Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany.
University Psychotherapeutic Outpatient Clinic, Institute of Psychology and Education, Ulm University, Ulm, Germany.
World J Biol Psychiatry. 2023 Jan;24(1):58-69. doi: 10.1080/15622975.2022.2070666. Epub 2022 May 9.
Major depressive disorder (MDD) involves peripheral low-grade pro-inflammatory activity. This multi-biomarker case-control study characterises the proinflammatory status in MDD beyond C-reactive protein (CRP) and Interleukin (IL)-6 levels through investigating concomitant alterations of immunoregulatory biomolecules.
In 20 female MDD patients and 24 non-depressed women, circulating levels of CRP, IL-6, cortisol, selected endocannabinoids (ECs; anandamide [AEA], 2-arachidonylglycerol [2-AG]), and -acylethanolamines (NAEs), as well as circulating cell-free mitochondrial DNA (ccf-mtDNA) were measured.
We found higher serum CRP and plasma AEA levels in MDD and a positive association of CRP and AEA levels with current depressive symptoms. Blood levels of cortisol, ccf-mtDNA, 2-AG, and NAEs did depend on MDD diagnosis nor correlated with the severity of current depressive symptoms. CRP correlated positively with AEA, and AEA showed positive associations with 2-AG and NAE levels.
In this study, female MDD outpatients with mild to moderate disorder severity did not substantially differ from non-depressed controls in the resting levels of multiple immunoregulatory markers in peripheral blood. Instead of investigating resting levels, future research on the role of inflammatory activity in MDD should focus on investigating the reactivity of pathways modulating the immune system upon exposure to physical and psychosocial stressors.
重度抑郁症（MDD）涉及外周低度炎症活性。本多生物标志物病例对照研究通过研究免疫调节生物分子的伴随变化，描述了 MDD 中除 C 反应蛋白（CRP）和白细胞介素（IL）-6 水平以外的促炎状态。
在 20 名女性 MDD 患者和 24 名非抑郁女性中，测量了循环 CRP、IL-6、皮质醇、选定的内源性大麻素（ECs；花生四烯酸乙醇胺[AEA]、2-花生四烯酰甘油[2-AG]）和 -酰基乙醇胺（NAEs）以及循环无细胞线粒体 DNA（ccf-mtDNA）的水平。
我们发现 MDD 患者血清 CRP 和血浆 AEA 水平升高，且 CRP 和 AEA 水平与当前抑郁症状呈正相关。皮质醇、ccf-mtDNA、2-AG 和 NAE 的血液水平既不依赖于 MDD 诊断，也与当前抑郁症状的严重程度无关。CRP 与 AEA 呈正相关，AEA 与 2-AG 和 NAE 水平呈正相关。
在这项研究中，轻度至中度疾病严重程度的女性 MDD 门诊患者在其外周血中多种免疫调节标志物的静息水平上与非抑郁对照组无明显差异。未来关于炎症活动在 MDD 中的作用的研究不应再调查静息水平，而应侧重于调查在暴露于生理和心理社会应激源时调节免疫系统的途径的反应性。
