抑郁焦虑情绪与肠道炎症潜在交互作用探讨

目的：探讨抑郁焦虑情绪与肠道炎症疾病之间存在的交互作用及其可能的机制。方法：建立大鼠慢性应激模型（应激组）、肠道炎症模型（肠道炎症组）、应激加肠道炎症模型（应激+肠道炎症组），并设正常组。采用强迫游泳实验和大理石掩埋实验评估动物抑郁焦虑样行为；采用排便颗粒数及腹壁撤退反射（AWR）评估动物肠道动力情况与内脏敏感性；采用Western blot法分析大鼠脑内及肠道内蛋白表达情况。结果：应激+肠道炎症组游泳不动时间抑制率为108.4%，远大于应激组的50.2%；应激+肠道炎症组的大理石掩埋颗粒数抑制率为211.6%，远大于应激组的112.3%。应激+肠道炎症组排便颗粒数增加的抑制率为131.4%，远大于肠道炎症组的97.1%；在内脏敏感性实验中，无论在60 mmHg还是在80 mmHg时，应激+肠道炎症组的AWR抑制率均大于肠道炎症组。应激+肠道炎症组大鼠海马及额叶皮层内脑源性神经营养因子（BDNF）、磷酸化环磷腺苷效应元件结合蛋白（p-CREB）表达降低较应激组更为显著；应激+肠道炎症组回肠及结肠内炎症因子IL-1β、IL-6表达升高均较肠道炎症组更为显著。结论：抑郁焦虑等情绪可通过调节肠内IL-1β及IL-6表达加重肠道功能紊乱，而肠道功能的紊乱又可通过调节脑内BDNF水平及降低环磷腺苷效应元件结合蛋白（CREB）的磷酸化加重抑郁焦虑等情绪，即抑郁焦虑情绪和肠道炎症两者之间具有一定程度的交互作用。

Study on interaction of depression,anxiety and intestinal inflammation

Objective: To investigate the interaction and the potential mechanism of stress and intestinal inflammation. Methods: Stress model was established by eight different stress factors within 21 days, The intestinal inflammation group was established by anal enema (TNBS), stress combined with intestinal inflammation model were established by the combination of two models above. From 22 days, all rats were given behavioral tests, including forced swimming test (FST), the marble burying test, the number of fecal output and AWR test, then rats were sacrificed. The expressions of BDNF and phosphorylated cAMP in the hippocampus and frontal cortex, IL-1β, IL-6 in the ileum and colon were detected by Western Blotting. Results: The freezing time of stressed combined with intestinal infection group was significantly lower in FST, the number of marbles buried in marble burying test was also significantly lower, the number of fecal output and the score of AWR were obviously reduced when compared with merely chronic stress group or merely intestinal inflammation group. The expression of BDNF and p-CREB were reduced more significantly whether in the hippocampus or frontal cortex. The expression of IL-1β and IL-6 increased more significantly whether in the ileum or colon when compared with merely chronic stress group or merely intestinal inflammation group. Conclusion: Depression or anxiety as psychological factors, has certain interaction with intestinal inflammation. depression and anxiety emotions can increase the intestinal disorders, and the intestinal disorders can exacerbate depression or anxiety emotions also. The mechanism may be involved with enteric nervous system and central nervous system, the two system play the role by regulate the braingut peptide.