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Xu D, Xu Y, Gao X, Yan M, Zhang C, Wu X, Xia Q, Ge J. Potential value of Interleukin-6 as a diagnostic biomarker in human MDD and the antidepressant effect of its receptor antagonist tocilizumab in lipopolysaccharide-challenged rats. Int Immunopharmacol 2023; 124:110903. [PMID: 37717319 DOI: 10.1016/j.intimp.2023.110903] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 09/19/2023]
Abstract
Depression is a common mental disease with disastrous effect on the health and wealth globally. Focusing on the role for inflammation and immune activation in the pathogenesis of depression, many tries have been taken into effect targeting at the blockage of inflammatory cytokines, among which interleukin- 6 (IL-6) and its receptor antagonist tocilizumab attracts more attention, with inconsistent findings. Moderate to severe depressive disorder (MSDD) patients were enrolled and the serum concentrations of IL-6 and tumor necrosis factor-α (TNF-α) measured, their correlation with the Hamilton Depression Rating Scale-24 (HAMD-24) scores was analyzed, and their role in discriminating MSDD patients from the health controls were evaluated. Meanwhile, a depression rat model was established by intraperitoneal injection of LPS, and tocilizumab was administrated doing 50 mg/kg via intravenous injection. The behavioral performance was observed, the serum concentration of IL-6, TNF-α, and C-reactive protein (CRP) was measured, and the protein expression of IL-6 and TNF-α in the hippocampus were also detected. The activity of the Hypothalamic-pituitary-adrenal (HPA) axis was observed, and the protein expression levels in the hippocampus were detected via western blot. Moreover, the immunofluorescence staining (IF) technique was used to investigate the co-location of IL-6 and neuron (MAP2), astrocyte (GFAP), or microglial (IBA-1). The results showed that the serum IL-6 level was significantly increased in the MSDD patients and lipopolysaccharide (LPS)-challenged rats, with a significant correlation with the HAMD-24 scores or struggling time in the FST and corticosterone (CORT) abundance. Results of ROC analysis showed a significant diagnosis value of IL-6 in discriminating MSDD patients or depression rats from the controls in the present study. Tocilizumab could relieve the depression-like behaviors induced by LPS, together with a normal abundance of serum CORT and hypothalamic CRH expression. Moreover, tocilizumab could alleviate the "inflammatory storm" and impaired hippocampal synaptic plasticity in LPS-challenged depression rats, inhibiting the hyperactivation of astrocyte and microglia, decreasing the peripheral and central abundance of IL-6, CRP, and TNF-α, and balancing the hippocampal expression levels of synaptic plasticity-associated proteins and key molecular in Wnt/β-catenin signaling pathway. These results indicated a predictive role of IL-6 in discriminating depression from controls, and demonstrated an antidepressant effect of tocilizumab in LPS-challenged rats, targeting at the inflammatory storm and the subsequent impairments of hippocampal synaptic plasticity.
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Affiliation(s)
- Dandan Xu
- School of Pharmacy, Anhui Medical University, 81 Mei-Shan Road, Hefei 230032, China; The Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Anhui Medical University, Hefei, China; Anhui Provincial Laboratory of Inflammatory and Immunity Disease, Anhui Institute of Innovative Drugs, Hefei, China.
| | - Yayun Xu
- School of Pharmacy, Anhui Medical University, 81 Mei-Shan Road, Hefei 230032, China; School of Public Health, Anhui Medical University, 81 Mei-Shan Road, Hefei 230032, China.
| | - Xinran Gao
- School of Pharmacy, Anhui Medical University, 81 Mei-Shan Road, Hefei 230032, China; The Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Anhui Medical University, Hefei, China; Anhui Provincial Laboratory of Inflammatory and Immunity Disease, Anhui Institute of Innovative Drugs, Hefei, China.
| | - Mengyu Yan
- School of Pharmacy, Anhui Medical University, 81 Mei-Shan Road, Hefei 230032, China.
| | - Chen Zhang
- The Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Anhui Medical University, Hefei, China; School of 1st Clinic Medicine, Anhui Medical University, 81 Mei-Shan Road, Hefei 230032, China.
| | - Xian Wu
- School of Pharmacy, Anhui Medical University, 81 Mei-Shan Road, Hefei 230032, China; The Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Anhui Medical University, Hefei, China; Anhui Provincial Laboratory of Inflammatory and Immunity Disease, Anhui Institute of Innovative Drugs, Hefei, China.
| | - Qingrong Xia
- Department of Pharmacy, Hefei Fourth People's Hospital, Hefei 230032, China; Clinical Pharmacy, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China; Psychopharmacology Research Laboratory, Anhui Mental Health Center, Hefei, China.
| | - Jinfang Ge
- School of Pharmacy, Anhui Medical University, 81 Mei-Shan Road, Hefei 230032, China; The Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Anhui Medical University, Hefei, China; Anhui Provincial Laboratory of Inflammatory and Immunity Disease, Anhui Institute of Innovative Drugs, Hefei, China.
