University of Groningen, University Medical Center Groningen, Interdisciplinary Center for Psychopathology of Emotion regulation (ICPE), Groningen, The Netherlands; Institute for Neuroimmunology and Clinical MS Research, Center for Molecular Neurobiology, University Hospital Eppendorf, Hamburg, Germany.
Department of Psychiatry, EMGO Institute for Health and Care Research and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
Brain Behav Immun. 2014 Feb;36:71-9. doi: 10.1016/j.bbi.2013.10.007. Epub 2013 Oct 16.
Inflammatory processes as well as attenuation of brain-derived neurotrophic factor (BDNF) availability are involved in the pathophysiology of major depressive disorder (MDD). Although it is generally presumed that these two systems interact negatively in the brain, preclinical and human in vitro studies have shown synergistic rather than antagonistic interactions in the periphery. We therefore examined the association between serum levels of BDNF and plasma levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in patients with MDD (n=1070) and non-depressed controls (n=379) from the Netherlands Study of Depression and Anxiety. We used multiple regression analyses with serum BDNF as the dependent variable and we specifically tested the presence of BDNF-cytokine associations in DSM-IV-assigned melancholic MDD patients, identified by the Inventory of Depressive Symptomatology. After adjustment for sociodemographics, sampling variability, lifestyle indicators, somatic diseases and medication use, BDNF levels were predicted by the interaction between MDD diagnosis and IL-6 (p-interaction=.006). Stratified analyses showed that BDNF levels are indeed positively associated with IL-6 levels in MDD patients (β=.07, p=.02), but not in non-depressed controls (β=-.07, p=.23). When further stratified for melancholic and non-melancholic MDD (p-interaction=.005), IL-6 emerged as a robust positive predictor of BDNF only in the melancholic sample (β=.21, p=.01), wherein serum BDNF levels were accordingly enhanced. Post-hoc exploratory analyses verified an accentuated positive association of BDNF levels with leucocyte counts in melancholia. No significant associations emerged between BDNF and TNF-α. Overall, our cross-sectional approach may have disclosed an allostatic, BDNF-inducing component of peripheral immunity and/or an immunotrophic function of peripheral BDNF. Both scenarios may warrant further exploration, as they could inform new research concepts towards immune-based antidepressive treatment strategies.
炎症过程以及脑源性神经营养因子 (BDNF) 可用性的衰减都与重度抑郁症 (MDD) 的病理生理学有关。尽管人们普遍认为这两个系统在大脑中相互负向作用,但临床前和人体体外研究表明,它们在周围组织中存在协同而非拮抗的相互作用。因此,我们在荷兰抑郁和焦虑研究中检查了 MDD 患者(n=1070)和非抑郁对照组(n=379)的血清 BDNF 水平与血浆白细胞介素-6 (IL-6) 和肿瘤坏死因子-α (TNF-α) 水平之间的关联。我们使用多元回归分析,将血清 BDNF 作为因变量,并特别测试了DSM-IV 诊断为忧郁型 MDD 患者中 BDNF-细胞因子关联的存在,这些患者是通过抑郁症状清单确定的。在调整了社会人口统计学、采样变异性、生活方式指标、躯体疾病和药物使用后,BDNF 水平受到 MDD 诊断和 IL-6 之间相互作用的预测(p 交互作用=.006)。分层分析表明,BDNF 水平确实与 MDD 患者的 IL-6 水平呈正相关(β=.07,p=.02),但与非抑郁对照组无相关性(β=-.07,p=.23)。当进一步按忧郁型和非忧郁型 MDD 分层(p 交互作用=.005)时,IL-6 仅在忧郁型样本中成为 BDNF 的强大正向预测因子(β=.21,p=.01),其中血清 BDNF 水平相应升高。探索性事后分析验证了 BDNF 水平与忧郁症中白细胞计数的正相关更为明显。BDNF 与 TNF-α 之间没有显著的关联。总的来说,我们的横断面方法可能揭示了外周免疫的一种适应、BDNF 诱导成分和/或外周 BDNF 的免疫营养功能。这两种情况都值得进一步探索,因为它们可以为基于免疫的抗抑郁治疗策略提供新的研究概念。