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Impact of endothelial inflammation on depression in patients with cerebral microangiopathy: a prospective study

https://doi.org/10.14412/2074-2711-2022-1-32-37

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Abstract

Epidemiological studies demonstrate a strong relationship between depression and cerebral microangiopathy (CM) associated with arterial hypertension (AH) and cerebral atherosclerosis, but the pathogenetic mechanisms underlying this relationship are not fully understood.

Objective: to evaluate the relationship between the level of peripheral markers of endothelial inflammation and depression severity in patients with CM.

Patients and methods. The level of peripheral markers of endothelial inflammation was assessed by enzyme immunoassay, and the severity of depression was assessed using the HADS scale in 262 patients with CM. All patients had correction of hypotensive, antiplatelet, anticoagulant, lipid-lowering, hypoglycemic therapy. Observation of the patients lasted 3 months with an assessment of the follow-up clinical and laboratory parameters. Results and discussion. Comparative analysis shown that in the group of patients with clinically significant depression (n=146) C-reactive protein (CRP) level was составил 6.11 mg/l, monocytic chemoatactic factor-1 (МСР-1) – 2.02 ng/ml, which differed significantly from the group f patients with subclinical depression (n=116): CRP – 2.03 mg/l, МСР-1 – 0.66 ng/ml (р<0.05). Correlation analysis showed a direct strong significant linear relationship between the depression severity and the level of CRP (correlation coefficient r=0.85, p><0.05). A similar significant correlation was found between the depression severity and the MCP-1 level – a direct strong linear relationship (r=0.8, p><0.05). The odds ratio assessment revealed that increased peripheral markers of endothelial inflammation are associated with clinically significant depression. The use of drugs aimed at correcting the main cardiovascular risk factors contributed to a significant normalization of the levels of peripheral markers of inflammation (p><0.05), accompanied by a reduction in depressive symptoms in patients with CM without the use of specific antidepressant therapy. Conclusion. The study revealed a relationship between altered levels of peripheral markers of inflammation and the severity of depression in patients with CM associated with hypertension and cerebral atherosclerosis. The normalization of the peripheral markers of endothelial inflammation contributed to the restoration of the emotional background. Keywords: endothelial inflammation; inflammatory markers; depression; cerebral microangiopathy>˂0.05). Correlation analysis showed a direct strong significant linear relationship between the depression severity and the level of CRP (correlation coefficient r=0.85, p˂0.05). A similar significant correlation was found between the depression severity and the MCP-1 level – a direct strong linear relationship (r=0.8, p˂0.05). The odds ratio assessment revealed that increased peripheral markers of endothelial inflammation are associated with clinically significant depression. The use of drugs aimed at correcting the main cardiovascular risk factors contributed to a significant normalization of the levels of peripheral markers of inflammation (p˂0.05), accompanied by a reduction in depressive symptoms in patients with CM without the use of specific antidepressant therapy.

Conclusion. The study revealed a relationship between altered levels of peripheral markers of inflammation and the severity of depression in patients with CM associated with hypertension and cerebral atherosclerosis. The normalization of the peripheral markers of endothelial inflammation contributed to the restoration of the emotional background. 

About the Authors

O. V. Vorobyeva
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

Department of Nervous Diseases, Institute of Professional Education, 

8, Trubetskaya St., Build. 2, Moscow 119991



A. A. Pilipovich
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

Department of Nervous Diseases, Institute of Professional Education, 

8, Trubetskaya St., Build. 2, Moscow 119991



V. V. Fateeva
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

Department of Nervous Diseases, Institute of Professional Education, 

8, Trubetskaya St., Build. 2, Moscow 119991



References

1. World Health Organization, Depression, Fact Sheet, 2017 (updated May 2019). Available from: http://www.who.int/mediacentre/factsheets/fs369/en/

2. Sassarini DJ. Depression in midlife women. Maturitas. 2016 Dec;94:149-54. doi: 10.1016/j.maturitas.2016.09.004. Epub 2016 Sep 16.

3. Dowlati Y, Herrmann N, Swardfager W, et al. A meta-analysis of cytokines in major depression. Biol Psychiatry. 2010 Mar 1;67(5):446-57. doi: 10.1016/j.biopsych.2009.09.033. Epub 2009 Dec 16.

4. Yu RH, Ho SC, Lam CW, et al. Psychological factors and subclinical atherosclerosis in postmenopausal Chinese women in Hong Kong. Maturitas. 2010 Oct;67(2):186- 91. doi: 10.1016/j.maturitas.2010.06.014. Epub 2010 Jul 17.

5. Chrysohoou C, Kollia N, Tousoulis D. The link between depression and atherosclerosis through the pathways of inflammation and endothelium dysfunction. Maturitas. 2018 Mar;109:1-5. doi: 10.1016/j.maturitas.2017.12.001. Epub 2017 Dec 6.

