Medical Psychology Unit, Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal.
I3S Instituto de Investigação e Inovação em Saúde, Porto, Portugal.
J Immunol Res. 2018 Jul 17;2018:5954897. doi: 10.1155/2018/5954897. eCollection 2018.
Rheumatoid arthritis (RA) is an often debilitating autoinflammatory disease. Patients with rheumatoid arthritis are often troubled by co-occurring depression or other psychological manifestations. RA patients have a variety of treatment options available, including biologicals that inhibit cytokines or immune cells. If these cytokines influence the psychological symptoms, then the use of cytokine inhibitors should modulate these symptoms.
A cohort of 209 individuals was recruited. This group included 82 RA patients, 22 healthy subjects, 32 depressed control subjects, and 73 subjects with systemic lupus erythematosus. Of the RA patients, 51% were on a biological therapeutic. ELISA was used to measure cytokine levels. A variety of psychological assessments were used to evaluate depression, anxiety, sleep, fatigue, and relationship status. Clinical values were obtained from medical records.
IL-10 concentration was associated with depressive symptoms in the RA patients, healthy controls, and the lupus patients. In the patients with primary depression, depressive symptoms were associated with IL-6 and TNF-alpha. In RA patients, Tocilizumab use was associated with decreased depressive symptoms. 14 RA patients who were not using biologicals began using them by a one-month follow-up. In these patients, there was no significant change to any value except for fatigue.
A variety of both biological and social factors influences depressive symptoms in RA. IL-10 and IL-6 are likely to be involved, since IL-10 concentration was associated with depression and Tocilizumab decreased depressive symptoms in the RA patients. The roles of these cytokines are different in RA and lupus, as high IL-10 in RA is associated with increased depressive symptoms, but high IL-10 in the lupus patients is associated with decreased depression. IL-6 was also associated with depressive symptoms in the patients with primary depression. These results strongly indicate that disease activity, including cytokine levels, has a strong impact on depressive symptoms.
类风湿关节炎（RA）是一种常使人虚弱的自身炎症性疾病。患有类风湿关节炎的患者常常受到抑郁或其他心理表现的困扰。RA 患者有多种治疗选择，包括抑制细胞因子或免疫细胞的生物制剂。如果这些细胞因子影响心理症状，那么使用细胞因子抑制剂应该调节这些症状。
招募了一个 209 人的队列。该组包括 82 名 RA 患者、22 名健康受试者、32 名抑郁对照组和 73 名系统性红斑狼疮患者。在 RA 患者中，51%的患者接受了生物治疗。使用 ELISA 测量细胞因子水平。使用各种心理评估来评估抑郁、焦虑、睡眠、疲劳和关系状况。临床值从病历中获得。
IL-10 浓度与 RA 患者、健康对照者和狼疮患者的抑郁症状相关。在原发性抑郁症患者中，抑郁症状与 IL-6 和 TNF-α相关。在 RA 患者中，Tocilizumab 的使用与抑郁症状的减少相关。14 名未使用生物制剂的 RA 患者在一个月的随访中开始使用它们。在这些患者中，除了疲劳之外，没有任何值发生显著变化。
多种生物和社会因素影响 RA 患者的抑郁症状。IL-10 和 IL-6 可能参与其中，因为 IL-10 浓度与抑郁相关，Tocilizumab 降低了 RA 患者的抑郁症状。这些细胞因子在 RA 和狼疮中的作用不同，因为 RA 中的高 IL-10 与抑郁症状增加有关，但狼疮患者中的高 IL-10 与抑郁症状减少有关。IL-6 也与原发性抑郁症患者的抑郁症状相关。这些结果强烈表明，疾病活动度，包括细胞因子水平，对抑郁症状有很大影响。
