Glycyrrhizic acid as an adjunctive treatment for depression through anti-inflammation: A randomized placebo-controlled clinical trial
| Autor: | Wen-Jun Su, Shi-Yang Zhong, Xiao-Ying Bi, Yun-Xia Wang, Wei Wang, Chun-Lei Jiang, Wen-Jie Yan, Yun-Zi Liu, Jia-Mei Li, Zhi-Yong Cao, Yi-Ming Ruan, Ran Wu, Ting Zhang, Bo Wang, Lin-Lin Liu |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Anti-Inflammatory Agents Placebo Proinflammatory cytokine 03 medical and health sciences 0302 clinical medicine Double-Blind Method Internal medicine medicine Humans Depression (differential diagnoses) Inflammation Response rate (survey) biology Depression business.industry C-reactive protein Glycyrrhizic Acid Antidepressive Agents Pathophysiology 030227 psychiatry Clinical trial Psychiatry and Mental health Clinical Psychology Treatment Outcome Adjunctive treatment biology.protein business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Affective Disorders. 265:247-254 |
| ISSN: | 0165-0327 |
| DOI: | 10.1016/j.jad.2020.01.048 |
| Popis: | Background Recently, abundant evidence indicated proinflammatory cytokines might play a crucial role in pathophysiology and treatment of depression. According to our preclinical research, we propose glycyrrhizic acid (GZA) for an adjunctive treatment owing to its safety, economical and anti-inflammatory profile. Methods Eligible participants were recruited and randomly allocated into independent treatment groups of SSRI+GZA (n = 30) and SSRI+PBO (placebo, n = 26). Depressive symptoms and specific serum biomarkers were detected during the 4-week treatment course. Afterward, the relationships between biomarkers and clinical effects were explored. Results Depressive symptoms relieved more in SSRI+GZA than SSRI+PBO, both at week 2 (P = 0.003) and week 4 (P = 0.016). Meanwhile, at week 4, both response rate (P = 0.035) and remission rate (P = 0.031) acutely became higher in SSRI+GZA compared with SSRI+PBO. Mediation analysis further demonstrated that TNF-α reduction mediated the association between GZA treatment and clinical improvement, the indirect effect lay between 0.124 and 3.514 (95% CI). The exploratory analysis also suggested that the symptomatic improvement existed in patients with high-inflammation (baseline CRP > 3 mg/L) rather than those with low-inflammation (baseline CRP ≤ 3 mg/L). Limitations The sample size in this study was not large enough and the follow-up duration was relatively short. Conclusions This study offers a novel strategy for the diagnosis, categorization, individualization and prognosis regarding upgrading traditional antidepressant therapy, which is from biomarkers to diagnostic indicator and therapeutic target. Patients are necessary to be classified according to the inflammatory state, those with high levels of baseline inflammation should receive combined treatment with anti-inflammatory agents like GZA. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect