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成年逆境与重性抑郁障碍中促炎表型:与抑郁的社会信号转导理论一致。

Proinflammatory phenotype in major depressive disorder with adulthood adversity: In line with social signal transduction theory of depression.

机构信息

Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China; Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, China.

Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.

出版信息

J Affect Disord. 2023 Nov 15;341:275-282. doi: 10.1016/j.jad.2023.08.104. Epub 2023 Aug 30.

Abstract

BACKGROUND

The social signal transduction theory of depression proposes that life stress can be transformed into inflammatory signals, and ultimately lead to the development of major depressive disorder (MDD). The hypotheses of this study were: (1) The pro-inflammatory effect of life stress was only seen in patients with MDD, but not in healthy controls (HCs); (2) Inflammation can mediate the relationship between life stress and depressive symptoms.

METHODS

This study included 170 MDD patients and 196 HCs, and 13 immune-inflammatory biomarkers closely related to MDD were measured, principal component analysis (PCA) was adopted to extract the inflammatory index. Life stress was assessed by Life Event Scale (LES), a total score of >32 points on the LES was considered as adulthood adversity (AA). Path analyses were used to explore the relationship among adulthood stress, inflammatory index, and severity of depression.

RESULTS

Among MDD patients, α2M, CXCL-1, IL-1β, and TLR-1 levels were higher in patients with AA than non-AA group (all FDR-adjusted P values <0.05), meanwhile, the levels of CCL-2 and IL-18 were lower. Path analyses suggested that pro- and anti-inflammatory index could mediate the association between AA and severity of depression in MDD patients.

CONCLUSION

This study found that inflammatory signals can mediate the relationship between adulthood adversity and depression, however, the causal relationship need to be further confirmed. These findings shed light on further understanding the theory of social signal transduction in MDD and provide clues for stress management and controlling inflammation strategies in depression.

CLINICAL TRIALS

NCT02023567.

摘要

背景

抑郁症的社会信号转导理论提出,生活应激可以转化为炎症信号,并最终导致重性抑郁障碍(MDD)的发生。本研究提出以下假设:(1)生活应激的促炎作用仅见于 MDD 患者,而不见于健康对照(HC);(2)炎症可以介导生活应激与抑郁症状之间的关系。

方法

本研究纳入了 170 例 MDD 患者和 196 例 HCs,检测了 13 种与 MDD 密切相关的免疫炎症生物标志物,采用主成分分析(PCA)提取炎症指标。采用生活事件量表(LES)评估生活应激,LES 总分>32 分被认为是成年逆境(AA)。采用路径分析探讨成年应激、炎症指标与抑郁严重程度之间的关系。

结果

在 MDD 患者中,AA 患者的 α2M、CXCL-1、IL-1β 和 TLR-1 水平高于非 AA 患者(均经 FDR 调整 P 值<0.05),而 CCL-2 和 IL-18 水平较低。路径分析提示促炎和抗炎指数可以介导 AA 与 MDD 患者抑郁严重程度之间的关系。

结论

本研究发现炎症信号可以介导成年逆境与抑郁之间的关系,但需要进一步确认因果关系。这些发现为进一步理解 MDD 中的社会信号转导理论提供了线索,并为抑郁的应激管理和控制炎症策略提供了依据。

临床试验

NCT02023567。

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