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摘要：抑郁障碍是临床上比较常见的精神疾病，经常伴随着严重影响患者社会功能的躯体和认知功能的改变。抑郁障碍不仅复发频率较高、治疗效果差，且诊断并无客观有效的生理或生化指标，目前临床主要是通过对患者访谈和临床观察进行诊断，主观性较强，影响因素较多，本文就抑郁障碍诊断有关的可能生化指标端粒展开相关论述。
关键词：抑郁障碍；端粒；端粒酶
本文引用格式：陈淑芳,王彦芳.端粒与抑郁障碍的相关研究[J].世界最新医学信息文摘,2019,19(90):33-34.
Related Research of Telomere and Depressive Disorder
CHEN Shu-fang,WABG Yan-fang
(Shanxi Medical University the First Hospital,Taiyuan Shanxi 030000)
ABSTRACT：Depression disorder is common psychiatric disorder in clinical practice,which is often accompanied by physical and cognitive changes seriously affecting social function of patients.Depressive disorder not only has high recurrence rate and poor curative effect,but has no objective and effective physiological or biochemical diagnosis indicators.At present,clinical diagnosis is mainly based on patient interviews and clinical observation,which has strong subjectivity and many influencing factors.The paper discusses possible biochemical indicators telomere related to diagnosis of depressive disorder.
KEY WORDS：Depressive disorder;Telomere;Telomere
0引言
抑郁障碍是临床上比较常见的精神疾病，它有很多发病机制，然而每一种机制都不完全清楚明白，对抑郁障碍的病理生理过程只能解释片面的、浅显的一部分，及可能的原因或疗效预后。抑郁障碍仍然是病因未明的复杂疾病，以致对其诊断、疗效及预后的判断主要通过对患者访谈和临床观察等症状学指标完成，缺乏客观的生理生化或影像学等生物学指标。因此给与抑郁障碍的诊断、治疗、预后带来很大挑战，并可导致患者出现严重的躯体症状及认知功能的改变而无法改善，严重增加了患者的痛苦、影响患者的生活质量。有统计学研究表明预计至2030年，抑郁障碍造成的疾病负担将上升到第二位[1]。本文主要对抑郁障碍的可能生化指标端粒与抑郁障碍的相关研究进行综述。
1抑郁与端粒的关系
抑郁障碍作为一种衰老相关性疾病，其发生发展可能与端粒的变化有关。已有研究显示抑郁障碍与端粒有关[2-4]。近期也有几项研究显示抑郁障碍缩短了端粒长度[5-12]，但抑郁障碍与端粒长度的关系仍有不同研究结果[13]。端粒长度受基因和环境双重调控[14]。还有研究表明端粒长度与亚端粒、LINE-1基因的甲基化程度密切相关[15]。研究结果表明，氧化应激很大程度上能增加外周血白细胞的复制率、降低染色体稳定性、增加染色体变异性，加速端粒的缩短[16-17]；慢性炎症能增加白细胞分裂次数，加速端粒的缩短。人的生活环境、生活方式、饮食等因素均与端粒有复杂的关系。而Teyssier[18]研究结果显示，尽管表明系统性炎症和氧化应激在抑郁障碍的作用，但端粒在大脑中的状态不受影响，但这只能说明端粒在正常人和抑郁障碍患者大脑中含量无区别，但外周血端粒长度是否有变化仍需进一步研究。
2国内外相关研究
端粒酶活性与端粒长短密切相关，可通过检测端粒长度间接反映端粒酶活性。国外有文献报道端粒酶与抗抑郁药物之间有密切关系[19]，研究显示抑郁障碍患者外周血端粒酶较健康对照组有较高的活性，进行抗抑郁药物治疗前端粒酶活性比健康对照相对较低，治疗后端粒酶活性增加相对较大，预示对抗抑郁药的反应更好，推测端粒酶活化可能有助于治疗抑郁障碍，然而，特别高的基线端粒酶活性可能表明更多潜在的抑郁障碍相关的病理学，其可能已经诱导更大的端粒酶活化[19]。目前国内几乎没有相关报道，只是有报道[20]显示慢性应激可使端粒酶活性较健康对照组增加，但抑郁障碍有研究共识慢性应激会导致抑郁障碍的发生发展及出现躯体疾病。
国内外关于端粒长度与精神药物之间的关系研究不多。有研究显示抗抑郁药能够降低患者促炎细胞因子和其他炎症标志物[21]，而端粒和促炎细胞因子和其他炎症标志物有关，推测端粒抗抑郁药物可能改变端粒长度。很少有研究报道端粒长度与精神药理学结果之间的关联。查阅相关文献，有三项研究（一项双相情感障碍和两项精神分裂症）中检测了相对端粒长度（LTL）与治疗精神病药物治疗反应之间的关系[22-23]。还有一项研究报告报道治疗前LTL与MDD中SSRIS药物临床应答之间的关系[24]，结果显示无应答者的治疗前LTL明显短于应答者。但该研究没有排除相关因素对端粒长度的影响，且缺少对照组，不能说明治疗前端粒及端粒酶的状态。
因端粒影响因素多，要想确认端粒能否作为抑郁障碍诊断的可能生化指标，研究抑郁障碍患者在SSRIS药物治疗前后与健康对照外周血白细胞的端粒长度变化可能是一个突破口，但要排除年龄、心脑血管疾病、肿瘤等因素对端粒长的影响，而且要研究中枢脑细胞端粒状态。
参考文献
[1]Organization W H.ES mediacentre:fs381 mental health and older adults[J].2013.
