Huang Tiao-Lai, Lin Chin-Chuen
Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Adv Clin Chem. 2015;68:177-204. doi: 10.1016/bs.acc.2014.11.003. Epub 2015 Jan 7.
Major depressive disorder (MDD) is characterized by mood, vegetative, cognitive, and even psychotic symptoms and signs that can cause substantial impairments in quality of life and functioning. Biomarkers are measurable indicators that could help diagnosing MDD or predicting treatment response. In this chapter, lipid profiles, immune/inflammation, and neurotrophic factor pathways that have long been implicated in the pathogenesis of MDD are discussed. Then, pharmacogenetics and epigenetics of serotonin transport and its metabolism pathway, brain-derived neurotrophic factor, and abnormality of hypothalamo-pituitary-adrenocortical axis also revealed new biomarkers. Lastly, new techniques, such as proteomics and metabolomics, which allow researchers to approach the studying of MDD with new directions and make new discoveries are addressed. In the future, more data are needed regarding pathophysiology of MDD, including protein levels, single nucleotide polymorphism, epigenetic regulation, and clinical data in order to better identify reliable and consistent biomarkers for diagnosis, treatment choice, and outcome prediction.
重度抑郁症（MDD）的特征在于情绪、植物神经、认知乃至精神病性症状和体征，这些可导致生活质量和功能的严重损害。生物标志物是可帮助诊断MDD或预测治疗反应的可测量指标。在本章中，将讨论长期以来被认为与MDD发病机制有关的脂质谱、免疫/炎症和神经营养因子途径。然后，血清素转运及其代谢途径、脑源性神经营养因子的药物遗传学和表观遗传学以及下丘脑-垂体-肾上腺皮质轴的异常也揭示了新的生物标志物。最后，还将探讨蛋白质组学和代谢组学等新技术，这些技术使研究人员能够以新的方向研究MDD并做出新的发现。未来，需要更多关于MDD病理生理学的数据，包括蛋白质水平、单核苷酸多态性、表观遗传调控和临床数据，以便更好地识别用于诊断、治疗选择和结果预测的可靠且一致的生物标志物。
