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评估治疗前后重性抑郁障碍和双相情感障碍伴有抑郁发作患者的炎症标志物。

Evaluation of Inflammatory Markers in Patients with Depressed Episodes in Major Depressive Disorder and Bipolar Disorder before and after Treatment.

机构信息

Psychosomatic Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Molecular Immunology Research Center, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Iran J Allergy Asthma Immunol. 2023 Apr 30;22(2):200-207. doi: 10.18502/ijaai.v22i2.12681.

Abstract

Depression is one of the current dilemmas in both developed and developing societies. Studies show that the severity of psychiatric symptoms is directly related to the degree of inflammation caused by cytokines secreted by the immune system. Hence, evaluating serum cytokine levels in patients with depression can help to understand the pathogenesis of the disease and make the best therapeutic decisions. The present study investigated the levels of inflammatory cytokines, tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1), and interleukin-6 (IL-6) in patients with major depression or bipolar disorder during depressive episodes (BDDE) before and after a 6-month pharmaceutical intervention. Patients referring to 3 clinics were recruited for the study. The diagnosis of major depression or bipolar disorder in a depressive phase was made according to the Diagnostic and Statistical Manual of Mental Disorders -5(DSM-5) criteria. There was a significant difference in depression levels between the pre-intervention and 6-month follow-up in both groups. After 6 months, IL-1 and IL-6 levels in the bipolar disorder group had decreased while TNF-α levels had increased. There was also a significant difference between pre-intervention and follow-up levels of IL-1.  Serum levels of IL-1 and IL-6 decreased significantly in both groups after the 6-month follow-up, and symptom improvement was observed. TNF-α levels, on the other hand, decreased in the major depression group but increased in the bipolar disorder group. Considering that inflammation is a major outcome of depression, treatment strategies to reduce inflammation could be a practical approach to improving psychiatric symptoms.

摘要

抑郁症是发达国家和发展中国家当前共同面临的难题之一。研究表明,精神症状的严重程度与免疫系统分泌的细胞因子引起的炎症程度直接相关。因此,评估抑郁症患者的血清细胞因子水平有助于了解疾病的发病机制,并做出最佳的治疗决策。本研究调查了 6 个月药物干预前后处于抑郁发作期的重度抑郁症或双相情感障碍患者的炎症细胞因子水平,包括肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)和白细胞介素-6(IL-6)。招募了 3 家诊所的患者参与研究。根据《精神障碍诊断与统计手册-5(DSM-5)》标准诊断重度抑郁症或双相情感障碍在抑郁期的诊断。两组患者在干预前和 6 个月随访时的抑郁水平均有显著差异。6 个月后,双相情感障碍组的 IL-1 和 IL-6 水平下降,TNF-α水平升高。IL-1 的干预前和随访水平之间也有显著差异。两组患者在 6 个月随访后血清 IL-1 和 IL-6 水平显著下降,症状改善。TNF-α水平在重度抑郁症组下降,但在双相情感障碍组升高。鉴于炎症是抑郁症的主要后果之一,减少炎症的治疗策略可能是改善精神症状的一种实用方法。

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