Pillai Anilkumar, Bruno Davide, Nierenberg Jay, Pandya Chirayu, Feng Tami, Reichert Chelsea, Ramos-Cejudo Jaime, Osorio Ricardo, Zetterberg Henrik, Blennow Kaj, Pomara Nunzio
Department of Psychiatry and Health Behavior, Augusta University, Augusta, GA, USA.
School of Psychology, Liverpool John Moores University, Liverpool, UK.
Biomark Neuropsychiatry. 2019 Dec;1. doi: 10.1016/j.bionps.2019.100007. Epub 2019 Nov 13.
Late-life major depression (LLMD) is a risk factor for the development of mild cognitive impairment and dementia, including Alzheimer's disease (AD) and vascular dementia. Immune dysregulation and changes in innate immune responses in particular, have been implicated in the pathophysiology of both LLMD and AD. Complement system, a key component of the innate immune mechanism, is known to play an important role in synaptic plasticity and cognitive functions. However, its role in LLMD remains unknown. In the present study, we examined the levels of complement component 3 (C3, the convergence point of all complement activation pathways) in the cerebrospinal fluid (CSF) of elderly depressed subjects compared to healthy controls; as well as the relationship of CSF C3 levels with amyloid-beta (Aβ42 and Aβ40), total tau (T-tau) and phosphorylated tau (P-tau) proteins and cognition scores. CSF was obtained from 50 cognitively intact volunteers (major depression group, N = 30; comparison group, N = 20) and analyzed for levels of C3 by ELISA. C3 levels were marginally lower in the major depression group relative to the comparison group. We did not find any significant association of C3 with the AD biomarkers Aβ42 reflecting plaque pathology, P-tau related to tau pathology or the neurodegeneration biomarker T-tau. In contrast, C3 was positively correlated with CSF Aβ40, which may reflect Aβ deposition in cerebral vessel walls. We observed a negative correlation between C3 levels and Total Recall on the Buschke Selective Reminding Test (BSRT) for memory performance in the depressed subjects when controlling for education. This initial evidence on C3 status in LLMD subjects may have implications for our understanding of the pathophysiology of major depression especially in late life.
老年期重度抑郁症(LLMD)是轻度认知障碍和痴呆症(包括阿尔茨海默病(AD)和血管性痴呆)发生的危险因素。免疫失调,尤其是先天免疫反应的变化,与LLMD和AD的病理生理学均有关联。补体系统是先天免疫机制的关键组成部分,已知其在突触可塑性和认知功能中发挥重要作用。然而,其在LLMD中的作用尚不清楚。在本研究中,我们检测了老年抑郁症患者与健康对照者脑脊液(CSF)中补体成分3(C3,所有补体激活途径的汇聚点)的水平;以及CSF中C3水平与淀粉样β蛋白(Aβ42和Aβ40)、总tau蛋白(T-tau)、磷酸化tau蛋白(P-tau)和认知评分之间的关系。从50名认知功能正常的志愿者(重度抑郁症组,N = 30;对照组,N = 20)获取CSF,并通过酶联免疫吸附测定法(ELISA)分析C3水平。重度抑郁症组的C3水平相对于对照组略低。我们未发现C3与反映斑块病理的AD生物标志物Aβ42、与tau病理相关的P-tau或神经退行性变生物标志物T-tau之间存在任何显著关联。相反,C3与CSF Aβ40呈正相关,这可能反映了Aβ在脑血管壁中的沉积。在控制教育因素后,我们观察到抑郁症患者在Buschke选择性提醒测试(BSRT)中C3水平与记忆表现的总回忆得分呈负相关。关于LLMD患者C3状态的这一初步证据可能对我们理解重度抑郁症尤其是老年期重度抑郁症的病理生理学具有启示意义。