白细胞介素1β和核因子κB相关免疫通路在冠状动脉粥样硬化性心脏病合并抑郁中的作用

Study of immunologic relationship between depression and coronary artery disease

目的:通过检测冠状动脉粥样硬化性心脏病(coronary artery disease,CAD)合并抑郁患者的免疫功能,探索疾病之间的免疫学关系。方法:连续收集173例CAD患者,运用患者健康量表-9(patient health questionnaire-9,PHQ-9)对已确诊的CAD患者进行抑郁症状评估。根据PHQ-9评分将患者分为情绪正常组(0≤PHQ-9评分<5)、轻度抑郁组(5≤PHQ-9评分<10分)、中度抑郁组(10≤PHQ-9评分≤14分)、中重度及重度抑郁组(15≤PHQ-9评分≤27),同期检测所有入组者免疫功能指标。将不同程度抑郁患者血清与人脐静脉内皮细胞(HUVEC)共培养,采用荧光素酶报告基因检测系统检测白细胞介素1β(IL-1β)和核因子κB(NF-κB)基因表达量的变化。结果:CAD伴中重度以上抑郁患者的IL-1β血清水平[11.73(9.40,17.46)ng/L]显著高于轻度抑郁[8.97(6.07,11.28)ng/L]及情绪正常患者[8.14(6.17,9.80)ng/L],P<0.05。CAD伴中重度抑郁患者的血清可激活HUVEC细胞,且其IL-1β、NF-κB基因表达水平显著升高。结论:炎性免疫机制可能为CAD与伴发抑郁之间的内在联系之一,IL-1β、NF-κB相关免疫通路可能为核心机制。

Objective：To explore the immunologic relationship between depression and coronary artery disease（CAD）. Methods：A total of 175 patients were enrolled continuously,and were divided into 4groups according to the scores of patient health questionnaire-9（PHQ-9）.Immunological function was assessed by measuring serum levels of immunologic factors and immunological cells. The relationship between serum level of immunological factors and degree of depression was analyzed.The human umbilical vein endothelial cells（HUVEC）were co-cultured with the serum of depressed CAD patients,and the expressions of interleukin（IL）-1βand nuclear factor（NF）-κB in HUVEC were measured by luciferase reporter gene detection system. Results：The serum levels of IL-1βwere significantly different among 4groups of patients.Patients with moderate to severe depression have a higher level of IL-1βthan those of CAD patients with minimal depression or without depression[11.73（9.40,17.46）ng/L vs.8.97（6.07,11.28）ng/L and 8.14（6.17,9.80）ng/L,P〈0.05].HUVEC co-cultured with the serum of moderate to severely depressed CAD patients expressed greater IL-1βand NF-κB. Conclusion：Immunological inflammation may be one of the pathogenic mechanisms accounting for CAD and depression.IL-1βand NF-κB related pathways may play a key role.