Bryleva E Y, Keaton S A, Grit J, Madaj Z, Sauro-Nagendra A, Smart L, Halstead S, Achtyes E, Brundin L
Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI, USA.
Division of Psychiatry and Behavioral Medicine, Michigan State University, Grand Rapids, MI, USA.
Acta Psychiatr Scand. 2017 May;135(5):409-418. doi: 10.1111/acps.12730. Epub 2017 Apr 4.
Establish whether inflammatory biomarkers-serum amyloid A (SAA), C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α)-are related to key symptoms of depression, including anxiety and fatigue, in a cross-sectional, out-patient setting to identify biomarkers that reflect psychiatric symptomatology in a naturalistic, real-life population.
We measured SAA, CRP, IL-6, and TNF-α in plasma samples from 89 adult psychiatric out-patients by multiplex, high-sensitivity electrochemiluminescent assays. Psychiatric symptoms were evaluated using the Hamilton Depression Rating Scale (HAMD-17), the Patient Health Questionnaire (PHQ-9), and the Center for Epidemiological Studies Depression Scale (CES-D).
Plasma SAA was most robustly associated with depressive symptoms across diagnostic boundaries in this cohort of out-patients. Elevated SAA was significantly associated with higher total scores on the HAMD-17 scale and correlated with multiple scale items that rated symptoms of fatigue and depressed mood, but not with anxiety-related items.
SAA might constitute a cross-diagnostic marker indicative of depressed mood and fatigue in a naturalistic patient setting. Because SAA activates Toll-like receptors 2 and 4, present on macrophages and glial cells, its association with depression severity could also implicate this inflammatory mediator in the pathogenesis of mood disorders.
在门诊横断面研究中确定炎症生物标志物——血清淀粉样蛋白A（SAA）、C反应蛋白（CRP）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）——是否与抑郁症的关键症状（包括焦虑和疲劳）相关，以识别在自然主义的现实生活人群中反映精神症状学的生物标志物。
我们通过多重高灵敏度电化学发光测定法测量了89名成年精神科门诊患者血浆样本中的SAA、CRP、IL-6和TNF-α。使用汉密尔顿抑郁评定量表（HAMD-17）、患者健康问卷（PHQ-9）和流行病学研究中心抑郁量表（CES-D）评估精神症状。
在该门诊患者队列中，血浆SAA与跨诊断界限的抑郁症状关联最为显著。SAA升高与HAMD-17量表上的更高总分显著相关，并与评定疲劳和情绪低落症状的多个量表项目相关，但与焦虑相关项目无关。
SAA可能构成一种跨诊断标志物，指示自然主义患者环境中的情绪低落和疲劳。由于SAA激活巨噬细胞和神经胶质细胞上存在的Toll样受体2和4，其与抑郁严重程度的关联也可能表明这种炎症介质在情绪障碍的发病机制中起作用。
