The role of IgG hypersensitivity in the pathogenesis and therapy of depressive disorders.

Depressive episodes are associated not only with changes in neurotransmission in the central nervous system, but also may lead to structural changes in the brain through neuroendocrine, inflammatory, and immunological mechanisms. The aim of this article is to present a new hypothesis connecting the inflammatory theory of depression with IgG food hypersensitivity and leaky gut syndrome. This new potential pathway that may mediate the pathogenesis of depression implies the existence of subsequent developmental stages. Overproduction of zonulin triggered, for example, by gliadin through activation of the epidermal growth factor receptor and protease-activated receptor causes loosening of the tight junction barrier and an increase in permeability of the gut wall ('leaky gut'). This results in a process allowing larger molecules that would normally stay in the gut to cross into the bloodstream and in the induction of IgG-dependent food sensitivity. This condition causes an increased immune response and consequently induces the release of proinflammatory cytokines, which in turn may lead to the development of depressive symptoms. It seems advisable to assess the intestinal permeability using as a marker, for example, zonulin and specific IgG concentrations against selected nutritional components in patients with depression. In the case of increased IgG concentrations, the implementation of an elimination-rotation diet may prove to be an effective method of reducing inflammation. This new paradigm in the pathogenesis of depressive disorders linking leaky gut, IgG-dependent food sensitivity, inflammation, and depression is promising, but still needs further studies to confirm this theory.

[Does diet affect our mood? The significance of folic acid and homocysteine]. / Czy dieta ma wplyw na nasz nastrój? Znaczenie kwasu foliowego i homocysteiny.

UNLABELLED: In recent years, there has been growing interest in the association between national diet and the possibility of developing various mental disorders, as well as between deficiency of such vitamins as, e.g. folic acid, vitamin B12, B6, and others (e.g., omega-3 fatty acids), elevated serum homocysteine level and the functioning of human brain as well as the occurrence of such disorders as dementia, central nervous system vascular disorders and depression. THE AIM OF THE STUDY: was to present the current state of knowledge about the role of folic acid and homocysteine in the human organism as well as the significance of vitamin deficiency, mainly folic acid and hyperhomocysteinemy for the occurrence of mood disorders. METHOD: The authors conducted the search of the Internet database Medline (www.pubmed.com) using as key words: depression, mood, homocysteine, vitamin deficiencies: folic acid, B6 and 812 and time descriptors: 1990-2007. RESULTS: In depression, folate, vitamins B12 and B6, as well as unsaturated omega-3 fatty acids deficiency affects the biochemical processes in the CNS, as folic acid and vitamin B12, participate in the metabolism of S-adenosylmethionine (SAM), a donator of methyl groups, which play a decisive role in the functioning of the nervous system; they are, among others, active in the formation of neurotransmitters (e.g. serotonin), phospholipids that are a component of neuronal myelin sheaths, and cell receptors. The deficiency of the vitamins in question results in hyperhomocysteinemia (the research shows that approximately 45-55% of patients with depression develop significantly elevated serum homocysteine), which causes a decrease in SAM, followed by impaired methylation and, consequently, impaired metabolism of neurotransmitters, phospholipids, myelin, and receptors. Hyperhomocysteinemia also leads to activation of NMDA receptors, lesions in vascular endothelium, and oxidative stress. All this effects neurotoxicity and promotes the development of various disorders, including depression. Vitamins B12 and B6, folic acid and omega-3 fatty acids supplementation is thus important in patients suffering from their deficiency; national diet as a significant factor in prevention of numerous CNS disorders, including depression, is also worth consideration.

[Present and premorbid self-image in patients with coronary heart disease]. / Aktualny i przedchorobowy obraz siebie pacjentów z choroba niedokrwienna serca.

AIM: The aim of this study was to find the differences between premorbid and present self-image in patients with coronary heart disease. METHODS: 70 patients with stable coronary heart disease treated at the Internal Medicine Department of the Military Hospital in Lublin and 70 healthy controls were studied. Mean age of the investigated patients was 53.11 years. 77% of the studied patients were city inhabitants and 23% were countryside dwellers. Subjects were studied with the use of the State-Trait Anxiety Inventory, by the Adjective Check List (ACL) and a questionnaire designed especially for the study of sociodemographic data of the investigated patients. Premorbid and present self-images were compared with the use of the ANOVA test. RESULTS: Our results showed that there are statistically significant differences between premorbid and present self-image in the perception of patients with coronary heart disease. CONCLUSIONS: 1. In present self-image, compared to the premorbid one, patients with coronary heart disease have low self-esteem, greater fear about the future, low endurance in performing tasks, they are less enterprising, have lower ability to overcome stress, they are more dependent and have a greater need to look for safety. 2. Women with coronary heart disease perceive themselves as having low self-esteem, low self-trust, more difficulties in overcoming stress and a lower ability to understand other people's behaviour as compared to the time before the disease. 3. Men with coronary heart disease perceive themselves as having less endurance, being less enterprising, having a negative attitude towards themselves and other people and being more dependant compared to the time before the illness.

[Level of anxiety and self-image in patients with coronary heart disease]. / Poziom leku a obraz siebie u osób z choroba niedokrwienna serca.

AIM: The aim of the article was to find the relationship between the level of anxiety and self-image in patients with coronary heart disease. METHODS: Subjects were 70 patients with stable coronary heart disease treated in the Internal Medicine Department of the Military Hospital in Lublin and 70 healthy controls. Mean age of the investigated patients was 53.11 years with the mean age in healthy controls being 50.1 years. Subjects were investigated with the use of Spielberg's State-Trait Anxiety Inventory (STAI), Adjective Check List (ACL) and a questionnaire especially designed for the study concerning the socio-demographic data of the investigated patients. RESULTS: Our results showed a statistically significant higher level of anxiety in men with coronary heart disease as compared to a group of healthy control men. Level of anxiety in women with coronary heart disease compared with healthy control women did not differ significantly. We found a statistically significant relationship between the elevated level of anxiety and certain features of self-image. CONCLUSIONS: 1. Men with coronary heart disease exhibit a higher level of anxiety compared with healthy men. 2. Higher level of anxiety in men is associated with the increased need of stabilization, withdrawal from achieving aims, lack of self-trust and lack of autonomy. 3. High level of anxiety in women is associated with negative self-assessment, lack of self-trust, tendency for isolation and stronger need of changes.