Specific peripheral markers of chronic stress load in the pathogenesis of depression: a clinical study

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Chronic stress, which causes disruption of brain and peripheral mechanisms of long-term adaptation, plays a key role in the development of affective disorders. Disruption of adaptive mechanisms manifests itself in the form of excessive and/or negative reactions to stressful situations. The aim of this study was to deepen the understanding of the involvement of chronic stress in the pathogenesis of depression by comparing psychometric and peripheral biochemical parameters in patients with depression who experience or do not experience chronic stress, in order to identify specific markers of these conditions and potential therapeutic targets. The study included 324 individuals (224 women, 80 men) with unipolar depressive disorder, 187of whom had experienced chronic stress during the year prior to testing. It has been shown that patients with depression and concomitant chronic stress have a specific biochemical and immunological profile that reflects the influence of chronic stress on the brain’s regulation of adaptive mechanisms. In particular, the depletion of adaptive systems (hypothalamic-pituitary-adrenocortical, immune) is manifested in a significantly lower level of free cortisol in saliva and lymphocytes in the blood, while the level of the active form of vitamin D in blood serum, which has neuroprotective, anti-inflammatory, and antioxidant effects, decreases. The elevated folate levels found in patients with chronic stress may reflect disturbances in their metabolism and interaction with vitamin D metabolism. A mathematical model has been developed to assess the likelihood of developing depression associated with chronic stress, according to which a combination of low levels of free cortisol in saliva, blood lymphocytes, the active form of vitamin D, and high levels of vitamin B9 in blood serum may be risk factors for the development of depressive symptoms in conditions of chronic stress. At a cutoff point of 0.75, the sensitivity of the model was 78% and the specificity was 71%. The results obtained not only reflect the neurohumoral and immune mechanisms at the intersection of chronic stress and mood disorders, but may also serve as a basis for the development of more effective treatment methods and strategies for the prevention of depressive states.

作者简介

T. Druzhkova

Moscow Research and Clinical Center for Neuropsychiatry

编辑信件的主要联系方式.
Email: nata_gul@ihna.ru
Moscow, Russia

M. Zhanina

Moscow Research and Clinical Center for Neuropsychiatry; Institute of Higher Nervous Activity and Neurophysiology, RAS

Email: nata_gul@ihna.ru
Moscow, Russia; Moscow, Russia

Y. Bryzgalova

Moscow Research and Clinical Center for Neuropsychiatry

Email: nata_gul@ihna.ru
Moscow, Russia

S. Popova

Moscow Research and Clinical Center for Neuropsychiatry

Email: nata_gul@ihna.ru
Moscow, Russia

A. Guekht

Moscow Research and Clinical Center for Neuropsychiatry; Pirogov Russian National Research Medical University

Email: nata_gul@ihna.ru
Moscow, Russia; Moscow, Russia

N. Gulyaeva

Moscow Research and Clinical Center for Neuropsychiatry; Institute of Higher Nervous Activity and Neurophysiology, RAS

Email: nata_gul@ihna.ru
Moscow, Russia; Moscow, Russia

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