基线免疫激活作为α干扰素治疗期间抑郁症发作的一个危险因素。
Baseline immune activation as a risk factor for the onset of depression during interferon-alpha treatment.
作者信息
Wichers Marieke C, Kenis Gunter, Leue Carsten, Koek Ger, Robaeys Geert, Maes Michael
机构信息
Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, Maastricht, The Netherlands.
出版信息
Biol Psychiatry. 2006 Jul 1;60(1):77-9. doi: 10.1016/j.biopsych.2005.11.024. Epub 2006 Feb 17.
BACKGROUND
Major depression has been associated cross-sectionally with increased cell-mediated immune activation but causality has been difficult to establish. This study prospectively investigated the hypothesis that baseline level of immune activation predicts the development of depression during interferon-alpha (IFN-alpha) treatment.
METHODS
Sixteen hepatitis C patients without psychiatric disorder underwent IFN-alpha treatment. Proinflammatory and anti-inflammatory cytokines were determined before starting treatment. Presence of a major depressive disorder (MDD) was assessed at baseline and several times during treatment.
RESULTS
Baseline soluble interleukin-2 receptor (sIL-2r), interleukin-6 (IL-6), and interleukin-10 (IL-10) concentrations were significantly increased in the five subjects that developed MDD during treatment compared with those that did not, with standardized effect sizes of 1.08, 1.16, and 1.25, respectively, controlling for marijuana use, cigarette smoking, and baseline level of depressive symptoms.
CONCLUSIONS
Results suggest that increased immune activation, rather than an epiphenomenon, is a causal risk factor for the development of MDD.
背景
在横断面研究中，重度抑郁症与细胞介导的免疫激活增加有关，但因果关系难以确定。本研究前瞻性地调查了免疫激活基线水平可预测α干扰素（IFN-α）治疗期间抑郁症发生这一假设。
方法
16名无精神疾病的丙型肝炎患者接受IFN-α治疗。在开始治疗前测定促炎和抗炎细胞因子。在基线和治疗期间多次评估是否存在重度抑郁症（MDD）。
结果
与未发生MDD的患者相比，治疗期间发生MDD的5名患者的基线可溶性白细胞介素-2受体（sIL-2r）、白细胞介素-6（IL-6）和白细胞介素-10（IL-10）浓度显著升高，在控制大麻使用、吸烟和抑郁症状基线水平的情况下，标准化效应大小分别为1.08、1.16和1.25。
结论
结果表明，免疫激活增加而非一种附带现象是MDD发生的因果风险因素。
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