Electroconvulsive therapy has acute immunological and neuroendocrine effects in patients with major depressive disorder
Electroconvulsive therapy has acute immunological and neuroendocrine effects in patients with major depressive disorder
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DOI：
10.1016/j.jad.2010.11.035
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发表时间：
2011-06-01
影响因子：
6.6
通讯作者：
Westenberg, Herman G. M.
中科院分区：
文献类型：
--
作者：
Fluitman, Sjoerd B. A. H. A.;Heijnen, Cobi J.;Westenberg, Herman G. M.
背景：重度抑郁症与神经内分泌和免疫系统的改变有关。很少有研究探讨电休克治疗 (ECT) 对重度抑郁症 (MDD) 患者这些系统的影响。 方法：在这项探索性研究中，在第一次、第五次和第十一次 ECT 期间对 12 名患有耐药性 MDD 或具有精神病特征的 MDD 的患者进行了研究。在电刺激前以及电刺激后 5、15 和 30 分钟采集血样，以评估各种脂多糖 (LPS) 刺激或 T 细胞有丝分裂原诱导的细胞因子、免疫细胞数量、自然杀伤细胞活性、皮质醇和 ACTH。 结果：急性 ECT 增加了外周血中 LPS 刺激的细胞因子 IL-6 和 TNF-α 的产生。 单核细胞，但不产生抗炎细胞因子 IL-10。急性ECT降低了T细胞有丝分裂原诱导的IFN-γ水平，但IL-10和IL-4水平不受影响，而NK细胞活性短暂但显着增加。电刺激后皮质醇和 ACTH 显着升高。重复 ECT 对任何参数都没有显着影响。 局限性：该研究的小组规模较小。此外，患者群体也存在异质性，因为它由伴有或不伴有精神病特征的难治性抑郁症患者组成。 结论：结果表明，急性 ECT 与短暂的免疫和神经内分泌变化相关，而重复 ECT 对免疫和神经内分泌功能没有附加作用。 (C) 2010 Elsevier B.V. 保留所有权利。
Background: Major depressive disorder is associated with alterations in the neuroendocrine as well as immune system. Few studies examined the impact of electroconvulsive therapy (ECT) on these systems in patients with major depressive disorder (MDD).Methods: In this explorative study 12 patients suffering from medication-resistant MDD or MDD with psychotic features were studied during the first, the fifth and eleventh session of ECT. Blood samples were taken immediately prior to the electrostimulus and 5, 15 and 30 min after the electrostimulus to assess various lipopolysaccharide (LPS) stimulated or T-cell mitogen induced cytokines, immune cell numbers, Natural Killer cell activity, cortisol and ACTH.Results: Acute ECT increased the LPS-stimulated production of the cytokines IL-6 and TNF-alpha by peripheral monocytes but not the production of the anti-inflammatory cytokine IL-10. Acute ECT decreased T cell mitogen-induced levels of IFN-gamma but IL-10 and IL-4 levels were left unaffected while NK cell activity increased momentarily but significantly. Cortisol and ACTH rose significantly after electrostimulus. Repeated ECT had no significant effect on any of the parameters.Limitations: The study had a small group size. Also the patient group was heterogeneous as it consisted of patients with therapy-resistant depression with or without psychotic features.Conclusions: Results suggest that acute ECT is associated with transient immunological and neuro-endocrine changes, while repeated ECT does not have an additive effect on the immune and neuroendocrine functions. (C) 2010 Elsevier B.V. All rights reserved.