Different activation patterns of proinflammatory cytokines in melancholic and non-melancholic major depression are associated with HPA axis activity
Different activation patterns of proinflammatory cytokines in melancholic and non-melancholic major depression are associated with HPA axis activity
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DOI：
10.1016/j.jad.2005.03.012
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发表时间：
2005-08-01
影响因子：
6.6
通讯作者：
Rothermundt, M
中科院分区：
文献类型：
--
作者：
Kaestner, F;Hettich, M;Rothermundt, M
背景：最近的研究表明，细胞因子系统和HPA轴在重度抑郁症中被激活，尽管结果不一致。当非忧郁亚型表现出促炎细胞因子模式时，忧郁亚型表现出细胞因子产生受损的迹象。为了进一步了解这些系统的潜在致病意义，我们研究了抑郁亚型中细胞因子系统和HPA轴之间的相互作用以及这些系统在病程中的潜在变化。方法：将37例最初未服药的急性重度抑郁症患者分为抑郁型和非抑郁型，并与N=37名匹配的健康对照组进行比较。在入院时和临床完全缓解后，测定基础血浆ACTH和血清皮质醇水平以及细胞因子(IL-1β、IL-1受体拮抗剂(IL-1RA))在丝裂原刺激(PHA)时的产生。结果：抑郁症患者入院时ACTH和皮质醇水平显著升高，而非抑郁症患者无明显变化。非抑郁症患者入院时产生的IL-1β和IL-1RA显著高于对照组或抑郁症患者。与抑郁症亚组相比，非抑郁症患者的IL-1RA/IL-1β比值显著降低，缓解后显著升高。限制：患者治疗不规范。未进行Dex/CRH试验。结论：抑郁症患者急性期HPA轴激活，缓解期部分恢复正常，但无炎症征象。非忧郁型患者在急性抑郁症中有炎症征象，缓解后恢复正常，而HPA轴功能正常。(C)2005 Elsevier B.V.保留所有权利。
Background: Recent studies showed an activation of the cytokine system and the HPA axis in major depression, although with inconsistent results. While the non-melancholic subtype displayed a proinflammatory cytokine pattern, the melancholic subtype showed signs of impaired cytokine production. In order to understand the potential pathogenic significance of these systems further, the interplay between the cytokine system and the HPA axis in depressive subtypes as well as potential changes of these systems during the course of disease were investigated.Methods: N = 37 initially unmedicated patients with acute major depression were sub-classified (melancholic vs. non-melancholic) and compared with N = 37 matched healthy controls. Upon admission and after complete clinical remission, basal plasma ACTH and serum cortisol levels as well as cytokine productions (IL-1 beta, IL-1 receptor antagonist (IL-1RA)) upon mitogen stimulation (PHA) were measured in a whole blood assay.Results: ACTH and cortisol concentrations were significantly elevated on admission in the melancholic but not the non-melancholic subgroup. Non-melancholic patients produced significantly more IL-1 beta and IL-1RA upon admission than controls or melancholic patients. The IL-1 RA/IL-1 beta ratio was significantly lower in the non-melancholic compared to the melancholic subgroup and increased significantly upon remission.Limitations: Patient treatment was not standardized. No Dex/CRH test was performed.Conclusions: Melancholic patients demonstrated an activation of the HPA axis in acute stage with partial normalization upon remission but no signs of inflammation. Non-melancholic patients showed signs of inflammation in acute depression with normalization upon remission while the function of the HPA axis was normal. (c) 2005 Elsevier B.V. All rights reserved.