Wuxi School of Medicine, Jiangnan University, China.
Department of Hematology, Affiliated Hospital of Jiangnan University, China.
J Affect Disord. 2024 Oct 1;362:485-492. doi: 10.1016/j.jad.2024.07.037. Epub 2024 Jul 14.
Major depression (MD) is recurrent and devastating mental disease with a high worldwide prevalence. Mounting evidence suggests neuroinflammation triggers cellular immune dysregulation, characterized by increased proportions of circulating monocytes, and T helper 17 cells and proinflammatory cytokines, thereby increasing susceptibility to MD. However, there is ambiguity in the findings of clinical studies that investigate CD4 T regulatory (Treg) cells in MD.
The proportion of CD4 Treg cell from blood mononuclear cells was examined using flow cytometry in healthy controls (HCs: n = 96) and patients with first (FEMD: n = 62) or recurrent (RMD: n = 41) disease episodes of MD at baseline (T0; hospital admission) and after a two-week antidepressant treatment (T14). All participants underwent comprehensive neuropsychological assessments.
The initial scores on emotional assessments in patients with MD significantly differed from those of HCs. Both FEMD and RMD patients exhibited a significant decrease in CD4 Treg cell proportion at baseline compared to HCs. Treg cell proportion rose significantly from T0 to T14 in FEMD patients, who responded to antidepressant therapy, whereas no significant changes were observed in FEMD patients in non-response as well as RMD patients. The improvement of 24-item Hamilton Depression Scale was correlate with changes of Treg cell proportion from T0 to T14 in FEMD patients in response, and the change in Treg cell proportion over a 14-day period exhibited an AUC curve of 0.710.
A decrease in the proportion of CD4 Treg cells points towards immune system abnormalities in patients with MD. Furthermore, our finding suggests that the immune activation state varies across different stages of depression.
重度抑郁症（MD）是一种反复发作且具有破坏性的精神疾病，在全球范围内的发病率很高。越来越多的证据表明，神经炎症会引发细胞免疫失调，表现为循环单核细胞、辅助性 T 细胞 17 细胞和促炎细胞因子的比例增加，从而增加了患 MD 的易感性。然而，在研究 MD 中 CD4 调节性 T 细胞（Treg 细胞）的临床研究中，结果存在不确定性。
采用流式细胞术检测健康对照组（HCs：n=96）和首次（FEMD：n=62）或复发（RMD：n=41）MD 发作的患者在基线（T0；住院时）和两周抗抑郁治疗（T14）后血液单个核细胞中 CD4 Treg 细胞的比例。所有参与者均接受了全面的神经心理学评估。
MD 患者的情绪评估初始评分明显不同于 HCs。与 HCs 相比，FEMD 和 RMD 患者在基线时 CD4 Treg 细胞比例显著降低。FEMD 患者对抗抑郁治疗有反应，Treg 细胞比例从 T0 到 T14 显著升高，而 FEMD 患者无反应和 RMD 患者则没有明显变化。汉密尔顿抑郁量表 24 项评分的改善与 FEMD 患者中 Treg 细胞比例从 T0 到 T14 的变化相关，Treg 细胞比例在 14 天内的变化曲线下面积为 0.710。
CD4 Treg 细胞比例的降低表明 MD 患者的免疫系统异常。此外，我们的发现表明，免疫激活状态在抑郁症的不同阶段有所不同。
