Qiu Tian, Li Xiao, Chen Wanjun, He Jinglan, Shi Lei, Zhou Chenxi, Zheng Anhai, Lei Zhongli, Tang Chenglu, Yu Qingchan, Du Lian, Guo Jiamei
Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Psychiatry. 2023 Mar 15;14:1132791. doi: 10.3389/fpsyt.2023.1132791. eCollection 2023.
Inflammation and immune activation may play a role in the pathological mechanism of Major Depressive Disorder (MDD). Evidence from cross-sectional and longitudinal studies of adolescents and adults has shown that MDD is associated with increased plasma pro-inflammatory cytokines (e.g., IL-1β, IL-6). It has been reported that Specialized Pro-resolving Mediators (SPMs) mediate inflammation resolution, and Maresin-1 can activate the process of inflammation and promote inflammation resolution by promoting macrophage phagocytosis. However, no clinical studies have been conducted to evaluate the relationship between the levels of Maresin-1 and cytokine and the severity of MDD symptomatology in adolescents.
40 untreated adolescent patients with primary and moderate to severe MDD and 30 healthy participants as the healthy control (HC) group aged between 13 and 18 years old were enrolled. They received clinical and Hamilton Depression Rating Scale (HDRS-17) evaluation and then, blood samples were collected. Patients in the MDD group were re-evaluated for HDRS-17, and blood samples were taken after a six to eight-week fluoxetine treatment.
The adolescent patients with MDD had lower serum levels of Maresin-1 and higher serum levels of interleukin 6 (IL-6) compared with the HC group. Fluoxetine treatment alleviated depressive symptoms in MDD adolescent patients, which was reflected by higher serum levels of Maresin-1 and IL-4 and lower HDRS-17 scores, serum levels of IL-6, and IL-1β. Moreover, the serum level of Maresin-1 was negatively correlated with the depression severity scores on the HDRS-17.
Adolescent patients with primary MDD had lower levels of Maresin-1 and higher levels of IL-6 compared with the HC group, implying that the peripheral level of pro-inflammatory cytokines may be elevated in MDD, resulting in the insufficiency of inflammation resolution. The Maresin-1 and IL-4 levels increased after anti-depressant treatment, whereas IL-6 and IL-1β levels decreased significantly. Moreover, Maresin-1 level negatively correlated with depression severity, suggesting that reduced levels of Maresin-1 promoted the progression of MDD.
炎症和免疫激活可能在重度抑郁症（MDD）的病理机制中起作用。来自青少年和成年人横断面及纵向研究的证据表明，MDD与血浆促炎细胞因子（如IL-1β、IL-6）水平升高有关。据报道，特异性促消退介质（SPM）介导炎症消退，而maresin-1可激活炎症过程并通过促进巨噬细胞吞噬作用促进炎症消退。然而，尚未进行临床研究来评估青少年中maresin-1水平与细胞因子及MDD症状严重程度之间的关系。
招募40名未接受治疗的原发性中重度MDD青少年患者和30名健康参与者作为健康对照组（HC），年龄在13至18岁之间。他们接受了临床和汉密尔顿抑郁量表（HDRS-17）评估，然后采集血样。MDD组患者再次接受HDRS-17评估，并在接受六至八周氟西汀治疗后采集血样。
与HC组相比，患有MDD的青少年患者血清maresin-1水平较低，白细胞介素6（IL-6）血清水平较高。氟西汀治疗缓解了MDD青少年患者的抑郁症状，这表现为血清maresin-1和IL-4水平升高，HDRS-17评分、IL-6和IL-1β血清水平降低。此外，maresin-1血清水平与HDRS-17上的抑郁严重程度评分呈负相关。
与HC组相比，原发性MDD青少年患者的maresin-1水平较低，IL-6水平较高，这意味着MDD中促炎细胞因子的外周水平可能升高，导致炎症消退不足。抗抑郁治疗后maresin-1和IL-4水平升高，而IL-6和IL-1β水平显著降低。此外，maresin-1水平与抑郁严重程度呈负相关，表明maresin-1水平降低促进了MDD的进展。