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Sun T, Chen Q, Mei J, Li Y. Associations between serum estradiol and IL-6/sIL-6R/sgp130 complex in female patients with major depressive disorder. BMC Psychiatry 2023; 23:742. [PMID: 37828513 PMCID: PMC10568828 DOI: 10.1186/s12888-023-05248-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/03/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND It has been hypothesized that the IL-6/sIL-6R/sgp130 complex, an inflammatory complex, plays a critical role in the pathogenesis of major depressive disorder (MDD). Estradiol (E2) is a sex steroid hormone involved in emotional regulation and MDD. This study aimed to investigate the relationship between E2 and IL-6/sIL-6R/sgp130 complex in patients with MDD. METHODS Using enzyme-linked immunosorbent assay, the levels of IL-6, sIL-6Rα, and sgp130 were compared between 117 female patients with MDD and 122 healthy controls.The serum concentrations of E2 and other biomarkers were also measured. RESULTS (1) The serum levels of IL-6 and sIL-6Rα in patients with MDD were significantly higher than those in the control group, while the serum levels of sgp130 and E2 were significantly lower (all P < 0.05). (2) Low levels of E2 were associated with high levels of IL-6 and low levels of sgp130 (all P < 0.01). (3) HAMD-24 score was positively correlated with the serum level of IL-6, but negatively correlated with the serum levels of sgp130 and E2(all P < 0.05). (4) IL-6 and sgp130 had certain prognostic values in MDD, and the combination of various indicators showed a significantly superior prognostic value. CONCLUSIONS The IL6/sIL-6R/sgp130 complex in female patients with MDD was closely related to E2 level. In addition, IL-6 and sgp130 may be valuable serum biomarkers for the diagnosis and prognosis of MDD in women.
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Affiliation(s)
- Ting Sun
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Zhangzhidong Road, Wuchang District, Wuhan, 430060, Hubei, China
| | - Qian Chen
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Zhangzhidong Road, Wuchang District, Wuhan, 430060, Hubei, China
| | - Junchi Mei
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Zhangzhidong Road, Wuchang District, Wuhan, 430060, Hubei, China
| | - Yan Li
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Zhangzhidong Road, Wuchang District, Wuhan, 430060, Hubei, China.
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Bai Z, Gao T, Zhang R, Lu Y, Tian J, Wang T, Zhao K, Wang H. Inhibition of IL-6 methylation by Saikosaponin C regulates neuroinflammation to alleviate depression. Int Immunopharmacol 2023; 118:110043. [PMID: 36965369 DOI: 10.1016/j.intimp.2023.110043] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/27/2023] [Accepted: 03/13/2023] [Indexed: 03/27/2023]
Abstract
PURPOSE Saikosaponin C (SSc) increases the expression of synaptic proteins and has a unexplored role in the prevention of AD and other neurodegeneration in humans. Therefore, we hypothesized that SSc has the potential to relief of depressive symptoms. Here, our study assessed the role of SSc on depression-like behaviors caused by a chronic social defeat stress (CSDS) in mice and explored the underlying mechanisms. METHODS Behavioral tests were conducted to verify the efficacy of SSC in treating depression-like behavior in mice. The levels of IL-6, TNF-α and IL-1β in brain tissue and BV2 cells were determined by ELISA. The effect of SSc on dendritic spine density was determined by Golgi staining. The percentage of monocytes in peripheral blood was measured using flow cytometry. The levels of STAT3 and DNMT1 under the influence of SSc were assessed by immunofluorescence. Protein expression of DNMT1, DNMT3a, DNMT3b, p-STAT3 and STAT3 in brain and BV2 cells was studied by Western blot. OE-DNMT1 was induced in the experiment to verify the inhibitory effect of DNMT1 on IL-6 methylation in SSC. Luciferase was used to detect SSC specific fragments affecting IL-6 methylation. RESULT SSC treatment significantly alleviated depressive-like behavior, inhibited the levels of inflammatory cytokines including IL-6, IL-1β and TNF-α, increased dendritic spine density and promoted synaptic plasticity in mice. SSC downregulated IL-6, STAT3 and DNMT1 expression in vivo and in vitro. SSC also decreased the percentage of monocytes in peripheral blood and suppressed neuroinflammation in mice. Overexpression of DNMT1 by shRNA abolished the inhibitory effect of SSc on IL-6 methylation. CONCLUSION This study showed that SSc reduced IL6 methylation by inhibiting DNMT1 protein, induced a decrease in IL6 expression, promoted synaptic plasticity, and attenuated CSDS-induced depression-like behavior.
