抑郁症患者外周血T细胞亚群、Tregs及细胞因子水平变化及意义

Changes and significance of peripheral blood T cell subsets,Tregs and cytokines in patients with depression

目的研究抑郁症患者外周血中T细胞亚群、调节性T细胞(regulatory T cells,Tregs)和白细胞介素(interleukin,IL)-6、IL-10、干扰素-γ(interferon-γ,INF-γ)以及肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)的表达水平,探讨其在郁抑症发病机制中的作用。方法选择2020年1月至2022年6月于皖西卫生职业学院附属医院就诊的初诊抑郁症患者82例作为病例组,同期选取我院体检中心体检健康的40例志愿者作为对照组。根据汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分,将病例组患者分为重度抑郁组(23例)和轻中度抑郁组(59例)。采用流式细胞仪检测两组研究对象外周血中T细胞和Tregs水平,采用酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)检测血浆中IL-6、IL-10、INF-γ以及TNF-α水平,对比分析T细胞亚群、Tregs及细胞因子水平的变化及意义。结果与对照组相比,初诊抑郁症患者外周血中CD8^(+)T、Tregs细胞比例显著升高,CD4^(+)/CD8^(+)比值显著降低,差异具有统计学意义[(23.13±9.24)%比(26.72±8.12)%,(5.31±1.65)%比(12.41±2.52)%,(1.71±0.32)比(1.28±0.51),t=3.22、5.94、4.20,P值均<0.05],CD3^(+)T、CD4^(+)T细胞比例的组间差异无统计学意义(P>0.05)。抑郁症患者外周血中IL-6和INF-γ表达水平较对照组明显升高,差异具有统计学意义[(2.89±2.11)pg/mL比(1.81±1.17)pg/mL,(28.12±11.02)pg/mL比(13.18±6.41)pg/mL,t=5.10、7.59,P值均<0.05],IL-10、TNF-α的组间差异无统计学意义(P>0.05)。重度组抑郁症患者Tregs和IL-6水平较轻中度抑郁症患者显著升高,差异具有统计学意义[(13.11±2.92)%比(8.31±2.05)%,(3.21±2.37)pg/mL比(2.59±1.91)pg/mL,t=7.43、5.93,P值均<0.05],而CD8^(+)T、INF-γ的组间差异无统计学意义(P>0.05)。与治疗前相比,治疗后抑郁症患者CD8^(+)T、Tregs细胞比例,IL-6、INF-γ水平显著下降,差异有统计学意义[(26.72±8.12)%比(22.18±8.14)%,(12.41±2.52)%比(8.11±1.95)%,(2.89±2.11)pg/mL比(2.21±1.87)pg/mL,(28.12±11.02)pg/mL比(17.21±9.46)pg/mL,t=21.04、51.33、35.38、7.11,P值均<0.05]。结论CD8^(+)T、Tregs和IL-6参与了郁抑症患者免疫耐受异常的形成,抑郁症的发生与免疫系统的异常改变密切相关。

Objective To investigate the expression levels of T-cell subsets,regulatory T cells(Tregs),interleukin(IL)-6,IL-10,interferon-γ(INF-γ),and tumor necrosis factor-α(TNF-α)in peripheral blood of patients with depression,in order to explore their roles in the pathogenesis of depressive disorders.Methods A total of 82 patients who visited the Affiliated Hospital of Health Vocational College of West Anhui University from January 2020 to June 2022 were selected as the case group.40 healthy volunteers from the hospital's physical examination center were selected as the control group during the same period.According to the Hamilton depression scale(HAMD)scores,the patients in the case group were divided into a severe depression group(23 cases)and a mild-to-moderate depression group(59 cases).Flow cytometry was used to detect the levels of T cells and Tregs in the peripheral blood.Enzyme-linked immunosorbent assay(ELISA)was performed to detect the levels of IL-6,IL-10,INF-γ,and TNF-α in the plasma.Changes and significance in the T-cell subsets,Tregs,and cytokine levels were compared and analyzed.Results Compared with the control group,the proportion of CD8^(+)T and Tregs cells in the peripheral blood of patients with newly diagnosed depression was significantly increased,and the CD4^(+)/CD8^(+)ratio was significantly reduced[(23.13±9.24)%vs(26.72±8.12)%,(5.31±1.65)%vs(12.41±2.52)%,(1.71±0.32)vs(1.28±0.51),t=3.22,5.94,4.20,all P values<0.05],but there was no statistically significant difference in the proportions of CD3^(+)T and CD4^(+)T cells between groups(P>0.05).The expression levels of IL-6 and INF-γ in the peripheral blood of patients with depression were significantly higher than those in the control group[(2.89±2.11)pg/mL vs(1.81±1.17)pg/mL,(28.12±11.02)pg/mL vs(13.18±6.41)pg/mL,t=5.10,7.59,both P values<0.05],there was no statistical significance in the expression of IL-10 and TNF-α between groups(P>0.05).The levels of Tregs and IL-6 in patients with severe depression were significantly higher than those in patients with mild-to-moderate depression[(13.11±2.92)%vs(8.31±2.05)%,(3.21±2.37)pg/mL vs(2.59±1.91)pg/mL,t=7.43,5.93,both P values<0.05],while no differences have been found in the levels of CD8^(+)T and INF-γ between groups(P>0.05).Compared with before treatment,the proportion of CD8^(+)T and Tregs cells,and the levels of IL-6 and INF-γ in patients with depression decreased significantly after treatment[(26.72±8.12)%vs(22.18±8.14)%,(12.41±2.52)%vs(8.11±1.95)%,(2.89±2.11)pg/mL vs(2.21±1.87)pg/mL,(28.12±11.02)pg/mL vs(17.21±9.46)pg/mL,t=21.04,51.33,35.38,7.11,all P values<0.05].Conclusion CD8^(+)T cells,Tregs and IL-6 are involved in the development of immune tolerance abnormalities in patients with depression.The occurrence of depression is closely associated with abnormal changes in the immune system.