Gasparini, Callegari, Lucca, Bellini, Caselli, Ielmini, Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Varese, Italy.
Psychopharmacol Bull. 2022 Feb 25;52(1):36-52.
Inadequate response to antidepressant treatment, in a significant proportion of patients diagnosed with Major Depressive Disorder, contributes to the large burden of disability associated with the disease; thus, predicting treatment response is one of the most important challenge for clinicians who deal with depressed patients. The cytokine hypothesis of depression suggests that altered pheripheral cytokine levels are involved in the pathophysiology of depressive disorder and in modulating response to treatment. Present meta-analysis aimed to investigate the association between cytokine levels at baseline and response to antidepressant therapies. Authors performed a systematic search of PubMed and Embase databases for studies published between 2010 and January 2021: of 3345 identified records, 31 studies met the inclusion criteria for the qualitative synthesis, whereas 19 studies were eligible for quantitative analysis. Patients who failed to respond to antidepressant had aberrant inflammatory process, namely higher baseline levels of C-Reactive Protein and Interleukine-8, which is associated with treatment outcome in Major Depressive Disorder. Despite these promising results, further investigations are needed in order to replicate the data and to examine the potential role of inflammatory marker as a novel predictive tool for pharmacological treatment of depressive disorder.
在被诊断患有重度抑郁症的患者中，相当一部分患者对抗抑郁治疗的反应不足，这导致了与该疾病相关的巨大残疾负担；因此，预测治疗反应是处理抑郁症患者的临床医生面临的最重要挑战之一。抑郁症的细胞因子假说表明，外周细胞因子水平的改变与抑郁障碍的病理生理学和对治疗反应的调节有关。本荟萃分析旨在研究基线细胞因子水平与抗抑郁治疗反应之间的关系。作者对 2010 年至 2021 年 1 月期间发表的研究进行了 PubMed 和 Embase 数据库的系统检索：在 3345 条鉴定记录中，有 31 项研究符合定性综合的纳入标准，而有 19 项研究符合定量分析的纳入标准。未能对抗抑郁治疗产生反应的患者存在异常的炎症过程，即 C 反应蛋白和白细胞介素-8 的基线水平较高，这与重度抑郁症的治疗结果相关。尽管有这些有希望的结果，但仍需要进一步的研究来复制这些数据，并研究炎症标志物作为抑郁障碍药物治疗新的预测工具的潜在作用。
