Department of Neurology and Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States.
Department of Psychiatry, University of Utah, Salt Lake City, UT, United States.
Psychoneuroendocrinology. 2020 Apr;114:104609. doi: 10.1016/j.psyneuen.2020.104609. Epub 2020 Feb 7.
In major depressive disorder (MDD) and remitted MDD (rMDD) alterations in cortisol and inflammation are associated with cognitive difficulties, but these relationships have not been investigated in HIV. We used secondary data from a placebo-controlled, cross-over study of cognitive performance following a probe of the hypothalamic-pituitary-adrenal (HPA) axis (low dose hydrocortisone; LDH 10 mg) in 65 people with HIV (PWH; 36 women). Using placebo data, we examined sex-specific associations between two biomarkers - basal afternoon salivary cortisol and salivary inflammatory cytokines - cognition, and rMDD. Salivary cortisol and inflammatory biomarkers were sampled across the 5 -h study. The panel of inflammatory markers included interleukin (IL)-6, IL-8, IL-1β, tumor necrosis factor-(TNF)-α, CRP, interferon gamma-induced protein (IP-10), monocyte chemotactic protein (MCP)-1, monokine induced by interferon (MIG), matrix metalloproteinase MMP-9, and MMP-1. Learning, memory, attention/concentration, and executive function were assessed 30 min and 4 h after the placebo intervention; visuospatial ability was also assessed 30 min after the placebo intervention. For women but not men with HIV, basal cortisol concentrations were higher in rMDD versus noMDD groups, and related to poorer learning and memory. For men and women with HIV, basal inflammatory cytokines were higher in rMDD versus noMDD groups, but were negatively related to cognition independent of rMDD status. Cortisol and cytokines relate to cognition in PWH, but the associations depended on sex, rMDD status, and their interaction.
在重度抑郁症（MDD）和缓解期 MDD（rMDD）中，皮质醇和炎症的改变与认知困难有关，但这些关系尚未在 HIV 中得到研究。我们使用了一项针对下丘脑-垂体-肾上腺（HPA）轴的皮质醇探测（低剂量氢化可的松；LDH 10mg）后认知表现的安慰剂对照、交叉研究的次要数据，该研究纳入了 65 名 HIV 感染者（PWH；36 名女性）。使用安慰剂数据，我们检查了两个生物标志物（基础下午唾液皮质醇和唾液炎症细胞因子）与认知和 rMDD 之间的性别特异性关联。在 5 小时的研究中采集了唾液皮质醇和炎症生物标志物样本。炎症标志物包括白细胞介素（IL）-6、IL-8、IL-1β、肿瘤坏死因子-α（TNF-α）、C 反应蛋白（CRP）、干扰素 γ 诱导蛋白（IP-10）、单核细胞趋化蛋白（MCP）-1、干扰素诱导的单核细胞趋化蛋白（MIG）、基质金属蛋白酶 MMP-9 和 MMP-1。学习、记忆、注意力/注意力集中和执行功能在安慰剂干预后 30 分钟和 4 小时进行评估；在安慰剂干预后 30 分钟还评估了视觉空间能力。对于 HIV 女性而非男性，rMDD 组的基础皮质醇浓度高于非 MDD 组，且与学习和记忆较差有关。对于 HIV 男性和女性，rMDD 组的基础炎症细胞因子高于非 MDD 组，但与认知有关，而与 rMDD 状态无关。皮质醇和细胞因子与 PWH 的认知有关，但关联取决于性别、rMDD 状态及其相互作用。
