Hacimusalar Yunus, Eşel Ertuğrul
Department of Psychiatry, Kayseri Training and Research Hospital, Kayseri, Turkey.
Department of Psychiatry, Erciyes University Faculty of Medicine, Kayseri, Turkey.
Noro Psikiyatr Ars. 2018 May 28;55(3):280-290. doi: 10.5152/npa.2017.19482. eCollection 2018 Sep.
Currently, the diagnosis of major depressive disorder (MDD) mainly relies on clinical examination and subjective evaluation of depressive symptoms. There is no non-invasive, quantitative test available today for the diagnosis of MDD. In MDD, exploration of biomarkers will be helpful in diagnosing the disorder as well as in choosing a treatment, and predicting the treatment response. In this article, it is aimed to review the findings of suggested biomarkers such as growth factors, cytokines and other inflammatory markers, oxidative stress markers, endocrine markers, energy balance hormones, genetic and epigenetic features, and neuroimaging in MDD and to evaluate how these findings contribute to the pathophysiology of MDD, the prediction of treatment response, severity of the disorder, and identification of subtypes. Among these, the findings related to the brain-derived neurotrophic factor, the hypothalamo-pituitary-adrenal axis, cytokines, and neuroimaging may be strong candidates for being biomarkers MDD, and may provide critical information in understanding biological etiology of depression. Although the findings are not sufficient yet, we think that the results of epigenetic studies will also provide very important contributions to the biomarker research in MDD. The availability of biomarkers in MDD will be an advancement that will facilitate the diagnosis of the disorder, treatment choices in the early stages, and prediction of the course of the disorder.
目前,重度抑郁症(MDD)的诊断主要依赖于临床检查和对抑郁症状的主观评估。如今尚无用于诊断MDD的非侵入性定量检测方法。在MDD中,探索生物标志物将有助于该疾病的诊断、治疗选择以及预测治疗反应。本文旨在综述如生长因子、细胞因子及其他炎症标志物、氧化应激标志物、内分泌标志物、能量平衡激素、遗传和表观遗传特征以及神经影像学等提示性生物标志物在MDD中的研究结果,并评估这些结果如何有助于MDD的病理生理学、治疗反应预测、疾病严重程度以及亚型识别。其中,与脑源性神经营养因子、下丘脑 - 垂体 - 肾上腺轴、细胞因子及神经影像学相关的研究结果可能是MDD生物标志物的有力候选者,并可能为理解抑郁症的生物学病因提供关键信息。尽管研究结果尚不充分,但我们认为表观遗传学研究结果也将为MDD生物标志物研究做出非常重要的贡献。MDD生物标志物的可用性将是一项进步,有助于该疾病的诊断、早期治疗选择以及疾病进程的预测。