Widerlöv E, Bissette G, Nemeroff C B
Department of Psychiatry and Neurochemistry, University of Lund, S:t Lars Hospital, Sweden.
J Affect Disord. 1988 Mar-Apr;14(2):99-107. doi: 10.1016/0165-0327(88)90051-1.
CSF samples from ten healthy volunteers and 22 patients with major depression were collected by lumbar puncture at 9 a.m. and the content of monoamine metabolites, corticotropin releasing factor (CRF) and somatostatin (SRIF) was analyzed. Plasma concentrations of TSH following a TRH challenge test (200 micrograms) and plasma cortisol following dexamethasone (1 mg; DST) were also analyzed. No relationships were observed between the CRF or SRIF concentrations and either basal or post-dexamethasone cortisol concentrations. Fourteen of 21 depressed patients were DST nonsuppressors using a plasma cortisol concentration cut off point greater than or equal to 138 nmol/l. If a more conservative cut off point was used (greater than 290 nmol/l) seven out of 21 patients revealed a severity-related cortisol nonsuppression. No significant difference was observed between healthy volunteers and depressed patients with regard to TSH response to TRH. The CSF content of CRF was elevated and the content of SRIF reduced in the depressed patients. In the healthy volunteers an inverse relationship was observed between CSF concentrations of CRF and MHPG (r = -0.72; P = 0.019); no relationship was observed between the concentrations of CRF and 5-HIAA or HVA. In the depressed patients positive correlations were found between CSF concentrations of CRF and 5-HIAA (r = 0.59; P = 0.004) and between CRF and HVA (r = 0.44; P = 0.042). These data are concordant with the view that norepinephrine and serotonin may be involved in the regulation of CRF secretion.(ABSTRACT TRUNCATED AT 250 WORDS)
上午9点通过腰椎穿刺收集了10名健康志愿者和22名重度抑郁症患者的脑脊液样本，并分析了单胺代谢产物、促肾上腺皮质激素释放因子（CRF）和生长抑素（SRIF）的含量。还分析了促甲状腺激素释放激素激发试验（200微克）后血浆促甲状腺激素（TSH）的浓度以及地塞米松（1毫克；地塞米松抑制试验）后血浆皮质醇的浓度。未观察到CRF或SRIF浓度与基础或地塞米松后皮质醇浓度之间存在相关性。21名抑郁症患者中有14名使用血浆皮质醇浓度截止点大于或等于138纳摩尔/升时为地塞米松抑制试验无抑制者。如果使用更保守的截止点（大于290纳摩尔/升），21名患者中有7名显示出与严重程度相关的皮质醇无抑制。在TSH对促甲状腺激素释放激素的反应方面，健康志愿者和抑郁症患者之间未观察到显著差异。抑郁症患者脑脊液中CRF含量升高，SRIF含量降低。在健康志愿者中，观察到脑脊液中CRF浓度与3-甲氧基-4-羟基苯乙二醇（MHPG）之间呈负相关（r = -0.72；P = 0.019）；未观察到CRF浓度与5-羟吲哚乙酸（5-HIAA）或高香草酸（HVA）之间存在相关性。在抑郁症患者中，脑脊液中CRF浓度与5-HIAA之间呈正相关（r = 0.59；P = 0.004），与HVA之间也呈正相关（r = 0.44；P = 0.042）。这些数据与去甲肾上腺素和5-羟色胺可能参与CRF分泌调节的观点一致。（摘要截短至250字）
