Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy.
PhD program in Pharmacology and Toxicology, Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy.
Transl Psychiatry. 2022 Jul 11;12(1):274. doi: 10.1038/s41398-022-02035-4.
The serotonin-transporter-linked promoter region (5-HTTLPR) has been widely investigated as contributing to depression vulnerability. Nevertheless, empirical research provides wide contrasting findings regarding its involvement in the etiopathogenesis of the disorder. Our hypothesis was that such discrepancy can be explained considering time as moderating factor. We explored this hypothesis, exploiting a meta analytic approach. We searched PubMed, PsychoINFO, Scopus and EMBASE databases and 1096 studies were identified and screened, resulting in 22 studies to be included in the meta-analyses. The effect of the 5-HTTLPR x stress interaction on depression risk was found to be moderated by the following temporal factors: the duration of stress (i.e. chronic vs. acute) and the time interval between end of stress and assessment of depression (i.e. within 1 year vs. more than 1 year). When stratifying for the duration of stress, the effect of the 5-HTTLPR x stress interaction emerged only in the case of chronic stress, with a significant subgroup difference (p = 0.004). The stratification according to time interval revealed a significant interaction only for intervals within 1 year, though no difference between subgroups was found. The critical role of time interval clearly emerged when considering only chronic stress: a significant effect of the 5-HTTLPR and stress interaction was confirmed exclusively within 1 year and a significant subgroup difference was found (p = 0.01). These results show that the 5-HTTLPR x stress interaction is a dynamic process, producing different effects at different time points, and indirectly confirm that s-allele carriers are both at higher risk and more capable to recover from depression. Overall, these findings expand the current view of the interplay between 5-HTTLPR and stress adding the temporal dimension, that results in a three-way interaction: gene x environment x time.
5-羟色胺转运体启动子区域(5-HTTLPR)已被广泛研究为导致抑郁易感性的因素。然而,实证研究对于其在该疾病发病机制中的作用提供了广泛的对比结果。我们的假设是,考虑到时间作为调节因素,可以解释这种差异。我们利用元分析方法来探索这个假设。我们搜索了 PubMed、PsychoINFO、Scopus 和 EMBASE 数据库,确定并筛选了 1096 项研究,最终有 22 项研究被纳入元分析。5-HTTLPR x 应激相互作用对抑郁风险的影响被发现受到以下时间因素的调节:应激的持续时间(即慢性与急性)以及应激结束与抑郁评估之间的时间间隔(即 1 年内与 1 年以上)。当按应激持续时间分层时,只有在慢性应激的情况下,5-HTTLPR x 应激相互作用的效果才会出现,且具有显著的亚组差异(p=0.004)。根据时间间隔进行分层,仅在 1 年内观察到显著的相互作用,但亚组之间没有差异。当仅考虑慢性应激时,时间间隔的关键作用明显显现:5-HTTLPR 和应激相互作用的显著效应仅在 1 年内得到确认,且亚组之间存在显著差异(p=0.01)。这些结果表明,5-HTTLPR x 应激相互作用是一个动态过程,在不同时间点产生不同的效果,间接证实了 s 等位基因携带者在抑郁的易感性和恢复能力上都更高。总体而言,这些发现扩展了 5-HTTLPR 和应激之间相互作用的现有观点,增加了时间维度,从而产生了一个三因素相互作用:基因 x 环境 x 时间。