Biological and Precision Psychiatry, Copenhagen Research Centre for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark; Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Biological and Precision Psychiatry, Copenhagen Research Centre for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.
Biol Psychiatry. 2022 Oct 1;92(7):563-572. doi: 10.1016/j.biopsych.2022.04.002. Epub 2022 Apr 10.
Neuroinflammation has been linked to depression; however, neuroinflammatory biomarkers in the cerebrospinal fluid (CSF) have not previously been thoroughly investigated in a large group of patients with recent-onset depression compared with healthy control subjects.
We conducted an individually matched case-control study comparing patients with recent-onset depression (ICD-10: F32) to control subjects. Primary outcomes were CSF white cell count (WCC), CSF-to-serum albumin ratio, CSF total protein, and immunoglobulin G (IgG) index. Secondary outcomes were CSF WCC differential count and CSF neutrophil-to-lymphocyte, CSF-to-serum IgG, and CSF-to-plasma glucose ratios. Linear models adjusting for sex and age were applied.
We included 106 patients with recent-onset depression (84.0% outpatients) and 106 healthy control subjects. Patients had 18% higher CSF WCC relative to control subjects (relative mean difference [MD]: 1.18; 95% CI: 1.02-1.40; p = .025). CSF WCC differed with depression symptomatology (p = .034), and patients with severe depression (n = 29) had 43% higher CSF WCC relative to control subjects (MD: 1.43; 95% CI: 1.13-1.80, p = .003). Two (1.9%) patients and no controls (0.0%) had CSF WCC above the normal range (>5 × 10/L). No significant differences between groups were observed regarding CSF-to-serum albumin ratio (MD: 1.07; 95% CI: 0.97-1.18; p = .191), CSF total protein (MD: 1.01; 95% CI: 0.94-1.09; p = .775), or IgG index (MD: 1.05; 95% CI: 0.97-1.15; p = .235). Regarding secondary outcomes, the proportion of CSF neutrophils was lower among patients (MD: 0.22; 95% CI: 0.08-0.59; p = .003) relative to control subjects, whereas the remaining outcomes were not significantly different (all p > .06).
Patients had higher CSF WCC relative to control subjects, indicating increased neuroimmunologic activation, particularly for severe depression.
神经炎症与抑郁症有关；然而，与健康对照组相比，以前在大量新发抑郁症患者中并未全面研究脑脊液（CSF）中的神经炎症生物标志物。
我们进行了一项个体匹配的病例对照研究，比较了新发抑郁症患者（ICD-10：F32）与对照组。主要结局为脑脊液白细胞计数（WCC）、CSF 与血清白蛋白比值、CSF 总蛋白和免疫球蛋白 G（IgG）指数。次要结局为 CSF WCC 差异计数和 CSF 中性粒细胞与淋巴细胞、CSF 与血清 IgG 以及 CSF 与血浆葡萄糖比值。应用调整性别和年龄的线性模型。
我们纳入了 106 例新发抑郁症患者（84.0%为门诊患者）和 106 名健康对照组。与对照组相比，患者 CSF WCC 高 18%（相对平均差异[MD]：1.18；95%CI：1.02-1.40；p=0.025）。CSF WCC 与抑郁症状学有关（p=0.034），重度抑郁患者（n=29）与对照组相比 CSF WCC 高 43%（MD：1.43；95%CI：1.13-1.80，p=0.003）。有 2 名（1.9%）患者和没有对照组（0.0%）的 CSF WCC 超过正常范围（>5×10/L）。两组间 CSF 与血清白蛋白比值（MD：1.07；95%CI：0.97-1.18；p=0.191）、CSF 总蛋白（MD：1.01；95%CI：0.94-1.09；p=0.775）或 IgG 指数（MD：1.05；95%CI：0.97-1.15；p=0.235）无显著差异。关于次要结局，与对照组相比，患者 CSF 中的中性粒细胞比例较低（MD：0.22；95%CI：0.08-0.59；p=0.003），而其余结局无显著差异（所有 p>0.06）。
与对照组相比，患者 CSF WCC 较高，表明神经免疫激活增加，尤其是重度抑郁症患者。
