[适应障碍中的炎症因子与免疫表型]
[Inflammatory factors and immunophenotypes in adjustment disorders].
作者信息
Klyushnik T P, Nikitina V B, Androsova L V, Vetlugina T P, Zozulya S A, Aksenov M M, Bokhan N A
机构信息
Mental Health Research Center, Moscow, Russia.
Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia.
出版信息
Zh Nevrol Psikhiatr Im S S Korsakova. 2018;118(3):83-88. doi: 10.17116/jnevro20181183183-88.
AIM
To identify inflammatory and autoimmune markers (enzymatic activity of leukocyte elastase (LE), functional α1-proteinase inhibitor (α1-PI), the level of autoantibodies to neurospecific antigens S100b and myelin basic protein (MBP)) as well as phagocytic activity of blood neutrophils of patients with disorders of adaptation, to determine certain immunophenotypes and analyze their possible relationships with disease characteristics.
MATERIAL AND METHODS
The study included 40 patients with adaptation disorders, mostly women. Diagnostic evaluation and clinical qualification of patients was carried out in accordance with ICD-10: 'Adjustment disorder' (F43.2). The control group consisted of 23 individuals matched for age and sex with patients. The activity of LE and α1-PI was determined by spectrophotometry, and the levels of autoantibodies to S100b and MBP by ELISA, phagocytic activity by the absorptive capacity of neutrophils of peripheral blood of melamine-formaldehyde latex particles.
RESULTS
In the total group of patients with adaptation disorders, increased enzymatic activity of LE and functional α1-PI was shown compared to controls (p<0.001 and p<0.0001, respectively). There were no differences in the level of autoantibodies to neuroantigens, and changes in phagocytic index (PhN) compared with the control, however the tendency to reduction of phagocytic number (PhN) was observed. Patients were stratified by leading psychopathological symptoms (predominance of asthenic-depressive or anxious-depressive symptoms, polymorphic symptomatology) and by immunophenotype: (A) inflammatory markers - in the range of control values, (B) - the increase compared to the control activity of both LE and α1-PI, (C) preferential increase in the activity of α1-PI only. The frequency of these immunophenotypes was similar within each of the clinical subgroups.
CONCLUSION
The results suggest the involvement of inflammation in the pathogenesis of adjustment disorders due to stress factors. Various immunological variants differed by proportion of inflammatory markers were not associated with clinical symptoms.
目的
识别适应障碍患者的炎症和自身免疫标志物（白细胞弹性蛋白酶（LE）的酶活性、功能性α1-蛋白酶抑制剂（α1-PI）、针对神经特异性抗原S100b和髓鞘碱性蛋白（MBP）的自身抗体水平）以及血液中性粒细胞的吞噬活性，确定某些免疫表型并分析它们与疾病特征的可能关系。
材料与方法
该研究纳入了40例适应障碍患者，其中大多数为女性。根据ICD-10：“适应障碍”（F43.2）对患者进行诊断评估和临床鉴定。对照组由23名年龄和性别与患者匹配的个体组成。通过分光光度法测定LE和α1-PI的活性，通过ELISA测定针对S100b和MBP的自身抗体水平，通过三聚氰胺-甲醛乳胶颗粒外周血中性粒细胞的吸收能力测定吞噬活性。
结果
与对照组相比，适应障碍患者总体组中LE的酶活性和功能性α1-PI升高（分别为p<0.001和p<0.0001）。与对照组相比，神经抗原自身抗体水平以及吞噬指数（PhN）没有差异，但观察到吞噬数量（PhN）有降低趋势。根据主要精神病理症状（虚弱抑郁或焦虑抑郁症状占主导、多形症状）和免疫表型对患者进行分层：（A）炎症标志物——在对照值范围内，（B）——与对照相比LE和α1-PI的活性均增加，（C）仅α1-PI的活性优先增加。这些免疫表型的频率在每个临床亚组中相似。
结论
结果表明炎症参与了应激因素导致的适应障碍的发病机制。炎症标志物比例不同的各种免疫变体与临床症状无关。
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