Fábregas Bruno C, Vieira Érica L M, Moura Alexandre S, Carmo Ricardo A, Ávila Renata E, Abreu Mery N S, Prossin Allan R, Teixeira Antônio L
Tropical Medicine Program, School of Medicine, Municipal Health Division/Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Neuroimmunomodulation. 2016;23(2):88-97. doi: 10.1159/000444531. Epub 2016 Apr 2.
Major depression (MD) is a condition associated with both hepatitis C virus (HCV) infection and pegylated interferon (IFN)-α treatment. IFN induces a depressive syndrome that is associated with an inflammatory profile. We aimed to investigate whether there is any specific alteration in plasma biomarkers associated with MD.
HCV-monoinfected patients, with and without IFN treatment, were followed up for 18 months and went through structured psychiatric evaluation. We assessed plasma levels of brain-derived neurotrophic factor, tumor necrosis factor (TNF) and its soluble type 1 and type 2 receptors (sTNFR1 and sTNFR2, respectively), and adipokines (adiponectin, leptin and resistin) using ELISA.
Among the 50 patients included in the study, 14 were treated with IFN during the follow-up. Being older, not married, presenting higher body mass index, higher liver inflammatory activity, lower baseline adiponectin levels and use of IFN were associated with MD development. Higher levels of sTNFR1 during IFN treatment were associated with sustained virological response. The lack of a control group without HCV infection did not allow any assumption of a biomarker change exclusively due to the infection itself.
Adiponectin may be a resilience biomarker for MD in HCV-infected patients.
重度抑郁症（MD）与丙型肝炎病毒（HCV）感染及聚乙二醇化干扰素（IFN）-α治疗均有关联。IFN可诱发一种与炎症特征相关的抑郁综合征。我们旨在研究与MD相关的血浆生物标志物是否存在任何特异性改变。
对接受和未接受IFN治疗的HCV单感染患者进行为期18个月的随访，并进行结构化精神评估。我们使用酶联免疫吸附测定法评估血浆中脑源性神经营养因子、肿瘤坏死因子（TNF）及其可溶性1型和2型受体（分别为sTNFR1和sTNFR2）以及脂肪因子（脂联素、瘦素和抵抗素）的水平。
在纳入研究的50例患者中，14例在随访期间接受了IFN治疗。年龄较大、未婚、体重指数较高、肝脏炎症活动度较高、基线脂联素水平较低以及使用IFN与MD的发生有关。IFN治疗期间sTNFR1水平较高与持续病毒学应答有关。缺乏未感染HCV的对照组，因此无法假定生物标志物的变化完全是由感染本身所致。
脂联素可能是HCV感染患者MD的一种恢复力生物标志物。
