{"title":"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。","authors":"Proteesh Rana, Bijo Varughese, Vandana Roy, Shreshth Khanna, Seema Kapoor, Ashwani Khanna","doi":"10.4103/ijp.ijp_252_23","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>These findings suggest that in TB patients, induction of IDO activity may be relevant to the development of comorbid depression.</p>","PeriodicalId":13490,"journal":{"name":"Indian Journal of Pharmacology","volume":"57 1","pages":"21-26"},"PeriodicalIF":1.4000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Tuberculosis and comorbid depression: Association with serum indoleamine 2,3-dioxygenase activity.\",\"authors\":\"Proteesh Rana, Bijo Varughese, Vandana Roy, Shreshth Khanna, Seema Kapoor, Ashwani Khanna\",\"doi\":\"10.4103/ijp.ijp_252_23\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>These findings suggest that in TB patients, induction of IDO activity may be relevant to the development of comorbid depression.</p>\",\"PeriodicalId\":13490,\"journal\":{\"name\":\"Indian Journal of Pharmacology\",\"volume\":\"57 1\",\"pages\":\"21-26\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indian Journal of Pharmacology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4103/ijp.ijp_252_23\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/5/6 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"PHARMACOLOGY & PHARMACY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Pharmacology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4103/ijp.ijp_252_23","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/6 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
Tuberculosis and comorbid depression: Association with serum indoleamine 2,3-dioxygenase activity.
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.
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.