首发重性抑郁障碍血NLRP3炎症小体及炎症因子水平研究  

A study on the levels of blood NLRP3 inflammasome and inflammatory factors in first-episode major depressive disorder

作　　者：刘雨佳 张秀森 邓亚洁 何漪 庞剑月[1] 李恒芬[1] LIU Yujia;ZHANG Xiusen;DENG Yajie;HE Yi;PANG Jianyue;LI Hengfen(The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院精神医学科,郑州450052

出　　处：《中国神经精神疾病杂志》2021年第6期367-371,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：河南省医学科技攻关计划省部共建项目(编号:SB201901012)。

摘　　要：目的探究首发重性抑郁障碍(first-episode major depressive disorder,F-MDD)患者外周血NOD样受体热蛋白结构域相关蛋白3(NOD-like receptors family pyrin domain containing 3,NLRP3)炎症小体及其相关炎症因子水平,并分析其与精神病性症状的相关性。方法选择F-MDD患者64例(患者组)和年龄、性别等相匹配的健康对照40名(对照组)为研究对象。根据有无精神病性症状,将患者组分为伴精神病性症状(psychotic depression,PD)组27例和不伴精神病性症状(non-psychotic depression,NPD)组37例。采用24项汉密尔顿抑郁量表(Hamilton depression scale-24,HAMD-24)评价患者疾病严重程度;采用酶联免疫吸附剂法检测研究对象血浆白介素(interleukin,IL)-18、IL-1β、神经丝蛋白轻链(neurofilament light,NFL)、Tau蛋白;采用蛋白印迹实验检测外周血单个核细胞(peripheral blood mononuclear cells,PBMC)中NLRP3炎症小体和Caspase-1水平。结果患者组血浆IL-18[中位数及上下四分位数52.386(21.796,112.010)pg/mL vs.21.124(7.917,42.558)pg/mL]、IL-1β[11.466(4.573,32.880)pg/mL vs.7.964(1.179,15.456)pg/mL]水平高于对照组(P<0.05)。患者组NLRP3炎症小体水平与对照组差异不具有统计学意义(P>0.05)。PD组IL-18[57.284(32.909,155.576)pg/mL]、IL-1β[11.915(5.321,36.912)pg/mL]水平均高于对照组(P<0.05);NPD组IL-18[37.302(20.721,80.444)pg/mL]水平高于对照组(P=0.004)。多因素logistic回归分析显示,婚姻状况(OR=0.171,95%CI:0.032~0.911)、IL-18水平(OR=1.023,95%CI:1.003~1.044)与患者伴精神病性症状相关(均P<0.05)。结论F-MDD存在由IL-18、IL-1β介导的免疫激活状态,已婚、IL-18高水平可能与F-MDD伴精神病性症状有关。Objective To explore the levels of NOD-like receptors family pyrin domain containing 3(NLRP3)inflammasome and related inflammatory factors in peripheral blood of patients with first-episode major depressive disorder(F-MDD),and to analyze their correlation with psychotic symptoms.Methods Sixty-four patients with F-MDD(patient group)and 40 gender-,age-matched healthy controls(control group)were recruited.According to the presence or absence of psychotic symptoms,the patients were divided into psychotic depression(PD)group(27 cases)and non-psychotic depression(NPD)group(37 cases).Hamilton Depression Scale-24(HAMD-24)was used to evaluate the severity of the disease.Plasma interleukin-18(IL-18),IL-1β,neurofilament light(NFL)and Tau protein were detected by using enzyme-linked immunosorbent assay.NLRP3 inflammasome and Caspase-1 in peripheral blood mononuclear cells(PBMC)were detected by western-blot.Results The plasma IL-18[52.386(21.796,112.010)pg/mL vs.21.124(7.917,42.558)pg/mL],IL-1β[11.466(4.573,32.880)pg/mL vs.7.964(1.179,15.456)pg/mL]in the patient group was higher than that of the control group(P<0.05).There was no significant difference in the level of NLRP3 inflammasome between the patient group and the control group(P>0.05).The levels of IL-18[57.284(32.909,155.576)pg/mL]and IL-1β[11.915(5.321,36.912)pg/mL]in the PD group were higher than those in the control group(P<0.05).The level of IL-18 in the NPD group[37.302(20.721,80.444)pg/mL]was higher than that of the control group(P=0.004).Multivariate logistic regression analysis showed that marital status(OR=0.171,95%CI:0.032~0.911)and IL-18 level(OR=1.023,95%CI:1.003~1.044)were related to PD(all P<0.05).Conclusion F-MDD has IL-18 and IL-1β-mediated immune activation.Married and high level of IL-18 may be related to F-MDD with psychotic symptoms.

关 键 词：首发重性抑郁障碍 NLRP3炎症小体 IL-18 精神病性症状 

分 类 号：R749.4[医药卫生—神经病学与精神病学]