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度洛西汀对抑郁症患者血清促炎细胞因子水平变化的影响。

Effect of duloxetine on changes in serum proinflammatory cytokine levels in patients with major depressive disorder.

机构信息

Affiliated Psychological Hospital of Anhui Medical University, Hefei, China.

Department of Pharmacy, Hefei Fourth People's Hospital, Hefei, China.

出版信息

BMC Psychiatry. 2024 Jun 14;24(1):449. doi: 10.1186/s12888-024-05910-0.

Abstract

OBJECTIVE

Accumulating evidence supports the idea that inflammation may contribute to the pathophysiology of major depressive disorder (MDD). Duloxetine, a serotonin-norepinephrine reuptake inhibitor, exhibits anti-inflammatory effects both in vitro and in vivo. In this study, we investigated the impact of duloxetine on changes in serum proinflammatory cytokine levels among individuals diagnosed with MDD.

METHODS

A cohort of 23 drug-naïve individuals diagnosed with MDD and 23 healthy controls were included in this study. The severity of depressive symptoms was evaluated using the 24-item Hamilton Depression Scale (HAMD-24). A panel of 7 proinflammatory cytokines, including interleukin-1β (IL-1β), IL-2, IL-6, IL-8, IL-12, tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ), were quantified using multiplex Luminex assays. The levels of serum cytokines in healthy controls and patients with MDD were compared at baseline. All patients received duloxetine at a dosage range of 40-60 mg/day for a duration of 4 weeks. The HAMD-24 scores and serum cytokine levels were compared before and after duloxetine treatment.

RESULTS

Compared with healthy controls, patients with MDD had significantly greater levels of IL-2, IL-6, IL-8, IL-12, TNF-α, and IFN-γ (P < 0.05). Moreover, there was a significant decrease in HAMD-24 scores observed pre- and post-treatment (t = 13.161, P < 0.001). Furthermore, after 4 weeks of treatment, the serum levels of IL-8 (t = 3.605, P = 0.002), IL-12 (t = 2.559, P = 0.018), and IFN-γ (t = 3.567, P = 0.002) decreased significantly. However, there were no significant differences in other cytokines, including IL-1β, IL-2, IL-6, and TNF-α, before and after treatment (P > 0.05).

CONCLUSIONS

These findings present compelling evidence, potentially for the first time, indicating that duloxetine treatment may effectively reduce the serum concentrations of IL-8, IL-12, and IFN-γ in individuals diagnosed with MDD. However, the precise mechanisms underlying this effect remain unclear and warrant further investigation.

摘要

目的

越来越多的证据支持炎症可能导致重度抑郁症(MDD)的病理生理学这一观点。度洛西汀是一种 5-羟色胺和去甲肾上腺素再摄取抑制剂,在体外和体内均具有抗炎作用。本研究旨在探讨度洛西汀对 MDD 患者血清前炎性细胞因子水平变化的影响。

方法

本研究纳入了 23 名未经药物治疗的 MDD 患者和 23 名健康对照者。采用 24 项汉密尔顿抑郁量表(HAMD-24)评估抑郁症状严重程度。采用多重 Luminex 检测法检测白细胞介素-1β(IL-1β)、IL-2、IL-6、IL-8、IL-12、肿瘤坏死因子-α(TNF-α)和干扰素-γ(IFN-γ)等 7 种前炎性细胞因子的水平。比较健康对照组和 MDD 患者的基线血清细胞因子水平。所有患者均接受度洛西汀治疗,剂量范围为 40-60mg/天,疗程 4 周。比较度洛西汀治疗前后 HAMD-24 评分和血清细胞因子水平。

结果

与健康对照组相比,MDD 患者的 IL-2、IL-6、IL-8、IL-12、TNF-α和 IFN-γ水平显著升高(P<0.05)。此外,治疗前后 HAMD-24 评分均显著降低(t=13.161,P<0.001)。进一步分析发现,治疗 4 周后,血清 IL-8(t=3.605,P=0.002)、IL-12(t=2.559,P=0.018)和 IFN-γ(t=3.567,P=0.002)水平显著降低。然而,治疗前后其他细胞因子(包括 IL-1β、IL-2、IL-6 和 TNF-α)水平无显著差异(P>0.05)。

结论

这些发现首次提供了令人信服的证据,表明度洛西汀治疗可能有效降低 MDD 患者血清中 IL-8、IL-12 和 IFN-γ的浓度。然而,其确切机制尚不清楚,需要进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acdf/11179362/7424507e7c92/12888_2024_5910_Fig1_HTML.jpg

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