Academic Primary Health Care Centre, Region Stockholm, Solnavägen 1E, Box 45436, 10431, Stockholm, Sweden.
Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, 18288, Stockholm, Sweden.
Sci Rep. 2021 Jan 21;11(1):2009. doi: 10.1038/s41598-021-81453-8.
Patients with stress-induced exhaustion disorder (SED) demonstrate cognitive dysfunction similar to patients with minor traumatic brain injury (TBI). We have previously detected elevated concentrations of astrocyte-derived extracellular vesicles (EVs) in patients with TBI. As such, we hypothesized that astrocyte-derived EVs could be higher in patients with SED than in patients with major depressive disorder (MDD) and healthy controls. Patients with SED (n = 31), MDD (n = 31), and healthy matched controls (n = 61) were included. Astrocyte-derived EVs (previously known as microparticles) were measured in plasma with flow cytometry and labeled against glial fibrillary acidic protein (GFAP) and aquaporin 4 (AQP4). In addition, platelet EVs and their CD40 ligand expression were measured. Patients with SED had significantly higher concentrations of AQP4 and GFAP-positive EVs and EVs co-expressing AQP4/GFAP than patients with MDD and healthy controls. Patients with MDD had significantly higher concentrations of GFAP-positive EVs and EVs co-expressing AQP4/GFAP than healthy controls. Platelet EVs did not differ between groups. CD40 ligand expression was significantly higher in patients with SED and MDD than in controls. In conclusion, the present study suggests that patients with SED, and to some extent, patients with MDD, have increased leakage of astrocyte-derived EVs through the blood-brain barrier.
应激相关耗竭障碍（SED）患者表现出与轻度创伤性脑损伤（TBI）患者相似的认知功能障碍。我们之前在 TBI 患者中检测到星形胶质细胞衍生的细胞外囊泡（EVs）浓度升高。因此，我们假设 SED 患者的星形胶质细胞衍生 EVs 可能高于重度抑郁症（MDD）患者和健康对照者。纳入了 SED 患者（n=31）、MDD 患者（n=31）和健康匹配对照者（n=61）。采用流式细胞术检测血浆中的星形胶质细胞衍生 EVs（以前称为微颗粒），并用胶质纤维酸性蛋白（GFAP）和水通道蛋白 4（AQP4）对其进行标记。此外，还测量了血小板 EVs 及其 CD40 配体的表达。SED 患者的 AQP4 和 GFAP 阳性 EVs 以及共表达 AQP4/GFAP 的 EVs 浓度明显高于 MDD 患者和健康对照者。MDD 患者的 GFAP 阳性 EVs 和共表达 AQP4/GFAP 的 EVs 浓度明显高于健康对照者。各组间血小板 EVs 无差异。SED 和 MDD 患者的 CD40 配体表达明显高于对照组。总之，本研究表明 SED 患者，在一定程度上，MDD 患者的星形胶质细胞衍生 EVs 通过血脑屏障的渗漏增加。
