Clinical Neuroendocrinology Branch, NIH/NIMH, 10 Center Drive, Bethesda, MD 20892, USA.
Department of Psychiatry, University of Utah, School of Medicine and Salt Lake VA Medical Center, 50 North Medical Drive, Salt Lake City, UT 84132, USA.
Neurosci Lett. 2012 Jun 27;520(1):1-5. doi: 10.1016/j.neulet.2012.04.072. Epub 2012 May 8.
Patents with major depression have evidence of a proinflammatory state with consistent elevations in acute phase proteins and in the levels of inflammatory mediators such as interleukin-6 and tumor necrosis factor-α. We report here a study of the serum levels of immunoglobulin A (IgA) in medication-free patients with major depression in the remitted state (ruMDD). Selective IgA deficiency is the most common form of immunoglobulin abnormality, and is often associated with a higher than expected incidence of proinflammatory and autoimmune phenomena. We measured serum IgG, IgM, and IgA in 28 ruMDD patients and 27 healthy subjects (Ctrl) at 0 (pretreatment), 7, and 24h following sham depletion and tryptophan (TrpD) depletion conducted at least 8 days apart under balanced, randomized, blinded conditions. Immunoglobulins were measured by automated immunonephelometry. Data were analyzed by repeated measures ANOVA with diagnosis as a fixed effect and drug (TrpD vs. sham), and time as repeated measures factors. Serum IgA was consistently lower in ruMDD patients vs. Ctrl at all time points examined (p<0.04 for main effect of diagnosis). Serum IgG and IgM levels did not show significant differences by diagnosis. Medication-free patients with major depression in the remitted state have a significant reduction in serum IgA levels measured on multiple occasions. In the light of the fact that IgA serves many immunomodulatory, anti-inflammatory roles, this finding supports the concept that major depressive illness represents a proinflammatory state.
患有重度抑郁症的患者具有促炎状态的证据，表现为急性期蛋白持续升高，以及白细胞介素-6 和肿瘤坏死因子-α 等炎症介质水平升高。我们在此报告一项对缓解期（ruMDD）重度抑郁症未用药患者血清免疫球蛋白 A（IgA）水平的研究。选择性 IgA 缺乏是最常见的免疫球蛋白异常形式，通常与促炎和自身免疫现象的发生率高于预期相关。我们在至少相隔 8 天的平衡、随机、盲法条件下，分别在 Sham 耗竭和色氨酸（TrpD）耗竭后 0（预处理）、7 和 24 小时，测量了 28 例 ruMDD 患者和 27 例健康对照者（Ctrl）的血清 IgG、IgM 和 IgA。免疫球蛋白通过自动免疫散射比浊法进行测量。采用重复测量方差分析对数据进行分析，以诊断为固定效应，药物（TrpD 与 Sham）和时间为重复测量因素。在所有检查的时间点，ruMDD 患者的血清 IgA 水平均明显低于 Ctrl（诊断主效应 p<0.04）。血清 IgG 和 IgM 水平在诊断上无显著差异。在多次测量时，缓解期重度抑郁症未用药患者的血清 IgA 水平显著降低。鉴于 IgA 具有许多免疫调节、抗炎作用，这一发现支持重度抑郁症代表促炎状态的概念。