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Affiliation(s)
- Zijun Bai
- College of Pharmacy, Ningxia Key Laboratory of Cerebrocranial Disease, Incubation Base of National Key Laboratory, Ningxia Medical University, Yinchuan, Ningxia 750004, China
| | - Tiantian Gao
- College of Pharmacy, Ningxia Key Laboratory of Cerebrocranial Disease, Incubation Base of National Key Laboratory, Ningxia Medical University, Yinchuan, Ningxia 750004, China
| | - Rui Zhang
- College of Pharmacy, Ningxia Key Laboratory of Cerebrocranial Disease, Incubation Base of National Key Laboratory, Ningxia Medical University, Yinchuan, Ningxia 750004, China
| | - Youyuan Lu
- College of Pharmacy, Ningxia Key Laboratory of Cerebrocranial Disease, Incubation Base of National Key Laboratory, Ningxia Medical University, Yinchuan, Ningxia 750004, China; Ningxia Regional Characteristic Traditional Chinese Medicine Collaborative Innovation Center Co-constructed by the Province and Ministry, Ningxia Engineering and Technology Research Center for Modernization of Regional Characteristic Traditional Chinese Medicine, Ningxia Medical University, Yinchuan 750004, China
| | - Jinlong Tian
- College of Pharmacy, Ningxia Key Laboratory of Cerebrocranial Disease, Incubation Base of National Key Laboratory, Ningxia Medical University, Yinchuan, Ningxia 750004, China
| | - Tao Wang
- College of Pharmacy, Ningxia Key Laboratory of Cerebrocranial Disease, Incubation Base of National Key Laboratory, Ningxia Medical University, Yinchuan, Ningxia 750004, China
| | - Keke Zhao
- College of Pharmacy, Ningxia Key Laboratory of Cerebrocranial Disease, Incubation Base of National Key Laboratory, Ningxia Medical University, Yinchuan, Ningxia 750004, China
| | - Hanqing Wang
- College of Pharmacy, Ningxia Key Laboratory of Cerebrocranial Disease, Incubation Base of National Key Laboratory, Ningxia Medical University, Yinchuan, Ningxia 750004, China; Ningxia Regional Characteristic Traditional Chinese Medicine Collaborative Innovation Center Co-constructed by the Province and Ministry, Ningxia Engineering and Technology Research Center for Modernization of Regional Characteristic Traditional Chinese Medicine, Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Ningxia Minority Medicine Modernization, Ministry of Education, Ningxia Medical University, Yinchuan 750004, China.
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Selected Biomarkers of Depression: What Are the Effects of Cytokines and Inflammation? Int J Mol Sci 2022; 24:ijms24010578. [PMID: 36614020 PMCID: PMC9820159 DOI: 10.3390/ijms24010578] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/22/2022] [Accepted: 12/25/2022] [Indexed: 12/31/2022] Open
Abstract
Depression is one of the leading mental illnesses worldwide and lowers the quality of life of many. According to WHO, about 5% of the worldwide population suffers from depression. Newer studies report a staggering global prevalence of 27.6%, and it is rising. Professionally, depression belonging to affective disorders is a psychiatric illness, and the category of major depressive disorder (MDD) comprises various diagnoses related to persistent and disruptive mood disorders. Due to this fact, it is imperative to find a way to assess depression quantitatively using a specific biomarker or a panel of biomarkers that would be able to reflect the patients' state and the effects of therapy. Cytokines, hormones, oxidative stress markers, and neuropeptides are studied in association with depression. The latest research into inflammatory cytokines shows that their relationship with the etiology of depression is causative. There are stronger cytokine reactions to pathogens and stressors in depression. If combined with other predisposing factors, responses lead to prolonged inflammatory processes, prolonged dysregulation of various axes, stress, pain, mood changes, anxiety, and depression. This review focuses on the most recent data on cytokines as markers of depression concerning their roles in its pathogenesis, their possible use in diagnosis and management, their different levels in bodily fluids, and their similarities in animal studies. However, cytokines are not isolated from the pathophysiologic mechanisms of depression or other psychiatric disorders. Their effects are only a part of the whole pathway.
