Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
J Affect Disord. 2018 Sep;237:65-72. doi: 10.1016/j.jad.2018.04.115. Epub 2018 Apr 25.
Immune system dysregulation is critical in the physiopathology of major depressive disorder (MDD) and bipolar disorder (BD). However, it is unclear whether both diseases present the same inflammatory patterns during depressive episodes. We explored the differences in pro- and anti-inflammatory cytokines between unipolar and bipolar depression (BDD) and the trajectory of these cytokines after acute-phase treatment.
Sixty-four MDD patients, 61 BDD patients, and 62 healthy controls (HCs) were enrolled. We assessed the clinical features and cytokines plasma levels at baseline and week 12. The pro-inflammatory cytokines (IL-6, TNF-α) and anti-inflammatory cytokines (IL-4, IL-13) of all subjects were assessed by multiplexed sandwich ELISA-based quantitative arrays.
Before acute-phase treatment, the initial levels of TNF-α and IL-13 were significantly lower in the BDD patients than in the MDD patients. The results demonstrated that there was no relationship between each cytokine level and clinical features of unipolar and bipolar depressions. After 12 weeks, TNF-α, IL-4, and IL-13 levels became lower in MDD patients than in the other two groups regardless of the patients' response to treatment while the levels of TNF-α and IL-4 increased only in the BDD responders.
The effects of different drugs on inflammatory cytokines in MDD or BDD could not be explored further due to the relatively small sample size.
Even within the same depressive states, MDD and BDD patients present different inflammatory features, particularly in regard to pro-inflammatory TNF-α and anti-inflammatory IL-13. In addition, the fluctuations of cytokines induced by medication may provide a hint regarding the prediction of treatment response.
免疫系统失调在重度抑郁症（MDD）和双相情感障碍（BD）的病理生理学中至关重要。然而，尚不清楚这两种疾病在抑郁发作期间是否表现出相同的炎症模式。我们探讨了单相和双相抑郁症（BDD）之间促炎和抗炎细胞因子的差异，以及这些细胞因子在急性期治疗后的变化轨迹。
共纳入 64 例 MDD 患者、61 例 BDD 患者和 62 例健康对照者（HCs）。我们在基线和第 12 周评估了临床特征和细胞因子的血浆水平。采用基于多重夹心酶联免疫吸附试验的定量阵列检测所有受试者的促炎细胞因子（IL-6、TNF-α）和抗炎细胞因子（IL-4、IL-13）。
在急性期治疗前，BDD 患者的 TNF-α和 IL-13初始水平明显低于 MDD 患者。结果表明，每个细胞因子水平与单相和双相抑郁的临床特征之间没有关系。治疗 12 周后，MDD 患者的 TNF-α、IL-4 和 IL-13 水平均低于其他两组，无论患者对治疗的反应如何，而 TNF-α和 IL-4 水平仅在 BDD 反应者中增加。
由于样本量相对较小，无法进一步探讨不同药物对 MDD 或 BDD 中炎症细胞因子的影响。
即使在相同的抑郁状态下，MDD 和 BDD 患者也表现出不同的炎症特征，特别是在促炎 TNF-α和抗炎 IL-13方面。此外，药物引起的细胞因子波动可能为预测治疗反应提供提示。
