单、双相抑郁患者外周血单个核细胞糖皮质激素受体表达研究  

Study on expression of glucocorticoid receptor(GR)α in the peripheral blood leucocytes in unipolar and bipolar depressive disorders

作　　者：姜傥[1] 陈怡丽[1] 徐贵云[2] 党亚梅[2] 刘学军[2] 陈培松[1] 欧阳涓[1] 欧阳惠怡 

机构地区：[1]中山大学附属第一医院医学检验部,广州510080 [2]广州市精神病医院

出　　处：《中国神经精神疾病杂志》2010年第12期727-731,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：广州市科技攻关计划项目(编号:2007Z3-E0611)

摘　　要：目的探讨单、双相抑郁障碍患者外周血单个核细胞糖皮质激素受体(glucocorticoid receptor,GR)mRNA的表达水平及其在亚细胞的分布的差异性。方法纳入符合美国精神障碍诊断与统计手册第4版修订版(DSM-IV-TR)诊断标准的单相抑郁障碍(简称单相抑郁)患者35例、双相抑郁障碍(简称双相抑郁)患者23例和正常对照30名,检测受试者外周血单个核细胞(peripheral blood monouclearcell,PBMC)中GRαmRNA表达水平,共聚焦显微镜下观察GRα在PBMC中的亚细胞分布,测定血浆促肾上腺皮质激素(ACTH)和血清皮质醇的浓度。结果与对照组比较,单、双相抑郁患者组GRαmRNA表达均下降(P<0.05),且与HAMD总分均呈负相关(r=-0.62,P<0.05;r=-0.79,P<0.05)。随着病情的加重,单、双相抑郁的轻中度、重度亚组的GRαmRNA表达递减(P<0.05)。单、双相抑郁患者组PBMC上GRα表达均显著减少,且主要分布在细胞浆内,提示存在核分布异常;随着抑郁程度的加重,核内分布呈下降趋势(P<0.05);但单、双相抑郁患者组间无明显差异(P>0.05)。单、双相抑郁组血浆ACTH和血清皮质醇浓度与GRαmRNA的表达均无关(P>0.05)。结论提示GR在单、双相抑郁障碍的发病机制中均可能起重要作用,且GRαmRNA可能仅是抑郁状态指标,无法鉴别单、双相抑郁障碍。Objective To investigate the mRNA expression and the subcellular distribution of GRα in the peripheral blood leucocytes in unipolar and bipolar depressive patients.Methods Thirty-five unipolar depressive patients,23 bipolar depressive patients and 30 healthy controls were included in this study.RT-PCR and confocal immunofluorescence technique were used to examine the mRNA expression and subcellular distribution of GRα in the peripheral blood monouclear cells（PBMCs）.Plasma adrenocorticotrophic hormone（ACTH） and serum cortisol concentrations were detected.Results Compared with the controls,both the unipolar and bipolar depressed patients had a significant decrease in GRα mRNA expression in PBMCs（P0.05）,and there were negative correlations between the GRα mRNA expression and the Hamilton depression rating scale（HAMD） total scores in both groups（r=-0.62,P0.05;r=-0.79,P0.05）.The decrease in GRα mRNA expression was more evident when patients＇ condition deteriorated（P0.05）.The GRα in depressed groups was more pronounced in the cytoplasm than in the nucleus（P0.05）,suggesting abnormalities in nuclear translocation.However,there were no significant differences in GR mRNA expression and cellular distrbution between the two groups（P0.05）.There was no significant correlations between GRα mRNA expression in PBMCs and plasma ACTH or serum cortisol concentrations（P0.05）.Conclusions The present results suggest that the glucocorticoid receptor plays an important role in the development of both of unipolar and bipolar depression,and thus may be an indicator of depressive state.

关 键 词：单相抑郁障碍 双相抑郁障碍 糖皮质激素受体 促肾上腺皮质激素 皮质醇 

分 类 号：R749.4[医药卫生—神经病学与精神病学]