Department of Psychiatry and Psychology, Hospital Clinic, Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Barcelona, Spain.
Hospital de día Córcega, Centre Psicoterapèutic Barcelona (CPB); and Department of Experimental and Health Sciences, Psychiatry Unit, Universitat Pompeu Fabra, Barcelona, Spain.
Int J Neuropsychopharmacol. 2022 Jun 21;25(6):468-478. doi: 10.1093/ijnp/pyac016.
The relationship between antidepressant response and glial, inflammatory, and metabolic markers is poorly understood in depression. This study assessed the ability of biological markers to predict antidepressant response in major depressive disorder (MDD).
We included 31 MDD outpatients treated with escitalopram or sertraline for 8 consecutive weeks. The Montgomery-Åsberg Depression Rating Scale (MADRS) was administered at baseline and at week 4 and 8 of treatment. Concomitantly, blood samples were collected for the determination of serum S100B, C-reactive protein (CRP), and high-density lipoprotein cholesterol (HDL)-C levels. Treatment response was defined as ≥50% improvement in the MADRS score from baseline to either week 4 or 8. Variables associated with treatment response were included in a linear regression model as predictors of treatment response.
Twenty-seven patients (87%) completed 8 weeks of treatment; 74% and 63% were responders at week 4 and 8, respectively. High S100B and low HDL-C levels at baseline were associated with better treatment response at both time points. Low CRP levels were correlated with better response at week 4. Multivariate analysis showed that high baseline S100B levels and low baseline HDL-C levels were good predictors of treatment response at week 4 (R2 = 0.457, P = .001), while S100B was at week 8 (R2 = 0.239, P = .011). Importantly, baseline S100B and HDL-C levels were not associated with depression severity and did not change over time with clinical improvement.
Serum S100B levels appear to be a useful biomarker of antidepressant response in MDD even when considering inflammatory and metabolic markers.
抗抑郁药反应与神经胶质、炎症和代谢标志物之间的关系在抑郁症中了解甚少。本研究评估了生物标志物预测重度抑郁症（MDD）抗抑郁反应的能力。
我们纳入了 31 名接受艾司西酞普兰或舍曲林治疗的 MDD 门诊患者，连续治疗 8 周。在基线和治疗第 4 周和第 8 周时使用蒙哥马利-Åsberg 抑郁评定量表（MADRS）进行评估。同时，采集血样以测定血清 S100B、C 反应蛋白（CRP）和高密度脂蛋白胆固醇（HDL-C）水平。治疗反应定义为 MADRS 评分从基线到第 4 周或第 8 周至少改善 50%。将与治疗反应相关的变量纳入线性回归模型，作为治疗反应的预测因子。
27 名患者（87%）完成了 8 周的治疗；分别有 74%和 63%的患者在第 4 周和第 8 周时为应答者。基线时 S100B 水平高和 HDL-C 水平低与两个时间点的更好治疗反应相关。基线时 CRP 水平低与第 4 周的更好反应相关。多变量分析表明，基线时 S100B 水平高和 HDL-C 水平低是第 4 周治疗反应的良好预测指标（R2=0.457，P=0.001），而 S100B 在第 8 周时（R2=0.239，P=0.011）。重要的是，基线 S100B 和 HDL-C 水平与抑郁严重程度无关，且随着临床改善而没有变化。
即使考虑炎症和代谢标志物，血清 S100B 水平似乎也是 MDD 抗抑郁反应的有用生物标志物。
