Hickie I, Hickie C, Lloyd A, Silove D, Wakefield D
Division of Psychiatry, Prince Henry Hospital, Sydney, Australia.
Br J Psychiatry. 1993 May;162:651-7. doi: 10.1192/bjp.162.5.651.
Previous attempts to establish a relationship between impaired cell-mediated immunity (CMI) and major mood disorders have been limited by a failure to explore the relevance of depressive subcategories or to assess CMI by in vivo methods. In this case-control study CMI was assessed in 57 patients with major depression (31 with melancholic, 26 with non-melancholic disorders), and in age- and sex-matched controls by both in vitro and in vivo immunological techniques. Compared with control subjects and patients with non-melancholic depression, patients with melancholia demonstrated reduced in vivo CMI as assessed by delayed-type hypersensitivity (DTH) skin responses. Although increasing age, severity of depression, hospital admission for treatment, and reported weight loss are correlates of melancholia, none of these factors alone, or in combination, accounted for the differences in DTH responses observed between the two depressive subtypes. These data suggest that impaired CMI in vivo may be limited to those with melancholic disorders. At this stage the factors which account for this effect are unclear.
先前尝试建立细胞介导免疫（CMI）受损与主要心境障碍之间的关系，但由于未能探究抑郁亚类的相关性或通过体内方法评估CMI而受到限制。在这项病例对照研究中，通过体外和体内免疫技术，对57例重度抑郁症患者（31例为 melancholic，26例为非 melancholic 障碍）以及年龄和性别匹配的对照组进行了CMI评估。与对照组和非 melancholic 抑郁症患者相比，通过迟发型超敏反应（DTH）皮肤反应评估，melancholia 患者的体内CMI降低。尽管年龄增长、抑郁严重程度、住院治疗以及报告的体重减轻与 melancholia 相关，但这些因素单独或组合起来，均不能解释两种抑郁亚型之间观察到的DTH反应差异。这些数据表明，体内CMI受损可能仅限于患有 melancholic 障碍的患者。目前，导致这种效应的因素尚不清楚。
