Zheng Wei, Gu Li-Mei, Zhou Yan-Ling, Wang Cheng-Yu, Lan Xiao-Feng, Zhang Bin, Ning Yu-Ping
The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.
The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.
Front Psychiatry. 2022 Apr 25;13:855995. doi: 10.3389/fpsyt.2022.855995. eCollection 2022.
Accumulating evidence supports a role for vascular endothelial growth factor (VEGF) in the pathogenesis of depression, but its relationship with the antisuicidal effects of ketamine is not clear. Our objective was to determine whether there was an association between the plasma VEGF (pVEGF) concentrations and the antisuicidal response to serial ketamine infusions.
Six ketamine infusions (0.5 mg/kg) over a 12-day period were administered to sixty depressed individuals suffering from suicidal ideation. The Hamilton Depression Rating Scale (HAMD) suicide item, the Montgomery-Åsberg Depression Rating Scale (MADRS) suicide item, and the Beck Scale for Suicide Ideation (SSI-part I) were used to assess suicidal ideation at baseline, 1 day after the first infusion (day 1), 1 day following the last infusion (day 13), and again 2 weeks post-infusion (day 26). For this purpose, plasma was obtained at baseline, day 13 and 26.
The rates of antisuicidal response to ketamine were 61.7% (37/60), 81.7% (49/60), and 73.3% (44/60) at days 1, 13, and 26, respectively. The linear mixed model revealed significant time effects on suicidal ideation and pVEGF concentrations over time (all < 0.05). Antisuicidal responders did not have significantly altered pVEGF concentrations compared with non-responders on day 13 and day 26 (all > 0.05). No significant correlation was found between the baseline pVEGF concentration and suicidal ideation as measured by the SSI part 1, HAMD suicide item and MADRS suicide item on days 1, 13, and 26 (all > 0.05).
This preliminary finding does not support a role for VEGF in the antisuicidal effects of serial ketamine treatments in individuals with depression and suicidal ideation. Further research is needed to confirm and expand these findings.
越来越多的证据支持血管内皮生长因子（VEGF）在抑郁症发病机制中起作用，但其与氯胺酮抗自杀作用的关系尚不清楚。我们的目的是确定血浆VEGF（pVEGF）浓度与连续氯胺酮输注的抗自杀反应之间是否存在关联。
在12天内对60名有自杀意念的抑郁症患者进行6次氯胺酮输注（0.5mg/kg）。采用汉密尔顿抑郁量表（HAMD）自杀项目、蒙哥马利-阿斯伯格抑郁量表（MADRS）自杀项目和贝克自杀意念量表（SSI第一部分）在基线、首次输注后1天（第1天）、最后一次输注后1天（第13天）以及输注后2周（第26天）评估自杀意念。为此，在基线、第13天和第26天采集血浆。
在第1天、第13天和第26天，氯胺酮的抗自杀反应率分别为61.7%（37/60）、81.7%（49/60）和73.3%（44/60）。线性混合模型显示，随着时间的推移，自杀意念和pVEGF浓度有显著的时间效应（均P<0.05）。在第13天和第26天，与无反应者相比，抗自杀反应者的pVEGF浓度没有显著变化（均P>0.05）。在第1天、第13天和第26天，通过SSI第一部分、HAMD自杀项目和MADRS自杀项目测量，基线pVEGF浓度与自杀意念之间未发现显著相关性（均P>0.05）。
这一初步发现不支持VEGF在抑郁症和自杀意念患者连续氯胺酮治疗的抗自杀作用中发挥作用。需要进一步的研究来证实和扩展这些发现。
