抑郁症患者抗抑郁治疗前后细胞免疫及单胺类神经递质代谢产物的变化特征(英文)

Variety of cell-mediated immunity and the metabolic products of monoamine neural transmitter in depression patients before and after therapy

背景:近期的研究表明细胞因子不但是免疫调节因子,而且具有广泛的中枢调节作用,对神经递质的合成和代谢产生影响。抑郁症的发病机制有着多种假说,但目前研究结果尚不一致。目的:探讨抑郁症患者抗抑郁剂治疗前后的细胞免疫及单胺类神经递质代谢产物的改变。设计:以诊断为依据的病例对照研究。地点、对象和方法:采用酶联免疫吸附法和高效液相电化学检测法,对南京医科大学脑科医院就诊的40例抑郁症患者在治疗前和抗抑郁药治疗4周后的血浆细胞因子白介素2(IL-2)和IL-6以及单胺代谢产物5-羟吲哚乙酸(5-hydroxyindoleaceticacid,5-HIAA)、3-甲基-4-羟-苯乙二醇(3-methoxy-4-hydroxyphenylglycol,MHPG)和高香草酸的水平进行测定,并以20例健康人作为对照组。主要观察指标:抑郁症患者治疗前后与对照组血浆IL-2,IL-6,5-HIAA,MHPG和高香草酸水平的比较;抑郁症患者治疗前后血浆IL-2,IL-6与5-HIAA,MHPG,高香草酸的相关性。结果:抑郁症组治疗前血浆IL-2,IL-6水平犤(4.11±0.53),(41.08±4.85)μg/L犦明显高于正常对照组犤(3.24±0.53),(35.81±4.32)μg/L犦(P<0.01),经过4周抗抑郁剂治疗后,随着病情显著好转IL-2,IL-6水平较治疗前显著降低(P<0.01);抑郁症组治疗前血浆5-HIAA,MHPG,高香草酸浓度显著低于正常对照组(P<0.

BACKGROUND:As indicated by the recent researches,cell factors are not only imm unity regulation factors but also have wide central regulation reactions,which a ffect the synthesis and metabolism of neural transmitters.There are many hypothe ses in the pathogenesis of depression;however,the results of recent researches w ere not accordance. OBJECTIVE:To discuss the variety of cell-mediated immunity and the metabolic products of monoamine neural transmitters in depression patients before and afte r therapy. DESIGN:A case control study on the basis of diagnosis. SETTING,PARTICIPANTS and INTERVENTION:Forty depression patients visited at bra in hospital affiliated with Nanjing Medical University were selected in the stud y.The serous interleukin-2(IL-2),interleukin-6 (IL-6) and the metabolic prod ucts of monoamine,which were 5-hydroxyindoleacetic acid(5-HIAA),3-methocy-4 -hydroxyphenylglycol(MHPG) and homovanillic acid,were assayed before and 4-wee k after therapy by ELISA and high efficiency liquid electrochemical method,and 2 0 healthy subjects were selected in the control group. MAIN OUTCOME MEASURES:Comparison of serous levels of IL-2,IL-6,5-HIAA,MHPG and homovanillic acid between the depression group(before and after therapy) and control group;the correlation of serous levels of IL-2,IL-6,5-HIAA,MHPG and homovanillic acid in the depression group between before and after therapy. RESULTS:The levels of serous IL-2 and IL-6[(4.11±0.53),(41.08±4.85) μg/L] in the depression group before therapy were significantly higher than those in the control group[(3.24±0.53),(35.81±4.32) μg/L,P< 0.01].After 4-week therap y,the disease conditions improved significantly.The serous levels of IL-2 and I L-6 significantly decreased compared with that before therapy(P< 0.01).The sero us levels of 5-HIAA,MHPG and homovanillic acid before therapy in the depression group were significantly lower than those in the control group(P< 0.05),and the levels were significantly increased after therapy compared with the levels befo re therapy(P< 0.05).There were negative correlations between the difference of s erous 5-HIAA before and after therapy and those of IL-2 and IL-6(r=0.42,-0.3 6,P< 0.05). CONCLUSION:There might be immunity activation and inflammation reaction compli cated with depression.There are hypofunctions of central 5-hydroxytryptamine(5 -HT) and noradrenalin existing in depression patients.IL-2 and IL-6 might aff ect the activities of central 5-HT.