Division of Psychiatry and Neuroscience, Institute for Clinical Research, NHO Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima, Japan.
Department of Psychiatry, NHO Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima, Japan.
Int J Neuropsychopharmacol. 2019 Apr 1;22(4):261-269. doi: 10.1093/ijnp/pyz005.
The autotaxin/lysophosphatidic acid axis is involved in diverse biological processes including neurodevelopment, inflammation, and immunological functioning. The lysophosphatidic acid 1 receptor has been implicated in the pathophysiology of major depressive disorder and in the mechanism of action of antidepressants. However, it is unclear whether central or peripheral autotaxin levels are altered in patients with major depressive disorder.
Serum autotaxin levels were measured by an enzyme-linked immunosorbent assay in 37 patients with major depressive disorder diagnosed using DSM-IV-TR who underwent electroconvulsive therapy and were compared with those of 47 nondepressed controls matched for age and sex between January 2011 and December 2015. Patient serum levels of autotaxin before and after electroconvulsive therapy were also compared. In a separate sample set, cerebrospinal fluid autotaxin levels were compared between 26 patients with major depressive disorder and 27 nondepressed controls between December 2010 and December 2015. A potential association was examined between autotaxin levels and clinical symptoms assessed with the Hamilton Depression Rating Scale.
Before electroconvulsive therapy, both serum and cerebrospinal fluidautotaxin levels were significantly lower in major depressive disorder patients than in controls (serum: P = .001, cerebrospinal fluid: P = .038). A significantly negative correlation between serum, but not cerebrospinal fluid, autotaxin levels and depressive symptoms was observed (P = .032). After electroconvulsive therapy, a parallel increase in serum autotaxin levels and depressive symptoms improvement was observed (P = .005).
The current results suggest that serum autotaxin levels are reduced in a state-dependent manner. The reduction of cerebrospinal fluidautotaxin levels suggests a dysfunction in the autotaxin/lysophosphatidic acid axis in the brains of patients with major depressive disorder.
自分泌酶/溶血磷脂酸轴参与多种生物学过程,包括神经发育、炎症和免疫功能。溶血磷脂酸 1 受体与重度抑郁症的病理生理学和抗抑郁药的作用机制有关。然而,中枢或外周自分泌酶的水平是否在重度抑郁症患者中发生改变尚不清楚。
采用酶联免疫吸附试验检测 2011 年 1 月至 2015 年 12 月期间接受电抽搐治疗的 37 例重度抑郁症患者(根据 DSM-IV-TR 诊断)和 47 例年龄和性别相匹配的非抑郁对照者的血清自分泌酶水平,并与后者进行比较。还比较了电抽搐治疗前后患者血清自分泌酶水平。在另一个样本集中,比较了 2010 年 12 月至 2015 年 12 月期间 26 例重度抑郁症患者和 27 例非抑郁对照者的脑脊液自分泌酶水平。检查了自分泌酶水平与汉密尔顿抑郁量表评估的临床症状之间的潜在关联。
在电抽搐治疗前,重度抑郁症患者的血清和脑脊液自分泌酶水平均明显低于对照组(血清:P =.001,脑脊液:P =.038)。观察到血清自分泌酶水平与抑郁症状呈显著负相关(P =.032),但脑脊液自分泌酶水平与抑郁症状无显著相关性(P =.032)。电抽搐治疗后,血清自分泌酶水平平行升高,抑郁症状改善(P =.005)。
目前的结果表明,血清自分泌酶水平呈状态依赖性降低。脑脊液自分泌酶水平降低提示重度抑郁症患者大脑中的自分泌酶/溶血磷脂酸轴功能障碍。