiologically different from non-melancholic MD, we focused on investigating immune parameters in these two subgroups.
43 in-patients suffering from acute major depression were diagnosed, sub-classified according to DSM IV criteria, and compared to 43 matched healthy controls. Cell counts were determined by morphology, and acute phase proteins [c-reactive protein (CRP), alpha(2)-macroglobulin (A2M), haptoglobin (HP)] were measured by laser nephelometry. Cytokine production (IL-1beta) upon mitogen stimulation was measured by ELISA in a whole blood assay.
Non-melancholic patients showed increased monocyte counts and A2M serum concentrations in the acute stage of disease and after 2 and 4 weeks of treatment. Melancholic patients demonstrated a decreased monocyte count upon admission and after 4 weeks of treatment. HP levels and IL-1beta production were unchanged in all studied subjects.
Medication of the patients varied. The differentiation between melancholic and non-melancholic depression was performed clinically and was not performed using any standardized instrument.
Melancholic and non-melancholic patients show different immune patterns. This differentiation might clarify immunological findings in MD and point towards etiological factors that are involved in the development of various subtypes of MD.
有证据表明，重度抑郁症（MD）患者也会出现炎症免疫反应。然而，结果仍不明确。这可能是由于许多已发表研究中所调查的患者样本在精神方面具有异质性。由于抑郁性抑郁症在精神病理学上以及可能在病因学上与非抑郁性MD不同，我们专注于研究这两个亚组的免疫参数。
对43名患有急性重度抑郁症的住院患者进行诊断，根据《精神疾病诊断与统计手册》第四版标准进行亚分类，并与43名匹配的健康对照进行比较。通过形态学确定细胞计数，通过激光散射比浊法测量急性期蛋白[c反应蛋白（CRP）、α2巨球蛋白（A2M）、触珠蛋白（HP）]。在全血检测中通过酶联免疫吸附测定法（ELISA）测量有丝分裂原刺激后细胞因子的产生（IL-1β）。
非抑郁性患者在疾病急性期以及治疗2周和4周后单核细胞计数和A2M血清浓度升高。抑郁性患者入院时和治疗4周后单核细胞计数降低。所有研究对象的HP水平和IL-1β产生均未改变。
患者的用药情况各不相同。抑郁性和非抑郁性抑郁症的区分是通过临床进行的，未使用任何标准化工具。
抑郁性和非抑郁性患者表现出不同的免疫模式。这种区分可能会阐明MD中的免疫学发现，并指向参与MD各种亚型发展的病因因素。
