外周血细胞因子可作为首发未用药的单相抑郁症患者自杀意念的潜在诊断生物标志物。
Peripheral blood cytokines as potential diagnostic biomarkers of suicidal ideation in patients with first-episode drug-naïve major depressive disorder.
机构信息
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China.
Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei, China.
出版信息
Front Public Health. 2022 Nov 7;10:1021309. doi: 10.3389/fpubh.2022.1021309. eCollection 2022.
OBJECTIVE
Major Depressive Disorder (MDD) is a leading cause of disability, with a high risk of suicidal ideation (SI). Few studies have evaluated the potential of multiple cytokines as biomarkers for SI in patients with MDD. In the present study, we examined the serum levels of multiple cytokines in patients with first-episode drug-naïve MDD, with the aim to discover and identify serum cytokines-based biomarkers for identification of SI in MDD.
METHODS
A total of 55 patients with first-episode drug-naïve MDD were enrolled and divided into two groups: 26 MDD patients without SI and 29 MDD patients with SI. Beck Scale for Suicide Ideation was used to estimate SI. A total of 37 cytokines were measured using Multiplex Luminex Assays. The levels of serum cytokines between MDD patients without SI and MDD patients with SI were compared and diagnostic values of different cytokines were evaluated using the receiver operating characteristic (ROC) curve method for discriminating MDD patients with SI from MDD patients without SI. The relationship between the group and the abnormal cytokines were investigated in multiple linear regression models, with adjustments for age, gender, BMI, smoking, and Hamilton Depression Rating Scale-24 (HAMD-24) scores.
RESULTS
The levels of CCL26 and VEGF in MDD patients with SI were significantly lower than those in MDD patients without SI (all < 0.05). On the contrary, the levels of IL-17C, CXCL10, and TNF-β in MDD patients with SI were significantly higher than those in MDD patients without SI (all < 0.05). Moreover, the results of multiple linear regression revealed that group was a significant independent predictor of serum IL-17C, CCL-26, VEGF, and TNF-β levels (all < 0.05). In terms of CXC10, group was also likely to be a significant independent predictor (β = 0.257, = 0.063). Furthermore, the AUC values of IL-17C and TNF-β were 0.728 and 0.732, respectively. Additionally, a combined panel of IL-17C and TNF-β achieved a high accuracy in discriminating MDD patients with SI from MDD patients without SI (AUC = 0.848, sensitivity = 75.9%, specificity = 72.7%).
CONCLUSIONS
These results suggested that circulating IL-17C and TNF-β may hold promise in the discovery of biomarkers for identification of SI in MDD.
目的
重度抑郁症（MDD）是导致残疾的主要原因之一，具有较高的自杀意念（SI）风险。很少有研究评估多种细胞因子作为 MDD 患者 SI 生物标志物的潜力。本研究旨在探讨初发未用药 MDD 患者血清中多种细胞因子的水平，以期发现并鉴定 MDD 患者 SI 的血清细胞因子生物标志物。
方法
共纳入 55 例初发未用药 MDD 患者，分为两组：26 例无 SI 的 MDD 患者和 29 例有 SI 的 MDD 患者。采用贝克自杀意念量表（Beck Scale for Suicide Ideation）评估 SI。采用多重 Luminex 检测法检测 37 种细胞因子。比较 MDD 患者无 SI 组和 MDD 患者有 SI 组之间的细胞因子水平，并采用受试者工作特征（ROC）曲线评估不同细胞因子对区分有 SI 的 MDD 患者和无 SI 的 MDD 患者的诊断价值。采用多元线性回归模型，在调整年龄、性别、BMI、吸烟和汉密尔顿抑郁量表-24 项（HAMD-24）评分后，对组与异常细胞因子之间的关系进行研究。
结果
MDD 患者有 SI 组的 CCL26 和 VEGF 水平明显低于无 SI 组（均<0.05）。相反，MDD 患者有 SI 组的 IL-17C、CXCL10 和 TNF-β水平明显高于无 SI 组（均<0.05）。此外，多元线性回归结果表明，组是血清 IL-17C、CCL-26、VEGF 和 TNF-β水平的显著独立预测因子（均<0.05）。对于 CXCL10，组也可能是一个显著的独立预测因子（β=0.257， =0.063）。此外，IL-17C 和 TNF-β的 AUC 值分别为 0.728 和 0.732。此外，IL-17C 和 TNF-β的联合检测在区分 MDD 患者有 SI 和无 SI 方面具有较高的准确性（AUC=0.848，敏感性=75.9%，特异性=72.7%）。
结论
这些结果表明，循环 IL-17C 和 TNF-β可能有望发现 MDD 患者 SI 识别的生物标志物。
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