Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
School of Public Health, National Defense Medical Center, Taipei, Taiwan.
Int J Rheum Dis. 2019 Jun;22(6):980-985. doi: 10.1111/1756-185X.13529. Epub 2019 Mar 7.
Mood disorders are a serious issue for patients with rheumatoid arthritis (RA) because poor mental health can exacerbate the disease course. This study aimed to identify the effect of proinflammatory cytokines on the mood of patients with RA.
This study was conducted at a rheumatology clinic in Northern Taiwan. In total, 113 patients with RA and 42 healthy controls were assessed for anxiety and depression symptoms using Hospital Anxiety and Depression Scale (HADS). RA was assessed using the Disease Activity Score of 28 joints (DAS28). Serum proinflammatory cytokine levels, including interleukin (IL)-1β, IL-6, IL-17 and tumor necrosis factor alpha (TNF-α) were measured and compared between different patient groups according to disease activity and pain level.
Serum IL-1β, IL-6, IL-17 and TNF-α levels were significantly higher in patients with RA than in healthy controls, as were the mean anxiety and depression subscale scores. In patients with RA who had different disease activities, pain severity correlated with both anxiety and depression symptoms. When HADS scores were analyzed according to pain levels, age was correlated with depression in the severe pain group. In the mild pain group, patients with higher IL-6 or higher IL-17 had a higher risk of depression. There was no correlation between mood symptoms and cytokine levels in healthy controls.
Elevated serum IL-6 and IL-17 levels in patients with RA induce arthritis and cause mood symptoms, especially depression symptoms.
情绪障碍是类风湿关节炎（RA）患者的一个严重问题，因为心理健康状况不佳会使病情恶化。本研究旨在确定促炎细胞因子对 RA 患者情绪的影响。
本研究在台湾北部的一家风湿病诊所进行。共有 113 名 RA 患者和 42 名健康对照者接受了医院焦虑和抑郁量表（HADS）评估焦虑和抑郁症状。使用 28 个关节疾病活动度评分（DAS28）评估 RA。根据疾病活动度和疼痛程度，比较不同患者组之间的血清促炎细胞因子水平，包括白细胞介素（IL）-1β、IL-6、IL-17 和肿瘤坏死因子-α（TNF-α）。
RA 患者的血清 IL-1β、IL-6、IL-17 和 TNF-α水平明显高于健康对照组，焦虑和抑郁亚量表评分也更高。在疾病活动度不同的 RA 患者中，疼痛严重程度与焦虑和抑郁症状均相关。根据疼痛程度分析 HADS 评分时，年龄与重度疼痛组的抑郁相关。在轻度疼痛组中，IL-6 或 IL-17 较高的患者抑郁风险更高。健康对照组中情绪症状与细胞因子水平之间无相关性。
RA 患者血清中升高的 IL-6 和 IL-17 水平引发关节炎并导致情绪症状，尤其是抑郁症状。
