Effects of Lycium barbarum polysaccharide on cytokines in adolescents with subthreshold depression:a randomized controlled study

Strong evidence has accumulated to show a correlation between depression symptoms and inflammatory responses.Moreover,anti-inflammatory treatment has shown partial effectiveness in alleviating depression symptoms.Lycium barbarum polysaccharide(LBP),derived from Goji berries,exhibits notable antioxidative and anti-inflammatory properties.In our recent double-blinded randomized placebo-controlled trial,we found that LBP significantly reduced depressive symptoms in adolescents with subthreshold depression.It is presumed that the antidepressant effect of LBP may be associated with its influence on inflammatory cytokines.In the double-blinded randomized controlled trial,we enrolled 29 adolescents with subthreshold depression and randomly divided them into an LBP group and a placebo group.In the LBP group,adolescents were given 300 mg/d LBP.A 6-week follow up was completed by 24 adolescents,comprising 14 adolescents from the LBP group(15.36±2.06 years,3 men and 11 women)and 10 adolescents from the placebo group(14.9±1.6 years,2 men and 8 women).Our results showed that after 6 weeks of treatment,the interleukin-17A level in the LBP group was lower than that in the placebo group.Network analysis showed that LBP reduced the correlations and connectivity between inflammatory factors,which were associated with the improvement in depressive symptoms.These findings suggest that 6-week administration of LBP suppresses the immune response by reducing interleukin-17A level,thereby exerting an antidepressant effect.

Integrated analyses of transcriptomics and network pharmacology reveal leukocyte characteristics and functional changes in subthreshold depression,elucidating the curative mechanism of Danzhi Xiaoyao powder

Objective:To investigate the molecular mechanism and identify potential drugs for subthreshold depression(SD),and elucidate the detalied mechanism of Danzhi Xiaoyao powder(DZXY)in SD.Methods:Using RNA-sequencing,we identified differentially expressed genes(DEGs)in leukocytes of SD compared to healthy controls,deciphered their functions and pathways,and identified the hub genes of SD.We also assessed changes in leukocyte transcription factor activity in patients with SD using the TELis platform.The Connectivity Map database was retrieved to screen candidate drugs for SD.Based on network pharmacology,we elucidated the"multi-component,multi-target,and multi-pathway"mechanism of DZXY in the treatment of SD.Results:We identified 1080 DEGs(padj<0.05 and|log2(fold change)l≥1&protein coding)in the leukocytes of patients with SD.These DEGs,including hub genes,were primarily involved in immune and inflammatory response-related processes.Transcription factor activity analysis revealed similarities between the leukocyte transcriptome profile in SD and the conserved transcriptional response to adversities in immune cells.Connectivity Map analysis identified 28 potential drugs for SD treatment,particularly SB-202190 and TWS-119.Constructing the"Direct Compounds-Direct Targets-Pathways"network for DZXY and SD revealed the curative mechanisms of DZXY in SD,primarily including inflammatory response,lipid metabolism,immune response,and other processes.Conclusion:These results provide new insights into the characteristics and functional changes of leukocytes in SD,partially illustrate the pathogenesis of SD,and suggest potential drugs for SD.The curative mechanisms of DZXY in SD are also partially elucidated.

Gender Differences in the Incidence and Related Factors of Low Social Support among Adolescents with Subthreshold Depression

Background:Social support is related to depression,but the gender differences and related factors that contribute to low social support among adolescents with subthreshold depression remain to be elucidated.This study explores the relationship between social support and depression,in addition to the gender difference in the incidence of low social support among adolescents with subthreshold depression and its related factors.Methods:A total of 371 Chinese adolescents with subthreshold depression were recruited.All subjects were rated on the Social Support Scale for Adolescents,the Response Style Scale,the Self-Perception Profile for Children,the Individualism-collectivism scale.Results:Binary logistic regression indicated that the stability dimension of cognitive style,the generality dimension of the Cognitive Style Questionnaire,and the social acceptance dimension of the Self-Perception Profile for Children scale were significantly correlated with social support level in male adolescents with subthreshold depression.In contrast,the total score of the Self-Perception Profile for Children scale,the social acceptance of the Self-Perception Profile for Children scale,total individualism,and total collectivism were significantly correlated with social support level in female adolescents with subthreshold depression.Limitations:This study is a cross-sectional study,and its effectiveness in explaining factors that influence levels of social support is limited.Conclusions:The gender difference between low social support among adolescents with subthreshold depression is related to cognitive style,self-perception,and collectivism–individualism.

