School of Educational Sciences, Ludong University, 246025 Yantai, Shandong, China; Correction Center, Shandong Women's Prison, 250013 Jinan, Shandong, China.
Student Affairs Office, North China Electric Power University, 071003 Baoding, Hebei, China.
Actas Esp Psiquiatr. 2024 Feb;52(1):1-9.
Depression has become one of the most common mood disorders in adolescents, with an increasing incidence each year. Abnormal activation of peripheral immunity causes an increase in pro-inflammatory factors, which in turn affects neuroendocrine dysfunction and alters neurobiochemistry, leading to depression. In this study, we aimed to explore the relationship between inflammatory immune function and intestinal flora in adolescents with first-episode depression.
A total of 170 cases of adolescent patients with first-episode depression who attended our hospital from January 2020 to March 2023 were retrospectively selected as the observation group. Simultaneously, 170 individuals who underwent a healthy physical examination during the same period were chosen as the control group. The enzyme-linked immunosorbent assay (ELISA) was employed to quantify the levels of monoamine neurotransmitters 5-hydroxytryptamine (5-HT), substance P (SP), neuropeptide Y (NPY), serum tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, and IL-6 in the patients. Flow cytometry was utilized to assess the levels of T-lymphocytes CD3+, CD4+, and CD8+ cells. The levels of 16S ribosomal RNA (16SrRNA) method were used to determine the intestinal flora of the subjects in both groups. Inflammatory factor levels, immune function, and intestinal flora expression were observed, and correlation analysis was performed.
The levels of 5-HT and NPY in the observation group were lower than those in the control group. The SP level was significantly higher in the observation group compared to the control group (p < 0.05). The observation group demonstrated significantly higher TNF-α, IL-1β, and IL-6 levels than the control group (p < 0.05). The values of CD3+, CD4+, CD4+/CD8+ in the observation group were lower than those in the control group (p < 0.05), whereas the CD8+ values were notably higher (p < 0.05). Bifidobacterium, Escherichia coli, Lactobacillus, and Bacteroides in the observation group were less than those in the control group (p < 0.05). The content of Bifidobacterium was negatively correlated with the level of TNF-α (r = -0.358, p < 0.001), positively correlated with the level of CD3+, CD4+, CD4+/CD8+ (r = 0.490, 0.169, 0.165, p < 0.05), and negatively correlated with the level of CD8+ (r = -0.154, p < 0.05). The level of Escherichia coli content was negatively correlated with the levels of IL-6, CD3+, CD4+, CD4+/CD8+ (r = -0.483, -0.548, -0.317, -0.328, p < 0.001), and positively correlated with the levels of CD8+ (r = 0.325, p < 0.001). The content of Lactobacillus was positively correlated with the levels of CD3+, CD4+, CD4+/CD8+ (r = 0.552, 0.188, 0.194, p < 0.05), and negatively correlated with the level of CD8+ (r = -0.186, p < 0.05). The content of Bacteroides was positively correlated with the level of CD3+, CD4+, CD4+/CD8+ (r = -0.570, -0.183, -0.193, p < 0.05), and negatively correlated with the level of CD8+ levels were positively correlated (r = 0.187, p < 0.05).
The intestinal flora is related to the level of inflammatory factors and immune function. Further study on the relationship between intestinal flora, inflammatory immune function, and depression could offer novel insights for the prevention and treatment of depressive disorders.
抑郁症已成为青少年中最常见的情绪障碍之一，每年的发病率都在上升。外周免疫异常激活导致促炎因子增加，进而影响神经内分泌功能，改变神经生化，导致抑郁。本研究旨在探讨青少年首发抑郁症患者炎症免疫功能与肠道菌群的关系。
回顾性选择 2020 年 1 月至 2023 年 3 月我院收治的 170 例青少年首发抑郁症患者为观察组，同时选择同期体检的 170 例个体为对照组。采用酶联免疫吸附试验（ELISA）定量检测患者 5-羟色胺（5-HT）、P 物质（SP）、神经肽 Y（NPY）、血清肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）和白细胞介素-6（IL-6）等单胺神经递质水平。采用流式细胞术检测 T 淋巴细胞 CD3+、CD4+和 CD8+细胞水平。采用 16S 核糖体 RNA（16SrRNA）方法检测两组受试者肠道菌群。观察炎症因子水平、免疫功能和肠道菌群表达，并进行相关性分析。
观察组 5-HT 和 NPY 水平低于对照组，SP 水平明显高于对照组（p<0.05）。观察组 TNF-α、IL-1β和 IL-6 水平明显高于对照组（p<0.05）。观察组 CD3+、CD4+、CD4+/CD8+值低于对照组（p<0.05），而 CD8+值明显升高（p<0.05）。观察组双歧杆菌、大肠杆菌、乳酸杆菌和拟杆菌均低于对照组（p<0.05）。双歧杆菌含量与 TNF-α水平呈负相关（r=-0.358，p<0.001），与 CD3+、CD4+、CD4+/CD8+水平呈正相关（r=0.490、0.169、0.165，p<0.05），与 CD8+水平呈负相关（r=-0.154，p<0.05）。大肠杆菌含量与 IL-6、CD3+、CD4+、CD4+/CD8+水平呈负相关（r=-0.483、-0.548、-0.317、-0.328，p<0.001），与 CD8+水平呈正相关（r=0.325，p<0.001）。乳酸杆菌含量与 CD3+、CD4+、CD4+/CD8+水平呈正相关（r=0.552、0.188、0.194，p<0.05），与 CD8+水平呈负相关（r=-0.186，p<0.05）。拟杆菌含量与 CD3+、CD4+、CD4+/CD8+水平呈正相关（r=-0.570、-0.183、-0.193，p<0.05），与 CD8+水平呈负相关（r=0.187，p<0.05）。
肠道菌群与炎症因子和免疫功能水平有关。进一步研究肠道菌群、炎症免疫功能与抑郁症的关系，可为抑郁症的预防和治疗提供新的思路。
