Department of Psychiatry and Behavioral Neurosciences, Loyola University Chicago, Stritch School of Medicine, Maywood, IL, USA.
Hemostasis and Thrombosis Research Laboratories, Loyola University Chicago, Stritch School of Medicine, Maywood, IL, USA.
Psychiatry Res. 2020 Feb;284:112781. doi: 10.1016/j.psychres.2020.112781. Epub 2020 Jan 11.
Vascular Endothelial Growth Factor (VEGF) has been implicated in the neurotrophic model of depression. We explored the potential role of VEGF in the pathophysiology of bipolar depression and potential utility as a diagnostic or outcome predictive biomarker.
In a double-blind study, treatment-resistant bipolar depressed patients received Escitalopram and were randomized to receive add-on Celecoxib (26 participants) or Placebo (21 participants). There were 32 healthy controls. Plasma levels of VEGF were determined at three timepoints over eight weeks.
Bipolar patients had significantly higher VEGF levels at baseline compared to healthy controls. Logistic regression analysis revealed that the AUC is 0.67 and the VEGF cut point is 8.21. At all timepoints, patients receiving Celecoxib had comparable VEGF levels to those receiving Placebo. VEGF levels did not change significantly over time. Baseline VEGF was a poor predictor of treatment response with an AUC of 0.53.
The increased VEGF in bipolar depression agrees with similar findings in major depressive disorder. A high VEGF level tended to accurately predict bipolar disorder, with apparent differential VEGF expression. Baseline VEGF did not predict treatment response, and levels did not change with treatment. Plasma VEGF may have diagnostic utility and guide personalized treatment.
血管内皮生长因子（VEGF）与抑郁症的神经营养模型有关。我们探讨了 VEGF 在双相抑郁症病理生理学中的潜在作用，以及作为诊断或预后预测生物标志物的潜在应用。
在一项双盲研究中，治疗抵抗性双相抑郁患者接受依西酞普兰治疗，并随机接受加用塞来昔布（26 名参与者）或安慰剂（21 名参与者）。共有 32 名健康对照者。在八周内的三个时间点测定血浆 VEGF 水平。
双相患者的 VEGF 水平在基线时明显高于健康对照组。逻辑回归分析显示，AUC 为 0.67，VEGF 切点为 8.21。在所有时间点，接受塞来昔布的患者的 VEGF 水平与接受安慰剂的患者相当。VEGF 水平随时间无显著变化。基线 VEGF 是治疗反应的不良预测因子，AUC 为 0.53。
双相抑郁症中 VEGF 的增加与重度抑郁症中的类似发现一致。高 VEGF 水平倾向于准确预测双相障碍，且 VEGF 表达存在明显差异。基线 VEGF 不能预测治疗反应，且治疗后水平不变。血浆 VEGF 可能具有诊断效用，并指导个体化治疗。
