Abstract
The transcription factor NF-kB (nuclear factor-kappa B) plays an important role in the regulation of the immune responses, cell proliferation and apoptosis. The present clinical trial tested the hypothesis that there is a positive correlation between NF-kB expression in inflammatory gastrointestinal tissue and psychometrically assessed, self-rated depression. A total of 52 patients were included in this prospective monocenter, observational study in whom biopsies were taken in a gastroscopic (n = 32) or colonoscopic examination (n = 20). In histological sections of the specimens, immunohistochemical stainings were performed to evaluate the level of NF-kB, MPO (myeloperoxidase) and iNOS (inducible nitric oxide synthase) expression. Prior to the endoscopic procedure, self-rated anxiety and depression were assessed using the German version of the Hospital Anxiety and Depression Scale (HADS) and individual quality of life was rated using the SF-36 questionnaire. The results showed that in total 40% (21/52) of the study cohort displayed positive HADS depression scores above the clinically relevant cut-off of ≥8. There was a positive and significant association between HADS depression and the expression level of NF-kB in samples from the upper gastrointestinal tract. Statistically significant relationships between the degree of NF-kB immunoreactivity and the anxiety score or quality of life were not found. However, there was a significant correlation between NF-kB and iNOS expression levels. In summary, the study demonstrated a significant correlation between NF-kB expression in inflammatory gastrointestinal tissue and depression. Evidence of a similar association with comorbid anxiety was not found. Further investigations are needed to confirm these relationships and to identify the involved pathophysiological mechanisms.
Published Version
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