哮喘联盟

   摘要
   背景：哮喘患者常常伴有抑郁，反之亦然。本综述旨在概述关于抑郁和哮喘共病的报道，并探寻过敏反应的生物学机制可能在哮喘和抑郁关联性中起着重要作用的证据。
   方法：为了探究该合并症基本通路及关联性，本文回顾了医学文献并对以下几方面的流行病学研究做了Meat分析：（i）抑郁患者中哮喘的发生率；（ii）哮喘患者中抑郁的发病率；（iii）抑郁受试者中细胞因子的浓度；
   结果：10项哮喘患者的研究和4项抑郁患者的研究均一致证实了哮喘和抑郁共病的高发生率。在两种疾病的生物学关联性搜索中，纳入了38项研究，旨在评估抑郁患者和非抑郁受试者中过敏相关细胞因子的差异。在抑郁患者中，单核细胞相关细胞因子如IL-1（1.56ng/mL, 95% CI: 0.00-3.12, p=0.05）的浓度显著高于非抑郁对照受试者。同时，抑郁患者中一些其它炎症因子包括IL-4(5.77pg/mL, 95% CI: 2.34-9.21, p=0.00010)、IL-6 (1.44ng/mL, 95% CI: 1.05-1.82, p<0.00001)和TNF-α(3.01ng/mL, 95% CI: 1.76-4.26, p<0.00001)显著高于对照受试者。抑郁和非抑郁组间与T细胞相关细胞因子水平，如IFN-γ(-0.16ng/mL, 95% CI: -0.85-7.73, p=0.97)、和IL-10（0.67ng/mL, 95% CI: -0.84-2.18, p=0.38)无显著差异。
   结论：某些特定细胞因子的不同水平在激发和缓解哮喘和抑郁中起到重要的作用。这提示了炎症应答可能是调节抑郁和哮喘的一个共同通路。
 

（林江涛 审校）
J Affect Disord. 2014 Sep;166C:22-29. doi: 10.1016/j.jad.2014.04.027. Epub 2014 May 10.

 

Comorbidity between depression and asthma via immune-inflammatory pathways: A meta-analysis.
 

Jiang M1, Qin P2, Yang X3.
 

ABSTRACT
BACKGROUND: Depression is often present in patients with asthma and vice versa. In this review, we aimed to summarize reports on the comorbidity of depression and asthma, and to seek evidence that the biological mechanisms of allergy may have an important role linking asthma and depression.
METHOD: To explore the relationship and pathway underpinning this comorbidity, we reviewed medical articles and undertook a meta-analysis of epidemiological studies on (i) incidence of asthma in patients with depression; (ii) morbidity of depression in patients with asthma; (iii) concentration of cytokines in depressed subjects.
RESULTS: High level of comorbidity of asthma and depression was consistently demonstrated in 10 studies of patients with asthma and four studies of patients with depression. In search of biological connection of the two illnesses, thirty-eight studies were included for Meta-analyses examining differences in allergy related cytokines between patients with depression and non-depressive subjects. In people with depression, concentration of monocytes related cytokines such as IL-1 (1.56ng/mL, 95% CI: 0.00-3.12, p=0.05) was significantly higher than that in non-depressive control subjects. At the same time, some other inflammatory factors including IL-4 (5.77pg/mL, 95% CI: 2.34-9.21, p=0.00010), IL-6 (1.44ng/mL, 95% CI: 1.05-1.82, p<0.00001) and TNF-α(3.01ng/mL, 95% CI: 1.76-4.26, p<0.00001) were extremely significantly higher in depressed people compared with the controls. There was no significant differences of the T cell related cytokine levels, IFN-γ (-0.16ng/mL, 95% CI: -0.85-7.73, p=0.97), accompanied with IL-10 (0.67ng/mL, 95% CI: -0.84-2.18, p=0.38) between depressive and non-depressive groups.
CONCLUSIONS: The varying levels of certain cytokines play an important role in arousing and remitting asthma and depression. That suggests inflammatory response could be a common pathway adjusting both depression and asthma.
 

J Affect Disord. 2014 Sep;166C:22-29. doi: 10.1016/j.jad.2014.04.027. Epub 2014 May 10.