Immunological effects of behavioral activation with exercise in major depression: an exploratory randomized controlled trial.
Immunological effects of behavioral activation with exercise in major depression: an exploratory randomized controlled trial.
复制标题
DOI：
10.1038/tp.2017.76
复制
发表时间：
2017-05-16
影响因子：
6.8
通讯作者：
Rief W
中科院分区：
文献类型：
--
作者：
Euteneuer F;Dannehl K;Del Rey A;Engler H;Schedlowski M;Rief W
重度抑郁症（MD）与外周炎症和心血管风险增加有关。定期的体育锻炼可以起到抗炎作用。本研究探讨了运动行为激活是否会影响MD的炎症过程。98例MD患者被随机分配到认知行为治疗（CBT），强调在行为激活过程中的运动（CBT-E），CBT与愉快的低能量活动作为主动控制条件（CBT-C）或被动等待列表控制组（WL）。在基线和第8周（行为激活后）和第16周（治疗后）分析C反应蛋白（CRP）、白细胞介素（IL）-6，IL-10、脂多糖（LPS）刺激的IL-6产生和血液免疫细胞计数的血浆水平。纳入了三十名年龄和性别匹配的非抑郁症对照组，以检查基线时MD的潜在免疫学变化。与对照组相比，MD患者的CRP水平较高，中性粒细胞和单核细胞计数较高，IL-10水平较低，LPS刺激的IL-6产生减少（P <0.001 - 0.045）。多水平模型表明，与CBT-C和WL相比，CBT-E在第8周和第16周与抗炎性IL-10增加相关（P = 0.004 - 0.018）。CBT-E对总样本中的其他免疫标记物无显著影响。包括潜在较高心血管风险（CRP <1 μ g ml − 1）患者的亚组分析表明，第16周后，CBT-E组的CRP低于CBT-C组（P <0.007），略低于WL组（P <0.085）。目前的研究结果为行为治疗对抑郁症的免疫学影响提供了新的见解。结合运动的行为激活可能有可能在一定程度上逆转MD的免疫学改变。
Major depression (MD) is associated with peripheral inflammation and increased cardiovascular risk. Regular physical exercise can have anti-inflammatory effects. The present study examined whether behavioral activation with exercise affects inflammatory processes in MD. Ninety-eight patients with MD were randomly assigned to cognitive-behavioral therapy (CBT) emphasizing exercise during behavioral activation (CBT-E), CBT with pleasurable low-energy activities as an active control condition (CBT-C) or a passive waiting list control group (WL). Plasma levels of C-reactive protein (CRP), interleukin (IL)-6, IL-10, lipopolysaccharide (LPS)-stimulated IL-6 production, and blood immune cell counts were analyzed at baseline and weeks 8 (post-behavioral activation) and 16 (post-treatment). Thirty non-depressed age- and sex-matched controls were included to examine potential immunological alterations in MD at baseline. Patients with MD exhibited higher levels of CRP, higher neutrophil and monocyte counts, lower IL-10 levels and reduced LPS-stimulated IL-6 production compared to controls (P<0.001−0.045). Multilevel modeling indicated that CBT-E was associated with increased anti-inflammatory IL-10 at weeks 8 and 16 compared to CBT-C and WL (P=0.004−0.018). CBT-E did not significantly affect other immunological makers in the total sample. A subgroup analysis including patients with potentially higher cardiovascular risk (CRP ⩾1 μg ml−1) indicated that CRP was reduced in CBT-E compared to CBT-C (P<0.007) and marginally reduced compared to WL (P<0.085) after week 16. The present findings provide new insights into immunological effects of behavioral treatments against depression. Behavioral activation in conjunction with exercise may have the potential to reverse, in part, immunological alterations in MD.
登录
查看更多内容
影响因子：
10.6
作者：
Dowlati, Yekta;Herrmann, Nathan;Lanctot, Krista L.
通讯作者：
Lanctot, Krista L.
影响因子：
6.8
作者：
AKAIKE, H
通讯作者：
AKAIKE, H
影响因子：
120.7
作者：
DIMSDALE, JE;MOSS, J
通讯作者：
MOSS, J
影响因子：
11
作者：
Anisman, H;Ravindran, AV;Merali, Z
通讯作者：
Merali, Z
影响因子：
6.6
作者：
Euteneuer, Frank;Schwarz, Markus J.;Rief, Winfried
通讯作者：
Rief, Winfried