[2]Pao-Yen Lin,Yu-Chi Huang,Chi-Fa Hung.Shortened telomere length in patients with depression:A meta-analytic study[J].Journal of Psychiatric Research,2016:76.
[3]刘泽玥.端粒DNA长度动态改变与重度抑郁症相关性研究及钙成像技术的建立[D].北京协和医学院,2016.
[4]刘佳佳.KIBRA基因多态性、社会心理因素及端粒在抑郁症中的研究[D].山东大学,2015.
[5]Cai N,Chang S,Li Y,et al.Molecular signatures of major depression.[J].Current Biology,2015,25(9):1146.
[6]Simon N M,Walton Z E,Bui E,et al.Telomere length and telomerase in a well-characterized sample of individuals with major depressive disorder compared to controls[J].Ps ychoneuroendocrinology,2015,58:9-22.
[7]Schaakxs R,Verhoeven J E,Oude Voshaar R C,et al.Leukocyte Telomere Length and Late-Life Depression.[J].Am J Geriatr Psychiatry,2015,23(4):423-432.
[8]Needham B L,Mezuk B,Bareis N,et al.Depression,anxiety and telomere length in young adults:evidence from the National Health and Nutrition Exa mination Survey[J].Molecular Psychiatry,2015,20(4):520-528.
[9]Verhoeven J E,Révész D,Epel E S,et al.Major depressive disorder and accelerated cellular aging:results from a large psychiatric cohort study.[J].Molecular Psychiatry,2014,19(8):895.
[10]Wikgren M,Maripuu M,Karls son T,et al.Short Telomeres in Depression and the General Population Are Associated with a Hypocortisolemic State[J].Biol Psychiatry,2012,71(4):294-300.
[11]Hoen P W,De Jonge P,Na B Y,et al.Depression and leukocyte telomere length in patients with coronary heart disease:data from the Heart and Soul Study.[J].Psychosomatic Medicine,2011,73(7):541-7.
[12]Schutte N S,Malouff J M.The association between depression and leukocyte telomere length:a meta-analysis[J].Depression and Anxiety,2015,32(4):229-238.
[13]Simon N M,Walton Z E,Bui E,et al.Telomere length and telomerase in a well-characterized sample of individuals with major depressive disorder compared to controls[J].Psychoneuroendocrinology,2015,58:9-22.
[14]Kappei D,Londo?O-Vallejo J A.Telomere length inheritance and aging[J].Mechanisms of Ageing&Developm ent,2008,129(1-2):17-26.
[15]Gadalla S M,Katki H A,Shebl F M,et al.The relationship between DNA methylation and telomere length in dyskeratosis congenita[J].Aging Cell,2012,11(1):24-28.
[16]Aviv A.Leukocyte Telomere Length,Hypertension,and Atherosclerosis[J].Hypertension,2009,53(4):590-1.
[17]Bhupatiraju C,Saini D,Patkar S,et al.Association of shorter telomere length with essential hypertension in Indian population[J].American Journal of Human Biology,2012,24(4).
[18]Teyssier J R,Ragot S,Anne Donzel….Telomeres in the Brain Cortex of Patients with Major Depressive Disorder[J].Activitas Nervosa Superior,2014,56(3):89-94.
[19]W olko w itz O M,Epel E S,Lin J,et al.Resting leukocyte telomerase activity is elevated in major depression and predicts treatment response.[J].Mol Psychiatry,2012,17(2):164-172.
[20]Damjanovic A K,Yang Y,Glaser R,et al.Accelerated Telomere Erosion Is Associated with a Declining Immune Function of Caregivers of Alzheimer\”s Dis ea s e P atient s[J].T h e Jo u rn al o f Im m un olo gy,2007,179(6):4249-4254.
[21]Martinsson L,Wei Y,Xu D,et al.Long-term lithium treatment in bipolar disorder is associated with longer leukocyte telomeres[J].Translational Psychiatry,2013,3(5):e261.
[22]Yu W Y,Chang H W,Lin C H,et al.Short telomeres in patients with chronic schizophrenia who show a poor response to treatment[J].Journal of psychiatry&neurosc ience:JPN,2008,33(3):244-247.
[23]Li Z,Hu M,Zong X,et al.Association of telomere length and mitochondrial DNA copy number with risperidone treatment response in first-episode antipsychotic-na?ve schizophrenia[J].Scientific Reports,2016,5(1):18553.
[24]Hough C M,Bersani F S,Mellon S H,et al.Leukocyte Telomere Length Predicts SSRI Response in Major Depressive Disorder:A Preli minary Report[J].Molecular Ne uropsychiatry,2016,2(2):88-96.
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