Exploration of 27 plasma immune markers: a cross-sectional comparison of 64 old psychiatric inpatients having unipolar major depression and 18 non-depressed old persons
Exploration of 27 plasma immune markers: a cross-sectional comparison of 64 old psychiatric inpatients having unipolar major depression and 18 non-depressed old persons
复制标题
DOI：
10.1186/s12877-018-0836-x
复制
发表时间：
2018-06-25
期刊：
影响因子：
4.1
通讯作者：
Castellheim, Albert
中科院分区：
文献类型：
--
作者：
Gaarden, Torfinn Lodoen;Engedal, Knut;Castellheim, Albert
背景：根据人群研究，老年人（65岁及以上）和年轻人的重度抑郁症（MD）患病率相同。与此相反，老年MD患者住院的比例较高，年轻的成年人与MD相比，这表明需要扩大老年住院MD患者的特点。为了说明这一点，炎症和MD之间的关联在老年精神病住院患者很少调查，即使炎症和治疗阻力之间的关联在年轻的成年人与MD已被报道。在这项研究中，我们的目的是探讨血浆中的27个免疫标记物的浓度在老年住院患者MD，我们的目的是扩大这些patients.Methods的炎症机制的理解：电休克治疗MD之前，我们比较了64例单极MD（平均年龄75.2岁）和18个非抑郁症对照组（平均年龄78.0岁）。采用汉密尔顿抑郁量表（HRSD）-17评定MD症状，并采用多重检测技术分析外周血免疫标志物。对于数据的统计分析，我们使用了独立样本中位数检验，独立样本t检验，卡方检验，受试者工作特征曲线分析，逐步判别分析，和多元线性regulation.Results：22个免疫标志物代表促炎和抗炎，适应性和营养信号在住院患者中的浓度高于对照组。在相当一部分（20%以上）患者病例中，仅四种免疫标志物IL-1 β、IL-5、IL-10和IL-15的浓度低于检测下限。结合血浆中TNF、血管内皮生长因子（VEGF）、IL-1 β、IL-7和单核细胞趋化蛋白（MCP）-1的浓度，正确分类了98.4%的抑郁症患者和83.3%的非抑郁症对照。TNF和VEGF的血浆浓度与HRSD-17评分（p = 0.017和0.005，分别）。结论：我们的研究结果表明，一些炎症机制可能是高度激活的老年精神病住院患者与MD，并表明免疫标志物可能有助于更全面地了解MD在老年人。
Background: The prevalence of major depression (MD) according to population studies is the same for old (65 years and older) and younger adults. In contrast, an elevated proportion of old MD patients are hospitalized compared to younger adults with MD, indicating a need to expand the characteristics of old inpatients with MD. To illustrate this point, the association between inflammation and MD in old psychiatric inpatients is sparsely investigated even though an association between inflammation and treatment resistance among younger adults with MD has been reported. In this study, we aimed to explore the plasma concentrations of 27 immune markers in old inpatients with MD, and our purpose was to expand the understanding of inflammatory mechanisms in these patients.Methods: Prior to electroconvulsive treatment of MD, we compared 64 inpatients with unipolar MD (mean age 75.2 years) and 18 non-depressed controls (mean age 78.0 years). Symptoms characterizing MD were assessed by the Hamilton Rating Scale of Depression (HRSD)-17, and the immune markers from peripheral blood plasma were analysed using multiplex assay technology. For statistical analysis of data, we used the independent samples median test, independent samples t-test, chi(2)-test, receiver operating characteristic curve analyses, stepwise discriminant analysis, and multivariate linear regression.Results: Twenty-two immune markers representing pro-and anti-inflammatory, adaptive and trophic signalling had higher concentrations in the inpatients compared to the controls. Only the four immune markers IL-1 beta, IL-5, IL-10 and IL-15 had concentrations below the lower detection limit in a considerable portion (above 20%) of the patient cases. A combination of the concentration in plasma of TNF, vascular endothelial growth factor (VEGF), IL-1 beta, IL-7 and monocyte chemotactic protein (MCP)-1, correctly classified 98.4% of the depressed patients and 83.3% of the non-depressed controls. Plasma concentration of TNF and VEGF were associated with the HRSD-17 scores (p = 0.017 and 0.005, respectively).Conclusions: Our results indicate that several inflammatory mechanisms may be highly activated in old psychiatric inpatients with MD, and indicate that immune markers may contribute to a more comprehensive understanding of MD in old persons.