Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Lisboa, Portugal.
Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal.
Acta Psychiatr Scand. 2019 May;139(5):420-433. doi: 10.1111/acps.13026. Epub 2019 Apr 9.
Obsessive-compulsive disorder (OCD) is a chronic, prevalent, and highly impairing psychiatric illness. Although the pathophysiology of OCD remains unknown, pathways involved in oxidative and nitrosative stress (O&NS) have been implicated. The present study aims to systematically review the literature for quantitative evidence that patients with OCD have altered measures of blood O&NS markers.
Independent random-effects meta-analyses using standardized mean differences were conducted to assess each marker separately. Additionally, data from multiple markers were pooled together in a meta-analysis for measures of oxidant activity and another for measures of antioxidant activity.
Thirteen studies met inclusion criteria, involving 433 OCD patients and 459 controls. Eleven blood O&NS markers were eligible for independent quantitative analyses. We found that, in OCD patients, the oxidant markers 8-hydroxydeoxyguanosine and malondialdehyde, and the antioxidants glutathione peroxidase and superoxide dismutase, were significantly increased while total antioxidant status, vitamin C, and vitamin E were significantly decreased, when comparing with controls. Regarding pooled meta-analyses, we found a statistically significant increase in oxidant markers, but non-significant results regarding antioxidant markers.
Our meta-analysis suggests that OCD patients have a systemic oxidative imbalance that is not adequately buffered by the antioxidant system. Additional studies are needed in order to support this association.
强迫症（OCD）是一种慢性、普遍存在且严重致残的精神疾病。尽管 OCD 的病理生理学仍然未知，但涉及氧化和硝化应激（O&NS）的途径已被涉及。本研究旨在系统地回顾文献，以获得定量证据，证明 OCD 患者的血液 O&NS 标志物发生了改变。
使用标准化均数差进行独立的随机效应荟萃分析，分别评估每个标志物。此外，还对多个标志物的数据进行了荟萃分析，以评估氧化剂活性的指标和抗氧化剂活性的指标。
符合纳入标准的研究有 13 项，涉及 433 名 OCD 患者和 459 名对照。有 11 个血液 O&NS 标志物有资格进行独立的定量分析。我们发现，与对照组相比，OCD 患者的氧化应激标志物 8-羟基脱氧鸟苷和丙二醛，以及抗氧化剂谷胱甘肽过氧化物酶和超氧化物歧化酶显著增加，而总抗氧化状态、维生素 C 和维生素 E 则显著降低。关于荟萃分析，我们发现氧化应激标志物有统计学上的显著增加，但抗氧化标志物的结果没有统计学意义。
我们的荟萃分析表明，OCD 患者存在系统性氧化失衡，抗氧化系统无法充分缓冲这种失衡。需要进一步的研究来支持这种关联。
