Tuberculosis and comorbid depression: Association with serum indoleamine 2,3-dioxygenase activity.

IF 1.4 4区 医学 Q4 PHARMACOLOGY & PHARMACY
Indian Journal of Pharmacology Pub Date : 2025-01-01 Epub Date: 2025-05-06 DOI:10.4103/ijp.ijp_252_23
Proteesh Rana, Bijo Varughese, Vandana Roy, Shreshth Khanna, Seema Kapoor, Ashwani Khanna
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Abstract

Introduction: Patients with tuberculosis (TB) may have depression as a comorbidity, which may be associated with poor treatment outcomes. Increased production of pro-inflammatory cytokines activating enzyme indoleamine 2,3-dioxygenase (IDO) has been reported in TB. We studied the association of IDO activity and comorbid depression in TB patients.

Materials and methods: Newly diagnosed, treatment-naïve TB patients were evaluated for symptoms of depression using the Patient Health Questionnaire (PHQ)-9 scale. A PHQ-9 score of ≥5 was taken as an indicator for depression. Patients were further categorized into two groups based on their PHQ-9 scores, Group-I with a PHQ-9 score of <5 and Group-II with a PHQ-9 score ≥5. The serum kynurenine (KYN) and tryptophan (TRP) levels were determined using liquid chromatography-mass spectrometry (LC-MS) and the KYN/TRP ratio was taken as a measure for IDO activity.

Results: A total of 106 TB patients and 106 healthy controls were enrolled in this study. Over 73.5% of TB patients had PHQ-9 scores of above 5 with an average score of 7.09 ± 2.83, a significant difference (P < 0.05) as compared to the average PHQ-9 scores of healthy controls (2.93 ± 1.20). Group-II TB patients had lower serum TRP 539.55 ± 194.31 ng/mL versus 1109.45 ± 186.04 ng/mL (P < 0.01) in Group-I; higher serum KYN 425.81 ± 65.51 ng/mL versus 250.06 ± 40.28 ng/mL (P < 0.01) and higher K/T ratio 0.906 ± 0.56 versus 0.251 ± 0.052 (P < 0.01). There was a significant linear correlation between PHQ-9 and serum KYN (r: 0.969; P: <0.01; R2: 0.909); serum TRP (r: 0.841; P: <0.01; R2: 0.745); and KYN/TRP ratio (r: 0.745; P < 0.01; R2: 0.618).

Conclusion: These findings suggest that in TB patients, induction of IDO activity may be relevant to the development of comorbid depression.

结核病和共病抑郁症:与血清吲哚胺2,3-双加氧酶活性的关系。
结核病(TB)患者可能同时伴有抑郁症,这可能与治疗效果差有关。据报道,在结核病中促炎细胞因子激活酶吲哚胺2,3-双加氧酶(IDO)的产生增加。我们研究了IDO活性与结核病患者共病抑郁的关系。材料与方法:采用患者健康问卷(PHQ)-9量表对新诊断的treatment-naïve结核病患者进行抑郁症状评估。以PHQ-9评分≥5分作为抑郁的诊断指标。根据患者的PHQ-9得分将患者进一步分为两组:第一组,PHQ-9得分为。结果:共有106名结核病患者和106名健康对照者参加了本研究。超过73.5%的结核病患者PHQ-9得分在5分以上,平均得分为7.09±2.83,与健康对照组的平均得分(2.93±1.20)相比,差异有统计学意义(P < 0.05)。ⅱ组TB患者血清TRP为539.55±194.31 ng/mL,低于ⅰ组的1109.45±186.04 ng/mL (P < 0.01);血清KYN(425.81±65.51 ng/mL)高于250.06±40.28 ng/mL (P < 0.01), K/T比值(0.906±0.56)高于0.251±0.052 (P < 0.01)。PHQ-9与血清KYN呈显著线性相关(r: 0.969;结论:这些发现提示,在结核病患者中,IDO活性的诱导可能与共病抑郁症的发生有关。
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来源期刊
CiteScore
4.00
自引率
4.20%
发文量
53
审稿时长
4-8 weeks
期刊介绍: Indian Journal of Pharmacology accepts, in English, review articles, articles for educational forum, original research articles (full length and short communications), letter to editor, case reports and interesting fillers. Articles concerning all aspects of pharmacology will be considered. Articles of general interest (e.g. methods, therapeutics, medical education, interesting websites, new drug information and commentary on a recent topic) are also welcome.
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