급성기 주요우울장애 환자에서 Natural Killer T 세포
Natural Killer T Cells in Acute and Unmedicated Patients with Major Depressive Disorder
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연구목적 유세포 분석을 이용하여 약물 복용의 병력이 없는 급성기 주요우울장애 환자에서 말초 림프구와 혈장 호르몬을 조사하여 면역 기능의 변화를 알아보고자 하였다. 방법 현 우울 삽화기간 중에 약물 복용을 한 과거력이 없는 비교적 짧은 유병기간의 주요우울장애 환자 42명과 정상 대조군 40명을 대상으로 하였다. 주요우울장애 환자에게 우울증상과 불안증상의 정도를 측정하기 위하여 Hamilton Rating Scale for Depression (HAM-D), Hamilton Rating Scale for Anxiety (HAM-A)를 적용하였다. 유세포 분석을 이용하여 말초 혈액에서 T 세포와 NK 세포 수와 혈장에서 ACTH와 cortisol을 측정하였다. 통계 처리는 Statistica (version 6.0)을 사용하였다. 결과 CD3, CD4, CD8, CD56 세포에서 두 군간의 차이는 유의하지 않았다. 주요우울장애 환자군에서 CD56 세포 수는 우울증상이 심할수록 적었지만 불안증상과는 상관관계를 나타내지 않았다. 정상 대조군에서 보이던 CD4/CD8과 CD56 세포수간의 상관관계가 주요우울장애 환자에서 나타나지 않았다. 주요 우울장애 환자군에서 정상범위내에 속해 있었지만 정상 대조군과 비교해서 cortisol의 분비량이 많았다. 결론 약물 복용을 하지 않은 급성기 상태의 주요우울장애 환자에서 cortisol이 정상인에 비해 상승되어 있었으며 HPA 축의 기능 이상은 없이 면역 기능의 균형이 정상적으로 유지되지 못하는 경향이 있음을 알 수 있었다. 또한 주요우울장애 환자에서 CD56 (NK T) 세포 수는 우울증상이 심할수록 감소되어 있었는데 이는 우울장애에서 흔히 동반되는 불안증상과는 상관관계를 보이지 않았다.
Abstract
Objectives: To evaluate an association between depression and altered immunity, we examined peripheral T lymphocyte or natural killer (NK) cell measures and plasma ACTH and cortisol using the flow cytometry in acute and unmedicated patients with major depressive disorder (MDD). Methods: Forty two patients with MDD from outpatient clinic and forty normal controls from hospital staff were recruited. We administered Hamilton Rating Scale for Depression (HAM-D), Hamilton Rating Scale for Anxiety (HAM-A) for depressed subjects. Peripheral T lymphocyte or NK cell measures (CD3, CD4, CD8, or CD56) and Plasma hormone (ACTH and cortisol) were obtained from all subjects. Results: There are no statistical differences in CD3, CD4, CD8, or CD56 between both subjects. The number of CD56 cells was negatively correlated with HAM-D scores (r=-0.42, p<0.01), but not with HAM-A scores in patients with MDD. The number of CD56 cells showed strong negative correlation with CD4/CD8 (r=-0.47, p<0.01) in controls but not in depressed patients. Patients with MDD had higher cortisol level than controls within normal range. Conclusions: The trait of immunological imbalance and HPA axis abnormality was shown in patients with MDD. Especially, the severity of depression, but not anxiety, could be reflected as decreased number of CD56 (NK T) cells in acute and unmedicated state.
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