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The association of disease activity, pro-inflammatory cytokines, and neurotrophic factors with depression in patients with rheumatoid arthritis

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Author(s)
Yun-Hong CheonSeung-Geun LeeMingyo KimHyun-Ok KimYoung Sun SuhKi-Soo ParkRock Bum KimHyun-Su YangJi-Min KimChang-Nam SonEun Kyoung ParkSang-Hyon KimSang-Il Lee
Keimyung Author(s)
Kim, Ji MinSon, Chang NamKim, Sang Hyon
Department
Dept. of Internal Medicine (내과학)
Journal Title
Brain, Behavior, and Immunity
Issued Date
2018
Volume
73
Issue
10
Keyword
Brain-derived neurotrophic factorDepressionDisease activityK-BDI II scoreRheumatoid arthritis
Abstract
Inflammation and trophic factors (brain-derived neurotrophic factor [BDNF], vascular endothelial growth factor, glial cell line-derived neurotrophic factor, and insulin-like growth factor-1) are associated with depression in the general population. Rheumatoid arthritis (RA) is a chronic representative inflammatory autoimmune disease; however, the association of disease activity, pro-inflammatory cytokines, and neurotrophic factors with depression has not been sufficiently investigated. Therefore, we determined the prevalence of depression and risk factors for depression and deterioration of depressive symptoms in RA patients. In addition, we analyzed the association between disease activity, pro-inflammatory cytokines, trophic factors, and depression in RA (N=474). Demographic and laboratory data were examined, and routine assessment of patient index data 3 (RAPID 3) and disease activity score 28-joint count C-reactive protein (DAS 28-CRP) was performed to assess disease activity of RA. Depression was measured using the Korean version of the Beck Depression Inventorysecond edition (K-BDI II). A K-BDI score ≥18 was considered the cut-off for depression in accordance with a previous validation study. The serum level of pro-inflammatory cytokines and neurotrophic factors was assessed by enzyme-linked immune sorbent assay. The prevalence of depression was 32.4% in patients with RA. The severity of disease activity of RA (RAPID 3 score [OR 2.34; 95% confidence interval, CI 1.22–4.51], DAS 28-CRP [≥3.2] [OR 1.60, 95% CI 1.01–2.53]) and severity of fatigue (OR 1.26 95% CI 1.15–1.38) were associated with depression and deterioration of depressive symptoms in the multivariate analysis. Among the components of RAPID 3 and DAS 28-CRP, patient assessment for global health and abilities for daily performance were more related to depression. The level of pro-inflammatory cytokines (IL-1β, IL-6, TNF-alpha) was not related to depression. The level of BDNF was significantly lower in RA patients with depression and was negatively correlated with K-BDI II score. Depression was related with the level of fatigue, low expression of BDNF, and high RA disease activity, which was associated with impaired ability to perform activities of daily life. Strict control of fatigue and disease activity to improve one’s capacity to perform daily life activities would be important to regulate depression. The level of BDNF might be one of the possible biomarkers to predict or monitor depression in patients with RA.
Keimyung Author(s)(Kor)
김지민
손장남
김상현
Publisher
School of Medicine (의과대학)
Citation
Yun-Hong Cheon et al. (2018). The association of disease activity, pro-inflammatory cytokines, and neurotrophic factors with depression in patients with rheumatoid arthritis. Brain, Behavior, and Immunity, 73(10), 274–281. doi: 10.1016/j.bbi.2018.05.012
Type
Article
ISSN
1090-2139
Source
https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0889159118301855?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0889159118301855%3Fshowall%3Dtrue&referrer=https:%2F%2Fwww.ncbi.nlm.nih.gov%2Fpubmed%2F%3Fterm%3D29787856
DOI
10.1016/j.bbi.2018.05.012
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41717
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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