6. Nicholson A, Kuper H, Hemingway H. Depression as an aetiologic and prognostic factor in coronary heart disease: a meta-analysis of 6362 events among 146,538 participants in 54 observational studies. Eur Heart J. 2006 Dec;27(23):2763-74. doi: 10.1093/eurheartj/ehl338. Epub 2006 Nov 2.

7. Kyrou I, Kollia N, Panagiotakos D, et al; ATTICA Study Investigators, Association of depression and anxiety status with 10-year cardiovascular disease incidence among apparently healthy Greek adults: the ATTICA study. Eur J Prev Cardiol. 2017 Jan;24(2):145-52. doi: 10.1177/2047487316670918. Epub 2016 Sep 27.

8. Wardlaw JM, Smith EE, Biessels GJ. Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. Lancet Neurol. 2013 Aug;12(8):822-38. doi: 10.1016/S1474- 4422(13)70124-8

9. Lanquillon S, Krieg JC, Bening-Abu-Shach U, Vedder H. Cytokine production and treatment response in major depressive disorder. Neuropsychopharmacology. 2000 Apr;22(4):370-9. doi: 10.1016/S0893-133X(99)00134-7

10. Maes M. Cytokines in major depression. Biol Psychiatry. 1994 Oct 1;36(7):498-9. doi: 10.1016/0006-3223(94)90652-1

11. Jokela M, Virtanen M, Batty GD, Kivimaki M. Inflammation and specific symptoms of depression. JAMA Psychiatry. 2016 Jan;73(1):87-8. doi: 10.1001/jamapsychiatry.2015.1977

12. Frasure-Smith N, Lesperance F, Irwin MR. Depression, C-reactive protein and two-year major adverse cardiac events in men after acute coronary syndromes. Biol Psychiatry. 2007 Aug 15;62(4):302-8. doi: 10.1016/j.biopsych.2006.09.029. Epub 2007 Jan 8.

13. Copeland WE, Shanahan L, Worthman C. Cumulative depression episodes predict later C-reactive protein levels: a prospective analysis. Biol Psychiatry. 2012 Jan 1;71(1):15-21. doi: 10.1016/j.biopsych.2011.09.023. Epub 2011 Nov 1.

14. Wium-Andersen MK, ∅rsted DD, Nielsen SF. Elevated C-reactive protein levels, psychological distress, and depression in 73 131 Individuals. JAMA Psychiatry. 2013 Feb;70(2):176-84. doi: 10.1001/2013.jamapsychiatry.102

15. Howren MB, Lamkin DM, Suls J. Associations of depression with C-reactive protein, IL-a, and IL-6: a meta-analysis. Psychosom Med. 2009 Feb;71(2):171-86. doi: 10.1097/PSY.0b013e3181907c1b. Epub 2009 Feb 2.

16. Hamer M, Batty GD, Marmot MG. Anti-depressant medication use and C-reactive protein: results from two population-based studies. Brain Behav Immun. 2011 Jan;25(1):168-73. doi: 10.1016/j.bbi.2010.09.013. Epub 2010 Sep 21.

17. Setiawan E, Wilson AA, Mizrahi R, et al. Role of translocator protein density, a marker of neuroinflammation, in the brain during major depressive episodes. JAMA Psychiatry. 2015 Mar;72(3):268-75. doi: 10.1001/jamapsychiatry.2014.2427

18. Davignon J, Ganz P. Role of endothelial dysfunction in atherosclerosis. Circulation. 2004 Jun 15;109(23 Suppl 1):III27-32. doi: 10.1161/01.CIR.0000131515.03336.f8

19. Verma S, Buchanan MR, Anderson TJ. Endothelial function testing as a biomarker of vascular disease. Circulation. 2003 Oct 28;108(17):2054-9. doi: 10.1161/01.CIR.0000089191.72957.ED

20. Rybakowski JK, Wykretowicz A, Heymann-Szlachcinska A, Wysocki H. Impairment of endothelial function in unipolar and bipolar depression. Biol Psychiatry. 2006 Oct 15;60(8):889-91. doi: 10.1016/j.biopsych.2006.03.025. Epub 2006 May 30.

21. Broadley AJ, Korszun A, Jones CJ, Frenneaux MP. Arterial endothelial function is impaired in treated depression. Heart. 2002 Nov;88(5):521-3. doi: 10.1136/heart.88.5.521


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For citations:


Vorobyeva O.V., Pilipovich A.A., Fateeva V.V. Impact of endothelial inflammation on depression in patients with cerebral microangiopathy: a prospective study. Neurology, Neuropsychiatry, Psychosomatics. 2022;14(1):32-37. (In Russ.) https://doi.org/10.14412/2074-2711-2022-1-32-37

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ISSN 2074-2711 (Print)
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