A Meta-Analysis of Cytokines in Major Depression
A Meta-Analysis of Cytokines in Major Depression
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DOI：
10.1016/j.biopsych.2009.09.033
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发表时间：
2010-03-01
影响因子：
10.6
通讯作者：
Lanctot, Krista L.
中科院分区：
文献类型：
--
作者：
Dowlati, Yekta;Herrmann, Nathan;Lanctot, Krista L.
背景：重度抑郁症发生在4.4%至20%的普通人群中。研究表明，重度抑郁症伴随着免疫失调和炎症反应系统(IRS)的激活。我们的目的是定量总结诊断为重度抑郁发作的患者和对照组的特定细胞因子浓度的数据。方法：我们对测量重度抑郁症患者细胞因子浓度的研究进行了荟萃分析，检索了英文文献(至2009年8月)，并手动搜索参考文献。结果：24篇涉及符合DSM抑郁症诊断标准的患者的细胞因子非刺激性测定的研究进入Meta分析；肿瘤坏死因子α13例，白介素1β9例，白介素6 16例，白介素4 5例，白介素2 5例，白介素8 4例，白介素10 6例，干扰素γ4例。与对照组(438例抑郁症/350例非抑郁组)相比，抑郁组血清中肿瘤坏死因子-α(P<；0.00001)、加权平均差值(WMD)(95%可信区间)为3.97 pg/mL(2.24~5.71)，差异有统计学意义。此外，抑郁组的IL-6浓度显著高于对照组(492例抑郁组/400例非抑郁组)，总体WMD为1.78pg/mL(1.23至2.33)。其他细胞因子在抑郁症患者和非抑郁症患者之间的差异无统计学意义。结论：Meta分析显示抑郁症患者的促炎细胞因子TNF-α和IL-6浓度显著高于对照组。虽然在个别研究中报道了积极和消极的结果，但这一荟萃分析结果强化了抑郁症伴随着IRS激活的证据。
Background: Major depression occurs in 4.4% to 20% of the general population. Studies suggest that major depression is accompanied by immune dysregulation and activation of the inflammatory response system (IRS). Our objective was to quantitatively summarize the data on concentrations of specific cytokines in patients diagnosed with a major depressive episode and controls.Methods: We performed a meta-analysis of studies measuring cytokine concentration in patients with major depression, with a database search of the English literature (to August 2009) and a manual search of references.Results: Twenty-four studies involving unstimulated measurements of cytokines in patients meeting DSM criteria for major depression were included in the meta-analysis; 13 for tumor necrosis factor (TNF)-alpha, 9 for interleukin (IL)-1 beta, 16 for IL-6, 5 for IL-4, 5 for IL-2, 4 for IL-8, 6 for IL-10, and 4 for interferon (IFN)-gamma. There were significantly higher concentrations of TNF-alpha (p < .00001), weighted mean difference (WMD) (95% confidence interval) 3.97 pg/mL (2.24 to 5.71), in depressed subjects compared with control subjects (438 depressed/350 nondepressed). Also, IL-6 concentrations were significantly higher (p < .00001) in depressed subjects compared with control subjects (492 depressed/400 nondepressed) with an overall WMD of 1.78 pg/mL (1.23 to 2.33). There were no significant differences among depressed and nondepressed subjects for the other cytokines studied.Conclusions: This meta-analysis reports significantly higher concentrations of the proinflammatory cytokines TNF-alpha and IL-6 in depressed subjects compared with control subjects. While both positive and negative results have been reported in individual studies, this meta-analytic result strengthens evidence that depression is accompanied by activation of the IRS.