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Reiter A, Bengesser SA, Hauschild AC, Birkl-Töglhofer AM, Fellendorf FT, Platzer M, Färber T, Seidl M, Mendel LM, Unterweger R, Lenger M, Mörkl S, Dalkner N, Birner A, Queissner R, Hamm C, Maget A, Pilz R, Kohlhammer-Dohr A, Wagner-Skacel J, Kreuzer K, Schöggl H, Amberger-Otti D, Lahousen T, Leitner-Afschar B, Haybäck J, Kapfhammer HP, Reininghaus E. Interleukin-6 Gene Expression Changes after a 4-Week Intake of a Multispecies Probiotic in Major Depressive Disorder-Preliminary Results of the PROVIT Study. Nutrients 2020; 12:E2575. [PMID: 32858844 PMCID: PMC7551871 DOI: 10.3390/nu12092575] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/20/2020] [Accepted: 08/21/2020] [Indexed: 12/13/2022] Open
Abstract
Major depressive disorder (MDD) is a prevalent disease, in which one third of sufferers do not respond to antidepressants. Probiotics have the potential to be well-tolerated and cost-efficient treatment options. However, the molecular pathways of their effects are not fully elucidated yet. Based on previous literature, we assume that probiotics can positively influence inflammatory mechanisms. We aimed at analyzing the effects of probiotics on gene expression of inflammation genes as part of the randomized, placebo-controlled, multispecies probiotics PROVIT study in Graz, Austria. Fasting blood of 61 inpatients with MDD was collected before and after four weeks of probiotic intake or placebo. We analyzed the effects on gene expression of tumor necrosis factor (TNF), nuclear factor kappa B subunit 1 (NFKB1) and interleukin-6 (IL-6). In IL-6 we found no significant main effects for group (F(1,44) = 1.33, p = ns) nor time (F(1,44) = 0.00, p = ns), but interaction was significant (F(1,44) = 5.67, p < 0.05). The intervention group showed decreasing IL-6 gene expression levels while the placebo group showed increasing gene expression levels of IL-6. Probiotics could be a useful additional treatment in MDD, due to their anti-inflammatory effects. Results of the current study are promising, but further studies are required to investigate the beneficial effects of probiotic interventions in depressed individuals.
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Affiliation(s)
- Alexandra Reiter
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria; (A.R.); (F.T.F.); (M.P.); (M.S.); (L.-M.M.); (R.U.); (M.L.); (S.M.); (N.D.); (A.B.); (R.Q.); (C.H.); (A.M.); (R.P.); (A.K.-D.); (J.W.-S.); (K.K.); (H.S.); (D.A.-O.); (T.L.); (B.L.-A.); (H.-P.K.); (E.R.)
| | - Susanne A. Bengesser
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria; (A.R.); (F.T.F.); (M.P.); (M.S.); (L.-M.M.); (R.U.); (M.L.); (S.M.); (N.D.); (A.B.); (R.Q.); (C.H.); (A.M.); (R.P.); (A.K.-D.); (J.W.-S.); (K.K.); (H.S.); (D.A.-O.); (T.L.); (B.L.-A.); (H.-P.K.); (E.R.)
| | - Anne-Christin Hauschild
- Department of Mathematics & Computer Science, University of Marburg, 35043 Marburg, Germany;
| | - Anna-Maria Birkl-Töglhofer
- Institute for Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (A.-M.B.-T.); (J.H.)
| | - Frederike T. Fellendorf
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria; (A.R.); (F.T.F.); (M.P.); (M.S.); (L.-M.M.); (R.U.); (M.L.); (S.M.); (N.D.); (A.B.); (R.Q.); (C.H.); (A.M.); (R.P.); (A.K.-D.); (J.W.-S.); (K.K.); (H.S.); (D.A.-O.); (T.L.); (B.L.-A.); (H.-P.K.); (E.R.)
