目的:越来越多的证据支持炎症可能与重度抑郁症(MDD)的病理生理学有关的观点。度洛西汀,5-羟色胺-去甲肾上腺素再摄取抑制剂,在体外和体内都表现出抗炎作用。在这项研究中,我们研究了度洛西汀对MDD患者血清促炎细胞因子水平变化的影响.
方法:本研究包括23名诊断为MDD的未用药个体和23名健康对照者。使用24项汉密尔顿抑郁量表(HAMD-24)评估抑郁症状的严重程度。一组7种促炎细胞因子,包括白细胞介素-1β(IL-1β),IL-2,IL-6,IL-8,IL-12,TNF-α,和干扰素-γ(IFN-γ),使用多重Luminex测定法进行定量。在基线时比较健康对照和MDD患者的血清细胞因子水平。所有患者均以40-60mg/天的剂量范围接受度洛西汀,持续4周。比较度洛西汀治疗前后的HAMD-24评分和血清细胞因子水平。
结果:与健康对照组相比,MDD患者的IL-2、IL-6、IL-8、IL-12、TNF-α、和IFN-γ(P<0.05)。此外,治疗前后HAMD-24评分均有显著下降(t=13.161,P<0.001)。此外,治疗4周后,血清IL-8水平(t=3.605,P=0.002),IL-12(t=2.559,P=0.018),IFN-γ显著降低(t=3.567,P=0.002)。然而,其他细胞因子没有显着差异,包括IL-1β,IL-2、IL-6和TNF-α,治疗前后差异无统计学意义(P>0.05)。
结论:这些发现提供了令人信服的证据,可能是第一次,这表明度洛西汀治疗可以有效降低诊断为MDD的个体的IL-8,IL-12和IFN-γ的血清浓度。然而,这种效应的确切机制尚不清楚,需要进一步研究.
OBJECTIVE: Accumulating evidence supports the idea that inflammation may contribute to the pathophysiology of major depressive disorder (MDD).
Duloxetine, a serotonin-norepinephrine reuptake inhibitor, exhibits anti-inflammatory effects both in vitro and in vivo. In this study, we investigated the impact of
duloxetine on changes in serum proinflammatory cytokine levels among individuals diagnosed with MDD.
METHODS: A cohort of 23 drug-naïve individuals diagnosed with MDD and 23 healthy controls were included in this study. The severity of depressive symptoms was evaluated using the 24-item Hamilton Depression Scale (HAMD-24). A panel of 7 proinflammatory cytokines, including interleukin-1β (IL-1β), IL-2, IL-6, IL-8, IL-12, tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ), were quantified using multiplex Luminex assays. The levels of serum cytokines in healthy controls and patients with MDD were compared at baseline. All patients received
duloxetine at a dosage range of 40-60 mg/day for a duration of 4 weeks. The HAMD-24 scores and serum cytokine levels were compared before and after
duloxetine treatment.
RESULTS: Compared with healthy controls, patients with MDD had significantly greater levels of IL-2, IL-6, IL-8, IL-12, TNF-α, and IFN-γ (P < 0.05). Moreover, there was a significant decrease in HAMD-24 scores observed pre- and post-treatment (t = 13.161, P < 0.001). Furthermore, after 4 weeks of treatment, the serum levels of IL-8 (t = 3.605, P = 0.002), IL-12 (t = 2.559, P = 0.018), and IFN-γ (t = 3.567, P = 0.002) decreased significantly. However, there were no significant differences in other cytokines, including IL-1β, IL-2, IL-6, and TNF-α, before and after treatment (P > 0.05).
CONCLUSIONS: These findings present compelling evidence, potentially for the first time, indicating that
duloxetine treatment may effectively reduce the serum concentrations of IL-8, IL-12, and IFN-γ in individuals diagnosed with MDD. However, the precise mechanisms underlying this effect remain unclear and warrant further investigation.