Abramenko I V, Bilous N I, Chumak S A, Loganovsky K M
State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Melnykova str., Kyiv, 04050, Ukraine.
Probl Radiac Med Radiobiol. 2017 Dec;22:282-291.
Mental disorders of the victims are one of the important medical consequences of the Chornobyl accident. It is also known that in the implementation of the pathogenesis of depressive states a significant role belongs to the sero tonin transporter gene (SLC6A4).
To determine the effect of polymorphic variants of the SLC6A4 gene on the frequency of detection of depression in a group of clean up workers in the remote period after the Chornobyl catastrophe.
The study was conducted in a group of 59 victims of the Chornobyl NPP accident, divided into two groups (without depression and with depressive symptoms). The diagnosis of depressive disorders was based on a compre hensive assessment of the complaints of the surveyed, the clinical and psychopathological data, the values of the Zung Self Rating Depression Scale (SDS), the Brief Psychiatric Rating Scale (BPRS), the General Health Questionnaire (GHQ 28). DNA from the peripheral blood mononuclear cells was isolated, and the 5 HTTLPR polymorphism was determined by polymerase chain reaction (PCR).
Depressive symptoms were more often found among reconvalescents of acute radiation sickness (ARS) than in the clean up workers without ARS: (p = 0.006). The tendencies of the association of the received dose of exter nal exposure with the number of points on the SDS scale (r = 0.284; p = 0.043), the sum of scores on the BPRS scale (r = 0.686; p = 0.001), depression (r = 0.323, p = 0.017) and its severity (r = 0.273; p = 0.051) were found. Among the examined clean up workers, in comparison with a large group of Europeans without mental disorders, an increase in the number of carriers of the genotype S/S SLC6A4 was found (p = 0.03). Only for the carriers of the S/S genotype, the reciprocal association between the development of depression and the age of the patient was found: r = 0.503 (p = 0.033), between the development of depression and the time from the ChNPP accident: r = 0.581 (p = 0.011), as well as positive correlation of development of depression with dose of irradiation: r = 0.515 (p = 0.025). Among people aged 55 and older, the development of depression was associated with a decrease in the frequency of high ly functional genotype LА/LА to 4.76% versus 31.25% in the absence of depressed symptoms (p = 0.042). In the group of younger patients, the distribution of genotypes did not differ depending on the signs of depression (p = 0.476).
The pilot analysis of the distribution of genotypes of the SLC6A4 gene for polymorphisms of 5 HTTLPR and rs25531 in the clean up workers group showed the promise of further studies of the contribution of LА/LА і S/S genotypes to the development of depressive states in combination with the action of the radiation factor.
受害者的精神障碍是切尔诺贝利事故重要的医学后果之一。众所周知,在抑郁状态发病机制的实现过程中,血清素转运体基因(SLC6A4)起着重要作用。
确定SLC6A4基因多态性变异对切尔诺贝利灾难后远期一组清理人员中抑郁症检出频率的影响。
对59名切尔诺贝利核电站事故受害者进行研究,分为两组(无抑郁症组和有抑郁症状组)。抑郁症的诊断基于对被调查者的主诉、临床和精神病理学数据、zung自评抑郁量表(SDS)、简明精神病评定量表(BPRS)、一般健康问卷(GHQ - 28)值的综合评估。从外周血单个核细胞中分离DNA,通过聚合酶链反应(PCR)确定5 - HTTLPR多态性。
急性放射病(ARS)康复者中抑郁症状的出现频率高于无ARS的清理人员:(p = 0.006)。发现外部暴露接受剂量与SDS量表得分(r = 0.284;p = 0.043)、BPRS量表得分总和(r = 0.686;p = 0.001)、抑郁症(r = 0.323,p = 0.017)及其严重程度(r = 0.273;p = 0.051)之间存在关联趋势。在接受检查的清理人员中,与一大组无精神障碍的欧洲人相比,发现S/S SLC6A4基因型携带者数量增加(p = 0.03)。仅对于S/S基因型携带者,发现抑郁症的发生与患者年龄之间存在负相关:r = 0.503(p = 0.033),与切尔诺贝利核电站事故发生后的时间之间存在负相关:r = 0.581(p = 0.011),以及抑郁症的发生与照射剂量之间存在正相关:r = 0.515(p = 0.025)。在55岁及以上人群中,抑郁症的发生与高功能基因型LA/LA频率降低有关,无抑郁症状者为31.25%,有抑郁症状者为4.76%(p = 0.042)。在年轻患者组中,基因型分布根据抑郁症状无差异(p = 0.476)。
对清理人员组中SLC6A4基因5 - HTTLPR和rs25531多态性基因型分布的初步分析表明,结合辐射因素作用,进一步研究LA/LA和S/S基因型对抑郁状态发展的贡献具有前景。