S100B Serum Levels Predict Treatment Response in Patients with Melancholic Depression.
S100B Serum Levels Predict Treatment Response in Patients with Melancholic Depression.
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DOI：
10.1093/ijnp/pyv103
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发表时间：
2015-09-12
期刊：
影响因子：
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通讯作者：
Birkenhäger TK
中科院分区：
文献类型：
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作者：
Ambrée O;Bergink V;Grosse L;Alferink J;Drexhage HA;Rothermundt M;Arolt V;Birkenhäger TK
目前正在精神病学中寻找生物标志物，例如，作为诊断工具或治疗反应的预测因子。神经营养因子S100钙结合蛋白B（S100 B）已被讨论作为一个可能的预测抑郁症患者的抗抑郁反应，但也作为一个可能的生物标志物的急性抑郁状态。本研究的目的是研究血清S100 B水平与抗抑郁药治疗反应和抑郁症严重程度的关系。经过一周的洗脱期后，40例抑郁症患者接受文拉法辛或丙咪嗪治疗。在基线、治疗7周后和6个月后评估S100 B水平和汉密尔顿抑郁量表（HAM-D）评分。基线时S100 B水平高的患者在7周（P= 0.002）和6个月（P= 0.003）后显示出明显更好的治疗反应，定义为HAM-D评分的相对降低。在线性回归模型中，S100 B是两个时间点治疗反应的显著预测因子。值得注意的是，无应答者的预测值为85%，假阴性率为7.5%。S100 B水平与抑郁症的严重程度无关，也不随临床改善而变化。低S100 B水平预测文拉法辛和丙咪嗪无反应具有高精度。未来的研究必须表明哪些治疗方法对低水平S100 B的患者有效，以便这种生物标志物有助于减少患者对常用抗抑郁药无反应的负担。
There is an ongoing search for biomarkers in psychiatry, for example, as diagnostic tools or predictors of treatment response. The neurotrophic factor S100 calcium binding protein B (S100B) has been discussed as a possible predictor of antidepressant response in patients with major depression, but also as a possible biomarker of an acute depressive state. The aim of the present study was to study the association of serum S100B levels with antidepressant treatment response and depression severity in melancholically depressed inpatients. After a wash-out period of 1 week, 40 inpatients with melancholic depression were treated with either venlafaxine or imipramine. S100B levels and Hamilton Depression Rating Scale (HAM-D) scores were assessed at baseline, after 7 weeks of treatment, and after 6 months. Patients with high S100B levels at baseline showed a markedly better treatment response defined as relative reduction in HAM-D scores than those with low baseline S100B levels after 7 weeks (P=.002) and 6 months (P=.003). In linear regression models, S100B was a significant predictor for treatment response at both time points. It is of interest to note that nonresponders were detected with a predictive value of 85% and a false negative rate of 7.5%. S100B levels were not associated with depression severity and did not change with clinical improvement. Low S100B levels predict nonresponse to venlafaxine and imipramine with high precision. Future studies have to show which treatments are effective in patients with low levels of S100B so that this biomarker will help to reduce patients’ burden of nonresponding to frequently used antidepressants.