Treatment-resistant depression and peripheral C-reactive protein
Treatment-resistant depression and peripheral C-reactive protein
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难治性抑郁症和外周 C 反应蛋白
DOI：
10.1101/197012
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Chamberlain S
中科院分区：
文献类型：
--
作者：
Chamberlain S
C-反应蛋白(CRP)是抑郁症(MDD)的候选生物标志物，但外周血CRP水平与MDD临床表型的异质性之间的关系尚不清楚。目的探讨CRP与MDD及其表型的相关性。检测外周静脉血超敏C反应蛋白、体重指数(BMI)和抑郁、焦虑、儿童创伤问卷评定。结果与健康志愿者相比，治疗耐药组体重指数校正后的C-反应蛋白显著升高(P=0.007.2 5；Cohen‘s d=0.47)，而治疗有效组(d=0.2 9)和未治疗组(d=0.18)差异无统计学意义。最优双因素解可解释临床指标变异的34.7%和C反应蛋白变异的36.0%。与C反应蛋白相关性最强且偏重于第一偏最小二乘成分的临床表型是植物性抑郁症状、体重指数、状态焦虑、儿时无人关爱或希望有不同的童年生活。结论在MDD患者中，C反应蛋白水平升高，且在耐药患者中更为明显。与CRP升高相关的其他表型包括童年逆境和特定的抑郁和焦虑症状。我们认为，像C反应蛋白这样的促炎症生物标志物分层的MDD患者具有独特的临床特征，可能对抗炎药物的二线治疗有反应。利益声明S.R.C.剑桥认知和夏尔的咨询；他在这个项目中的投入得到了惠康信托临床研究基金的资助(110049/Z/15/Z)。E.T.B.一半时间受雇于剑桥大学，一半时间受雇于葛兰素史克；他持有葛兰素史克的股票。在过去的三年里，P.J.C.一直在伦德贝克的顾问委员会任职。NA.H.为葛兰素史克提供咨询服务。P.D.B.、D.N.C.J.和W.C.D.是强生公司Janssen Research&Development，LLC的员工，并持有强生公司的股票。其他作者没有报告财务披露或潜在的利益冲突。
BackgroundC-reactive protein (CRP) is a candidate biomarker for major depressive disorder (MDD), but it is unclear how peripheral CRP levels relate to the heterogeneous clinical phenotypes of the disorder.AimTo explore CRP in MDD and its phenotypic associations.MethodWe recruited 102 treatment-resistant patients with MDD currently experiencing depression, 48 treatment-responsive patients with MDD not currently experiencing depression, 48 patients with depression who were not receiving medication and 54 healthy volunteers. High-sensitivity CRP in peripheral venous blood, body mass index (BMI) and questionnaire assessments of depression, anxiety and childhood trauma were measured. Group differences in CRP were estimated, and partial least squares (PLS) analysis explored the relationships between CRP and specific clinical phenotypes.ResultsCompared with healthy volunteers, BMI-corrected CRP was significantly elevated in the treatment-resistant group (P = 0.007; Cohen's d = 0.47); but not significantly so in the treatment-responsive (d = 0.29) and untreated (d = 0.18) groups. PLS yielded an optimal two-factor solution that accounted for 34.7% of variation in clinical measures and for 36.0% of variation in CRP. Clinical phenotypes most strongly associated with CRP and heavily weighted on the first PLS component were vegetative depressive symptoms, BMI, state anxiety and feeling unloved as a child or wishing for a different childhood.ConclusionsCRP was elevated in patients with MDD, and more so in treatment-resistant patients. Other phenotypes associated with elevated CRP included childhood adversity and specific depressive and anxious symptoms. We suggest that patients with MDD stratified for proinflammatory biomarkers, like CRP, have a distinctive clinical profile that might be responsive to second-line treatment with anti-inflammatory drugs.Declaration of interestS.R.C. consults for Cambridge Cognition and Shire; and his input in this project was funded by a Wellcome Trust Clinical Fellowship (110049/Z/15/Z). E.T.B. is employed half time by the University of Cambridge and half time by GlaxoSmithKline; he holds stock in GlaxoSmithKline. In the past 3 years, P.J.C. has served on an advisory board for Lundbeck. N.A.H. consults for GlaxoSmithKline. P.d.B., D.N.C.J. and W.C.D. are employees of Janssen Research & Development, LLC., of Johnson & Johnson, and hold stock in Johnson & Johnson. The other authors report no financial disclosures or potential conflicts of interest.
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DOI：
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发表时间：
1970
期刊：
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影响因子：
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作者：
C. Spielberger;R. Gorsuch;R. Lushene
通讯作者：
C. Spielberger;R. Gorsuch;R. Lushene
DOI：
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发表时间：
--
期刊：
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影响因子：
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作者：
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影响因子：
10.6
作者：
Miller, Gregory E.;Cole, Steve W.
通讯作者：
Cole, Steve W.
影响因子：
2.7
作者：
A. Walker;Brittany M. Foley;S. Sutor;J. McGillivray;M. Frye;S. Tye
通讯作者：
A. Walker;Brittany M. Foley;S. Sutor;J. McGillivray;M. Frye;S. Tye
影响因子：
6.8
作者：
Mechawar N;Savitz J
通讯作者：
Savitz J