背景:重度抑郁症(MDD)和双相情感障碍(BD)与免疫激活有关,氧化应激增加,和较低的抗氧化防御。
目的:系统回顾和荟萃分析所有有关胆固醇逆向转运(RCT)生物标志物的数据,脂质相关抗氧化剂,脂质过氧化产物,以及对MDD和BD中氧化修饰的脂质表位的自身免疫反应。
方法:包括PubMed、谷歌学者和SciFinder进行了搜索,以确定从开始到1月10日的合格研究,2023年。遵循系统审查和荟萃分析(PRISMA)指南的首选报告项目指南。
结果:当前的荟萃分析包括176项研究(60项BD和116项MDD),并检查了34,051名参与者,即17,094名情感障碍患者和16,957名健康对照者。MDD和BD患者显示a)RCT显着降低(主要降低高密度脂蛋白胆固醇和对氧磷酶1);b)脂溶性维生素(包括维生素A,D,和辅酶Q10);c)增加脂质过氧化和醛形成,主要增加丙二醛(MDA),4-羟基壬烯醛,过氧化物,和8-异前列腺素;和d)免疫球蛋白(Ig)G对氧化低密度脂蛋白的反应和IgM对MDA的反应。MDD中所有脂质过氧化生物标志物/所有脂质相关抗氧化剂防御的比率显着增加(标准化平均差或SMD=0.433;95%置信区间(CI):0.312;0.554)和BD(SMD=0.653;CI:0.501-0.806)。BD中的该比率显著大于MDD(p=0.027)。
结论:在MDD/BD中,降低了RCT,一个关键的抗氧化剂和抗炎途径,可能导致脂质过氧化增加,醛的形成,和对氧化特异性表位的自身免疫反应,它们共同导致免疫炎症反应和神经情感毒性增加。
Major depression (MDD) and bipolar disorder (BD) are linked to immune activation, increased oxidative stress, and lower antioxidant defenses.
To systematically
review and meta-analyze all data concerning biomarkers of reverse cholesterol transport (RCT), lipid-associated antioxidants, lipid peroxidation products, and autoimmune responses to oxidatively modified lipid epitopes in MDD and BD.
Databases including PubMed, Google scholar and SciFinder were searched to identify eligible studies from inception to January 10th, 2023. Guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.
The current meta-analysis included 176 studies (60 BD and 116 MDD) and examined 34,051 participants, namely 17,094 with affective disorders and 16,957 healthy controls. Patients with MDD and BD showed a) significantly decreased RCT (mainly lowered high-density lipoprotein cholesterol and paraoxonase 1); b) lowered lipid soluble vitamins (including vitamin A, D, and coenzyme Q10); c) increased lipid peroxidation and aldehyde formation, mainly increased malondialdehyde (MDA), 4-hydroxynonenal, peroxides, and 8-isoprostanes; and d) Immunoglobulin (Ig)G responses to oxidized low-density lipoprotein and IgM responses to MDA. The ratio of all lipid peroxidation biomarkers/all lipid-associated antioxidant defenses was significantly increased in MDD (standardized mean difference or SMD = 0.433; 95% confidence intervals (CI): 0.312; 0.554) and BD (SMD = 0.653; CI: 0.501-0.806). This ratio was significantly greater in BD than MDD (p = 0.027).
In MDD/BD, lowered RCT, a key antioxidant and anti-inflammatory pathway, may drive increased lipid peroxidation, aldehyde formation, and autoimmune responses to oxidative specific epitopes, which all together cause increased immune-inflammatory responses and neuro-affective toxicity.