Consortium Psychiatricum
2024. Том 5. № 4. С. 64–77
doi:10.17816/CP15543
ISSN: 2712-7672 / 2713-2919 (online)
Сравнение показателей иммунной системы и системного воспаления у пациентов с депрессивным эпизодом при биполярном аффективном и рекуррентном депрессивном расстройствах: обзор предметного поля
Аннотация
ВВЕДЕНИЕ: Многие исследования ставили задачей изучение и сравнение показателей иммунной системы и системного воспаления при депрессивных эпизодах у пациентов с биполярным аффективным расстройством (БАР) и рекуррентным депрессивным расстройством (РДР). Однако систематическое обобщение их результатов до настоящего времени не проводилось.
ЦЕЛЬ: Провести обзор предметного поля исследований, в которых сравнивали показатели иммунной системы и системного воспаления при текущем депрессивном эпизоде у пациентов с БАР и РДР.
МЕТОДЫ: Поиск исследований проводился в базах данных Medline и eLIBRARY (статьи на русском языке) за период с января 1994 г. по декабрь 2022 г. Отбирались статьи в открытом доступе, написанные на английском и русском языках. В обзор были включены оригинальные исследования, в которых сравнивали группы пациентов с текущим депрессивным эпизодом при БАР и РДР (диагнозы установлены по критериям DSM-IV, DSM-5 или МКБ-10) по показателям иммунной системы и системного воспаления (количество, соотношение и функции клеток крови, скорость оседания эритроцитов, концентрации иммуноглобулинов, цитокинов, белков острой фазы воспаления, компонентов комплемента, аутоантител).
РЕЗУЛЬТАТЫ: В обзор включено 24 исследования. С текущим депрессивным эпизодом при БАР ассоциированы более высокие концентрации хемокинов (C-C motif chemokine ligand 3 (CCL3), CCL4, CCL5, CCL11), тромбоцитарного фактора роста B, интерлейкина 9 (ИЛ-9) (по 2 исследования в каждом случае), при РДР — более высокие концентрации растворимого рецептора фактора некроза опухоли 1 и иммуноглобулинов класса G к окисленным липопротеинам низкой плотности (по 2 исследования). Пациенты с БАР и РДР имели сопоставимые концентрации ИЛ-8 (5 исследований); ИЛ-2 и ИЛ-10 (по 4 исследования); ИЛ-13 и интерферона гамма (по 3 исследования); ИЛ-17, ИЛ-1Rα, фактора роста эндотелия сосудов, а также количество лейкоцитов, моноцитов и тромбоцитов (по 2 исследования). Противоречивые результаты были получены для фактора некроза опухоли α (концентрации не различались в 5 исследованиях, повышены при БАР в 5, повышены при РДР в 2), ИЛ-6 (концентрации не различались в 8 исследованиях, повышены при БАР в 4), С-реактивного белка (концентрации не различались в 6 исследованиях, повышены при БАР в 2), ИЛ-4 (концентрации не различались в 3 исследованиях, повышены при РДР в 2), ИЛ-1β и количества нейтрофилов (не различались по 1 исследованию, повышены при БАР в 2). В нескольких исследованиях была обнаружена ассоциация показателей иммунной системы и системного воспаления с тяжестью депрессивной и тревожной симптоматики, меланхолическим подтипом депрессии, возрастом дебюта расстройства настроения, индексом массы тела и имипраминовым эквивалентом.
ЗАКЛЮЧЕНИЕ: Ряд показателей иммунной системы и системного воспаления ассоциирован с текущим депрессивным эпизодом у пациентов с РДР или БАР. Эти показатели могут быть рассмотрены в качестве потенциальных биомаркеров для дифференциальной диагностики указанных расстройств.
Общая информация
Ключевые слова: депрессивные расстройства, биполярное аффективное расстройство (БАР), рекуррентное депрессивное расстройство, дифференциальная диагностика, иммунная система, системное воспаление
Рубрика издания: Обзоры
Тип материала: научная статья
DOI: https://doi.org/10.17816/CP15543
Финансирование. This study was conducted with financial support from the Russian Science Foundation (Grant No. 24-25-00166).
Получена: 26.11.2024
Принята в печать:
Для цитаты: Касьянова А.А., Соболевская П.А., Лиманкин О.В., Петрова Н.Н. Сравнение показателей иммунной системы и системного воспаления у пациентов с депрессивным эпизодом при биполярном аффективном и рекуррентном депрессивном расстройствах: обзор предметного поля // Consortium Psychiatricum. 2024. Том 5. № 4. С. 64–77. DOI: 10.17816/CP15543
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