Uint Luciana, Bastos Gisele Medeiros, Thurow Helena Strelow, Borges Jessica Bassani, Hirata Thiago Dominguez Crespo, França João Italo Dias, Hirata Mario Hiroyuki, Sousa Amanda Guerra de Moraes Rego
Dante Pazzanese Institute of Cardiology, São Paulo, SP, Brasil.
School of Pharmaceutical Science, University of São Paulo, São Paulo, SP, Brasil.
Rev Assoc Med Bras (1992). 2019 Mar;65(3):361-369. doi: 10.1590/1806-9282.65.3.361. Epub 2019 Apr 11.
There is no strong evidence on the link between inflammatory profile and pattern of drug treatment response in depressive patients that could result in Coronary Artery Disease occurrence.
This study aimed to compare the subclinical atherosclerosis markers, inflammatory profile, and BDNF production in Resistant Depression (RD) or Bipolar Affective Disorder (BAD) patients under conventional treatment.
The population evaluated was comprised of 34 RD, 43 BAD, and 41 controls. Subclinical atherosclerosis markers were evaluated using ultrasonography, tomography, and exercise stress test. Plasma concentrations of TNFα, IL-1β, IL-6, and BDNF were measured using Luminex100™. The usCRP concentration was measured using turbidimetric immunoassay. IL1B, IL6, and TNFA expression were determined using TaqMan®. For the statistical analysis, the significance level was established at p<0.05.
Concerning subclinical atherosclerosis markers, only O2 consumption was reduced in the BAD group (p = 0.001). Although no differences were found in gene expression, BDNF and IL-1β plasma concentration was increased in the RD group (p = 0.002 and p = 0.005, respectively) even with an antidepressant treatment, which suggests that these drugs have no effect in IL-1β secretion and that the inflammasome may play a role in therapy response.
Taken together, both BDNF and IL-1β plasma concentrations could be used to the early identification of RD patients.
目前尚无有力证据表明抑郁症患者的炎症特征与药物治疗反应模式之间存在关联，而这种关联可能导致冠状动脉疾病的发生。
本研究旨在比较接受传统治疗的难治性抑郁症（RD）或双相情感障碍（BAD）患者的亚临床动脉粥样硬化标志物、炎症特征和脑源性神经营养因子（BDNF）的产生情况。
评估的人群包括34例RD患者、43例BAD患者和41例对照。使用超声、断层扫描和运动应激试验评估亚临床动脉粥样硬化标志物。使用Luminex100™测量血浆中肿瘤坏死因子α（TNFα）、白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）和BDNF的浓度。使用比浊免疫分析法测量超敏C反应蛋白（usCRP）浓度。使用TaqMan®测定IL1B、IL6和TNFA的表达。对于统计分析，显著性水平设定为p<0.05。
关于亚临床动脉粥样硬化标志物，仅BAD组的耗氧量降低（p = 0.001）。尽管基因表达未发现差异，但即使在接受抗抑郁治疗的情况下，RD组的BDNF和IL-1β血浆浓度仍升高（分别为p = 0.002和p = 0.005），这表明这些药物对IL-1β分泌无影响，且炎性小体可能在治疗反应中起作用。
综上所述，BDNF和IL-1β血浆浓度均可用于RD患者的早期识别。
