Zhang Yang, He Yihui, Fang Yuan, Cai Miaotian, Sun Guangqiang, Wang Rui, Zhen Jiaxin, Zhang Yulin, Li Zhen, Ma Yundong, Zhang Tong
Center for Infectious Disease, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Beijing Institute for Sexually Transmitted Disease Control, Beijing, China.
Front Psychiatry. 2025 Jan 20;15:1438085. doi: 10.3389/fpsyt.2024.1438085. eCollection 2024.
Depressive disorders are highly prevalent among people with HIV (PWH) and are related to aberrant inflammation and immune responses. However, there is currently a lack of investigation into the neurological, inflammatory, endocrine, and immune aspects of HIV-associated depressive disorders (HADD).
The study involved 33 HIV-positive men who have sex with men with depressive disorders (HADD group) and 47 without neuropsychiatric disorders (HIV control group). Participants underwent resting-state functional magnetic resonance imaging (rs-fMRI) scans and assessments of peripheral blood. Peripheral blood cytokines, plasma concentrations of hormone and neurotrophic factors, and immune cell levels were determined using liquid chip, enzyme-linked immunosorbent assay, and flow cytometry, respectively. The correlation of imaging alterations with clinical variables and peripheral blood indicators was assessed.
Compared to the HIV control group, the HADD group exhibited a higher fractional amplitude of low-frequency fluctuations in the left superior parietal gyrus, lower regional homogeneity in the left precentral gyrus, and reduced voxel-wise functional connectivity for the seed region in the right precentral gyrus with clusters in the right cuneus, etc. Furthermore, the HADD group had higher levels of interferon-gamma, a higher frequency of non-classical monocytes, and higher expression levels of perforin and CD38 on specific cells. These imaging results were significantly correlated with peripheral blood indicators and clinical variables.
This rs-fMRI study provides considerable evidence for abnormal intrinsic brain activity in people with HADD. Furthermore, our data also indicate the detrimental effects of depression-related inflammation on PWH. Therefore, it is imperative to increase attention to HADD and implement effective preventive interventions accordingly.
抑郁症在艾滋病毒感染者(PWH)中极为普遍,且与异常炎症和免疫反应有关。然而,目前对于与艾滋病毒相关的抑郁症(HADD)的神经、炎症、内分泌和免疫方面缺乏研究。
该研究纳入了33名患有抑郁症的男男性接触艾滋病毒阳性者(HADD组)和47名无神经精神疾病的男男性接触艾滋病毒阳性者(艾滋病毒对照组)。参与者接受了静息态功能磁共振成像(rs-fMRI)扫描和外周血评估。分别使用液相芯片、酶联免疫吸附测定和流式细胞术测定外周血细胞因子、激素和神经营养因子的血浆浓度以及免疫细胞水平。评估成像改变与临床变量和外周血指标的相关性。
与艾滋病毒对照组相比,HADD组在左侧顶上叶回表现出更高的低频波动分数振幅,在左侧中央前回表现出更低的局部一致性,并且右侧中央前回种子区域与右侧楔叶簇之间的体素功能连接减少等。此外,HADD组的干扰素-γ水平更高、非经典单核细胞频率更高,特定细胞上穿孔素和CD38的表达水平更高。这些成像结果与外周血指标和临床变量显著相关。
这项rs-fMRI研究为HADD患者大脑内在活动异常提供了大量证据。此外,我们的数据还表明与抑郁相关的炎症对PWH有有害影响。因此,必须更加关注HADD并相应地实施有效的预防干预措施。