Efficacy of Lycium barbarum polysaccharide in adolescents with subthreshold depression: interim analysis of a randomized controlled study

Subthreshold depression is a highly prevalent condition in adolescents who are at high risk for developing major depressive disorder.In preclinical models of neurological and psychiatric diseases,Lycium barbarum polysaccharide(LBP)extracted from Goji berries had antidepressant effects including but not limited to anti-oxidative and anti-inflammatory properties.However,the effect of LBP on subthreshold depression is unclear.To investigate the clinical efficacy and safety of LBP for treating subthreshold depression in adolescents,we conducted a randomized,double-blind,placebo-controlled trial(RCT)with 29 adolescents with subthreshold depression recruited at The Fifth Affiliated Hospital of Guangzhou Medical University.The participants were randomly assigned to groups where they received either 300 mg LBP(LBP group,n=15,3 boys and 12 girls aged 15.13±2.17 years)or a placebo(placebo group,n=14,2 boys and 12 girls aged 15±1.71 years)for 6 successive weeks.Interim analyses revealed that the LBP group exhibited a greater change in Hamilton Depression Scale(HAMD-24)scores relative to the baseline and a higher remission rate(HAMD-24 total score≤7)at 6 weeks compared with the placebo group.Scores on the Beck Depression Inventory-II(BDI-II),Pittsburgh Sleep Quality Index(PSQI),Kessler Psychological Distress Scale(Kessler),and Screen for Child Anxiety-Related Emotional Disorders(SCARED)were similar between the LBP and placebo groups.No side effects related to the intervention were reported in either group.These results indicate that LBP administration reduced depressive symptoms in adolescents with subthreshold depression.Furthermore,LBP was well tolerated with no treatment-limiting adverse events.Clinical trials involving a larger sample size are needed to further confirm the anti-depressive effects of LBP in adolescents with subthreshold depression.This study was approved by the Medical Ethics Committee of the Fifth Affiliated Hospital of Guangzhou Medical University(Guangzhou,China;approval No.L2019-08)on April 4,2019 and was registered on ClinicalTrials.gov(identifier:NCT04032795)on July 25,2019.

Impact of comorbid subthreshold depressive symptoms on cancerrelated fatigue and complications in adults with leukemia

BACKGROUND Patients not only experience symptoms caused by cancer but also suffer from the accompanying psychological pain.Therefore,these patients do not have high quality of life.According to the World Health Organization,the incidence of leukemia in China in 2020 was 5.1/100000,the mortality rate was 3.3/100000,and the prevalence rate was 16.7/100000.Therefore,it is important to examine the influence of comorbid subthreshold depressive symptoms on leukemia patients.AIM To determine the impact of comorbid subthreshold depressive symptoms on cancer-related fatigue and complications in leukemia patients,thereby providing a basis for early diagnosis and treatment in clinical practice.METHODS A questionnaire survey was conducted among leukemia patients admitted to a tertiary hospital in Xi'an,Shaanxi Province,China,from August 2022 to December 2023.Patients with a score>16 on the Chinese Classification of Mental Disorders(CCMD-3)and a Hamilton Depression Rating Scale score of 8-17 were classified as the subthreshold depressive group(n=95),while 100 leukemia patients admitted during the same period were classified as the control group.Data were collected using Epidata 3.1 software,and comparisons were made between the two groups regarding general clinical data,the Piper Fatigue Scale(PFS),the Pittsburgh Sleep Quality Index(PSQI),the Numeric Rating Scale for pain assessment,laboratory indicators,and the occurrence of complications.RESULTS In this survey,120 leukemia patients with depression were preliminarily screened,95 patients with subthreshold depression were ultimately selected as the subthreshold depression group,and 100 leukemia patients admitted during the same period were enrolled as the normal group.Comparison of basic clinical data between the two groups revealed no significant differences in age,sex,body mass index,cognitive function,or comorbidity with other chronic diseases.However,there were statistically significant differences in the use of radiotherapy and regular exercise between the two groups(P<0.05).Comparisons of scales and laboratory indicators revealed no significant differences in albumin or PSQI scores between the two groups,but there were statistically significant differences in pain scores,PSQI scores,PFS scores,hemoglobin levels,and C-reactive protein levels(P<0.05).Spearman’s correlation analysis indicated that cancer-related fatigue was correlated with age,hemoglobin levels,C-reactive protein levels,pain,and regular exercise among leukemia patients with subthreshold depression.Multivariate regression analysis revealed that advanced age,combined radiotherapy,pain,and low hemoglobin levels were risk factors for cancer-related fatigue in leukemia patients with comorbid subthreshold depression,while regular exercise was a protective factor against cancer-related fatigue.Follow-up comparisons revealed a significantly lower overall incidence of complications in the control group(4%)than in the depressive group(24.21%;P<0.001).CONCLUSION Leukemia patients with comorbid subthreshold depressive symptoms experience more severe cancer-related fatigue and a higher incidence of complications.These findings may be related to advanced age,combined radiotherapy,pain,and low hemoglobin levels,while regular exercise may effectively alleviate symptoms.