| | - Martina Platzer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria; (A.R.); (F.T.F.); (M.P.); (M.S.); (L.-M.M.); (R.U.); (M.L.); (S.M.); (N.D.); (A.B.); (R.Q.); (C.H.); (A.M.); (R.P.); (A.K.-D.); (J.W.-S.); (K.K.); (H.S.); (D.A.-O.); (T.L.); (B.L.-A.); (H.-P.K.); (E.R.)
| | - Tanja Färber
- Institute of Psychology, University of Bamberg, 96047 Bamberg, Germany;
| | - Matthias Seidl
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria; (A.R.); (F.T.F.); (M.P.); (M.S.); (L.-M.M.); (R.U.); (M.L.); (S.M.); (N.D.); (A.B.); (R.Q.); (C.H.); (A.M.); (R.P.); (A.K.-D.); (J.W.-S.); (K.K.); (H.S.); (D.A.-O.); (T.L.); (B.L.-A.); (H.-P.K.); (E.R.)
| | - Lilli-Marie Mendel
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria; (A.R.); (F.T.F.); (M.P.); (M.S.); (L.-M.M.); (R.U.); (M.L.); (S.M.); (N.D.); (A.B.); (R.Q.); (C.H.); (A.M.); (R.P.); (A.K.-D.); (J.W.-S.); (K.K.); (H.S.); (D.A.-O.); (T.L.); (B.L.-A.); (H.-P.K.); (E.R.)
| | - Renate Unterweger
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria; (A.R.); (F.T.F.); (M.P.); (M.S.); (L.-M.M.); (R.U.); (M.L.); (S.M.); (N.D.); (A.B.); (R.Q.); (C.H.); (A.M.); (R.P.); (A.K.-D.); (J.W.-S.); (K.K.); (H.S.); (D.A.-O.); (T.L.); (B.L.-A.); (H.-P.K.); (E.R.)
| | - Melanie Lenger
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria; (A.R.); (F.T.F.); (M.P.); (M.S.); (L.-M.M.); (R.U.); (M.L.); (S.M.); (N.D.); (A.B.); (R.Q.); (C.H.); (A.M.); (R.P.); (A.K.-D.); (J.W.-S.); (K.K.); (H.S.); (D.A.-O.); (T.L.); (B.L.-A.); (H.-P.K.); (E.R.)
| | - Sabrina Mörkl
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria; (A.R.); (F.T.F.); (M.P.); (M.S.); (L.-M.M.); (R.U.); (M.L.); (S.M.); (N.D.); (A.B.); (R.Q.); (C.H.); (A.M.); (R.P.); (A.K.-D.); (J.W.-S.); (K.K.); (H.S.); (D.A.-O.); (T.L.); (B.L.-A.); (H.-P.K.); (E.R.)
| | - Nina Dalkner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria; (A.R.); (F.T.F.); (M.P.); (M.S.); (L.-M.M.); (R.U.); (M.L.); (S.M.); (N.D.); (A.B.); (R.Q.); (C.H.); (A.M.); (R.P.); (A.K.-D.); (J.W.-S.); (K.K.); (H.S.); (D.A.-O.); (T.L.); (B.L.-A.); (H.-P.K.); (E.R.)
| | - Armin Birner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria; (A.R.); (F.T.F.); (M.P.); (M.S.); (L.-M.M.); (R.U.); (M.L.); (S.M.); (N.D.); (A.B.); (R.Q.); (C.H.); (A.M.); (R.P.); (A.K.-D.); (J.W.-S.); (K.K.); (H.S.); (D.A.-O.); (T.L.); (B.L.-A.); (H.-P.K.); (E.R.)
| | - Robert Queissner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria; (A.R.); (F.T.F.); (M.P.); (M.S.); (L.-M.M.); (R.U.); (M.L.); (S.M.); (N.D.); (A.B.); (R.Q.); (C.H.); (A.M.); (R.P.); (A.K.-D.); (J.W.-S.); (K.K.); (H.S.); (D.A.-O.); (T.L.); (B.L.-A.); (H.-P.K.); (E.R.)
