Department of Psychiatry, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czechia,
Department of Psychiatry, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czechia.
Psychopathology. 2023;56(5):403-416. doi: 10.1159/000528907. Epub 2023 Feb 22.
The aim of this work was to summarize relationships between two subtypes of major depressive disorder (melancholic and atypical) and four core features of depression that reflect the domains identified consistently in previous studies of major depressive disorder endophenotypes (exaggerated reactivity to negative information, altered reward processing, cognitive control deficits, and somatic symptoms) on the one hand and selected peripheral inflammatory markers (C-reactive protein [CRP], cytokines, and adipokines) on the other.
A systematized review was conducted. The database used for searching articles was PubMed (MEDLINE).
According to our search, most peripheral immunological markers associated with major depressive disorder are not specific to a single depressive symptom group. The most evident examples are CRP, IL-6, and TNF-α. The strongest evidence supports the connection of peripheral inflammatory markers with somatic symptoms; weaker evidence indicates a role of immune changes in altered reward processing. The least amount of evidence was found for the role of peripheral inflammatory markers in exaggerated reactivity to negative information and cognitive control deficits. Regarding the depression subtypes, a tendency for higher CRP and adipokines was observed in atypical depression; increased IL-6 was found in melancholic depression.
Somatic symptoms of depression could be a manifestation of a specific immunological endophenotype of depressive disorder. Melancholic and atypical depression may be characterized by different profiles of immunological markers.
本研究旨在总结两种主要抑郁障碍亚型（忧郁型和非典型型）与反映抑郁障碍内表型（对负性信息反应过度、奖赏加工改变、认知控制缺陷和躯体症状）的四个核心特征之间的关系，同时也总结这些特征与选定外周炎症标志物（C 反应蛋白[CRP]、细胞因子和脂肪因子）之间的关系。
系统地进行了文献检索。用于检索文章的数据库是 PubMed（MEDLINE）。
根据我们的检索，大多数与主要抑郁障碍相关的外周免疫标志物并不特定于单一的抑郁症状组。最明显的例子是 CRP、IL-6 和 TNF-α。最有力的证据支持外周炎症标志物与躯体症状之间的联系；较弱的证据表明免疫变化在奖赏加工改变中起作用。关于外周炎症标志物在对负性信息反应过度和认知控制缺陷中的作用，证据最少。在抑郁障碍亚型方面，非典型抑郁患者的 CRP 和脂肪因子水平较高，而忧郁型抑郁患者的 IL-6 水平较高。
抑郁的躯体症状可能是抑郁障碍特定免疫内表型的表现。忧郁型和非典型抑郁可能表现出不同的免疫标志物特征。
