Kotulla Simone, Elsenbruch Sigrid, Roderigo Till, Brinkhoff Alexandra, Wegner Alexander, Engler Harald, Schedlowski Manfred, Benson Sven
Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Front Behav Neurosci. 2018 Aug 21;12:183. doi: 10.3389/fnbeh.2018.00183. eCollection 2018.
A role of inflammatory processes in the pathophysiology of depression is increasingly recognized. Experimental endotoxemia offers an established model to induce transient systemic inflammation in healthy humans, and has been proposed as an experimental paradigm of depression. Indeed, different symptoms of depression can be observed during experimental endotoxemia, including negative mood or dysthymia as key symptoms of depression. Hopelessness and low self-esteem constitute common cognitive symptoms in depression, but have not been specifically assessed during endotoxemia. Thus, we pooled data from healthy volunteers who received low-dose endotoxin (i.e., 0.4 or 0.8 ng/kg lipopolysaccharide, LPS) or placebo in three randomized, controlled studies to investigate the effects of LPS on cognitive schemata related to depression. Validated questionnaires were used to assess self-esteem, hopelessness and the vulnerability factor intolerance of uncertainty after intravenous injection of LPS or placebo. Plasma tumor necrosis factor (TNF)-α and interleukin (IL)-6 were repeatedly assessed, along with self-reported mood. Because not all questionnaires were available from primary studies, data were analyzed in two separate data sets: In data set 1, self-esteem and intolerance of uncertainty were assessed in = 87 healthy volunteers, who randomly received either 0.4 or 0.8 ng/kg LPS or placebo. In data set 2, hopelessness was measured in = 59 volunteers who randomly received either LPS (0.8 ng/kg) or placebo. In both data sets, LPS-application led to significant increases in TNF-α and IL-6, reflecting systemic inflammation. Positive mood was significantly decreased in response to LPS, in line with inflammation-induced mood impairment. General self-esteem, intolerance of uncertainty and hopelessness did not differ between LPS- and placebo groups, suggesting that these negative cognitive schemata are not responsive to acute LPS-induced systemic inflammation. Interestingly, LPS-treated volunteers reported significantly lower body-related self-esteem, which was associated with increased TNF-α concentration. Thus, certain aspects of self-esteem related to physical attractiveness and sportiness were reduced. It is conceivable that this effect is primarily related to physical sickness symptoms and reduced physical ability during experimental endotoxemia. With respect to cognitive symptoms of depression, it is conceivable that LPS affects cognitive , but not negative cognitive schemata, which are rather based on learning and repeated experiences.
炎症过程在抑郁症病理生理学中的作用日益受到认可。实验性内毒素血症提供了一个在健康人类中诱导短暂全身性炎症的既定模型,并已被提议作为抑郁症的实验范式。事实上,在实验性内毒素血症期间可以观察到不同的抑郁症状,包括消极情绪或心境恶劣作为抑郁症的关键症状。绝望和低自尊是抑郁症常见的认知症状,但在内毒素血症期间尚未进行专门评估。因此,我们汇总了来自三项随机对照研究中接受低剂量内毒素(即0.4或0.8 ng/kg脂多糖,LPS)或安慰剂的健康志愿者的数据,以研究LPS对与抑郁症相关的认知模式的影响。在静脉注射LPS或安慰剂后,使用经过验证的问卷来评估自尊、绝望和不确定性不耐受这一易损因素。血浆肿瘤坏死因子(TNF)-α和白细胞介素(IL)-6以及自我报告的情绪被反复评估。由于并非所有问卷都可从原始研究中获得,数据在两个单独的数据集中进行分析:在数据集1中,对n = 87名随机接受0.4或0.8 ng/kg LPS或安慰剂的健康志愿者评估了自尊和不确定性不耐受。在数据集2中,对n = 59名随机接受LPS(0.8 ng/kg)或安慰剂的志愿者测量了绝望。在两个数据集中,LPS的应用导致TNF-α和IL-6显著增加,反映了全身性炎症。与炎症引起的情绪损害一致,LPS导致积极情绪显著下降。LPS组和安慰剂组之间的总体自尊、不确定性不耐受和绝望没有差异,这表明这些消极认知模式对急性LPS诱导的全身性炎症没有反应。有趣的是,接受LPS治疗的志愿者报告与身体相关的自尊显著降低,这与TNF-α浓度升高有关。因此与身体吸引力和运动能力相关的自尊的某些方面降低了。可以想象,这种效应主要与实验性内毒素血症期间的身体疾病症状和身体能力下降有关。关于抑郁症的认知症状,可以想象LPS影响认知,但不影响消极认知模式,消极认知模式更多地基于学习和反复经历。