Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Post Box 104, Ottestad, N-2381, Brumunddal, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
BMC Psychiatry. 2018 Apr 10;18(1):95. doi: 10.1186/s12888-018-1677-z.
Depression is associated with immunological responses as reflected by altered levels of circulating cytokines. Alcohol use and trauma may modulate immune activity, and few studies have investigated these factors in depressed patients. We aimed to explore the association between circulating peripheral cytokine levels and degree of depressive symptoms, taking trauma and alcohol into account.
The study was a cross-sectional assessment of patients at admission to a specialized psychiatric center in Norway. A total of 128 patients were included. Information was gathered using the self-administered questionnaires Beck Depression Inventory-II (BDI-II) and the Alcohol Use Disorders Identification Test (AUDIT), in addition to clinical interviews recording childhood or adult life trauma. Serum levels of the cytokines Interleukin-1β (IL-1β), Interleukin-1 Receptor Antagonist (IL-1RA), Tumor Necrosis Factor-α (TNF-α) and the chemokine Monocyte Chemoattractant Protein-1 (MCP-1) were assessed. A Luminex bead-based multiplex assay was used for cytokine measurements. Patient cytokine levels were compared to those of healthy volunteers by the Mann-Whitney U test.
Levels of cytokines did not differ across patients with mild, moderate and severe depression. AUDIT score was not related to cytokine levels, but to level of depression. A history of trauma was related to higher levels of IL-1RA and TNF-α (p = 0.048 and p = 0.033, respectively), especially among the severely depressed. Serum levels of MCP-1 and TNF-α were significantly higher among psychiatric patients than in healthy volunteers.
Findings indicate that depression was not related to levels of circulating cytokines among patients in treatment, but that traumatized patients had higher levels of IL-1RA and TNF-α than patients without trauma experience. The lack of relationship between cytokine level and depression was evident both in those without and with trauma.
抑郁症与循环细胞因子水平改变所反映的免疫反应有关。酒精使用和创伤可能会调节免疫活性，很少有研究调查过抑郁症患者的这些因素。我们旨在探讨考虑到创伤和酒精因素后，循环外周细胞因子水平与抑郁症状严重程度之间的关系。
该研究是对挪威一家专门精神科中心入院患者的横断面评估。共纳入 128 例患者。通过贝克抑郁量表第二版（BDI-II）和酒精使用障碍识别测试（AUDIT）的自我管理问卷以及记录儿童或成年生活创伤的临床访谈收集信息。评估了细胞因子白细胞介素-1β（IL-1β）、白细胞介素-1 受体拮抗剂（IL-1RA）、肿瘤坏死因子-α（TNF-α）和趋化因子单核细胞趋化蛋白-1（MCP-1）的血清水平。采用 Luminex 珠基多重分析测定细胞因子。通过 Mann-Whitney U 检验比较患者细胞因子水平与健康志愿者的水平。
轻度、中度和重度抑郁症患者的细胞因子水平没有差异。AUDIT 评分与细胞因子水平无关，但与抑郁程度有关。创伤史与较高的 IL-1RA 和 TNF-α水平相关（分别为 p=0.048 和 p=0.033），尤其是在重度抑郁患者中。与健康志愿者相比，精神病患者的血清 MCP-1 和 TNF-α水平明显更高。
研究结果表明，在接受治疗的患者中，抑郁症与循环细胞因子水平无关，但与创伤经历的患者相比，IL-1RA 和 TNF-α水平较高。在有创伤和无创伤经历的患者中，细胞因子水平与抑郁之间缺乏关系。
