National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA.
Int J Psychophysiol. 2011 Sep;81(3):191-7. doi: 10.1016/j.ijpsycho.2011.06.009. Epub 2011 Jul 6.
Cross-sectional and case-control studies have reported that psychological distress and depression are associated with reduced cellular immune competence but the directionality of the relationship remains uncertain. This study investigated whether levels of psychological distress and depressive symptoms are related to subsequent changes in counts of lymphocyte subsets (natural killer (NK), B, and T cell) and/or whether changes of immune markers predict psychological distress/depressive symptoms in a 1-year prospective study design. A total of 105 healthy employees (67 men and 38 women), aged 23-59 (mean 40) years with an average of 15years of education, underwent a blood draw for the measurement of circulating immune cells and completed the Japanese version of the 28-item General Health Questionnaire (GHQ-28) and the Center for Epidemiologic Studies Depression Scale (CES-D) in April 2002 (time 1) and 2003 (time 2). Hierarchical multiple linear regression analyses revealed that GHQ-28 and CES-D scores at time 1 were significantly (p<.05) and inversely associated with NK cells at time 2 controlling for potential confounders including time 1 NK cells (β=-.221 and -.177, respectively). In contrast, NK cells and NK cell cytotoxicity at time 1 did not predict GHQ-28 or CES-D score at time 2 controlling for GHQ-28/CES-D score at time 1. GHQ-28 and CES-D scores were not related to T or B cells at times 1 and 2. The present findings indicate that psychological distress and depressive symptoms may precede and predict suppression of NK cell immunity while NK cells did not lead to subsequent psychological distress and depressive symptoms, suggesting an absence of the bi-directional relationships.
横断面研究和病例对照研究报告称，心理困扰和抑郁与细胞免疫功能下降有关，但两者之间的关系仍不确定。本研究通过一项为期 1 年的前瞻性研究设计，调查了心理困扰和抑郁症状的水平是否与淋巴细胞亚群（自然杀伤 (NK)、B 和 T 细胞）计数的后续变化有关，以及免疫标志物的变化是否预测心理困扰/抑郁症状。共有 105 名健康员工（67 名男性和 38 名女性），年龄 23-59 岁（平均 40 岁），平均受教育 15 年，进行了血液采集以测量循环免疫细胞，并在 2002 年 4 月（时间 1）和 2003 年 4 月（时间 2）完成了日本版 28 项一般健康问卷（GHQ-28）和中心流行病学研究抑郁量表（CES-D）。分层多元线性回归分析显示，控制时间 1 NK 细胞等潜在混杂因素后，时间 1 的 GHQ-28 和 CES-D 评分与时间 2 的 NK 细胞呈显著负相关（p<.05；β=-.221 和 -.177）。相比之下，时间 1 的 NK 细胞和 NK 细胞细胞毒性并不能预测时间 2 的 GHQ-28 或 CES-D 评分，控制时间 1 的 GHQ-28/CES-D 评分。时间 1 和 2 的 GHQ-28 和 CES-D 评分与 T 或 B 细胞均无相关性。本研究结果表明，心理困扰和抑郁症状可能先于 NK 细胞免疫抑制，并预测 NK 细胞免疫抑制，而 NK 细胞不会导致随后的心理困扰和抑郁症状，提示两者之间不存在双向关系。
