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在主要的情感障碍中,早年生活创伤可预测增加的氮氧化物应激、脂质过氧化和蛋白质氧化,以及主要情感障碍、自杀行为的复发和生活质量的降低。

In major affective disorders, early life trauma predict increased nitro-oxidative stress, lipid peroxidation and protein oxidation and recurrence of major affective disorders, suicidal behaviors and a lowered quality of life.

机构信息

Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch 60, Londrina, PR, 86035-380, Brazil.

Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand.

出版信息

Metab Brain Dis. 2018 Aug;33(4):1081-1096. doi: 10.1007/s11011-018-0209-3. Epub 2018 Mar 14.

Abstract

Early life trauma (ELT) may increase the risk towards bipolar disorder (BD) and major depression (MDD), disorders associated with activated neuro-oxidative and neuro-nitrosative stress (O&NS) pathways. It has remained elusive whether ELTs are associated with O&NS and which ELTs are associated with distinct affective disorder phenotypes. This case-control study examined patients with BD (n = 68) and MDD (n = 37) and healthy controls (n = 66). The Child Trauma Questionnaire (CTQ) was used to assess specific ELT. We measured malondialdehyde (MDA), lipid hydroperoxides (LOOH), superoxide dismutase (SOD), catalase, advanced oxidation protein products (AOPP); NO metabolites (NOx), paraoxonase 1 activity, zinc, albumin, high density lipoprotein cholesterol and -SH groups and computed z-unit weighted composite scores. Physical neglect significantly predicts higher z-unit weighted composite scores of LOOH+SOD, LOOH+SOD+NOx, LOOH+SOD+NOx + MDA and LOOH+SOD+NOx + AOPP. Sexual abuse was associated with a significantly lower composite score of zinc+albumin+SH. Emotional abuse was associated with severity of depression and anxiety, number of depressive and manic episodes, alcohol and hypnotics use, lifetime suicidal behavior and lowered quality of life. Sexual abuse was associated with an increased risk towards BD, but not MDD. ELT, especially physical neglect, may drive increased (nitro-)oxidative stress coupled with lipid and protein oxidation, which - together with emotional abuse - may play a role in severity of illness, lowered quality of life and MDD. ELTs are also associated with the onset of BD, but this link did not appear to be related to activated O&NS pathways. These novel findings deserve confirmation in prospective studies.

摘要

早期生活创伤 (ELT) 可能会增加双相情感障碍 (BD) 和重度抑郁症 (MDD) 的风险,这些疾病与神经氧化和神经硝化应激 (O&NS) 途径的激活有关。目前仍不清楚 ELT 是否与 O&NS 有关,以及哪些 ELT 与不同的情感障碍表型有关。这项病例对照研究检查了 68 名 BD 患者、37 名 MDD 患者和 66 名健康对照组。使用儿童创伤问卷 (CTQ) 评估特定的 ELT。我们测量了丙二醛 (MDA)、脂质过氧化物 (LOOH)、超氧化物歧化酶 (SOD)、过氧化氢酶、高级氧化蛋白产物 (AOPP);NO 代谢物 (NOx)、对氧磷酶 1 活性、锌、白蛋白、高密度脂蛋白胆固醇和 -SH 基团,并计算了 z 单位加权复合评分。身体忽视显著预测 LOOH+SOD、LOOH+SOD+NOx、LOOH+SOD+NOx+MDA 和 LOOH+SOD+NOx+AOPP 的 z 单位加权复合评分较高。性虐待与锌+白蛋白+SH 的复合评分显著降低有关。情感虐待与抑郁和焦虑的严重程度、抑郁和躁狂发作的次数、酒精和催眠剂的使用、终生自杀行为和生活质量下降有关。性虐待与 BD 的风险增加有关,但与 MDD 无关。ELT,特别是身体忽视,可能会导致(硝化)氧化应激增加,加上脂质和蛋白质氧化,这可能与疾病的严重程度、生活质量下降和 MDD 有关。ELT 也与 BD 的发病有关,但这种联系似乎与激活的 O&NS 途径无关。这些新发现值得在前瞻性研究中进一步证实。

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