Cytokines, Treatment Responses, and Body Weight Changes in Major Depressive Patients Treated with Antidepressants

抗鬱劑治療前後重鬱症病人之細胞因子、治療反應、以及體重變化之關係

林敬淳(Chin-Chuen Lin) ； 李建德(Chien-Te Lee) ； 黃條來(Tiao-Lai Huang)

《台灣精神醫學》 28卷2期 (2014/06) Pp. ii+95-102

摘要

目的：血清中的細胞因子濃度可能與重鬱症急性期之致病機轉有關。此研究探討細胞因子濃度、治療反應、以及體重變化在重鬱症病人接受四週抗鬱劑治療後的關係。方法：五十四位重鬱症病人血清中的干擾素γ（interferon-γ, IFN-γ）、腫瘤壞死因子α（tumor necrosis factor-α, TNF-α）、白細胞介素10（interleukin-10, IL-10）、以及轉化生長因子β1（transforming growth factorβ1, TGF-β1）以酵素免疫分析法測量。精神科診斷依據DSM-IV。重鬱症之嚴重度則以十七題漢式憂鬱量表評估。結果：接受治療前，之後對抗鬱劑反應佳的病人有顯著較低的IL-10濃度（p = 0.001）及顯著較低的IL-10/TGF-β1比例（p ＜ 0.01）。接受抗鬱劑治療後，在所有的病人中，體重變化與TNF-α/TGF-β1比例變化有顯著的正相關（p ＜ 0.05）。若只分析對抗鬱劑反應佳的病人，體重變化與TNF-α/TGF-β1比例變化仍有有顯著的正相關（p ＜ 0.05）。但若只分析對抗鬱劑反應不佳的病人，體重變化則與IL-10/TGF-β1比例變化有顯著的負相關（p ＜ 0.01）。結論：血清中的TNF-α、IL-10、以及TGF-β1可能可以用來預測重鬱症病人對抗鬱劑治療之反應及治療後體重的變化。

關鍵字

抗憂鬱劑 ； 體重 ； 細胞因子 ； 重鬱症

並列摘要

Objectives: Serum cytokine levels are implicated in the action of mechanism for acute-phase major depression. In this study, we intended to investigate the relationships between cytokine serum levels and treatment responses as well as body weight changes after a four-week antidepressant treatment in patients with major depressive disorders. Methods: Fifty-four major depressive patients were recruited. Their serum cytokine levels of interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), and transforming growth factor β1 (TGF-β1) were examined using ELISA kits. Psychiatric diagnoses were made using the DSM-IV criteria. Severity of major depression was assessed using the 17-item Hamilton Depression Rating Scale. Results: We found significantly lower baseline serum IL-10 level (p = 0.001) and significantly lower baseline IL-10/TGF-β1 ratio (p ＜ 0.01) in responders compared to those in non-responders. In all patients after antidepressant treatment, we found a significant positive correlation between body weight change and TNF-α/TGF-β1 ratio change (p ＜ 0.05). In responders alone, a significant positive correlation between body weight change and TNF-α/ TGF-β1 ratio change (p ＜ 0.05) was found. In non-responders, a significant negative correlation between body weight change and IL-10/TGF-β1 ratio change (p ＜ 0.01) was found. Conclusion: Serum levels of TNF-α, IL-10 and TGF-β1 could be used to predict the treatment response and body weight change in patients with major depression.

並列關鍵字

antidepressant ； body weight ； cytokine ； major depression

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