Department of Physiology and Pharmacology, Federal University of Santa Maria, 1000 Roraima Avenue, Building 21, Santa Maria, Rio Grande do Sul, Brazil.
Division of Neurology, University Hospital of Santa Maria, Santa Maria, Brazil.
Neurol Sci. 2022 Dec;43(12):6707-6717. doi: 10.1007/s10072-022-06363-7. Epub 2022 Aug 30.
Parkinson's disease (PD) patients experience non-motor symptoms (NMS), which may appear before motor manifestations. The most common NMS is depression, affecting about 30-40% of PD patients. Both PD and depression are associated with an increased inflammatory burden, with studies showing elevation of diverse inflammatory markers in patients with both conditions.
A systematic review was conducted in PubMed and PsycINFO databases to investigate what inflammatory markers are associated with PD depression (PDD). Only studies in English that measured inflammatory markers and analyzed against depression scores in PD patients were included.
A total of 1132 articles were retrieved, and 14 entries were found to be eligible. Twelve were cross-sectional studies, one was a cohort, and one was a non-randomized controlled trial. IL-17A was the only marker strongly associated with PDD, while studies assessing sIL-2R and serum amyloid A found a moderate correlation. C-reactive protein, IL-10, tumor necrosis factor-α, monocyte chemoattractant protein-1, and IL-6 yielded conflicting results. Their possible roles in PDD are discussed. PDD was also related to longer disease duration and other NMS, such as anxiety, fatigue, dementia, REM sleep behavior disorder, and autonomic dysfunction.
We suggest that these markers may be used for distinguishing isolated depression from that related to neurodegeneration, especially in individuals that concurrently present with other known prodromal symptoms of PD and other α-synucleinopathies. However, future prospective studies are warranted to confirm this hypothesis.
帕金森病（PD）患者会出现非运动症状（NMS），这些症状可能在运动表现之前出现。最常见的 NMS 是抑郁症，影响约 30-40%的 PD 患者。PD 和抑郁症都与炎症负担增加有关，研究表明，这两种疾病的患者体内多种炎症标志物水平升高。
在 PubMed 和 PsycINFO 数据库中进行了系统综述，以研究哪些炎症标志物与 PD 伴发的抑郁症（PDD）相关。仅纳入了测量炎症标志物并针对 PD 患者的抑郁评分进行分析的英文研究。
共检索到 1132 篇文章，有 14 项研究符合入选标准。其中 12 项为横断面研究，1 项为队列研究，1 项为非随机对照试验。IL-17A 是唯一与 PDD 强烈相关的标志物，而评估 sIL-2R 和血清淀粉样蛋白 A 的研究发现两者中度相关。C 反应蛋白、IL-10、肿瘤坏死因子-α、单核细胞趋化蛋白-1 和 IL-6 的结果存在矛盾。讨论了它们在 PDD 中的可能作用。PDD 还与疾病持续时间较长和其他 NMS 有关，如焦虑、疲劳、痴呆、快速眼动睡眠行为障碍和自主神经功能障碍。
我们认为这些标志物可用于区分与神经退行性变相关的孤立性抑郁症，特别是在同时存在其他已知 PD 前驱症状和其他 α-突触核蛋白病的个体中。然而，需要进一步的前瞻性研究来验证这一假设。