Navigating emotional challenges:A journey with patients undergoing chemotherapy

A recent article reported that cancer patients with subthreshold depression are more likely to develop major depression within a year.Multivariate regression analysis revealed that regular exercise was a protective factor against cancerrelated fatigue,whereas advanced age,radiotherapy,pain,and low hemoglobin were risk factors for cancer-related fatigue.A limitation of this study was the lack of methodological details about leukemia patients receiving depressive treatment at a specific hospital.Professional assessment,behavioral modification plans,communication,destressing techniques,and educational plans may help chemotherapy patients manage emotional issues and reduce anxiety.Furthermore,these strategies can inspire patients to create,facilitate their treatment,and help them to remain healthy.

Depression in Patients with Parkinson’s Disease and the Associated Features

The study was aimed to examine the prevalence of depression in patients with Parkinson’s disease （PD） and identify its features. A total of 131 out-patients, diagnosed as having idiopathic PD in accordance with the United Kingdom Parkinson’s Disease Society Brain Bank criteria, were interviewed with questionnaire and evaluated by Mini-Mental State Examination （MMSE）, Unified Parkinson’s Disease Rating Scale （UPDRS）, Hohen ＆Yahr staging （H＆Y staging） and Hamilton Rating Scale for Depression （HRSD）. Patients were divided into three groups in terms of HRSD score： depression group, sub-threshold depression group and non-depression group. The clinical variables and symptom profiles were obtained and compared among the three groups. The results showed that 27 patients （20.6%） fell into the depression group, 71 （54.2%） into the sub-threshold depression group, and 33 （25.2%） into the non-depression group. There were no differences in age, gender or tremor score among the groups （P〉0.05）. Significant differences were found in duration of PD, UPDRS score, rigidity score and H＆Y stage between the sub-threshold depression group （or the depression group） and the non-depression group （P〈0.05）. Moreover, the clinical variables in the subthreshold depression group had the trend of increasing with the severity of PD and their values were similar to those in the depression group. Anhedonia, feeling of incapability, sleep disturbance, gastrointestinal symptoms and depressive moods were most common in the depression group. And these symptoms also were more common in the other two groups. It is concluded that depression and sub-threshold depression are common in PD and share similar clinical features. Furthermore, subthreshold depression might be the prodrome of depression and may develop into depression as the condition progresses.

疏肝调神针法结合择时耳穴压豆治疗阈下抑郁

ObjectiveTo observe the clinical therapeutic effect on subthreshold depression of liver stagnation and spleen deficiency treated with acupuncture therapy for soothing the liver and regulating the mind combined with the well-timed auricular acupressure.MethodsA total of 34 patients were treated with acupuncture therapy for soothing the liver and regulating the mind combined with well-timed auricular acupressure.In acupuncture therapy for soothing the liver and regulating the mind,main acupoints included Baihui(BL20),Neiguan(PC6)and Taichong(LR3),and supplementary acupoints included Sishencong(EX-HN1),Shenting(GV24),Benshen(GB13),Zusanli(ST36),Ganshu(BL18)and Pishu(BL20).Acupuncture was given three times a week as one course and 4 courses of treatment were required.In well-timed auricular acupressure,auricular points included Xin(CO15),Pizhixia(AT4),Shenmen(TF4),Gan(CO12)and Pi(CO13).Acupressure with herbal seeds at those auricular points was applied at three time divisions,i.e.9:00 to 11:00,11:00 to 13:00 and 15:00 to 17:00 successively.The auricular acupressure with herbal seeds was given once every 3 days,the treatment for 1 week was 1 course and 4 courses were required.At the end of treatment and in 3 months of follow-up,the score of Hamilton depression scale-24(HAMD-24),syndrome score of traditional Chinese medicine(TCM),the score of Center for epidemiologic studies depression scale(CES-D)and the score of Short-form 36 item health survey(SF-36)were adopted to evaluate clinical therapeutic effect.ResultsAfter treatment and in three months of follow-up,HAMD-24 score,TCM syndrome score and CES-D score were all reduced as compared with the scores before treatment(all P<0.05)and SF-36 score was higher than the score before treatment,respectively(both P<0.05).In comparison of the scores after treatment with those in 3 months of follow-up,differences were not statistically significant(all P>0.05).Of 34 patients with subthreshold depression,8 cases were cured,15 cases effective remarkably,9 cases improved and 2 cases no effect.The total effective rate was 94.12%.ConclusionThe combined treatment of acupuncture therapy for soothing the liver and regulating the mind with the well-timed auricular acupressure can be benefit for relieving the symptoms and improves the quality of life in the patients with subthreshold depression of liver stagnation and spleen deficiency.