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자살을 기도한 우울증 환자에서 사이토카인의 병태생리적 역할

The Pathophysiological Role of Cytokines in Suicide Attempters with Major Depressive Disorder

김용구|김성재
대한신경정신의학회 (Korean Neuropsychiatric Association)|2006.03|신경정신의학 (JOURNAL OF THE KOREAN NEUROPSYCHIATRIC ASSOCIATION)|제45권 제2호|pp. 117-127

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참고문헌

키워드

No 2 / March2006 126Cytokine· Depresion· Suicide· Risk-rescue rating· Lethality of suicide attempt rating scale.
주제분류정신과학

초록

목 적 사이토카인은 주요우울장애의 병인과 병태생리에 중요한 역할을 하는 것으로 알려져 있다. 그러나, 주요 우울증을 가진 자살 환자에서의 사이토카인의 역할은 아직 철저하게 탐색되지 않았다. 이 연구의 목적은 자살을 시도한 우울증 환자에서 Th1, Th2, Th3 사이토카인의 상호작용의 역할을 규명하는 것이다. 방 법 DSM-IV 진단기준으로 주요우울장애의 진단을 받은 10명의 환자(자살사고가 없는 우울증 환자군 29명, 자살사고가 있는 우울증 환자군 32명, 자살을 시도한 우울증 환자군 49명)가 연구에 참여하였다. 자살의 심각도는 Leth-ality of Suicide Attempt Rating Scale(LSARS)와 Risk-Rescue Rating(R) system을 이용하여 측정하였다. Mitogen 촉진에 의한 사이토카인의 생성(TNF-α, IFN-γ, IL-2, IL-4, IL-6)은 전혈 분석에 의한 ELISA로 측정되었다. TGF-β1은 혈장에서 ELISA로 측정하였다.

Abstract

disorders. However, the role of cytokines in suicide in major depression has not been explored thoroughly. The purpose of this study is to identify the roles of cytokine interaction of Th1, Th2, Th3 cytokines in suicidal depressive patients. Methods：110 major depressive patients (29 depressive patients without suicidal ideation, 32 depressive patients with suicidal ideation, and 49 depressive patients with suicide attempts) diagnosed by DSM-IV criteria were included in this study. The severity of suicide ideations and attempts was measured by Lethality of Suicide Attempt Rating Scale (LSARS) and Risk-Rescue Rating (RRR) system. Cytokine productions (TNF-α, IFN-γ, IL-2, IL-4, and IL-6) upon mitogen stimulation were measured by ELISA in a whole blood assay. TGF-β1 were measured in plasma by ELISA. Results：There were no significant differences in age, sex and BMI among the three groups. IL-2 and IL-6 levels were significantly lower in the suicide attempt group than other two groups while TNF-α, IFN-γ, IL-4 and TGF-β1 did not differ among the groups. Significant positive correlations between TNF-α/IL-4, IL-6/IL-4, IFN-γ/IL-4 and IL-6/TGF-β1 ratio and LSARS scores in suicidal patients were found. In addition, there were significant correlations between TNF-α/IL-4 or IL- 6/IL-4 and RRR scores in suicidal patients. Conclusion：These results indicate that decrease in Th1 cytokines may be associated with suicidal behavior in major depression. These findings suggest that cytokines may play a role in the pathogenesis of suicidal depression. (J Korean Neuropsychiatr Assoc 2006;45(2):117-127)

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