Krause Daniela, Myint Aye-Mu, Schuett Christine, Musil Richard, Dehning Sandra, Cerovecki Anja, Riedel Michael, Arolt Volker, Schwarz Markus J, Müller Norbert
Department of Psychiatry and Psychotherapy, Ludwig Maximilian University , Munich , Germany.
Institute for Transfusion Medicine, Ernst Moritz Arndt University , Greifswald , Germany.
Front Psychiatry. 2017 Feb 13;8:16. doi: 10.3389/fpsyt.2017.00016. eCollection 2017.
Signs of an inflammatory process have been described in major depression.
In a double-blind, randomized study of celecoxib or placebo add-on to reboxetine in 40 depressed patients, celecoxib treatment has beneficial effects. In order to evaluate the tryptophan/kynurenine metabolism and to identify predictors for remission, tryptophan (TRP), kynurenine (KYN), kynurenic acid (KYNA), and quinolinic acid (QUIN) were estimated in the serum of 32 patients before and after treatment and in a group of 20 healthy controls.
KYN levels were significantly lower in patients ( = 0.008), and the QUIN/KYN ratios were significantly higher ( = 0.028). At baseline, the higher KYN/TRP ratio was predictive for remission during celecoxib add-on treatment ( = 0.04) as well as for remission in the overall patient group ( = 0.01). In the placebo group, remitters showed a higher KYNA/QUIN ratio ( = 0.032). In the overall group, remitters showed lower KYNA/KYN ( = 0.035) and QUIN/KYN ( = 0.011) ratios. The lower the formation of downstream metabolites, especially QUIN, the better the treatment outcome.
The high KYN/TRP ratio predicted remission after treatment with celecoxib in this small sample of depressed patients. Eventually, the KYN/TRP ratio might be a marker for those patients, which benefit from an additional anti-inflammatory treatment.
在重度抑郁症中已描述了炎症过程的迹象。
在一项针对40名抑郁症患者，将塞来昔布或安慰剂加用至瑞波西汀的双盲、随机研究中，塞来昔布治疗具有有益效果。为了评估色氨酸/犬尿氨酸代谢并确定缓解的预测因素，在32名患者治疗前后的血清以及20名健康对照者的血清中对色氨酸（TRP）、犬尿氨酸（KYN）、犬尿喹啉酸（KYNA）和喹啉酸（QUIN）进行了测定。
患者的KYN水平显著较低（P = 0.008），且QUIN/KYN比值显著较高（P = 0.028）。在基线时，较高的KYN/TRP比值可预测塞来昔布加用治疗期间的缓解情况（P = 0.04）以及整个患者组的缓解情况（P = 0.01）。在安慰剂组中，缓解者的KYNA/QUIN比值较高（P = 0.032）。在整个组中，缓解者的KYNA/KYN（P = 0.035）和QUIN/KYN（P = 0.011）比值较低。下游代谢产物尤其是QUIN的生成越低，治疗结果越好。
在这个小样本的抑郁症患者中，高KYN/TRP比值可预测塞来昔布治疗后的缓解情况。最终，KYN/TRP比值可能是那些受益于额外抗炎治疗的患者的一个标志物。
