Zengil Sertaç, Laloğlu Esra
Department of Psychiatry, University of Health Sciences Erzurum Faculty of Medicine, Erzurum, Türkiye.
Department of Medical Biochemistry, Ataturk University Faculty of Medicine, Erzurum, Türkiye.
Front Psychiatry. 2024 Jul 23;15:1395235. doi: 10.3389/fpsyt.2024.1395235. eCollection 2024.
The aim of this study is to determine whether the levels of zonulin and occludin, tight junctions (TJ) proteins in the intestinal epithelium, will differ between obsessive compulsive disorder (OCD) patients and healthy controls. We also intended to investigate whether these would vary in OCD patients with and without major depressive disorder (MDD) comorbidity and in comparison with healthy controls.
Sixty patients diagnosed with OCD and 30 healthy controls were included in the study. The cases were administered the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Hamilton Depression Rating Scale (HDRS). The patients were divided into two subgroups based on their HDRS scores and presence of MDD comorbidity. Zonulin and occludin levels were measured using the ELISA method. The research was carried out between April 2021 and October 2021.
Zonulin and occludin levels were significantly higher in the OCD patient group than in the control group (p<0.001). The levels of both were also significantly higher in the OCD patients with MDD comorbidity (OCD+MDD) compared to those without MDD (OCD-MDD) (p<0.001). Zonulin and occludin levels also rose significantly as disease severity increased in the OCD patient group (respectively; p<0.001, p=0.001). The levels of both increased in line with the severity of depression based on HDRS scores in the OCD+MDD group (p<0.001). A positive correlation was determined between the duration of OCD and zonulin and occludin levels. Evaluation of the entire OCD group revealed a moderate positive correlation between Y-BOCS and HDRS scores and zonulin and occludin.
Zonulin and occludin levels in this research were significantly higher in the patients with OCD than in the healthy controls. That elevation was positively correlated with disease duration and severity, and the increase was significantly more pronounced in OCD with MDD comorbidity. These findings point to a possible disorder in the intestinal barrier and blood-brain barrier in OCD patients.
本研究旨在确定强迫症（OCD）患者与健康对照者之间，肠道上皮紧密连接（TJ）蛋白zonulin和occludin的水平是否存在差异。我们还打算研究这些蛋白在合并和未合并重度抑郁症（MDD）的OCD患者中与健康对照相比是否会有所不同。
本研究纳入了60例诊断为OCD的患者和30名健康对照者。对病例进行耶鲁-布朗强迫症量表（Y-BOCS）和汉密尔顿抑郁量表（HDRS）评估。根据HDRS评分和MDD合并症的存在情况，将患者分为两个亚组。采用ELISA法测量zonulin和occludin水平。研究于2021年4月至2021年10月进行。
OCD患者组的zonulin和occludin水平显著高于对照组（p<0.001）。与未合并MDD的OCD患者（OCD-MDD）相比，合并MDD的OCD患者（OCD+MDD）中两者水平也显著更高（p<0.001）。在OCD患者组中，随着疾病严重程度增加，zonulin和occludin水平也显著升高（分别为p<0.001，p=0.001）。在OCD+MDD组中，基于HDRS评分，两者水平随着抑郁严重程度增加而升高（p<0.001）。确定OCD病程与zonulin和occludin水平之间存在正相关。对整个OCD组的评估显示，Y-BOCS和HDRS评分与zonulin和occludin之间存在中度正相关。
本研究中，OCD患者的zonulin和occludin水平显著高于健康对照者。这种升高与疾病持续时间和严重程度呈正相关，并且在合并MDD的OCD患者中升高更为明显。这些发现表明OCD患者的肠道屏障和血脑屏障可能存在紊乱。
