Reduced immunity to measles in adults with major depressive disorder.
Reduced immunity to measles in adults with major depressive disorder.
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DOI：
10.1017/s0033291718000661
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发表时间：
2019-01
影响因子：
6.9
通讯作者：
Savitz J
中科院分区：
文献类型：
--
作者：
Ford BN;Yolken RH;Dickerson FB;Teague TK;Irwin MR;Paulus MP;Savitz J
抑郁症会损害成年人接种疫苗后的免疫原性。虽然许多疫苗是在儿童时期接种的，但青少年或成年期发病的抑郁症是否与儿童疫苗保护作用的维持受损有关尚不清楚。本研究验证了一个假设，即青少年或成年期发病的情绪障碍患者对麻疹（儿童疫苗的一个针对目标）会表现出免疫力受损。
采用固相免疫测定法对患有双相情感障碍的志愿者（BD，n = 64，平均发病年龄 = 16.6±5.6岁）、目前患有重度抑郁症的抑郁个体（cMDD，n = 85，平均发病年龄 = 17.9±7.0岁）、有重度抑郁症病史的缓解个体（rMDD，n = 82，平均发病年龄 = 19.2±8.6岁）以及非抑郁的对照者（HC，n = 202）体内的麻疹IgG抗体进行定量检测，所有受试者均出生于1963年美国引入麻疹疫苗之后。
与对照组相比，目前患有重度抑郁症组（p = 0.021，校正比值比 = 0.47，置信区间 = 0.24 - 0.90）和有重度抑郁症病史的缓解组（p = 0.038，校正比值比 = 0.50，置信区间 = 0.26 - 0.97）麻疹血清学检测呈阳性的可能性更低。与未用药的重度抑郁症参与者相比，目前正在用药的重度抑郁症参与者患病的总时长更长，且麻疹血清学检测呈阳性的可能性更低。
青少年或成年期发病的重度抑郁症患者麻疹血清学检测呈阳性的可能性更低。由于较低的IgG滴度与麻疹感染风险增加有关，重度抑郁症可能会增加感染的风险和严重程度，这可能是因为与疫苗相关的麻疹保护作用的维持受损。
Depression can impair the immunogenicity of vaccine administration in adults. Whereas many vaccinations are administered in childhood, it is not known whether adolescent or adult onset depression is associated with impairments in maintenance of protection of childhood vaccines. This study tested the hypothesis that individuals with adolescent or adult onset mood disorders would display compromised immunity to measles, a target of childhood vaccination. IgG antibodies to measles were quantified using a solid phase immunoassay in volunteers with bipolar disorder (BD, n=64, mean age of onset=16.6±5.6), currently depressed individuals with major depressive disorder (cMDD, n=85, mean age of onset=17.9±7.0), remitted individuals with a history of MDD (rMDD, n=82, mean age of onset=19.2±8.6), and non-depressed comparison controls (HC, n=202), all born after the introduction of the measles vaccine in the USA in 1963. Relative to HC, both the cMDD group (p=0.021, adjusted OR=0.47, CI=0.24–0.90) and the rMDD group (p=0.038, adjusted OR=0.50, CI=0.26–0.97) were less likely to test seropositive for measles. Compared with unmedicated MDD participants, currently medicated MDD participants had a longer lifetime duration of illness and were less likely to test seropositive for measles. Individuals with adolescent or adult onset MDD are less likely to test seropositive for measles. Because lower IgG titers are associated with increased risk of measles infection, MDD may increase the risk and severity of infection possibly because of impaired maintenance of vaccine related protection from measles.