Inflammation as a predictor for depression in multiple sclerosis

炎症是多发性硬化症抑郁症的预测因子

• 批准号: 511312822
• 负责人: Dr. Yavor Yalachkov, Ph.D.
• 金额: --
• 依托单位: Klinik für Neurologie
• 依托单位国家: 德国
• 项目类别: Research Grants
• 资助国家: 德国
• 项目状态: 未结题
• 来源: https://gepris.dfg.de/gepris/projekt/511312822?language=en
• 关键词: Inflammation; predictor; depression; multiple; sclerosis

Due to its effect on patients’ quality of life and its contribution to the respective economic burden, depression is one of the most relevant comorbidities of multiple sclerosis (MS). Identifying predictors of depression would allow initiating diagnostic and therapeutic steps as early as possible and improve MS care. Major depressive disorder (MDD) studies have highlighted the relevance of inflammatory molecules in the development of depressive symptoms. Thus, investigating inflammatory processes and their relevance for depressive symptoms in MS – which itself is a chronic inflammatory condition – is highly interesting from both scientific and clinical point of view. Our project addresses the unanswered question which inflammatory markers predict the development of depressive symptoms in newly diagnosed MS patients. We focus on studying serum markers which can be determined in both MS and MDD patients. Furthermore, they can be easily obtained with a minimally invasive procedure and are thus potential candidates for a possible implementation in the clinical routine at a later stage. Additionally, we consider also other clinical, demographic, laboratory and imaging parameters (especially MS lesions and the lesion location) as predictors of depression. The project is designed as a prospective cohort study with two cohorts (60 newly diagnosed MS patients and 60 patients with MDD and no history of antidepressant medication in the last 12 months) and measurements at baseline and at a follow-up 12 months later. Serum inflammatory markers (CRP, Albumin, IL-1, sIL2R, IL-3, IL-6, IL-12, IL-17, IL-18, IL-38, TNF-α, Th1-/Th17-/T-regulatory lymphocytes) as well as clinical (including EDSS as an indicator for physical disability) and other variables (for MS patients: cerebrospinal fluid at baseline and MRI parameters at baseline and follow up) will be tested as predictors for depressive symptoms. Furthermore, a comparison between MS and MDD patients will allow the identification of those inflammatory markers, which are relevant for the occurrence of depressive symptoms especially in MS. The effects of disease modifying therapy on depressive symptoms and proinflammatory molecules will be studied as well. The insights from this study would allow to identify MS patients with a higher risk for developing depressive symptoms. Those patients could be more closely monitored and a respective treatment could be provided timely, if necessary. Thus, the disease burden of MS-related depression can be significantly reduced.

由于其对患者生活质量的影响以及对各自经济负担的影响，抑郁症是多发性硬化症 (MS) 最相关的合并症之一。识别抑郁症的预测因素将有助于尽早启动诊断和治疗步骤，并改善多发性硬化症的护理。重度抑郁症（MDD）研究强调了炎症分子在抑郁症状发展中的相关性。因此，从科学和临床的角度来看，研究多发性硬化症（本身就是一种慢性炎症）的炎症过程及其与抑郁症状的相关性都非常有趣。 我们的项目解决了一个尚未解答的问题：哪些炎症标记物可以预测新诊断的多发性硬化症患者抑郁症状的发展。我们专注于研究可在 MS 和 MDD 患者中测定的血清标志物。此外，它们可以通过微创手术轻松获得，因此是后期临床常规中可能实施的潜在候选者。此外，我们还考虑其他临床、人口统计、实验室和影像学参数（尤其是多发性硬化症病变和病变位置）作为抑郁症的预测因素。该项目被设计为一项前瞻性队列研究，有两个队列（60 名新诊断的 MS 患者和 60 名 MDD 患者，并且在过去 12 个月内没有抗抑郁药物治疗史），并在基线和 12 个月后的随访中进行测量。血清炎症标志物（CRP、白蛋白、IL-1、sIL2R、IL-3、IL-6、IL-12、IL-17、IL-18、IL-38、TNF-α、Th1-/Th17-/T 调节性淋巴细胞）以及临床（包括 EDSS 作为身体残疾指标）和其他变量（对于 MS 患者：脑脊液 基线以及基线和随访时的 MRI 参数）将作为抑郁症状的预测因子进行测试。此外，多发性硬化症和重度抑郁症患者之间的比较将有助于识别这些炎症标志物，这些标志物与抑郁症状的发生相关，尤其是在多发性硬化症患者中。还将研究疾病修饰疗法对抑郁症状和促炎分子的影响。这项研究的见解将有助于识别出现抑郁症状风险较高的多发性硬化症患者。可以对这些患者进行更密切的监测，并在必要时及时提供相应的治疗。因此，多发性硬化症相关抑郁症的疾病负担可以显着减轻。