| | - Carlo Hamm
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria; (A.R.); (F.T.F.); (M.P.); (M.S.); (L.-M.M.); (R.U.); (M.L.); (S.M.); (N.D.); (A.B.); (R.Q.); (C.H.); (A.M.); (R.P.); (A.K.-D.); (J.W.-S.); (K.K.); (H.S.); (D.A.-O.); (T.L.); (B.L.-A.); (H.-P.K.); (E.R.)
| | - Alexander Maget
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria; (A.R.); (F.T.F.); (M.P.); (M.S.); (L.-M.M.); (R.U.); (M.L.); (S.M.); (N.D.); (A.B.); (R.Q.); (C.H.); (A.M.); (R.P.); (A.K.-D.); (J.W.-S.); (K.K.); (H.S.); (D.A.-O.); (T.L.); (B.L.-A.); (H.-P.K.); (E.R.)
| | - Rene Pilz
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria; (A.R.); (F.T.F.); (M.P.); (M.S.); (L.-M.M.); (R.U.); (M.L.); (S.M.); (N.D.); (A.B.); (R.Q.); (C.H.); (A.M.); (R.P.); (A.K.-D.); (J.W.-S.); (K.K.); (H.S.); (D.A.-O.); (T.L.); (B.L.-A.); (H.-P.K.); (E.R.)
| | - Alexandra Kohlhammer-Dohr
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria; (A.R.); (F.T.F.); (M.P.); (M.S.); (L.-M.M.); (R.U.); (M.L.); (S.M.); (N.D.); (A.B.); (R.Q.); (C.H.); (A.M.); (R.P.); (A.K.-D.); (J.W.-S.); (K.K.); (H.S.); (D.A.-O.); (T.L.); (B.L.-A.); (H.-P.K.); (E.R.)
| | - Jolana Wagner-Skacel
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria; (A.R.); (F.T.F.); (M.P.); (M.S.); (L.-M.M.); (R.U.); (M.L.); (S.M.); (N.D.); (A.B.); (R.Q.); (C.H.); (A.M.); (R.P.); (A.K.-D.); (J.W.-S.); (K.K.); (H.S.); (D.A.-O.); (T.L.); (B.L.-A.); (H.-P.K.); (E.R.)
| | - Kathrin Kreuzer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria; (A.R.); (F.T.F.); (M.P.); (M.S.); (L.-M.M.); (R.U.); (M.L.); (S.M.); (N.D.); (A.B.); (R.Q.); (C.H.); (A.M.); (R.P.); (A.K.-D.); (J.W.-S.); (K.K.); (H.S.); (D.A.-O.); (T.L.); (B.L.-A.); (H.-P.K.); (E.R.)
| | - Helmut Schöggl
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria; (A.R.); (F.T.F.); (M.P.); (M.S.); (L.-M.M.); (R.U.); (M.L.); (S.M.); (N.D.); (A.B.); (R.Q.); (C.H.); (A.M.); (R.P.); (A.K.-D.); (J.W.-S.); (K.K.); (H.S.); (D.A.-O.); (T.L.); (B.L.-A.); (H.-P.K.); (E.R.)
| | - Daniela Amberger-Otti
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria; (A.R.); (F.T.F.); (M.P.); (M.S.); (L.-M.M.); (R.U.); (M.L.); (S.M.); (N.D.); (A.B.); (R.Q.); (C.H.); (A.M.); (R.P.); (A.K.-D.); (J.W.-S.); (K.K.); (H.S.); (D.A.-O.); (T.L.); (B.L.-A.); (H.-P.K.); (E.R.)
| | - Theresa Lahousen
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria; (A.R.); (F.T.F.); (M.P.); (M.S.); (L.-M.M.); (R.U.); (M.L.); (S.M.); (N.D.); (A.B.); (R.Q.); (C.H.); (A.M.); (R.P.); (A.K.-D.); (J.W.-S.); (K.K.); (H.S.); (D.A.-O.); (T.L.); (B.L.-A.); (H.-P.K.); (E.R.)
| | - Birgitta Leitner-Afschar
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria; (A.R.); (F.T.F.); (M.P.); (M.S.); (L.-M.M.); (R.U.); (M.L.); (S.M.); (N.D.); (A.B.); (R.Q.); (C.H.); (A.M.); (R.P.); (A.K.-D.); (J.W.-S.); (K.K.); (H.S.); (D.A.-O.); (T.L.); (B.L.-A.); (H.-P.K.); (E.R.)
