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造血细胞移植后炎症细胞因子与抑郁症状。

Inflammatory cytokines and depression symptoms following hematopoietic cell transplantation.

机构信息

Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, Boston, MA, USA.

Department of Pediatrics, Division of Pediatric Cardiology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.

出版信息

Brain Behav Immun. 2023 Aug;112:11-17. doi: 10.1016/j.bbi.2023.05.012. Epub 2023 May 25.

Abstract

Increased synthesis and release of inflammatory signalling proteins is common among individuals with hematologic malignancies undergoing hematopoietic cell transplantation (HCT) due to intensive conditioning regimens and complications such as graft-versus-host-disease and infections. Prior research indicates that inflammatory responses can activate central nervous system pathways that evoke changes in mood. This study examined relationships between markers of inflammatory activity and depression symptoms following HCT. Individuals undergoing allogeneic (n = 84) and autologous (n = 155) HCT completed measures of depression symptoms pre-HCT and 1, 3, and 6 months post-HCT. Proinflammatory (IL-6, TNF-α) and regulatory (IL-10) cytokines were assessed by ELISA in peripheral blood plasma. Mixed-effects linear regression models indicated that patients with elevated IL-6 and IL-10 reported more severe depression symptoms at the post-HCT assessments. These findings were replicated when examining both allogeneic and autologous samples. Follow-up analyses clarified that relationships were strongest for neurovegetative, rather than cognitive or affective, symptoms of depression. These findings suggest that anti-inflammatory therapeutics targeting an inflammatory mediator of depression could improve quality of life of HCT recipients.

摘要

由于强化的预处理方案以及移植物抗宿主病和感染等并发症,正在接受造血细胞移植(HCT)的血液系统恶性肿瘤患者的炎症信号蛋白的合成和释放增加。先前的研究表明,炎症反应可以激活中枢神经系统途径,引发情绪变化。本研究调查了 HCT 后炎症活动标志物与抑郁症状之间的关系。正在接受异基因(n=84)和自体(n=155)HCT 的个体在 HCT 前和 HCT 后 1、3 和 6 个月完成了抑郁症状的测量。通过 ELISA 在外周血血浆中评估促炎(IL-6、TNF-α)和调节(IL-10)细胞因子。混合效应线性回归模型表明,IL-6 和 IL-10 升高的患者在 HCT 后评估时报告了更严重的抑郁症状。当同时检查异基因和自体样本时,发现了同样的结果。随访分析表明,与认知或情感症状相比,与神经植物性症状的相关性最强。这些发现表明,针对抑郁的炎症介质的抗炎治疗可能会改善 HCT 受者的生活质量。

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What else do I need to worry about when treating graft-versus-host disease?在治疗移植物抗宿主病时,我还需要担心什么?
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