血小板激活因子与抑郁症冠心病患者的认知缺陷相关：一项提出假设的研究。
Platelet-activating factors are associated with cognitive deficits in depressed coronary artery disease patients: a hypothesis-generating study.
作者信息
Mazereeuw Graham, Herrmann Nathan, Xu Hongbin, Figeys Daniel, Oh Paul I, Bennett Steffany A L, Lanctôt Krista L
机构信息
Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Room FG08, Toronto, ON M4N 3M5, Canada.
出版信息
J Neuroinflammation. 2014 Jul 4;11:119. doi: 10.1186/1742-2094-11-119.
BACKGROUND
Patients with coronary artery disease (CAD) are at risk of accelerated cognitive decline, particularly those with major depression. Mechanisms for cognitive deficits associated with CAD, and the effects of depression, remain poorly understood. However, CAD is associated with inflammatory processes that have been linked to neurodegeneration, may contribute to cognitive decline, and are elevated in depression. Platelet-activating factors (PAFs) are emerging as key lipid mediators that may be central to those processes and highly relevant to cognitive decline in CAD.
METHODS
This cross-sectional study investigated relationships between various PAFs and cognitive performance in 24 patients with CAD (age, 60.3 ± 9.4; 70.8% male). Analyses were repeated in a subgroup of 15 patients with CAD with major depression (DSM-IV). Cognitive performance was assessed using a standardized battery and summary z scores were calculated based on age, sex, and education norms. Global cognitive performance was the average of domain-specific z scores. Plasma PAF analyses were performed using electrospray ionization mass spectrometry (precursor ion scan).
RESULTS
A greater abundance of PAF PC(O-18:0/2:0) was associated with poorer global cognitive performance in patients with CAD (r=-0.45, P=0.03). In the major depressed subgroup, PAF PC(O-18:0/2:0) (r=-0.59, P=0.02) as well as PC(O-16:0/2:0) (r=-0.52, P=0.04), and lyso-PAF PC(O-16:0/0:0) (r=-0.53, P=0.04) were associated with poorer global cognitive performance. A greater abundance of PAF PC(O-19:5/2:0) was associated with better global cognitive performance (r=0.55, P=0.03), suggesting a possible compensatory species.
CONCLUSIONS
This study suggests that certain PAFs might be associated with global cognitive performance in patients with CAD, with stronger relationships observed in those with major depression. Confirmation of these preliminary findings is warranted.
背景
冠心病（CAD）患者存在认知功能加速衰退的风险，尤其是那些患有重度抑郁症的患者。与CAD相关的认知缺陷机制以及抑郁症的影响仍知之甚少。然而，CAD与炎症过程相关，炎症过程与神经退行性变有关，可能导致认知衰退，且在抑郁症中炎症水平会升高。血小板激活因子（PAF）正成为关键的脂质介质，可能在这些过程中起核心作用，并且与CAD患者的认知衰退高度相关。
方法
这项横断面研究调查了24例CAD患者（年龄60.3±9.4岁；70.8%为男性）中各种PAF与认知表现之间的关系。对15例患有重度抑郁症（DSM-IV）的CAD患者亚组重复进行了分析。使用标准化测试组合评估认知表现，并根据年龄、性别和教育规范计算汇总z分数。整体认知表现是特定领域z分数的平均值。采用电喷雾电离质谱法（前体离子扫描）进行血浆PAF分析。
结果
PAF PC（O-18:0/2:0）丰度越高，CAD患者的整体认知表现越差（r=-0.45，P=0.03）。在重度抑郁亚组中，PAF PC（O-18:0/2:0）（r=-0.59，P=0.02）以及PC（O-16:0/2:0）（r=-0.52，P=0.04）和溶血PAF PC（O-16:0/0:0）（r=-0.53，P=0.04）与整体认知表现较差有关。PAF PC（O-19:5/2:0）丰度越高，整体认知表现越好（r=0.55，P=0.03），提示可能是一种代偿性物质。
结论
本研究表明，某些PAF可能与CAD患者的整体认知表现有关，在患有重度抑郁症的患者中观察到的相关性更强。有必要对这些初步发现进行验证。
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