| | - Johannes Haybäck
- Institute for Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (A.-M.B.-T.); (J.H.)
| | - Hans-Peter Kapfhammer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria; (A.R.); (F.T.F.); (M.P.); (M.S.); (L.-M.M.); (R.U.); (M.L.); (S.M.); (N.D.); (A.B.); (R.Q.); (C.H.); (A.M.); (R.P.); (A.K.-D.); (J.W.-S.); (K.K.); (H.S.); (D.A.-O.); (T.L.); (B.L.-A.); (H.-P.K.); (E.R.)
| | - Eva Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, 8036 Graz, Austria; (A.R.); (F.T.F.); (M.P.); (M.S.); (L.-M.M.); (R.U.); (M.L.); (S.M.); (N.D.); (A.B.); (R.Q.); (C.H.); (A.M.); (R.P.); (A.K.-D.); (J.W.-S.); (K.K.); (H.S.); (D.A.-O.); (T.L.); (B.L.-A.); (H.-P.K.); (E.R.)
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6
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Petralia MC, Mazzon E, Fagone P, Basile MS, Lenzo V, Quattropani MC, Di Nuovo S, Bendtzen K, Nicoletti F. The cytokine network in the pathogenesis of major depressive disorder. Close to translation? Autoimmun Rev 2020; 19:102504. [PMID: 32173514 DOI: 10.1016/j.autrev.2020.102504] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 12/25/2019] [Indexed: 12/18/2022]
Abstract
Major depressive disorder (MDD) is a common condition that afflicts the general population across a broad spectrum of ages and social backgrounds. MDD has been identified by the World Health Organization as a leading cause of disability worldwide. Approximately 30% of patients are poor responsive to standard of care (SOC) treatment and novel therapeutic approaches are warranted. Since chronic inflammation, as it is often observed in certain cancers, type 2 diabetes, psoriasis and chronic arthritis, are accompanied by depression, it has been suggested that immunoinflammatory processes may be involved in the pathogenesis of MDD. Cytokines are a group of glycoproteins secreted from lymphoid and non-lymphoid cells that orchestrate immune responses. It has been suggested that a dysregulated production of cytokines may be implicated in the pathogenesis and maintenance of MDD. On the basis of their functions, cytokines can be subdivided in pro-inflammatory and anti-inflammatory cytokines. Since abnormal blood and cerebrospinal fluid of both pro and anti-inflammatory cytokines are altered in MDD, it has been suggested that abnormal cytokine homeostasis may be implicated in the pathogenesis of MDD and possibly to induction of therapeutic resistance. We review current data that indicate that cytokines may represent a useful tool to identify MDD patients that may benefit from tailored immunotherapeutic approaches and may represent a potential tailored therapeutic target.
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Affiliation(s)
| | | | - Paolo Fagone
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Maria Sofia Basile
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Vittorio Lenzo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | | | - Santo Di Nuovo
- Department of Educational Sciences, University of Catania, Catania, Italy
| | | | - Ferdinando Nicoletti
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
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Wang X, Cheng S, Xu H. Systematic review and meta-analysis of the relationship between sleep disorders and suicidal behaviour in patients with depression. BMC Psychiatry 2019; 19:303. [PMID: 31623600 PMCID: PMC6798511 DOI: 10.1186/s12888-019-2302-5] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 09/20/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The potential link between sleep disorders and suicidal behaviour has been the subject of several reviews. We performed this meta-analysis to estimate the overall association between sleep disorders and suicidal behaviour and to identify a more specific relationship in patients with depression. METHODS A systematic search strategy was developed across the electronic databases PubMed, EMBASE and the Cochrane Library from inception to January 1, 2019 for studies that reported a relationship between sleep disorders and suicidal behaviour in depressed patients. The odds ratio (OR) and corresponding 95% confidence interval (CI) were used to measure the outcomes. Heterogeneity was evaluated by Cochran's Q test and the I2 statistic. The Newcastle-Ottawa Scale (NOS) was adopted to evaluate the methodological quality of each of the included studies, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the quality of the evidence. We calculated the overall association between sleep disorders and suicidal behaviour and estimated more specific categories, including insomnia, nightmares, hypersomnia, suicidal ideation, suicide attempt, and completed suicide. RESULTS A total of 18 studies were included in this study. Overall, sleep disorders were closely related to suicidal behaviour in patients with depression (OR = 2.45 95% CI: 1.33 4.52). The relatively increased risks of sleep disorders with suicidal ideation, suicide attempt and completed suicide ranged from 1.24 (95% CI: 1.00 1.53) to 2.41 (95% CI: 1.45 4.02). Nightmares were found to be highly correlated with the risk of suicidal behaviour (OR = 4.47 95% CI: 2.00 9.97), followed by insomnia (OR = 2.29 95% CI: 1.69 3.10). The certainty of the evidence was rated as very low for the overall outcome and the major depression subgroup and was rated as low for the depression subgroup. CONCLUSIONS This meta-analysis supports the finding that sleep disorders, particularly nightmares and insomnia, increase the risk of suicidal behaviour in depressed patients. Considering that all included studies were observational, the quality of the evidence is rated as very low. More well-designed studies are needed to confirm our findings and to better explain the mechanisms by which sleep disorders aggravate suicidal behaviour in depressed patients.
