| Objective:Suicide has become a main public health problem all over the world. According to the statistics of the Ministry of Health: every year at least 290,000 people die from suicide, and 2 million people with attempted suicide accept the medical treatment in our country. Nearly 80% of suicide people have suffered from depression. Depression has become the first major cause of death in 15 to 34-year-old people in China. The research has found that the immune system and the central nervous system of the body have two-way regulation. The nervous system, the endocrine system and the immune system interact one another and commonly accommodate and maintain the stability of the inner environment of the body. Depression has a variety of hypotheses in the pathogenesis, but the results are not consistent at present. The immunities of depression have attracted much attention. The internal and external studies show that patients with depression have broad immunosuppression. Cytokine plays an important role in the pathogenesis of depression, but other conclusions are inconsistent. Therefore, we detected CD4~+CD25~+ regulatory T cells, IL-2 and IL-6 in the peripheral blood of patients suffering from attempted suicide to explore the relationship between the change the immune function and suicidal behavior. Thus we can find the prevention of suicidal risk factors of depression patients, and reduce or prevent the occurrence of suicidal behavior.Materials and Methods : We chose 44 cases of patients with depression suffering from suicide attempters including 18 cases of men and 26 cases of women. Their average age was 36.45±10.6 years. We chose 30 cases of the normal psychical and mental health of the same period in the control group, including 12 cases of men and 18 cases of women patients aged 18-50 years with an average age of 32.60±10.84 years. Matching the age and gender with the suicide attempters group, they had no significant difference. We can use Incomplete Suicide Questionnaire to assess the serious extent of suicide. All patients can be treated by SSRI or Venlafaxine. We used scale and determine blood of patients treated before and after 8 weeks. Blood samples used EDTA to anticoagulation. Anti-coagulation of blood was installed in 2 ml and 4 ml tubes, respectively. The small one was analyzed by Flow Cytometry using CD4~+CD25~+.The other one was routinely centrifuged. Plasma and blood cells were separated from each other. Plasma was packed in two EP tubes. Then they were kept in refrigerators with -70℃. After blood samples was collected, IL-2 and IL-6 were once detected. The control group was only blooded one time. IL-2 and IL-6 were detected by ELISA. All datum were described by mean and standard deviation ( X±S). The test results were handled with SPSS13.0 statistical software package.Results:(1) Comparing with CD4~+CD25~+ (6.54±0.96) (p <0.01) in the peripheral blood of the control group, CD4~+CD25~+ (13.4±5.31) of the suicide attempters with depression before therapy was obviously higher. Comparing with IL-2 (6.37±2.93) pg/ml (p<0.05) and IL-6 (33.46±19.78) pg/ml (p<0.05) in plasma of the control group, IL-2 (11.28±6.32) pg/ml and IL-6 (46.26±22.87) pg/ml in plasma of the suicide attempters with depression before therapy were remarkably higher.(2) Compared with the control group, CD4~+CD25~+ in the peripheral blood of the suicide attempters with depression after therapy was slightly higher, but the difference was not obvious (p>0.05); Compared with the control group, IL-2 in plasma of the suicide attempters with depression after therapy was slightly higher, but the difference was also not obvious (p>0.05); Compared with the control group, IL-6 in plasma of the suicide attempters with depression after therapy was obviously higher (p<0.05).(3) The suicide attempters with depression were treated after 8 weeks, the HAMD score decreased from (38±8) to (15±7) (p<0.01). CD4~+CD25~+ (7.58±2.60) in the peripheral blood was significantly lower than before therapy (13.4±5.31) (p <0.01). Compared with pretherapy (11.28±6.32), IL-2 (6.86±4.22) in plasma was obviously lower. IL-6 in plasma increased from (46.26±22.87) to (47.56±21.83) after therapy, but the change was not obvious.(4) Comparison of the relevance of the serious extent (the total score of HAMD) of the suicide attempters before therapy and the levels of CD4~+CD25~+, IL-2 and IL-6, we found that the serious extent of the suicide attempters with depression and the levels of CD4~+CD25~+, IL-2 and IL-6 were not obviously correlated (r = 0.224 to 0.546, p> 0.05).(5) Compared with the average course of diseases, we found that the levels of CD4~+CD25~+, IL-2 and IL-6 between the long subgroup and the short subgroup were not obviously different (P>0.05).(6) The total scores of HAMD in the group of suicide attempters with depression before therapy and after therapy of 8 weeks were (38±8) and (15±7), respectively. The difference was very obvious before and after therapy (p<0.01). The total score of the BECK depression scale was (41±11) in the group of suicide attempters with depression before therapy, and the total score was (22±7) after 8 weeks therapy. The difference was very remarkable before and after therapy (p <0.05). There were 37 cases (84.1%) patients with negative life events in the group of suicide attempters with depression before therapy.Conclusions:We examined the levels of CD4~+CD25~+ regulatory T cells, IL-2 and IL-6 in the peripheral blood of suicide attempters with depression, and analyzed the change of their contents. The obtained conclusions were as follows:1. Suicide attempters with depression had immunosuppression, which may be related to their CD4~+CD25~+ regulatory T cells. CD4~+CD25~+ regulatory T cells may become prevailing one of the causes of the immunosuppression of patients with depression.2. The results showed that the IL-2 level in their plasma decreased obviously after the symptoms of the suicide attempters with depression were eased by giving medication. Therefore, we thought that the decrease of the IL-2 level may be as the most sensitive index in antidepressant drugs which affected the immunological change of suicide attempters with depression (particularly Venlafaxime).3. The results showed that the IL-6 level in plasma of suicide attempters with depression were significantly higher than that before therapy. After therapy of 8 weeks, the symptoms of patients were improved, but the IL-6 level in plasma of patients did not change with the symptoms improving. Compared with that before therapy, the IL-6 level had an increasing trend after easing symptoms. Therefore, we thought that the IL-6 level in plasma may be as a characteristic sign of suicidal behaviors in patients with depression.
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