抑郁症患者的全血BDNF较低，艾司西酞普兰对患者和健康对照组没有影响。

IF 3.9 2区医学 Q1 CLINICAL NEUROLOGY

Progress in Neuro-Psychopharmacology & Biological Psychiatry Pub Date : 2025-08-13 DOI:10.1016/j.pnpbp.2025.111470

Miriam L. Navarro , Alberte Wollesen Breum , Brice Ozenne , Arafat Nasser , Sagar Sanjay Aripaka , Sophia Armand , Martin Balslev Jorgensen , Vibe G. Frokjaer , Gitte M. Knudsen

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引用次数: 0

摘要

背景：脑源性神经营养因子（BDNF）在神经可塑性中起着关键作用，在重度抑郁症（MDD）的病理生理和治疗效果中都有涉及。血清BDNF （s-BDNF）主要反映凝血过程中血小板来源的BDNF释放，与之不同的是，全血BDNF （wb-BDNF）测量血液中总BDNF池，最大限度地减少与血小板聚集相关的混淆。本研究旨在评估wb-BDNF水平是否可以作为重度抑郁症的生物标志物和/或作为抗抑郁治疗反应的预测因子。方法：我们在两项研究中测量了艾司西酞普兰干预前后4-12 周的wb-BDNF：一项非随机、单臂临床试验，纳入97名未服药的重度抑郁症患者，另一项随机、双盲、安慰剂对照试验，纳入66名健康对照者（HC）。BDNF Val65Met多态性也被确定。结果：未服药的MDD患者的wb-BDNF比HC患者低14 %，但干预前的wb-BDNF与症状严重程度无关，也不能预测患者的药物治疗结果。此外，服用艾司西酞普兰8周和12 周后抑郁评分的改善与wb-BDNF的变化无关。在HC中，干预4 周后，安慰剂组和艾司西酞普兰组的wb-BDNF相似。BDNF多态性在HC和MDD、应答者和无应答者之间相似，与wb-BDNF水平无关。结论：wb-BDNF反映了总血BDNF池，避免了s-BDNF测量中出现的血小板聚集相关混淆。wb-BDNF可作为重度抑郁症的诊断指标，但不能作为预后指标。需要进一步研究BDNF储层的变化及其影响。

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Whole blood BDNF is lower in patients with depression and unchanged by escitalopram in patients and healthy controls

Background

Brain-derived neurotrophic factor (BDNF) plays a key role in neuroplasticity and has been implicated in both the pathophysiology of Major Depressive Disorder (MDD) and treatment effects. Unlike serum BDNF (s-BDNF), which largely reflects platelet-derived BDNF released during coagulation, whole blood BDNF (wb-BDNF) measures the total blood BDNF pool, minimizing confounds related to platelet aggregation. This study aims to assess whether wb-BDNF levels can serve as a biomarker for MDD and/or as a predictor of antidepressant treatment response.

Methods

We measured wb-BDNF before and after 4–12 weeks of escitalopram intervention in two studies: a non-randomized, single-arm clinical trial of 97 unmedicated patients with MDD and a randomized, double-blind, placebo-controlled trial with 66 healthy controls (HC). The BDNF Val65Met polymorphism was also determined.

Results

Unmedicated patients with MDD had 14 % lower wb-BDNF than HC, but wb-BDNF prior to intervention was not associated with symptom severity, nor did it predict drug treatment outcome in the patients. Further, improvements in depression scores after 8 and 12 weeks of escitalopram was not associated with changes in wb-BDNF. In HC, wb-BDNF was similar in the placebo and escitalopram groups after 4 weeks of intervention. BDNF polymorphism was similar between HC and MDD, and responders and non-responders, and was not associated with wb-BDNF levels.

Conclusion

wb-BDNF reflects the total blood BDNF pool and avoids platelet aggregation-related confounds seen in s-BDNF measures. wb-BDNF could be used as diagnosis but not as a prognosis biomarker, in MDD. Further research is needed to investigate changes in BDNF reservoirs and their implications.

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来源期刊

Progress in Neuro-Psychopharmacology & Biological Psychiatry 医学-精神病学

CiteScore

12.00

自引率

1.80%

发文量

153

审稿时长

56 days

期刊介绍： Progress in Neuro-Psychopharmacology & Biological Psychiatry is an international and multidisciplinary journal which aims to ensure the rapid publication of authoritative reviews and research papers dealing with experimental and clinical aspects of neuro-psychopharmacology and biological psychiatry. Issues of the journal are regularly devoted wholly in or in part to a topical subject. Progress in Neuro-Psychopharmacology & Biological Psychiatry does not publish work on the actions of biological extracts unless the pharmacological active molecular substrate and/or specific receptor binding properties of the extract compounds are elucidated.