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Affiliation(s)
- Xiaofen Wang
- 0000 0001 0379 7164grid.216417.7Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, NO.238 Shang Ma Yuan Ling Road, Kaifu District, Changsha, 410078 Hunan Province China
| | - Sixiang Cheng
- 0000 0001 0379 7164grid.216417.7Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, NO.238 Shang Ma Yuan Ling Road, Kaifu District, Changsha, 410078 Hunan Province China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, NO.238 Shang Ma Yuan Ling Road, Kaifu District, Changsha, 410078, Hunan Province, China.
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8
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Eftekharian MM, Noroozi R, Omrani MD, Sharifi Z, Komaki A, Taheri M, Ghafouri-Fard S. Single-Nucleotide Polymorphisms in Interleukin 6 (IL-6) Gene Are Associated with Suicide Behavior in an Iranian Population. J Mol Neurosci 2018; 66:414-419. [DOI: 10.1007/s12031-018-1190-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 09/25/2018] [Indexed: 12/18/2022]
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9
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Heese K. Functional repertoire of interleukin-6 in the central nervous system – a review. Restor Neurol Neurosci 2017; 35:693-701. [DOI: 10.3233/rnn-170772] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Klaus Heese
- Graduate School of Biomedical Science and Engineering, Hanyang University, Wangsimni-ro, Seongdong-gu, Seoul, Republic of Korea
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10
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Pedroni MN, Hirotsu C, Porro AM, Tufik S, Andersen ML. The role of sleep in pemphigus: a review of mechanisms and perspectives. Arch Dermatol Res 2017; 309:659-664. [PMID: 28726005 DOI: 10.1007/s00403-017-1765-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 07/06/2017] [Accepted: 07/11/2017] [Indexed: 12/25/2022]
Abstract
Pemphigus is an autoimmune bullous disease that causes the development of blisters and erosions on the skin and/or mucosa. Its inflammatory process is mediated by cytokines, which interact with sleep in a bidirectional manner. Pain, a frequent symptom due to pemphigus lesions, is well known to impair sleep quality. Depression is also associated with pemphigus and pro-inflammatory cytokines and may impair sleep. Additionally, a common relationship among other dermatological diseases and sleep has increasingly been described. Poor sleep quality is associated with an increased risk for autoimmune diseases, and insomnia is a comorbidity that has recently been associated with pemphigus. Thus, this review will explore the evidence supporting the likely bidirectional relationship between pemphigus and sleep quality and its possible mechanisms involved. This approach covering both pemphigus and sleep will open a research avenue for future studies focusing on the efficacy of the sleep disorders treatment in patients with pemphigus. In the long term, this may provide relevant information to dermatologists regarding new strategies for the management of pemphigus clinical condition, allowing possibly a better quality of life for the patients.
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Affiliation(s)
- Matheus Negrao Pedroni
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Napoleão de Barros, 925, Vila Clementino, São Paulo, SP, 04024-002, Brazil
| | - Camila Hirotsu
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Napoleão de Barros, 925, Vila Clementino, São Paulo, SP, 04024-002, Brazil
| | - Adriana Maria Porro
- Departamento de Dermatologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Napoleão de Barros, 925, Vila Clementino, São Paulo, SP, 04024-002, Brazil
| | - Monica Levy Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Napoleão de Barros, 925, Vila Clementino, São Paulo, SP, 04024-002, Brazil.
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