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临床试验/NCT04156425
NCT04156425尚未招募不适用

The Role of PKC Activation in the Immune-inflammatory Mechanism of Major Depressive Depression

Shanghai Mental Health Center0 个研究点目标入组 180 人开始时间: 2020年7月1日最近更新:
适应症
干预措施
相关药物

试验速览

阶段
不适用
状态
尚未招募
入组人数
180
主要终点
remission of acute phase

研究概览

简要总结

Major Depressive disorder (MDD) is a heterogeneous mental illness. Treated with antidepressants that act on the neurotransmitter and/or their receptors just remitted only one third of patients with MDD, Thus, to improve the efficacy is a major unmet need for depression. Based on the scientific reports, inflammation plays a definite role in the development and treatment of depression, which may be an important way to understand and finally solve the problem. Our team found that there were significant changes in tumor necrosis factor (TNF)-α and other inflammatory factors in depressed patients, which caused neuronal apoptosis and depressive symptoms; PRKCB1(gene of protein kinase C-β) plays an anti-inflammatory role by regulating protein kinase C(PKC) activation in specific brain region, improving neuroplasticity and playing an antidepressant role. In this study, we assumes that the treatment-resistant depression patients maybe due to the immune inflammation and PKC activation inconsistency or unsynchronized, which couldn't reversible microglia polarization and neuronal apoptosis in specific brain regions, then, caused the significant changes at emotional and cognitive neural circuits, so as to exhibit such as emotional, cognitive symptoms of depression. Therefore, activating PKC and regulating immune/inflammatory process will be another way to improve the treatment outcome of depression. Take consideration, we focus on treatment-resistant depression patients, to validate the relationship between PKC activation and the immune inflammatory mechanism of depression, evaluate the antidepressant effect of golimumab or calcium tablet (a PKC activator) plus escitalopram, and initially proposes idividualized treatment strategies for MDD.

详细描述

This is a randomized, double blind, placebo-controlled antidepressant augmentation trial. All participants are randomly divided into 3 groups treated orally with "escitalopram + golimumab" (N = 60), "escitalopram + calcium tablet" (N = 60) or "escitalopram +placebo" (N = 60).

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Treatment
盲法
Single (Outcomes Assessor)

入排标准

年龄范围
18 Years 至 65 Years(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • Healthy men or women of matched age, gender and education with that of treatment-resistant depression (TRD) group;
  • A willingness to adhere to all prohibitions and restrictions necessary for the study;
  • Signed informed consent.

排除标准

  • Participant who have severe mental diseases, physical diseases, cerebrovascular disease, or a history of traumatic brain injury;
  • Participant who had a serious allergic reaction disease or those who have suffered from diseases of the immune system;
  • Participant who used anti-inflammatory drugs, or immunomodulatory drugs no more than 1 month prior randomization;
  • Pregnant or lactating female.

研究组 & 干预措施

escitalopram + golimumab

Experimental

Patients will be treated with escitalopram from the minimum dosage and golimumab according to direction for use.

干预措施: Escitalopram+golimumab (Drug)

escitalopram + calcium tablet

Experimental

Patients will be treated with escitalopram from the minimum dosage and calcium tablet according to direction for use.

干预措施: Escitalopram+Calcium Tablet (Dietary Supplement)

escitalopram

Active Comparator

Patients will be treated with escitalopram from the minimum dosage.

干预措施: Escitalopram (Drug)

结局指标

主要结局

remission of acute phase

时间窗: 12th week

scored 7 or lower on the Hamilton's Depression Scale with 17 items

次要结局

未报告次要终点

研究者

申办方类型
Other
责任方
Sponsor

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