Capuron Lucile, Raison Charles L, Musselman Dominique L, Lawson David H, Nemeroff Charles B, Miller Andrew H
Department of Psychiatry and Behavioral Sciences and the Winship Cancer Institute, Department of Hematology and Oncology, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
Am J Psychiatry. 2003 Jul;160(7):1342-5. doi: 10.1176/appi.ajp.160.7.1342.
The authors assessed the relationship between the hypothalamic-pituitary-adrenal (HPA) axis response to interferon-alpha (IFN-alpha) and the development of major depression during IFN-alpha treatment.
Adrenocorticotropic hormone (ACTH), cortisol, and interleukin-6 (IL-6) plasma concentrations were measured in 14 patients with malignant melanoma at regular intervals during the first 12 weeks of IFN-alpha therapy, both immediately before and 1, 2, and 3 hours after IFN-alpha administration. Symptom criteria for major depression were also evaluated at each visit.
ACTH and cortisol responses but not IL-6 responses to the initial administration of IFN-alpha were significantly higher in the seven patients who subsequently developed symptom criteria for major depression than in those who did not. No differences in hormonal or cytokine responses were found between these two groups during chronic IFN-alpha administration.
The HPA axis response to the acute administration of IFN-alpha reveals a vulnerability to IFN-alpha-induced depression, possibly due to sensitization of corticotropin-releasing factor pathways.
作者评估了下丘脑-垂体-肾上腺（HPA）轴对α干扰素（IFN-α）的反应与IFN-α治疗期间重度抑郁症发生之间的关系。
在14例恶性黑色素瘤患者接受IFN-α治疗的前12周内，定期测量促肾上腺皮质激素（ACTH）、皮质醇和白细胞介素-6（IL-6）的血浆浓度，分别在IFN-α给药前以及给药后1、2和3小时进行测量。每次就诊时还评估重度抑郁症的症状标准。
在随后出现重度抑郁症症状标准的7例患者中，对初始给予IFN-α的ACTH和皮质醇反应显著高于未出现该症状标准的患者，但IL-6反应无显著差异。在慢性给予IFN-α期间，两组之间的激素或细胞因子反应未发现差异。
HPA轴对急性给予IFN-α的反应揭示了对IFN-α诱导的抑郁症的易感性，这可能是由于促肾上腺皮质激素释放因子途径的致敏作用。
