Avaliação do estresse na infância, nível de funcionalidade e da sinalização purinérgica em pacientes adultos com transtorno depressivo

Abstract

Depressive disorder (TD) is a common, frequent and serious mental disorder that worsens people's level of functioning. Neglect, abuse, violence and abandonment related to biological factors are proven to be relevant risk factors for this disorder. Attention is drawn to the relationship between DT and the purinergic system, which is a signaling system composed mainly of adenosine triphosphate (ATP) nucleotides and enzymes that hydrolyze it and its metabolites and receptors. The aim of this study was to evaluate the presence of childhood stress (PE) through the questionnaire on childhood trauma (CTQ), level of functionality through the FAST scale and changes in components of the purinergic system, in adult patients with TD in blood cells. This is a cross-sectional study with a quantitative approach. The sample consisted of a control group (GC n=36) and a patient group (GP n=36), aged between 40 and 59 years, mean age 46.92 ± 5.14 in the CG and 47.12 ± 6 , 68 in GP, (p=0.6380), which were selected in pairs. To compare the statistical data, Student's t test was used and Pearson's brightness was also applied. The significance level used was 0.05 and the statistical program GraphPad Prism 8.0.1. The lymphocytes, platelets and serum samples used were collected by venipuncture (30 mL) from 36 GC and 36 GP individuals. Biological samples were confirmed by colorimetric biochemical and flow cytometric methods. The CTQ shows that the GP was more exposed to trauma in childhood compared to the CG and the FAST scale shows a worse level of functionality in the GP compared to the CG (p=0.0001). Between depression escalation (BDI) and FAST escalation in GP, there were robust positive Pearson demonstrations (r=0.6722, ****p<0.0005) showing that DT worsens individuals' functionality. Also noticeable was the increase in IL-6 and IL-10 cytokines in GP compared to GC. There was a positive manifestation between ADP hydrolysis in lymphocytes and GP IL-6 (r=0.3734, *p<0.05). Through the analysis of enzymatic activities, it was possible to notice that there was a higher NTPDase and 5'-nucleotidase activity in platelets and a lower activity of adenosine deaminase (ADA) in the PG when compared to the CG. It is concluded that the results of this study reveal a significant association between exposure to childhood trauma and TD, indicating a possible role of these traumatic events in the later development of psychological difficulties. In addition, the evaluation of functionality using the FAST revealed significantly worsened functionality in the GP compared to the CG, confirming that the presence of TD is associated with a decrease in the individuals' functionality. The high concentrations of cytokines IL-6 and IL-10 and the correlation of ADP in lymphocytes and IL-6 in GP suggest that the immune system is being stimulated to modulate the symptoms of the psychiatric condition and the hydrolysis activity of ATP and ADP in platelets showed a significant difference between the groups, greater in GP, demonstrating that they are interacting with the inflammatory environment, undergoing greater activation and thus releasing inflammatory mediators contributing to systemic inflammatory responses. This excessive activation is involved in cardiovascular diseases, stroke and increased risk of thrombotic complications that can be the main causes of patient morbidity and mortality. Decreased ADA activity is also related to systemic metabolic and inflammatory processes, possibly playing a role in the manifestation and severity of symptoms in GP.