Mandal Sucharita, Spoorthy Mamidipalli Sai, Godi Sangha Mitra, Nanda Rachita, Mukherjee Bhaskar, Mishra Nihar Ranjan
Psychiatry, All India Institute of Medical Sciences, Kalyani, Kalyani, IND.
Psychiatry, All India Institute of Medical Sciences, Bibinagar, Bibinagar, IND.
Cureus. 2023 Aug 7;15(8):e43059. doi: 10.7759/cureus.43059. eCollection 2023 Aug.
Background Patients with major depressive disorder have varying response rates to treatment. Multiple factors such as non-adherence, comorbidity, chronic stressors, and biological factors may be responsible for this variation. Inflammatory (pro and anti) markers have been well studied as a cause for depression, predisposing factors, and a consequence of depression. Among these, interleukins (ILs), interferons, C-reactive protein (CRP), and tumor necrosis factor-alpha (TNF-α) have been studied repeatedly. We conducted a pilot study to assess the levels of these inflammatory markers in patients with major depressive disorder. The specific objectives of this study were to compare and correlate changes in pro- and anti-inflammatory markers throughout different phases of depression, including pretreatment and posttreatment periods, and to evaluate the pattern of pro- and anti-inflammatory markers in patients who experienced remission or showed a positive response to treatment. Methodology This was a prospective, clinic-based, cohort study done for a period of one and a half years. Patients aged 18-65 years with depressive disorder per the International Classification of Diseases Tenth Edition and who scored more than 7 on the Hamilton Depression Rating Scale were included in this study. A total of 81 patients were recruited who were followed up till eight weeks after inclusion. A total of 31 patients completed the eight weeks of follow-up. Levels of IL-10 and TNF-α were assessed at baseline, two weeks, four weeks, and eight weeks of follow-up. Results This study tried to compare the levels of pro- and anti-inflammatory markers across pretreatment and various posttreatment phases of depression. Results showed that the levels of pro-inflammatory cytokine TNF-α increased from baseline till eight weeks of follow-up, and levels of IL-10 decreased from baseline till eight weeks of follow-up. However, these changes were not statistically significant. Conclusions This study supports the hypothesis that inflammatory markers can be trait markers of depression rather than the consequence or result.
重度抑郁症患者对治疗的反应率各不相同。多种因素，如不依从、合并症、慢性应激源和生物学因素，可能导致这种差异。炎症（促炎和抗炎）标志物作为抑郁症的病因、易感因素和抑郁症的后果已得到充分研究。其中，白细胞介素（ILs）、干扰素、C反应蛋白（CRP）和肿瘤坏死因子-α（TNF-α）已被反复研究。我们进行了一项初步研究，以评估重度抑郁症患者这些炎症标志物的水平。本研究的具体目标是比较和关联抑郁症不同阶段（包括治疗前和治疗后时期）促炎和抗炎标志物的变化，并评估缓解或对治疗有积极反应的患者中促炎和抗炎标志物的模式。
这是一项前瞻性、基于临床的队列研究，为期一年半。纳入年龄在18 - 65岁、符合《国际疾病分类第十版》中抑郁症诊断标准且汉密尔顿抑郁量表评分超过7分的患者。共招募了81名患者，纳入后随访至8周。共有31名患者完成了8周的随访。在随访的基线、2周、4周和8周评估IL - 10和TNF - α的水平。
本研究试图比较抑郁症治疗前和治疗后各阶段促炎和抗炎标志物的水平。结果显示，促炎细胞因子TNF - α的水平从基线到随访8周升高，IL - 10的水平从基线到随访8周下降。然而，这些变化无统计学意义。
本研究支持以下假设，即炎症标志物可能是抑郁症的特质标志物，而非抑郁症的后果或结果。
