Povezanost trombocitnog serotonina i svojstava trombocita s kliničkom slikom i liječenjem depresivnog poremećaja

doctoral thesis

• Title (english): Correlation between the platelet serotonin and properties of platelets and the clinical picture of a depressive disorder
• Author: Lidija Kostanjšak
• Mentor: Dalibor Karlović (mentor)
• Committee member: Zlatko Trkanjec (predsjednik povjerenstva)
• Committee member: Neven Ljubičić (član povjerenstva)
• Committee member: Ana Matošić (član povjerenstva)
• Committee member: Nada Vrkić (član povjerenstva)
• Committee member: Ante Silić (član povjerenstva); MBZ: 339734
• Granter: University of Zagreb; School of Dental Medicine; (Chair of Psychiatry and Medical Psychology); Zagreb
• Defense date and country: 2016-01-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine
• Universal decimal classification (UDC): 616.31 - Stomatology

Abstract

Depresija spada u najučestalije psihijatrijske poremećaje. Brojna istraživanja usmjerena su na pronalaženje bioloških markera depresije koji bi pomogli u upotpunjavanju dijagnoze za koju je i dalje klinički pregled bolesnika najvažniji. Ciljevi ovog istraživanja bili su odrediti i usporediti koncentraciju trombocitnog serotonina, broj trombocita i trombocitne pokazatelje u zdravih i depresivnih ispitanika, ispitati njihovu povezanost s kliničkom slikom depresije, te ispitati postoji li promjena koncentracije trombocitnog serotonina i pokazatelja trombocitnih svojstava tijekom terapije serotoninergičkim antidepresivima. Istraživanje je provedeno na 60 depresivnih bolesnika i 63 zdrava ispitanika oba spola, dobi od 18-55 godina. Za dijagnosticiranje depresije primijenjeni su upitnici: MINI, CGI, HAM-D, HAM-A. Biokemijske analize krvi izvršene su u Kliničkom zavodu za kemiju Kliničkog bolničkog centra „Sestre milosrdnice“. Zaključili smo da koncentracija serotonina i trombocitni pokazatelji nisu različiti u depresivnih ispitanika i kontrolne grupe. Nakon terapije serotoninergičkim antidepresivima kod depresivnih bolesnika utvrdili smo smanjenje srednje vrijednosti volumena trombocita u punoj krvi, te sniženje koncentracije trombocitnog serotonina. Utvrdili smo da postoji povezanost između koncentracije trombocitnog serotonina i serotonina u punoj krvi s dijagnostičkim obilježjima prisutnosti ili neprisutnosti depresije. Kroz naše istraživanje utvrdili smo da je dijagnostička točnost koncentracije serotonina u trombocitima zadovoljavajuća s obzirom na visoku osjetljivost pretrage, te smo utvrdili dobru prediktivnu vrijednost navedenog parametra. Utvrdili smo važnost prepoznavanja depresije kod bolesnika s kardiovaskularnim bolestima, s obzirom da liječenje serotoninergičkim antidepresivima utjeće na sniženje srednje vrijednosti volumena trombocita u punoj krvi i na sniženje koncentracije serotonina u trombocitima, a što smanjuje mogućnost komplikacija bolesti i poboljšava tijek oporavka tih bolesnika.

Abstract (english)

Mood disorders are among the most common "major" psychiatric disorders. One of the more prominent among them is depression, the 4th leading health problem in the world accounting for 4.5% of the global burden of disease. A high level of importance is attributed to depression since it has a serious impact on the ability to work as well as on personal, family and social performance. Moreover, patients suffering from depression are also distinguished by a significant risk of suicide. Although clinical examination of patients is still the most important activity in diagnosing depression, numerous studies have focused on finding biological markers of depression that would assist in completing the diagnosis. The objectives of this study were to determine and compare the level of serotonin in platelets, the platelet count and the platelet parameters in healthy subjects and in patients with a depressive disorder, and then investigate the correlation between the level of platelet serotonin and platelet indicators and the clinical picture of a depressive disorder, as well as determine whether the platelet serotonin level and indicators of platelet properties changed during the therapy with serotonergic antidepressants in patients with a depressive disorder. The study involved 60 patients suffering from depression and 63 healthy subjects of both sexes, aged 18 to 55. To diagnose depression, we used the following questionnaires: MINI, CGI, HAM-D, HAM-A. The biochemical analysis of blood needed for this study was performed in the Department of Chemistry of the University Hospital Center "Sestre Milosrdnice". The research showed that the level of platelet serotonin and serotonin in whole blood and the platelet indicators did not differ between the patients suffering from depression and the control group. After an eight-week long treatment with serotonergic antidepressants, the patients suffering from depression recorded a reduction in the mean platelet volume in whole blood and a decrease in the platelet serotonin level. We also established correlation between platelet serotonin levels and levels of serotonin in whole blood and the diagnostic features indicating presence or absence of depression. On the basis of our study, we determined that the diagnostic accuracy of the level of serotonin in platelets was satisfactory given the high sensitivity of the test, as well as the positive predictive value of the relevant parameter used. We also found that it was highly important to recognize depression in patients with cardiovascular diseases, especially coronary heart diseases, because therapy with serotonergic antidepressants has an effect on the mean platelet volume in whole blood and the level of serotonin in platelets, and both of these parameters are factors in the process of platelet activation. By reducing both values, therapy with serotonergic antidepressants reduces possible complications and improves the course of recovery of these patients.

• Keywords: depresija; serotonin; trombociti; trombocitni pokazatelji
• Keywords (english): depression; serotonin; platelets; platelet indicator
• Language: croatian
• URN:NBN: urn:nbn:hr:127:533055
• Study programme: Title: dental medicine; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo, polje dentalna medicina (doktor/doktorica znanosti, područje biomedicine i zdravstvo, polje dentalna medicina)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-06-08 11:22:18