辅助性T细胞17相关细胞因子与抑郁症患者选择性5-羟色胺再摄取抑制剂治疗反应性的关系研究

Relationship between T helper 17 cell-related cytokines and response to selective serotonin reuptake inhibitors in patients with depression

  • 摘要:
    目的 探讨抑郁症患者辅助性T细胞17(Th17)相关细胞因子水平与选择性5-羟色胺再摄取抑制剂(SSRIs)治疗反应性的关系。
    方法 选取98例抑郁症患者作为研究对象,均接受SSRIs治疗。依据治疗反应性汉密尔顿抑郁量表(HAMD)减分率,将患者分为反应组和无反应组。比较2组患者治疗前及治疗后Th17相关细胞因子水平及变化率,采用Pearson相关性分析探讨HAMD减分率与Th17相关细胞因子水平的相关性。采用多因素Logistic回归分析筛选SSRIs治疗反应性的影响因素; 绘制受试者工作特征(ROC)曲线,评估Th17相关细胞因子对治疗反应性的预测效能。
    结果 经SSRIs治疗12周后, 64例(65.31%)患者HAMD减分率≥50%, 归为反应组; 其余34例(34.69%)患者HAMD减分率<50%, 归为无反应组。治疗前,反应组转化生长因子β(TGF-β)水平低于无反应组,白细胞介素(IL)-17、IL-6水平高于无反应组,差异有统计学意义(P<0.05); 治疗后,反应组TGF-β、IL-17、IL-6水平低于无反应组,且反应组TGF-β、IL-17变化率高于无反应组,差异有统计学意义(P<0.05)。Pearson相关性分析显示, HAMD减分率与治疗前IL-6水平、治疗前IL-17水平、IL-17变化率、TGF-β变化率呈正相关,与治疗前TGF-β水平呈负相关(P<0.05)。多因素Logistic回归分析结果显示,治疗前IL-6、IL-17是抑郁症患者SSRIs治疗反应性的独立保护因素,治疗前TGF-β是独立危险因素(P<0.05)。ROC曲线显示,治疗前IL-6、IL-17、TGF-β单独及联合预测SSRIs治疗反应性的曲线下面积分别为0.841、0.694、0.862及0.952。
    结论 抑郁症患者Th17相关细胞因子IL-17、IL-6、TGF-β与SSRIs治疗反应性存在关联。治疗前IL-17、IL-6、TGF-β水平可预测SSRIs治疗反应性,联合检测能进一步提高预测效能。

     

    Abstract:
    Objective To investigate the relationship between the levels of T helper 17 (Th17) cell-related cytokines and the response to selective serotonin reuptake inhibitors (SSRIs) in patients with depression.
    Methods A total of 98 patients with depression were selected as the study subjects, all of whom received SSRIs treatment. Based on the treatment response the reduction rate of the Hamilton Depression Rating Scale (HAMD), the patients were divided into responder group and non-responder group. The levels and change rates of Th17 cell-related cytokines before and after treatment were compared between the two groups. Pearson correlation analysis was used to explore the correlation between the HAMD reduction rate and the levels of Th17 cell-related cytokines. Multifactorial logistic regression analysis was employed to screen the influencing factors of the SSRIs treatment response. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive efficacy of Th17 cell-related cytokines for the treatment response.
    Results After 12 weeks of SSRIs treatment, 64 patients (65.31%) had an HAMD reduction rate of ≥50% and were classified into responder group; the remaining 34 patients (34.69%) had an HAMD reduction rate of < 50% were classified into non-responder group. Before treatment, the level of transforming growth factor-β (TGF-β) in the responder group was lower than that in the non-responder group, while the levels of interleukin (IL)-17 and IL-6 were higher than those in the non-responder group, with statistically significant differences (P < 0.05). After treatment, the levels of TGF-β, IL-17, and IL-6 in the responder group were lower than those in the non-responder group, and the change rates of TGF-β and IL-17 in the responder group were higher than those in the non-responder group, with statistically significant differences (P < 0.05). Pearson correlation analysis showed that the HAMD reduction rate was positively correlated with the pre-treatment IL-6 level, pre-treatment IL-17 level, IL-17 change rate, and TGF-β change rate, and negatively correlated with the pre-treatment TGF-β level (P < 0.05). The results of multifactorial logistic regression analysis indicated that pre-treatment IL-6 and IL-17 were independent protective factors for the SSRIs treatment response in patients with depression, while pre-treatment TGF-β was an independent risk factor (P < 0.05). The ROC curves demonstrated that the areas under the curves for predicting the SSRIs treatment response using pre-treatment IL-6, IL-17, and TGF-β alone and their combination were 0.841, 0.694, 0.862, and 0.952, respectively.
    Conclusion There are associations of Th17 cell-related cytokines (IL-17, IL-6, and TGF-β) with the SSRIs treatment response in patients with depression. The pre-treatment levels of IL-17, IL-6, and TGF-β can predict the SSRIs treatment response, and combined detection can further improve the predictive efficacy.

     

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