Schmitt Junior Antonio Augusto, Primo de Carvalho Alves Lucas, Padilha Barbara Larissa, da Rocha Neusa Sica
Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
Center for Clinical Research, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.
Ther Adv Psychopharmacol. 2023 Feb 16;13:20451253221135463. doi: 10.1177/20451253221135463. eCollection 2023.
There is increasing evidence of the association between chronic low-grade inflammation and severe mental illness (SMI). The objective of our study was to assess serum cytokine levels (SCLs) at admission and discharge in a true-to-life-setting population of inpatients with major depression (MD), bipolar disorder (BD), and schizophrenia (Sz), as well as of healthy controls.
We considered MD, BD, and Sz to be SMIs. We evaluated 206 inpatients [MD, = 92; BD, = 26; mania (Ma), = 44; Sz, = 44). Generalized estimating equations were used to analyze variations in SCL [interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), interleukin (IL)-2, IL-4, IL-6, IL-10, and IL-17] at hospital admission and discharge. Results of 100 healthy controls were compared with those of SMI patients at both time points. We evaluated patients' improvement during in-hospital treatment in terms of general psychiatric symptoms, global clinical impression, functionality, and manic and depressive symptoms with validated scales.
In all, 68.9% of patients completed the study. Overall, SMI inpatients had higher SCL when compared with controls regardless of diagnosis. There was a significant decrease in Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression-Severity Scale (CGI-S) scores, and an increase in Global Assessment of Functioning (GAF) scores for all disorders evaluated ( < 0.001), as well as a significant decrease in HDRS-17 scores among MD inpatients ( < 0.001) and in YMRS scores among Ma inpatients ( < 0.001). IL-2 and IL-6 levels decreased significantly between admission and discharge only among MD inpatients ( = 0.002 and = 0.03, respectively). We found no further statistically significant changes in SCL among the remaining disorders (BD, Ma, and Sz). There was no significant decrease in IFN-γ ( = 0.64), TNF-α ( = 0.87), IL-4 ( = 0.21), IL-10 ( = 0.88), and IL-17 ( = 0.71) levels in any of the evaluated diagnoses.
MD inpatients had a decrease in IL-2 and IL-6 levels during hospitalization, which was accompanied by clinical improvement. No associations were found for the remaining SMIs (BD, Ma, and Sz).
越来越多的证据表明慢性低度炎症与严重精神疾病（SMI）之间存在关联。我们研究的目的是评估在现实环境中，重度抑郁症（MD）、双相情感障碍（BD）、精神分裂症（Sz）住院患者以及健康对照者入院时和出院时的血清细胞因子水平（SCL）。
我们将MD、BD和Sz视为SMI。我们评估了206名住院患者[MD，=92；BD，=26；躁狂症（Ma），=44；Sz，=44]。使用广义估计方程分析入院时和出院时SCL[干扰素γ（IFN-γ）、肿瘤坏死因子α（TNF-α）、白细胞介素（IL）-2、IL-4、IL-6、IL-10和IL-17]的变化。在两个时间点将100名健康对照者的结果与SMI患者的结果进行比较。我们使用经过验证的量表从一般精神症状、整体临床印象、功能以及躁狂和抑郁症状方面评估患者在住院治疗期间的改善情况。
共有68.9%的患者完成了研究。总体而言，无论诊断如何，SMI住院患者的SCL均高于对照组。所有评估的疾病的简明精神病评定量表（BPRS）和临床总体印象严重程度量表（CGI-S）得分均显著降低，功能总体评定量表（GAF）得分升高（<0.001），MD住院患者的汉密尔顿抑郁量表-17项（HDRS-17）得分显著降低（<0.001），Ma住院患者的杨氏躁狂量表（YMRS）得分显著降低（<0.001）。仅MD住院患者入院时和出院时的IL-2和IL-6水平显著降低（分别为=0.002和=0.03）。我们发现其余疾病（BD、Ma和Sz）的SCL没有进一步的统计学显著变化。在任何评估的诊断中，IFN-γ（=0.64）、TNF-α（=0.87）、IL-4（=0.21）、IL-10（=0.88）和IL-17（=0.71）水平均无显著降低。
MD住院患者在住院期间IL-2和IL-6水平降低，同时伴有临床改善。其余SMI（BD、Ma和Sz）未发现相关性。
