[Immune profiles of patients with juvenile depression: association with clinically high risk of psychosis manifestation].
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OBJECTIVES: To study the change of the levels of inflammatory markers in young patients with depression with a clinically high risk of psychosis manifestation (CHR-P) during therapy. MATERIAL AND METHODS: The study included 80 adolescent patients (mean age 19.6±2.3 years) with the first depressive episode (F32.1, F32.2, F32.38, F32.8 according to ICD-10), who were divided into two groups: Group 1 with CHR-P (n=58) and Group 2 without CHR-P (n=22). The HDRS-21, SOPS, and SANS scales were used to assess the severity of psychopathological symptoms. Patients received combined pharmacotherapy with antidepressants and antipsychotics. The mean duration of treatment was 1.16±0.2 months. Blood levels of tumor necrosis factor-α, interleukins IL-6, IL-8, IL-10, C-reactive protein (CRP), the activity of leukocyte elastase and α1-proteinase inhibitor, their ratio (leukocyte inhibitory index, LII), as well as the level of autoantibodies to the S100B protein and the myelin basic protein were measured. RESULTS: Patients with juvenile depression associated with CHR-P had qualitative and quantitative features of the spectrum of inflammatory indicators, both before and after the therapy, different from those in patients without CHR-P. The key differences between the groups were in the levels of TNF-α, IL-6, IL-10, CRP, and autoantibodies to S100B (p<0.05). Despite the improvement in clinical symptoms (p<0.001), the inflammatory response persisted in some patients (both with and without CHR-P) after treatment, indicating an ongoing pathological process in the brain. The most unfavorable in terms of prognosis was an immunotype characterized by a decrease in LII combined with a high level of other inflammatory markers (CRP, IL-6, and autoantibodies to neural tissue proteins). It was detected in 70% of patients with CHR-P and was associated with a longer duration of the depressive episode and the severity of symptoms detected before the start of therapy. CONCLUSION: The results support using the studied inflammation markers to assess the prognosis of the disease development and the risk of psychosis manifestation in young patients.