Pedrosa Gil Francisco, Schwarz Markus J, Müller Norbert, Nickel Marius, Ridout Nathan, Schmidmaier Ralf
1Psychosomatic Out-Patient Clinic, Department of Internal Medicine Innenstadt, Ludwig Maximilians University, Munich, Germany.
2Hospital of Psychiatry and Psychotherapy, Ludwig Maximilians University, Munich, Germany.
Acta Neuropsychiatr. 2007 Dec;19(6):368-75. doi: 10.1111/j.1601-5215.2007.00233.x.
Previous studies have suggested that somatoform disorders (SFD) might be associated with changes in the function of the central and autonomic nervous systems. The aim of this study was to examine the possible immunological differences between SFD and healthy controls.
Twenty-four patients with SFD and 13 healthy individuals completed the psychological questionnaires to assess symptom reporting [Symptom Checklist-90 Revised (SCL-90-R)] and to diagnose for SFD [Screening for Somatoform Symptoms scale (SOMS-scale)]. Participants also provided a blood sample taken in the morning, which was analysed with an automated cell counter to determine the number of leucocytes per μl and with flow cytometry to determine lymphocyte subsets.
With the exception of a higher T4/T8 ratio in the patient group, which was mainly because of lower CD8 counts, there were no significant differences in the absolute number of lymphocytes (subsets) between patients with SFD and healthy subjects. A positive correlation between B-lymphocyte subsets (CD19+CD22+, CD19+CD5+, CD19+CD3-) to all scales of the SCL-90-R, except somatisation, were found in SFD. Additionally, a positive correlation was found in SFD between CD14+CD16+ monocytes and somatisation (0.573) on the SCL-90-R scale.
These data indicate that patients with SFD have an enhanced humoral immunity as shown by increased B-cell numbers and furthermore an elevated T4/T8 ratio because of lower CD8 suppressor cells. Further studies will be required to determine whether these alterations in lymphocyte subsets are directly involved in the pathophysiology of SFD.
先前的研究表明，躯体形式障碍（SFD）可能与中枢和自主神经系统功能的变化有关。本研究的目的是检查SFD患者与健康对照者之间可能存在的免疫学差异。
24例SFD患者和13名健康个体完成了心理问卷，以评估症状报告[症状自评量表-90修订版（SCL-90-R）]并诊断SFD[躯体形式症状筛查量表（SOMS量表）]。参与者还提供了早晨采集的血样，用自动血细胞计数器分析以确定每微升白细胞数量，并用流式细胞术确定淋巴细胞亚群。
除患者组中T4/T8比值较高（主要是由于CD8计数较低）外，SFD患者与健康受试者之间淋巴细胞（亚群）的绝对数量没有显著差异。在SFD中，发现B淋巴细胞亚群（CD19+CD22+、CD19+CD5+、CD19+CD3-）与SCL-90-R的所有量表（除躯体化量表外）之间呈正相关。此外，在SFD中，发现CD14+CD16+单核细胞与SCL-90-R量表上的躯体化（0.573）之间呈正相关。
这些数据表明，SFD患者具有增强的体液免疫，表现为B细胞数量增加，此外由于CD8抑制细胞数量减少，T4/T8比值升高。需要进一步研究以确定淋巴细胞亚群的这些改变是否直接参与SFD的病理生理学过程。
