Kawamura Clinic for General Practice, Gyouki-Kai Medical Corporation, Tokyo, Japan.
Human Metabolome Technologies Inc., Tsuruoka, Japan.
Psychiatry Clin Neurosci. 2018 May;72(5):349-361. doi: 10.1111/pcn.12638. Epub 2018 Mar 3.
This study sought to characterize the plasma metabolite profiling of patients with major depressive disorder (MDD).
Psychiatric assessments were made with the Structured Clinical Interview for DSM-IV Axis I Disorders. In the exploratory cohort, plasma metabolite profiles of 34 MDD patients and 31 mentally healthy controls were compared using capillary electrophoresis-mass spectrometry. Among the candidate metabolites, we focused on a metabolite showing the largest difference. The absolute concentrations were measured in two cohorts from a psychiatric primary care clinic to characterize the accuracy of the metabolite biomarker.
Among 23 metabolites significantly lower in the MDD group than in healthy controls, we focused on phosphoethanolamine (PEA) as a candidate. The reduction of PEA levels in MDD was checked in independent clinical sample sets. An ion-chromatography-fluorescence detection method was developed to measure plasma PEA levels. In the preliminary cohort, we examined 34 MDD and 43 non-MDD subjects. The area under the receiver-operator curve (AUC) was 0.92, with sensitivity/specificity greater than 88%, at a cut-off of 1.46 μM. In the checking cohort, with 10 MDD and 13 non-MDD subjects, AUC was 0.89, with sensitivity/specificity of 86% and 100%, respectively, at a cut-off of 1.48 μM. Plasma PEA inversely correlated with MDD severity, depressed mood, loss of interest, and psychomotor retardation.
These results suggest that plasma PEA level could be a candidate biomarker of MDD in the clinical setting. Further studies comparing MDD and mentally healthy controls are needed to confirm the utility of PEA as a biomarker for depression.
本研究旨在描述重性抑郁障碍（MDD）患者的血浆代谢组特征。
采用DSM-IV轴 I 障碍定式临床访谈对精神状态进行评估。在探索性队列中，采用毛细管电泳-质谱联用技术比较了 34 例 MDD 患者和 31 例心理健康对照者的血浆代谢组谱。在候选代谢物中，我们关注显示最大差异的代谢物。在精神科初级保健诊所的两个队列中测量绝对浓度，以表征代谢物生物标志物的准确性。
在 MDD 组显著低于健康对照组的 23 种代谢物中，我们选择磷酸乙醇胺（PEA）作为候选物。在独立的临床样本集中检查了 MDD 患者中 PEA 水平的降低。开发了离子色谱-荧光检测法来测量血浆 PEA 水平。在初步队列中，我们检查了 34 例 MDD 和 43 例非 MDD 患者。在 1.46 μM 的截止值时，曲线下面积（AUC）为 0.92，灵敏度/特异性大于 88%。在检查队列中，有 10 例 MDD 和 13 例非 MDD 患者，AUC 为 0.89，灵敏度/特异性分别为 86%和 100%，截止值为 1.48 μM。血浆 PEA 与 MDD 严重程度、抑郁情绪、兴趣丧失和精神运动迟缓呈负相关。
这些结果表明，血浆 PEA 水平可能是临床环境中 MDD 的候选生物标志物。需要进一步比较 MDD 和心理健康对照者的研究来确认 PEA 作为抑郁生物标志物的效用。
